Neurology Flashcards
1
Q
At what age does social smile occur
A
2 months
2
Q
When can ca child use 3 finger pincer
A
9 months
3
Q
When does a child kick a ball
A
18 months
4
Q
When is speech 75% and 100% intelligible
A
3 yrs and 4 yrs
5
Q
First step in speech or language disorder
A
Hearing test
6
Q
Diagnosis of intraventricular haemorrhage
A
Cranial USG
7
Q
Sequelae of IVH
A
Cerebral palsy, intellectual disability
8
Q
Rx of apnea of prematurity
A
Caffeine, NIV, self resolving
9
Q
MRI Brain findings in CP
A
Periventricular leukomalacia, basal ganglia lesions
10
Q
First sign of CP
A
Delayed gross motor findings, diagnosis by age 2
11
Q
Types of tonicity in CP
A
Spastic, dyskinetic, ataxic
12
Q
Types of breath holding spells
A
Cyanotic, pallid
13
Q
Causes of hemiplegia in children
A
Ischemia stroke, intracranial haemorrhage, Todd paralysis, hemiplegic migraine
14
Q
Risk factors of haemorrhaging stroke
A
AVM, Aneurysm, hemoglobinopathies
15
Q
MCC of paediatric stroke
A
Sickle cell disease
16
Q
When is autism screening performed
A
18 months and 2 yrs
17
Q
When is depression screening initially done
A
12 yrs
18
Q
Cranial moulding helmets are used for which condition
A
Positional plagiocephaly
19
Q
Syringomyelia is associated with which condition
A
Arnold chiari malformation 1, meningitis, inflammatory disorders, tumours, spinal cord injury
20
Q
Initial presentation of syringomyelia and Arnold chiari malformation
A
Scoliosis maybe the only sign, Arnold - presents with occipital headache in adolescence
21
Q
Myelomeningocele associated with ?
A
Arnold chiari malformation 2
22
Q
Mutation involved in Rett syndrome
A
MECP2
23
Q
Landau Kleffner syndrome
A
Normal development followed by regressive language milestones
24
Q
Rx of homocysteinuria
A
B6, folate, B12, anti platelets or anticoagulant
25
Common causes of ID in children
FAS, Downs. Fragile X
26
Management of essential tremors?
Propranolol, primidone, topiramate
27
Meige syndrome. How is spasm terminated
Blepharospasm with spasm of lower face. Rx- sensory trick
28
Pronator drift is seen in
Pyramidal tract lesion
29
Upward drift is seen in
Cerebellar lesion
30
Lesion in hemineglect syndrome
Non dominant parietal lobe
31
Gerstmann syndrome
Dominant parietal lobe
32
Rx of restless leg syndrome
Pramipexole, gabapentin enacarbil
33
Nest step after diagnosing epidural abscess spinal cord compression
IV glucocorticoids
34
A complication of neuraxial block causing spinal cord compression
Spinal epidural hematoma
35
Confirmatory diagnosis of central canal syndrome
Cervical myelogram
36
Positive spurling test in
Radiculopathy causing neck pain
37
Presentation of spondylitic myelopathy
LE weakness, gait, bowel bladder dysfunction, Lhermitte sign
38
Rx for Freidrich ataxia
Only supportive therapies, physical and psychological
39
Rx of ALS
Riluzole, respiratory support, nutritional support- per cutaneous endoscopic gastrostomy tube.
40
Meds that cause distal symmetric polyneuropathy
FQ, metronidazole, dapsone, amiodarone, digoxin, cisplatin, paclitaxel
41
Triggers of AIP
CYP450 inducers, progesterone, fasting, surgery, illness, alcohol, tobacco
42
Lab findings, rx of AIP
Positive for urobilinogen
Elevated serum and urine PBG, ALA, porphyrins
Hyponatremia, elevated transaminases
Mx- glucose and hemin
43
Next step in hemodynamically stable patient in GBS. Tx?
