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Barts Final Year > Neurology > Flashcards

Neurology Flashcards

1
Q

Subungual fibromas are seen in what neurocutaneous disorder?

A

Tuberous Sclerosis

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1
Q

Edrophonium is used to diagnose what neurological disorder?

A

Myasthenia gravis
(the drug is an acetylcholinesterase inhibitor)

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2
Q

What is the MOA of Sumitriptan?

A

5-HT1B and 1D agonist

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3
Q

A craniopharyngioma causes an upper or lower bitemporal hemianopia?

A

Lower Bitemporal hemianopia
(pit adenoma -> Upper)

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4
Q

Symptoms of Freidrich’s ataxia?

A
  • Bilateral spastic paresis
  • Loss of proprioception and vibration
    (Same as SCD of cord)
  • Ataxia - intention tremor
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5
Q

Wernicke’s aphasia is a disease of what lobe?

A

Temporal

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6
Q

Auditory agnosia, prospagnosia (inability to recognise faces) can be result of a lesion to what lobe?

A

Temporal

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7
Q

Sensory inattention, apraxias (inability to perform a task when asked), astereognosis (tactile agnosia) and Gerstmann’s syndrome are caused by lesions to what lobe?

A

Parietal

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8
Q

Describe Gerstmann’s syndrome

A

Lesion of dominant Parietal
- Alexia (comprehension of language)
- Aculculia (maths inability)
- FInger agnosia
- R-L disorientation

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9
Q

How is Freidrich’s ataxia inherited?

A

AR

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10
Q

What neurocutaneous disorder may feature pheochromocytoma?

A

Neurofibromatosis

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11
Q

What drugs are 1st line for focal seizures?

A
  • Lamotrigine and levitiracetam
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12
Q

What drugs are 1st line for myoclonic seizures?

A
  • Men: Sodium Valproate
  • Women: Levitiracetam
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13
Q

Sagittal sinus thrombosis has what sign on imaging?

A

Empty delta sign

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14
Q

What venous sinus thrombosis has an association with 6th and 7th cranial nerves?

A

Lateral sinus thrombosis

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15
Q

What sinus thrombosis is associated with trauma, infection and 3456 (eyes and trigeminal) CNs?

A

Cavernous sinus thrombosis

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16
Q

Treatment of ring-enhancing lesion

A
  • Ceftriaxone
  • Metronidazole
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17
Q

What drugs increase idiopathic intracranial hypertension?

A
  • COCP
  • Tetracyclines
  • Steroids
  • Retinoids
  • Lithium
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18
Q

What nerve abducts the thumb?

A

Median

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19
Q

What are the features of Wernicke’s encephalopathy?

A
  • Oculomotor dysfunction (nystagmus and/or Opthalmoplegia)
    (LR palsy, conjugate gaze oalsy)
  • Gait ataxia
  • Encephalopathy (confusion, disorientation, indifference, inattentiveness)
  • Peripheral sensory neuropathy
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20
Q

What are the features that would give Korsakoff syndrome?

A
  • Amnesia (mem loss)
  • Confabulation
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21
Q

Muscle spasticity in MS is treated with what?

A
  • Baclofen (muscle relaxant)
  • Gabapentin
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22
Q

A lesion in the left trochlear nerve would cause a head tilt toward what side?

A

Right side

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23
Q

Post stroke meds

A
  • Clopidogrel
  • Statin

If clopidogrel contra-indicated:
- Aspirin + MR dipyridamole

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24
Q

Ischaemic stoke management

A
  • Aspirin 300mg
  • Thrombolysis (within 4.5 hrs)
  • Thromobectomy (within 6 hrs or 24 hrs)
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25
Q

What autoimmune disease may cause bilateral facial nerve palsy and bilateral parotid gland enlargement?

A

Sarcoidosis

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26
Q

Foul smelling discharge from ear can indicate what?

A

Cholsteatoma

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27
Q

What subtype of GBS has descending wekaness, areflexia, opthalmoplegia and ataxia?

A

Miller-Fisher syndrome

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28
Q

A subdural and epidural bleed may require what surgery?

A

Burr hole evacuation

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29
Q

How is MG diagnosed?

A

Antibody screen

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30
Q

Diplopia and vertical gaze palsy is a feature of what Parkinson’s plus syndrome?

A

PSP

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31
Q

Diabetes insipidus (cranial) may cause what visual disturbance?

A

Bitemporal hemianopia (lower)

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32
Q

What drugs (or class of drugs) may help in rigidity in Parkinson’s?

A

Antimuscarnics - Procyclidine

33
Q

What Parkinoson’s drugs have the highest side-effect profile?

A

Dopamine agonists (e.g bromocriptine)

34
Q

Give an example of a MAO-B (Monoamine Oxidase-B) inhibitor - used in Parkinson’s

A

Selegiline (inhibits breakdown of dopamine secreted by dopaminergic neurons)

35
Q

Give an example of COMT (Catechol-O-Methyl Transferase) inhibitors (enzyme involved in breakdown of dopamine) can be used as adjunct to levodopa?

