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Passmed wrong > Neurology > Flashcards

Neurology Flashcards

1
Q

Colles fracture

A

distal radius
median nerve
thumb and lateral 2 fingers

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2
Q

C8 radiculopathy

A

reduced sensation over the medial side of the hand over the little finger

reduced flexion of the distal interphalangeal and metacarpophalangeal joints

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3
Q

Klumpke’s palsy

A

damage to T1
loss of intrinsic hand muscles (thumb adduction and finger abduction)
claw hand
loss of sensation over medial epicondyle of elbow
due to traction

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4
Q

myoclonic vs tonic seizure female first line

A

myoclonic = levetiracetam

tonic= lamotrigine

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5
Q

3rd nerve palsy vs Horners

A

3rd nerve= ptosis + mydriasis (dilated)

Horners= ptosis + miosis (constricted)

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6
Q

Required before thrombolysis in acute ischaemic stroke

A

lower blood pressure if >185/110

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7
Q

surgical third nerve palsy

A

ptosis, enlarged pupil and inability to adduct/supraduct.

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8
Q

cubital tunnel syndrome

A

ulnar nerve neuropathy

sensory innervation to the palmar and dorsal aspects of 1.5 fingers medially (4th and 5th fingers)

wasting and paralysis of intrinsic hand muscles (except lateral two lumbricals) and the hypothenar muscles

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9
Q

Focal seizures Tx

A

lamotrigine or levetiracetam are first-line

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10
Q

Aphasia

A

Dominant hemisphere (left) middle cerebral artery

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11
Q

hyperdense crescentic/concave collection

A

acute subdural

hypodense= chronic

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12
Q

raised intracranial pressure (ICP) secondary to traumatic brain injury Tx

A

IV mannitol

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13
Q

raised ICP secondary to vasogenic oedema from central nervous system infections or neoplasms Tx

A

IV dexamethasone

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14
Q

GBS Ix

A

Nerve conduction studies

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15
Q

Gait ataxia

A

cerebellar vermis

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16
Q

finger-nose ataxia

A

cerebellar hemisphere

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17
Q

phenytoin side effects

A

peripheral neuropathy
gingival hyperplasia
hirsutism
megaloblastic anaemia

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18
Q

raised ICP -positioning

A

worse on lying flat as this raises ICP
therefore elevate bed to 30 degrees

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19
Q

loss of corneal reflex

A

CN V1

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20
Q

Narcolepsy Ix

A

multiple sleep latency EEG

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21
Q

tonic seizure

A

muscles become stiff

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22
Q

atonic seizure

A

muscles become floppy

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23
Q

myoclonic seizure

A

short, jerking movements

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24
Q

Brown-Sequard syndrome

A

same sided weakness and proprioception/vibration loss

loss of pain/temperature on the opposite side to the hemisection

(This is because the pathway for pain/temperature sensation decussates at the level of the nerve root)

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25
Q

most sensitive test for myasthenia gravis

vs most specific

A

single fibre EMG

antibody testing for antibodies against acetylcholine receptors in the neuromuscular junction

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26
Q

Ondansetron (5HT-3 antagonist) side effect

A

QT prolongation

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27
Q

Widespread convulsions without conscious impairment

A

psychogenic non-epileptic seizure (pseudoseizure)

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28
Q

MND associated with what dementia

A

frontotemporal

29
Q

trigeminal neuralgia Red flag symptoms

A

Sensory changes
Deafness or other ear problems
History of skin or oral lesions that could spread perineurally
Pain only in the ophthalmic division of the trigeminal nerve (eye socket, forehead, and nose), or bilaterally
Optic neuritis
A family history of multiple sclerosis
Age of onset before 40 years

30
Q

Pituitary apoplexy Tx

A

urgent IV hydrocortisone

31
Q

supracondylar fracture injury- nerve

A

median nerve

32
Q

axillary dissection nerve injury

A

intercostobrachial nerves
sensation to axilla

33
Q

smiths fracture nerve injury

A

median nerve

34
Q

erb’s palsy

A

C5-6
arm pronated and medially rotated.

35
Q

pontine haemorrhage

A

Cx secondary to chronic hypertension

reduces Glasgow coma score, quadriplegia, miosis, and absent horizontal eye movements.

36
Q

Miller Fisher syndrome

A

areflexia, ataxia, ophthalmoplegia

37
Q

Meningioma

A

arise from the arachnoid cap cells of the meninges and are typically located next to the dura and cause symptoms by compression rather than invasion.