Assess pulmonary function with spirometry.
If FVC <20 ml/kg, warrants endotracheal intubation
Tx- IVIG, Plasmapheresis
44
Presentation of Miller Fischer syndrome
Ophthalmoplegia, ataxia, areflexia
45
Miller Fischer syndrome associated with which antibody
Anti GQ1b
46
Rx for food borne botulism
Equine serum heptavalent botulinum antitoxin
47
Werdnig Hoffman syndrome
Floppy baby syndrome
48
RF of MS
Female, Caucasian, HLA DRB1, USA, Europe, cold climate, low vit d, smoking
49
Diagnostic imaging in MS, CSF findings?
T2 weighted MRI of brain and spinal cord.
Oligoclonal IgG bands
50
Tx of MS
IV methylprednisolone, plasmapheresis, IFN beta, natalizumab, glatiramer acetate
Baclofen for spasticity
Gabapentin for neuropathic pain
51
DD of UMN cause of NM weakness
Leukodystrophies, vasculitis, brain mass, B12 def, ALS
52
DD of anterior horn cell cause of NM weakness
SMA, ALS, Polio, paraneoplastic syndromes
53
DD of peripheral nerves causes of NM weakness
Hereditary primary motor sensory neuropathy, GBS, Diabetic neuropathy, amyloid neuropathy, lead poisoning
54
NMJ cause of NM weakness
Myasthenia gravis, Lambert Eaton, OPC poisoning, Botulism
55
Muscle fibres causes of NM weakness
Muscular dystrophies, polymyositis, dermatomyositis, hypothyroidism, corticosteroids, HIV myopathy
56
Symptomatic treatment of lambert Eaton syndrome
Guanidine or 3,4 - diaminopyridine- increases acetylcholine levels
refractory -IVIG, Immunosuppressants
57
Dd of myopathies
1. Glucocorticoid induced 2. Polymyalgia rheumatica 3. Inflammatory 4. Statin induced 5. Hypothyroid
58
Trinueleolide repeat in DMDK gene seen in
Myotonic dystrophy
59
Associated findings in myotonic dystrophy
Arrhythmia, cataracts, increased day time sleepiness, testicular atrophy
60
Manifestations of malignant hyperthermia and treatment
Masseter muscle rigidity, sinus tachycardia, hypercarbia, rhabdomyolysis, hyperkalemia, hyperthermia
Treatment - dantrolene
61
Most important RF for stroke
Hypertension
62
Mx of TIA
Smoking cessation, start aspirin and statin, reduce BP
63
Initial imaging for acute stroke
NCCT head
64
Lacunae infarct presentation
Unilateral motor impairment
65
MCA occlusion ppt
C/L somatosensory and motor deficit, conjugate eye deviation towards side of infarct, homonymous hemianopia, aphasia, hemineglect
66
ACA occlusion ppt
C/L somatosensory and motor deficit in LL extremity, abulia, dyspraxia, emotional disturbance, urinary incontinence
67
Areas affected in lacunae stroke
Basal ganglia, subcortical white matter, pons
68
Dejerine Roussy syndrome
Thalamic pain syndrome- paroxysmal burning pain exacerbated by light touch due to stroke involving posterolateral thalamus
69
PCA stroke
Homonymous hemianopia, alexia without agraphia, visual hallucinations, sensory symptoms, 3rd nerve palsy with paresis of vertical and horizontal eye movements, C/L Motor deficits
70
Wallenburg syndrome
Lateral medullary syndrome- intracranial vertebral artery, vestibulocerebellar, sensory, ipsilateral bulbar, autonomic dysfunction
71
Medial medullary syndrome
C/L hemiparesis, C/L vibration loss, ipsilateral tongue paralysis
72
BP meds for haemorrhagic stroke
IV nicardipine, labetalol, goal 140-160mm hg
73
Ppt of carotid artery injury, diagnosis
Hemiplegia, aphasia, thunder clap headache, neck pain
CT or MR angiography
74
Pathology behind IIH
Impaired absorption of CSF by arachnoid villi
75
Tx of IIH
Weight reduction, acetazolamide, may use furosemide on acetazolamide, corticosteroids and serial LP while awaiting surgery
76
RF of cerebral vein thrombosis. Diagnosis and Tx?
