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AMC Key > Neurology > Flashcards

Neurology Flashcards

1
Q

Common complications of COVID 19 vaccine who presented with headache
Sx
∆?
Ix?

A

SX: headache after 4-42 days post vaccine
∆: CSVT
Ix : d- Dimer, fibrinogen, plt
CT brain

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2
Q

Hemineglect
What?
Site?

A

Spatial neglect on contralateral post stroke as if the side does not exist
Eg shaving one side of face
Site: parietal cortex

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3
Q

Carotid artery stenosis

A
  1. CDUS initial choice
  2. Symptomatic: endarterectomy in 2 weeks (> 50%)
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4
Q

Brain tumour in elderly

A

nagging headaches in the morning and the associated vomiting not preceded by nausea (projectile vomiting) are highly suggestive of a space occupying lesion in the brain such as a tumor or an abscess

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5
Q

Temporal lobe epilepsy
PABAPA pneumonic SX

A

Aura
Autonomic dysfunction
Psychic sensation: jamais vu deja vu
Blank stare, pupil dilation
Post ictal drowsiness , confusion,amnesia
Automatism: chewing, fidgeting

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6
Q

Optic neuritis
SX?
Ix?

A

Pain on eye movement, reduced vision , reduced V/A ( retrobulbar)
Ix: Visual evoked potentials

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7
Q

Vertebro basilar insufficiency
Sx

A

Vertigo
Cerebellar signs
Diplopia
Horner syndrome: unilateral

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8
Q

Bppv
Sx
Ix
Rx

A

Vertigo, nausea, nystagmus
Dix halpike
Epley manoeuvre, ressurance and vestibular rehab

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9
Q

Acute labyrinthitis
Sx

A

Sudden acute vertigo, hearing loss and tinnitus with nausea+ vomiting
50% post urti

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10
Q

Vestibular neuronitis vs
Bppv

A

Similar vertigo, nausea and imbalance, nystagmus.. but more profound imbalance in VN
Caloric test : COWS ( cold opposite warm same)

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11
Q

PICA occlusion ( lateral medullary syndrome/ Wallenberg syndrome)

A

Part of vertebrobasillar artery:
Vertigo, hearing loss
Ipsilateral Horner syndrome, contralateral sensory loss of limb

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12
Q

PCA stroke

A

Acute confusion, memory, vision loss, posterior headache

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13
Q

Temporal lobe epilepsy
Rx

A

Carbamazepine

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14
Q

Syringomyelia

A

Fluid filled cavity
Tumor/trauma/congenital
Cape like distribution of deficits
Hand 👏 upwards progression
Sensory,motor pain+temperature

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15
Q

Syringomyelia
Ix
Rx

A

MRI
Tumor excise
Fluid : drainage

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16
Q

Ulnar nerve injury at elbow

A

Small muscles of of hand affected
Most: hypothenar, lumbricals, introssei muscle
Median: 2nd and 3rd lumbricals only

17
Q

Anterior interosseous nerve

A

Branch of medial nerve
Supplies flexor digitorum profunda, pronator quadratus, flexor pollicis longus

18
Q

Parkinson disease vs drug induced Parkinson
Sparing effect

A

Tremor absent in DIP
Unilateral in PD

19
Q

ALS
Stephen Hawking

A

Umn + Lmn
20-40 yrs
Progressive loss of MOTOR function only !!!
Swallowing if bulbar involved

20
Q

ALS
Complications?
Rx?
Ix?

A

Aspiration, pneumonia
Rituzole
EMG and NCS

21
Q

SAH

A

Sudden, thunder ⚡ clap headache
Severe

22
Q

Sciatic nerve root formed by

A

L4, L5, S1, S2, and S3 nerve roots.

23
Q

Sciatic nerve injury specific

A

Weak or absent ankle reflex

24
Q

Ankle jerk present+
Eversion,inversion , flexion and extension loss ( -)

A

Common peroneal nerve injury

25
Q

Stroke less than 4.5 hrs
CT 🧠: not hemorrhage

A

rTPA

26
Q

Stroke ( CT 🧠 negative) > 4.5 hrs

A

Aspirin+ Clopidogrel for 3 weeks

27
Q

Carotid endarterectomy
Indicated?

A

Carotid endarterectomy (CEA) is considered for secondary prevention of ischemic stroke and TIA in selected patients. It prevents further ischemic eventsbut does not affect the outcomes of the patient’s current condition

28
Q

Lung monitoring in GBS

A

Patient should always be managed in an inpatient setting. Vital capacity should be monitored 4-hourly and if it falls to less than 20 ml/kg or is declining rapidly, the patient should be transferred to an intensive care unit.

29
Q

Amaurosis fugax

A

Emboli at retinal artery is likely which is originating from carotid
So CDUS is a priority

30
Q

Transient monocular vision loss aka amaurosis fugax
Carotid bruit absent

A

Still perform CDUS as the embolization could be occurred at ICA or retinal arteries

31
Q

Commonest brain tumour metastasis

A

Breast
Lung
Melanoma

32
Q

Melanoma risk of metastasis

A

Male
Mucosal surfaces
Upper trunk, head or neck
Acral lentiginous, nodular
Wide, deep, thick, ulcerated lesions
Involvement of > 3 regional lymph nodes

33
Q

Parkinson disease Rx
Mild

A

Mild: benztropine & trihexyphenidyl : anticholinergic to reduce tremor and rigidity
Amantadine: > 60 yrs not tolerate Ach (-)

34
Q

Severe Parkinson disease Rx

A

Severe : levodopa + carbidopa
Prob: on & off phenomenon
COMT (-) Capone only used for those on Rx with levodopa+ carbidopa , reducing the on/off phenomenon
MAO (-) : sepegiline either as single or adjuvant
Deep brain stimulation: highly effective for tremor and rigidity

35
Q

Huntington disease
Triad
Ix

A

Autosomal dominant
Dementia+chorea+behaviour ∆
Usually 30-50 yrs
Genetic testing ( CAG trinucleotide repeat) at 18yrs old

36
Q

Multiple sclerosis
SX
Ix
Rx
Remember white matter, white lady

A

Usually focal sensory deficit and gait /imbalance
+ eye:optic neuritis+ internuclear opthalmoplegia
MRI best initial and most accurate
High dose steroids
Glatiramer

37
Q

Charcot Marie Tooth
What?
SX?
Ix?
Rx?

A

Genetic loss of motor a d sensory
Distal weakness & sensory loss
Muscle leg wasting
Decreased DTR
Tremor
Pes cavus ( high arched foot)
EMG
Nil of Rx

AMC Key (11 decks)

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