38
Q

cataplexy

A

a sudden and transient episode of muscle weakness, typically triggered by strong emotions such as laughter, anger or surprise

39
Q

Aspirin CI

A

high risk of GI bleed–> clopidogrel +PPI

40
Q

4th nerve palsy

A

up and out

41
Q

Medication overuse headache Tx

A

simple analgesia + triptans: stop abruptly
opioid analgesia: withdraw gradually

42
Q

anterior inferior cerebellar artery stroke vs posterior inferior cerebellar artery stroke

A

supplies medulla brainstem
both:
ataxia
nystagmus
contralateral pain and temperature loss

Anterior:
ipsilateral facial paralysis
deafness

43
Q

highest chance of inhibition disorders out of the antiparkinsonian medications

A

dopamine agonists

44
Q

internuclear ophthalmoplegia:
features
seen in

A

impaired adduction of the ipsilateral eye

horizontal nystagmus of the abducting eye on the contralateral side

seen in MS, vascular disease

45
Q

cervical radiculopathy causes

A

nerve root becomes pinched and inflamed:

cervical spondylosis
disc herniation
osteophyte formation
trauma

46
Q

3rd nerve palsy + decreasing conscious level and an intracranial mass

A

trans-tentorial herniation
due

47
Q

if GCS<8

A

intubate with endotracheal tube

48
Q

Ataxic gait

A

wide based gait with loss of heel to toe walking

49
Q

Controlled hyperventilation in raised ICP

A

hyperventilation –> reduce CO2–> vasoconstriction of cerebral arteries–> reduce ICP

50
Q

Headache + muscle weakness

A

Temporal arteritis (PMR)

51
Q

bilateral vs unilateral foot drop

A

bilateral= peripheral neuropathy
unilateral= common perineal nerve injury

52
Q

mononeuritis multiplex

A

simultaneous or sequential involvement of individual non-contiguous nerve trunks.

It typically presents with acute or subacute loss of sensory and motor function of individual nerves.

asymmetric –> symmetric

53
Q

wrist drop

A

fracture of shaft of humerus w associated radial nerve damage

54
Q

myasthenia gravis patients resistant to what anaesthetic

A

Suxamethonium

55
Q

bulbar-onset amyotrophic lateral sclerosis

A

Patients often have more difficulty swallowing liquids than solids in the early stages.

Facial weakness, hypophonic speech, fasciculations and reduced jaw jerk reflex (LMN sign) are all features.

Eye movements are typically spared.

56
Q

significant risk factor for bells palsy

A

pregnancy

57
Q

cavernous sinus thrombosis

A

pain, opthalmoplegia, proptosis, trigeminal nerve lesion (opthalmic branch) and Horner’s syndrome.

58
Q

venous sinus thrombosis Ix

A

MR venogram

59
Q

Managing tremor in drug induced Parkinson’s

A

procyclidine

60
Q

saturday night palsy

A

radial nerve
wrist drop

61
Q

where is the lesion:
left homonymous hemianopia with some macula sparing.

A

occipital cortex

62
Q

Wernicke’s dysphasia

A

speech fluent, comprehension abnormal, repetition impaired

63
Q

Complications of SAH

A

rebleeding
hydrocephalus
hyponatraemia
vasospasm
seizures

64
Q

Severe TBI (GCS ≤8) and abnormal CT findings–>

A

insertion of ICP monitoring device

65
Q

CT head within 1 hour

A

GCS < 13 on initial assessment
GCS < 15 at 2 hours post-injury

suspected open or depressed skull fracture

any sign of basal skull fracture

post-traumatic seizure.

focal neurological deficit.

more than 1 episode of vomiting

66
Q

signs of basal skull fracture

A

haemotympanum
‘panda’ eyes
cerebrospinal fluid leakage from the ear or nose
Battle’s sign- bruising over mastoid

67
Q

CT head within 8 hours

A

age 65 years or older

any history of bleeding or clotting disorders including anticogulants

dangerous mechanism of injury (a pedestrian or cyclist struck by a motor vehicle, an occupant ejected from a motor vehicle or a fall from a height of greater than 1 metre or 5 stairs)

more than 30 minutes’ retrograde amnesia of events immediately before the head injury

68
Q

Binocular vision post-facial trauma

A

depressed fracture of the zygoma

69
Q

Infants with hydrocephalus presentation

A

increased head circumferences
a bulging fontanelle
sunsetting of the eyes (impaired upward gaze)

Passmed wrong (9 decks)

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