Inherited thrombophilia, pregnancy, post partum, OCP, malignancy, infection
MRI brain with venography
Anticoagulants heparin acutely
77
Subclavian steal syndrome, diagnosis, Tx
Upper extremity ischemia, vertebrobasilar insufficiency
Lower brachial SBP, systolic bruit, S4+
Doppler USG or MR angiography
Tx- lifestyle management, stent
78
Uncal herniation findings
Ipsilateral fixed and dilated pupil, c/l hemiparesis, c/l homonymous hemianopia
79
Abnormal posturing seen with which type of brain herniation
Central, decorticate and decerebrate
80
Routine lab tests for dementia
CBC, VIT B12, TSH, CMP
Folate, syphilis, vit d
Atypical- CSF
Imaging- CT or MRI brain, atypical- EEG
81
Neuro imaging finding in Alzheimers
Medial temporal lobe atrophy
82
Neuro imaging in vascular dementia
Cerebral infarction, deep white matter changes
83
Findings in dementia with Lewy bodies
Visual hallucinations, spontaneous parkinsonism, fluctuating cognition, REM sleep behaviour disorder
84
Anti Parkinson’s meds causing psychosis
Levodopa, dopamine agonists
85
PD in younger patients, treatment where tremor is the primary symptom
Trihexiphenidyl
86
Old patients, mild tremor dominant PD, TX?
Amantadine
87
Tx of hallucinations in PD
Initial trial adjustment, low dose anti psychotic like quetiapine, Pimavanserin
88
Lewy bodies
Eosinophilic intractyoplasmic inclusions
89
Shy drager syndrome, Tx
Multiple system atrophy- parkinsonism, autonomic dysfunction, neurological signs
Fludrocortisone, salt supplementation, alpha agonists, constrictive garments to lower body
90
Riley Day syndrome
Familial dysautonomia- Askanazi Jew children, feeding problems, hypotonia, decreased lacrimation with severe ortho static hypotension
91
Findings in Huntington
CAG repeat expansion, loss of GABAergic neurons, caudate and putamen atrophy
92
Mx of frontotemporal dementia
SSRI, trazodone for neuropsychiatric symptoms
93
Findings in CJD
EEG shows periodic sharp wave complexes
MRI, Widespread atrophy, cortical enhancement, hockey stick sign
CSF-positive 14-3- 3, positive RT-QulC test
94
Rx of Sturgge Weber syndrome
Laser therapy, anti epileptics, intraocular pressure reduction
95
Findings in tuberous sclerosis
Ash leaf spots, angiofibromas, shagreen patches, subependymal tumours, infantile spasms, ID, autism, ADHD, rhabdomyoma, angiomyolipoma
96
Screening for tuberous sclerosis
Regular skin and eye examination
Serial MRI of brain and kidney
Echo, ECG
EEG, neuropsychiatric screening
97
Features of craniopharyngioma
Optic chasm and pituitary stalk compression-Bitemporal hemianopsia, growth failure, pubertal delay, sexual dysfunction, diabetes insipidus
98
Cranial nerve palsy involved in medulloblastoma
Abducens
99
Features of pinealoma
Parinaud syndrome, obstructive hydrocephalus
100
MRI appearance of glioblastoma
Butterfly appearance with central necrosis, heterogeneous serpiginous contrast enhancement shows high grade astrocytoma
101
Which brain tumor has a bimodal presentation
Craniopharyngioma
102
Location of metastatic brain disease
Grey white matter junction
103
Metastatic brain frequency
Lung> breast> unknown primary> melanoma> colon
104
Tx for malignant neurological compromise like spinal cord compressions causing bone pain and neurological deficits
Systemic glucocorticoids
105
Psychogenic pseudosyncope
Conversion disorder, LOC without impaired cerebral perfusion
106
Neurogenic orthostatic hypotension seen in
Parkinsonism
107
Causes of cardiogenic syncope
AS, HCM, VT, TDP, AV block, sick sinus
108
How does cluster headache improve
Oxygen therapy
109
Prophylactic for cluster headache
Verapamil, lithium
110
First line for trigeminal neuralgia
Carbamazepine, oxcarbazepine
111
Mx of traumatic brain injury
Maintain MAP, reduce ICP, prevent ICH, prevent seizures, control blood glucose, maintain normothermia
112
GCS to who tranexamic acid is to be given with TBI
9-12 within 3 hrs of injury
113
Imaging performed in primary survey in ATLS
Chest and pelvis x ray, FAST, cervical spine imaging
114
What should be done in anterior cord syndrome to prevent bladder distension.
