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XUAN MSRA > Neurology > Flashcards

Neurology Flashcards

1
Q

What is caused by damage to the common peroneal nerve?

A

Weakness of:
1) foot dorsiflexion
2) foot eversion

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2
Q

How does a patient with lacunar infarct present?

A

1) Purely motor
2) Purely sensory
3) Mixed motor and sensory

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3
Q

What symptoms does C& impingement cause?

A

1) Pain in neck and arm on flexing neck
2) Sensory loss over middle finger and palm of the hand

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4
Q

What is the pattern of inheritance for essential tremor?

A

Autosomal dominant

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4
Q

What are the options for migraine prophylaxis?

A

1) Propranolol
2) Topiramate (avoid in women of childbearing age)
3) Amitriptyline

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5
Q

What is the management of essential tremors?

A

1st line: propranolol
2nd: primidone

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6
Q

What is the treatment of trigeminal neuralgia?

A

Carbamazepine

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6
Q

What are second line treatments in status epilepticus?

A

Levetiracetam, Phenytoin, Sodium valproate

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7
Q

What are the features of third nerve palsy?

A

1) Ptosis
2) Down and out eye
3) Mydriasis

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8
Q

How does Levodopa work?

A

increasing dopamine concentrations in the brain, which helps to alleviate motor symptoms

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9
Q

What is management of Parkinson’s?

A

1st line:
If affecting QoL: Levodopa
If not affecting QoL: Dopamine agonist, Levodopa or monoamine oxidase B (MAO-B) inhibitor

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10
Q

What can be prescribed with Levodopa to improve side effects?

A

nearly always combined with a decarboxylase inhibitor (e.g. carbidopa or benserazide)

this prevents the peripheral metabolism of levodopa to dopamine outside of the brain and hence can reduce side effects

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10
Q

What are common side effects of levodopa?

A
  • postural hypotension!
  • dry mouth!
  • anorexia
  • palpitations
  • psychosis
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11
Q

What are the features of a vestibular Schwannoma (acoustic neuroma)?

A
  • Vertigo (CN VIII)
  • Hearing loss (CN VIII)
  • Tinnitus (CN VIII)
  • Absent corneal reflex (CN V)
  • Can have facial nerve palsy (CN VII)
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11
Q

What is Cushing’s triad?

A

1) Bradycardia
2) Irregular breathing
3) Wide pulse pressure

Seen in pts with increased ICP

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12
Q

What are the effects of an anterior cerebral artery stroke?

A

Contralateral hemiparesis and sensory loss
Lower extremity > upper

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13
Q

What are the effects of a middle cerebral artery stroke?

A
  • Contralateral hemiparesis and sensory loss (upper extremity > lower)
  • Contralateral homonymous hemianopia
  • Aphasia
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14
Q

What are the effects of a posterior cerebral artery stroke?

A
  • Contralateral homonymous hemianopia with macular sparing
  • Visual agnosia
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15
Q

What is Weber’s syndrome?

A

Stroke of branches of the posterior cerebral artery that supply the midbrain

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16
Q

What are the signs in Weber’s syndrome?

A
  • Ipsilateral CN III palsy
  • Contralateral weakness of upper and lower extremity
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17
Q

What are the effects of a posterior inferior cerebellar artery (lateral medullary syndrome, Wallenberg syndrome) stroke?

A
  • Ipsilateral: facial pain and temperature loss
  • Contralateral: limb/torso pain and temperature loss
  • Ataxia, nystagmus
18
Q

What are the effects of an anterior inferior cerebellar artery (lateral pontine syndrome) stroke?

A

Symptoms are similar to Wallenberg’s but:

Ipsilateral: facial paralysis and deafness

19
Q

What are the effects of a stroke of the retinal/ophthalmic artery?

A

Amaurosis fugax

20
Q

What are the effects of a lacunar stroke?