A

Entacapone, Tolcapone

36
Q

Treatment of DCM?

A

Decompressive surgery

37
Q

MG treatments? (management + crisis) (5)

A
  • Pyridostigmine (long-acting acetylcholin
  • Immunosuppression
  • ?Thymectomy

Crisis:
- Plasmapheresis
- IVIG

38
Q

What nerve extends the wrist?

A

Radial

39
Q

What brainstem stroke affects CN V (ipsilateral)?

A

PICA

40
Q

What brainstem stroke affects CN VII VIII (ipsilateral)?

A

AICA - lateral pontine

41
Q

MOA of ondansetron

A

5-HT3 antagonist

42
Q

What diet is good for epilepsy

A

Ketogenic

43
Q

What antiemetic is contraindicated in long QT

A

Ondansetron

44
Q

Thickened skin (shagreen patches are a feature of what neurocutaneous disorder)

A

Tuberous sclerosis

45
Q

A surgical neck of humerus fracture is likely to cause a lesion in wjat nerve?

A

Axillary

46
Q

What brainstem stroke can cause an ipsilateral Horner’s ?

A

PICA

47
Q

Withdrawing from pain indicates an M of what on GCS?

A

4

48
Q

Hand above clavicle indicates an M of what on GCS?

A

5

49
Q

Intubate at what GCS?

A

8

50
Q

Blood resuts show what on Neuroleptic Malignant Syndrome

A
  • Increased WCC (also pyrexia)
  • Increased CK
51
Q

A positive Rombergs indicates an issue where?

A

Dorsal columns

52
Q

Immediate management of pituitary apoplexy

A

IV Hydrocortisone

53
Q

What is the timings for stopping anti-epileptics

A
  • Seizure free for > 2 years
  • AEDs being stopped over 2-3 months
54
Q

Adenoma sebaceum is a feature of what neurocutaneous disorder?

A

Tuberous Sclerosis

55
Q

What response may be preserved in an optice nerve lesion?

A

Consensual response

56
Q

A total vs a partial anterior circulation infarct can be decided based on the patient have either 2 or 3 symptoms. What are these 3 symptoms?

A

1 Unilateral hemiparesis and/or hemisensory loss of face/arm/leg
2. Homonymous hemianopia
3. Higher cognitive dysfunction (e.g. dysphagia)

57
Q

What is L’hermitte sign?

A

Electrical shock sensation on flexion of neck
- Seen in MS, DCM, cervical spondy

58
Q

McArdles sign is what?

A

Impaired gait and muscle weakness with neck flexion
- Seen in MS

59
Q

What muscles are spared in MND?

A

Ocular

60
Q

What is the most common form of hereditary peripheral neuropathy?

A

CMT

61
Q

What is the predominant management of CMT?

A

PT and OT

62
Q

What nerve has sensation of palmar aspect of thumb?

A

Median

63
Q

Axillary freckles are a feature of what neurocutaneous disorder?

A

NF1

63
Q

What nerve root is affected:
- Finger abduction weakness
- Medial aspect of elbow numb

A

T1

64
Q

The adductor pollicis (thumb adduction) is controled by what nerve?

A

Ulnar

65
Q

Is ICP headache worse when lying flat or upright?

A

Lying flat worse
- Also remember it worsens with Valsalva

66
Q

What index measures Disability post-stroke?

A

Barthel index

67
Q

Paroxysmal Hemicrania (unilateral headache occuring multiple times a day) is treated with what?

A

Indomethacin

68
Q

Name a commonly prescribed mab for MS?

A

Natalizumab

69
Q

Name a commonly prescribed drug for ALS?

A

Riluzole

70
Q

Types of MND

A
  • ALS (LMN signs in arms, UMN in legs)
  • Primary Lateral sclerosis (UMN signs only)
  • Progressive muscular atrophy (LMN signs)
  • Progressive Bulbar palsy (tongue, chewing, swallow)
71
Q

What type of MND has the best prognosis?

A

Progressive Muscular Atrophy

72
Q

What type of MND has the worst prognosis?

A

Progressive Bulbar palsy

73
Q

What anti-epeliptic causes bleeding gums and lymphadenopathy?

A

Phenytoin

74
Q

Topiramate causes what in a child (teratogenic effect)

A

Cleft lip and palate

75
Q

How is stroke assessed in ED (scoring system)

A

ROSIER

76
Q

Syringomelia has what 2 main signs?

A
  • Loss of pain and temp sensation in cape-like distribution
  • Wasting of small hand muscles
77
Q

What drug is prescribed to prevent vasospasm in SAH?

A

Nimodipine

78
Q

What is the condition similar and often associated with syringomyelia but in the medulla and affecting the face and tongue / swallowning?

A

Syringobulbia

79
Q
A

Barts Final Year (13 decks)

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