Catheterisation
115
MRI findings in diffuse axonal injury
Punctuate haemorrhages in white matter, blurring of grey white matter junction
116
Artery involved in epidural hematoma, CT findings
Middle meningeal artery, sphenoid bone trauma
Biconvex lens shaped hyper density, does not cross suture lines
117
Pathogenesis of SDH, CT findings
Rupture of bridging veins
Crescent hyperdensity crosses suture lines
118
Tx of SAH
Angiographic procedure to stabilise aneurysm by coiling or stenting, nimodipine and hyperdynamic therapy for vasospasm
119
Common sites of hypertensive haemorrhage
Basal ganglia> cerebellar nuclei> thalamus> pons> cerebral cortex
120
Sites involved in cerebral amyloid angiopathy, condition associated with it?
Occipital and parietal lobes, Alzheimers.
121
Man with aortic dissection, improves with meds but can’t move lower limbs, distended bladder, weakness and decreased reflexes in legs, loss of touch and pain. Cause?
Thoracic spinal cord ischemia- T10-12
122
Rx of AIP
Glucose and hemin
123
Parkinson disease dementia, psychosis rx
Anticholinesterase inhibitors- eg- donepezil. psychosis- low dose antipsych- pimavanserin, quetiapine
124
Decreased sensation in ant thigh, medial leg, knee extension, patellar reflex. nerve inj?
Femoral nerve
125
Focal to GTCS, h/o RCC, hypoNa
Do MRI brain- for mets
126
Kid- speech delay, decreased attention, diff opening hands after squeezing someone's fingers
Myotonic dystrophy
127
Girl- breathing prob, seizures, unsteady gait, twisting fingers, not speaking words anymore
Rett syndrome- look for head growth deceleration
128
right temporal Headache, ICP findings, left DTR increased, HTN, bradycardia
AVM
129
TBI- ICP, fever, HTN, tachycard, tachypnea, diaphoresis on sponge bath
Paroxysmal sympathetic hyperactivity
130
Acute headache, nausea, htn, right ptosis, mydriasis
SAH- PCom aneurysm
131
Aneurysm causing u/l vision loss or bitemp hemianopsia
ACom or ICA
132
Confusion, fever, takes TNF alpha for RA, MR+, MRI shows brain abscess. NBS
Echo for IE
133
MRI finding in CJD
Widespread cortical atrophy, enhancement-ribboning, caudate and putamen enhancement- hockey stick sign
134
In 18hrs- Progressive ascending paralysis, paraesthesias, areflexia, hiking to colorado
Search for tick- tick borne paralysis
135
Underwent SAH aneursym repair- POD5 confused, tingling in right hand, weakness, facial droop
Cerebral vasospasm- causing cerebral ischemia- prevention- nimodipine, euvolemia
136
Neuroimaging findings in diffuse axonal inj?
Punctate hemorrhages in white matter, blurring of gray white interface
137
Post herpetic neuralgia rx
gabapentin, pregabalin, TCA
138