A
  • either isolated hemiparesis, hemisensory loss or hemiparesis with limb ataxia

NOTE: common sites include the basal ganglia, thalamus and internal capsule
NOTE: strong association with HTN

21
Q

The hemorrhage of which vessel most commonly leads to the formation of an subdural hematoma?

A

Bridging vein

22
Q

The haemorrhage of which vessel most commonly leads to the formation of an extradural haematoma?

A

Middle meningeal artery

23
Q

The haemorrhage of which vessel most commonly leads to the formation of an subarachnoid haematoma?

A

Vessels of the circle of Willis, such as: - basilar artery
- anterior circulating arteries

24
Q

What visual field defect is caused by pituitary tumour?

A
  • Bitemporal hemianopia, upper quadrant defect >lower quandrant

NOTE: if lower quadrant defect more likely due to craniopharyngioma

25
Q

Management of neuroleptic malignant syndrome?

A
  • Stop antipsychotic
  • IVI
  • Sometimes dantrolene
  • Sometimes bromocriptine, dopamine agonist
26
Q

What are the typical 3 features of Parkinson’s?

A

1) Bradykinesia
2) Tremor (resting)
3) Rigidity

27
Q

GCS points?

A

Motor (6)
6. Obeys commands
5. Localises to pain
4. Withdraws from pain
3. Abnormal flexion to pain (decorticate posture)
2. Extending to pain
1. None

Verbal (5)
5. Orientated
4. Confused
3. Words
2. Sounds
1. None

Eyes (4)
4. Spontaneous
3. To speech
2. To pain
1. None

28
Q

Which nerve roots does the ankle reflex test?

A

S1-S2

29
Q

Which nerve roots does the knee reflex test?

A

L3-L4

30
Q

Which nerve roots does the biceps reflex test?

A

C5-C6

31
Q

Which nerve roots does the triceps reflex test?

A

C7-C8

32
Q

What is the most common complication following meningitis?

A

Sensorineural hearing loss

33
Q

What are some common side effects of phenytoin?

A
  • Megaloblastic anaemia
  • Peripheral neuropathy
  • Gingival hyperplasia
34
Q

What nerve is most likely to be damaged as a result of mid-shaft of humerus fracture? Symptom?

A
  • Radial nerve
  • Wrist drop
35
Q

What are the features of Wernicke’s?

A

Nystagmus
Opthalmoplegia
Ataxia
Confusion

36
Q

What are the features of Wernicke’s?

A

Nystagmus
Opthalmoplegia
Ataxia
Confusion

+
Amnesia (antero- and retrograde)
Confabulation

37
Q

What is the most common presenting symptom of posterior circulation stroke?

A

Dizziness

38
Q

What is the long-term management for nutrition in patients with motor neurone disease?

A

Percutaneous gastrostomy tube (PEG)

39
Q

What is the management of generalised tonic-clonic seizures?

A
  • males: sodium valproate
  • females: lamotrigine or levetiracetam

NOTE: girls aged under 10 years and who are unlikely to need treatment when they are old enough to have children or women who are unable to have children may be offered sodium valproate first-line

40
Q

What is the management of focal seizures?

A

first line: lamotrigine or levetiracetam
second line: carbamazepine, oxcarbazepine or zonisamide

41
Q

What is the management of Absence seizures (Petit mal)?

A
  • first line: ethosuximide
  • second line:
    male: sodium valproate
    female: lamotrigine or levetiracetam

NOTE: carbamazepine may exacerbate absence seizures

42
Q

What is the management of Myoclonic seizures?

A

males: sodium valproate
females: levetiracetam

43
Q

What is the management of tonic or atonic seizures?

A

males: sodium valproate
females: lamotrigine

44
Q

What is drug prophylaxis for cluster headaches?

A

Verapamil

45
Q

What are the features of Huntington’s?

A

1) chorea
2) personality changes (e.g. irritability, apathy, depression) and intellectual impairment
3) dystonia
4) saccadic eye movements

46
Q

What is the most appropriate antiemetic in Parkinson’s?

A

Domperidone

XUAN MSRA (20 decks)

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