Neurology Flashcards
What is lateral medullary syndrome? and what causes it?
Wallenberg syndrome - acute ischaemic infarct of lateral medulla oblongata
What are the symptoms of a medulla oblongata infarct?
eople with conduction aphasia have good comprehension and coherent speech, but have difficulty repeating words or phrases
What is the pneumonic to remember features of cerebellar disease?
DANISH
Dysdiadochokinesis
Ataxia
Nystagmus
Intention tremor
Scanning dysarthria / slurred speech
Heel-shin test positivity/ hypotonia
If there is a pontine lesion how does it present?
Will affect the cranial nerves - v,v1 and v3 and v4 so ipsilateral weakness of abduction of eye and ipsilateral facial weakness and ipsilateral deafness
What is first line treatment for essential tremor?
Propranolol
If patient has asthma and essential tremor what is treatment?
Topiramate
What anti-platelet should be given after thrombolysis ensuring there is no haemorrhage?
\Aspirin 300mg after 24 hours
What is the most common hereditary peripheral neuropathy?
Charcot-marie-tooth disease
What is charcot marie tooth disease?
Distal muscle weakness
Foot drop
Decreased sensation
What is the inheritance pattern of caharcot marie tooth disease?
Autosomal dominant
If common fibular nerve (common peroneal nerves) was damaged what signs would you expect?
Foot drop
Which dementia is linked to amyotrophic lateral sclerosis?
Fronto-temporal dementia
Which gene is found in amyotrophic lateral sclerosis and fronto-temporal dementia?
C9orf72
What is driving advice for first seizures?
After a one off seizure you can’t drive for a minimum of 6 months
What is preferred treatment for a subarachnoid haemorrhage?
Endovascular coiling
If a CT head is negative for a subarachnoid haemorrhage but it’s still suspected what other test can be done?
Lumbar puncture - as it may reveal blood in CSF or xanthochromia - yellowed CSF from haemolysis - indicates an older bleed
What is brown-sequard syndrome?
Due to damage affecting one half of spinal cord - usually due to knife or gunshot wound. Can also be due to other trauma like falls or malignancy
What are the symptoms of posterior cord syndrome?
Loss of fine touch, proprioception and vibration
Which column tract does posterior cord syndrome affect?
Dorsal column
What symptoms appear with anterior cord syndrome?
Loss of pain and temperature sensation
Which vitamin deficiency is a risk factor for subacute combined degeneration of the spinal cord?
B12
What is first line for seizing patient?
2 doses of IV lorezapam
If after 2 doses of IV lorezapam there is not stopping the seizure what should be tried?
IV infusion of phenytoin
What is used in acute treatment of cluster headaches?
High flow oxygen also triptans can be used
What is initial treatment for trigeminal neuralgia?
Carbamazepine
How does a cluster headache present?
Worst pain ever
Usually temporal around eyes
can last from 15 mins to three hours
Which region in brain is degenerated in parkison’s?
Substantia nigra
What is the definition of status epilepticus ?
Seizure lasting 5 mins or more or multiple seizures occurring within a 5 min windows without regaining full consciousness
What is first line treatment for Myasthenia gravis?
Pyridostigmine
What’s the mechanism of action of pyridostigmine?
Acetylcholinesterase inhibitor
Which nerve supplies sensation to the little finger?
Ulnar nerve
What is the gold standard treatment for symptomatic parkinson’s?
Levodopa + carbidopa
What visual defect is seen with optic chiasm compression?
Bitemporal hemianopia
What is a major complication to be aware of with subarachnoid haemorrhage in the first 12 hours?
Anyeurysmal rebleed
What are the symptoms of an aneurysm rebleed?
Sudden worsening of neuro symptoms after presenting
What is an important side effect of levodopa?
Postural hypotension
In bell’s vs stroke which one is forehead sparing?
Stroke spares forehead but bell’s doesn’t - meaning forehead can’t wrinkle in bells bcos it’s a lower motor neurone disease
What is the gold standard way to measure a patients with breathing difficulty respiratory effort?
FVC
What is myasthenia gravis?
Autoimmune disease - where antibodies that target the post synaptic nicotinic acetylcholine receptors at neuromuscular junction are targeted