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OSCE Pharmacology > Neurology > Flashcards

Neurology Flashcards

1
Q

What kind of aura would you expect for epilepsy?

A

Dizziness
Deja vu/Jamais vu
Unusual smell/taste/vision

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2
Q

Which cranial nerves may be affected by a cavernous sinus thrombosis?

A

3, 4, 5, 6

5 is particularly associated with pain and loss of corneal reflex

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3
Q

Give 5 causes of any cranial nerve palsy.

A 
Diabetes
Stroke
MS
Tumour
Vasculitis
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4
Q

Give 3 causes of a unilateral Ptosis. Will they be partial or complete?

A

Horner’s - partial
CN 3 palsy - complete
Congenital

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5
Q

Give 3 causes of a bilateral Ptosis.

A

Myaesthenia gravis
Myotonic dystrophy
Congenital

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6
Q

What are the features of a cranial nerve 3 palsy?

A

Eye down and out
Complete Ptosis
Dilated pupil

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7
Q

What are the signs of Horner’s syndrome?

A

Unilateral:

Partial Ptosis
Miosis (constricted pupil)
Anhydrosis

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8
Q

How would you differentiate between Bell’s palsy and a umn facial nerve palsy?

A

If frontalis is spared then it is umn stroke.

Due to bilateral innervation of this muscle.

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9
Q

What are the bulbar signs? What are they indicative of?

A

Slurred speech, dysphagia, absent gag reflex.

LMN damage to CN9-12 in medulla
Polio
MND
Myaesthenia gravis

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10
Q

What is your differential for a CN1 problem?

A

Trauma
Viral infection
Meningitis

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11
Q

What is your differential for monocular blindness?

A

Retinal detachment
Ophthalmic artery thrombus
Giant cell arteritis

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12
Q

What is your differential for bitemporal hemianopia?

A

Pituitary adenoma

Aneurysm in the circle of Willis

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13
Q

What is your differential for a homonymous hemianopia?

A

Anything behind the chiasm:

Stroke
Tumour
Abcess

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14
Q

What is your differential for a CN5 problem?

A

Trigeminal neuralgia

Herpes zoster

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15
Q

What is your differential for a CN8 problem?

A

Furosemide
Gentamicin
Age

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16
Q

What kind of aura would you expect for a simple vasovagal faint?

A

Nausea
Sweating
Dizziness

17
Q

What are the myotomal roots of the reflexes?

A

Ankle - S1/2
Knee - L3/4
Biceps and brachioradialis - C5/6
Tricep - C7/8

18
Q

What are the cardinal signs of Parkinson’s?

A

Bradykinesia
Rigidity (cog wheel)
Resting tremor (pill rolling)

May also have masked fascies and slurred speech.

19
Q

What are the signs of a cerebellar lesion?

A

DANISH

Disdiadokinesis
Ataxia
Nystagmus 
Intention tremor
Speech - slurred
Hypotonia
20
Q

What are the signs of an ulnar nerve lesion?

A

LMN signs in fourth and fifth fingers

21
Q

What are the signs of a median nerve lesion?

A

LMN signs in the thenar muscles and palmar surface

22
Q

What are the signs of a radial nerve lesion?

A

Wrist drop and weakness of extension of the elbow

23
Q

What are the signs of an upper motor neuron lesion?

A 
Hypertonia
Hyperreflexia
Spastic muscle weakness
Babinski's 
Clonus
24
Q

What are the signs of a lower motor neuron lesion?

A 
Hypotonia
Hyporeflexia
Flaccid weakness
Muscle wasting
Fasciculations
25
Q

How would you grade muscle weakness?

A 
0 - no movement
1 - flicker
2 - unable to move against gravity
3 - unable to move against resistance
4 - reduced power, able to move against resistance
5 - normal
26
Q

What birth injury causes damage to the upper brachial plexus? How does it present?

A

Erbs = waiters tip

Shoulder adducted
Arm internally rotated
Forearm pronated

27
Q

What birth injury causes damage to the lower brachial plexus? How does it present?

A

Klumpke’s

Wasting of small muscles in hand - claw
Flexion of the elbow and wrist
Horner’s may accompany

28
Q

Give 5 causes of peripheral neuropathy?

A 
Diabetes
Uraemia (kidney failure)
Vasculitis
Anaemia
Alcohol
29
Q

Give 4 causes of foot drop.

A

Common peroneal nerve palsy
Stroke
L4/5 lesion
Motor neurone disease

30
Q

What is syringomyelia? How does it present?

A

Blockage of CSF in spinal canal - syrinx
Affects spinothalamic tracts as they cross

Loss of pain and temperature on both sides in a cape like pattern.

31
Q

What is brown squared syndrome and how does it present?

A

Lateral hemi section of the spinal cord

Lose vibration and proprioception on same side
Lose pain and temperature and crude touch on opposite side.

32
Q

What is cauda equina? How does it present?

A

Damage to the lumbar region L1-5 can also damage the sacral nerve roots.

Leads to saddle anaesthesia, urinary incontinence, sexual dysfunction, motor and sensory deficits.

33
Q

What is the differential for a positive Romberg test?

A

NOT cerebellar, they will not balance with eyes open.

Lesion to dorsal columns (proprioception) eg Neurosyphilis
Alcohol
B12/thiamine deficiency
MS

34
Q

Give three types of gait and what causes them.

A

Festinating - Parkinson’s
Trendelenberg - superior gluteal nerve palsy or fractured neck of femur
Antalgic - arthritis

35
Q

Give four types of tremor and what causes them.

A

Intention tremor - cerebellar lesion
Resting tremor - Parkinson’s
Flapping - metabolic
Drug induced - anti psychotics

36
Q

What are the main causes of carpal tunnel syndrome?

A 
Idiopathic
Pregnancy
Repetitive strain injury
Arthritis
Diabetes
Hypothyroid
37
Q

Give three causes of nystagmus

A

Alcohol
Cerebellar lesion
CN8 lesion

OSCE Pharmacology (10 decks)

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