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JG EMQ revision > Neurology > Flashcards

Neurology Flashcards

1
Q

Sensory ataxia

A

High-stepping gait due to peripheral sensory neuropathy

Possible anaemia/B12 deficiency/DM/cord degeneration

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2
Q

What comprises the GCS?

A

Eye opening response

Best verbal response

Best motor response

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3
Q

GCS - eye opening response

A 
4 = Spontaneously
3 = To speech
2 = To pain
1 = No response
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4
Q

GCS - best verbal response

A 
5 = Oriented to TPP
4 = Confused
3 = Inappropriate words
2 = Incomprehensible words
1 = No response
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5
Q

GCS - best motor response

A 
6 = Obeys commands
5 = Moves to localised pain
4 = Flexion withdrawal from pain
3 = Abnormal flexion (decorticate)
2 = Abnormal extension (decerebrate)
1 = No response
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6
Q

Medullary stroke

A

Also known as a ‘bulbar stroke/palsy’

Ipsilateral vagus nerve palsy –> palate deviates AWAY
Ipsilateral hypoglossal nerve palsy –> tongue deviates TOWARDS

Clinically, this = dysarthria (nasal voice)+ swallowing problems

Investigation = MRI

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7
Q

Pontine stroke

A

Sudden LOC, pinpoint pupils, Cheyne-Stokes breathing, eyes deviate towards hemiparesis

Investigation = MRI

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8
Q

Thalamic stroke

A

Burning/shooting pain down hemiparetic limbs

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9
Q

Subarachnoid haemorrhage

A

SUDDEN ONSET severe occipital headache

MC rupture berry aneuryms (RF = HTN, ADPKD, collagen Dx)

Vomiting, meningism, photophobia

**CT = BICONVEX shape

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10
Q

Subdural haemorrhage

A

Insidious bleed = increasing ICP

Headaches, focal neurology, fluctuating GCS

**CT = CRESCENT SHAPE

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11
Q

Extradural haemorrhage

A

Temporoparietal injury (pterion)

Lucid interval –> rapidly deteriorating consciousness + focal neurology

***CT = BICONVEX shape

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12
Q

Stroke — frontal cortex

A

Monoparesis, personality changes, urinary incontinence

Broca’s dysphasia (LEFT only)

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13
Q

Stroke — parietal cortex

A

Complex disabilities, contralateral sensory neglect, dyspraxia

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14
Q

Stroke — occipital cortex

A

Cortical blindness

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15
Q

Stroke — Temporoparietal cortex

A

CONTRALATERAL symptoms

Receptive dysphasia, contralateral sensory inattention, homonymous field defects, hemiparesis

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16
Q

Stroke — Cerebellar

A

IPSILATERAL symptoms

Past-pointing, dysdiadochokinesia, nystagmus, hypotonia/reflexia

Bilateral –> ataxia, slurred/scanning speech

17
Q

Seizure — simple partial

A

Anatomical site of abnormal epileptic focus

Motor/sensory/olfactory/aphasic

NO loss of consciousness

18
Q

Seizure — complex partial

A

Imparied level of consciousness

Prodromal feelings, responsive to surrounding, AUTOMATISMS

Post-ictal drowsiness

19
Q

Seizure — typical absence

A

Spikes/waves at 3Hz on EEG

Decreases consciousness +/- myoclonic/tonic/autonomic components

20
Q

Seizure — tonic-clonic

A

Tonic phase = jaw/face contracts, cyanosis, tongue biting, bellowing cry, incontinence

Clonic phase = rhythmic contraction of truncal/limb muscles

Post-ictal = headache + drowsy

21
Q

Seizure — status epilepticus

A

> 30min without regaining consciousness

IV benzodiazepines –> IV phenytoin

22
Q

Labyrinthitis

A

MCC vertigo

Viral origin?

Explosive severe vertigo, vomiting and ataxia WITHOUT tinnitus and deafness

23
Q

Cerebellar speech

A

Dysarthria
Ataxia
Nystagmus
Poor coordination

Stroke/alcohol excess

24
Q

Wernicke’s aphasia

A

Wernicke’s area found in LEFT TEMPORAL LOBE near PRIMARY AUDITORY CORTEX

Fluent aphasia with poor comprehension and poor repetition (due to intact Broca’s area)

Note: the two areas are connected by the ARCUATE FASCICULUS

25
Q

Broca’s aphasia

A

Broca’s area found in LEFT TEMPORAL LOBE near PRIMARY MOTOR CORTEX

Non-fluent aphasia with good comprehension and poor aphasia (due to intact Wernicke’s)

26
Q

Arcuate fasciculus lesion

A

Fluent aphasia with good comprehension but poor repetition

27
Q

Pseudobulbar palsy (speech)

A

UPPER MOTOR NEURONE Sx

Small, contracted tongue + jaw jerk

MND, MS, brainstem lesion

28
Q

Sagittal sinus thrombosis

A

Sudden-onset headache, seizures, and signs of raised ICP

**CT/MRI to confirm (‘empty delta sign’)

29
Q

Brown-sequard syndrome

A

Hemisection of spinal cord

IPSILATERAL motor loss + proprioception

CONTRALATERAL spinothalamic loss

30
Q

Syringomyelia

A

20-30yo

Dorsal and motor column INTACT

Neck/shoulder achey pain

**MRI to confirm

31
Q

Central cord syndrome

A

Cervical spondylosis

Flaccid weakness of arms but lower limb preserved (located in peripheral spinal cord)

32
Q

Cauda equina syndrome

A

Narrowing of spinal canal below L2

TRIAD of incontinence/retention, bilateral leg pain/weakness, and loss of sensation in the perineal area

33
Q

Posterior cord syndrome

A

Hyperextension injury

Loss of DORSAL column function

Impaired gait due to impaired proprioception

34
Q

Anterior cord syndrome

A

Flexion-compression injury

Impaired SPINOTHALAMIC and CORTICOSPINAL function

Legs&raquo_space;> arms

35
Q

How do you manage a stroke in the acute setting?

A

Patient must be put NBM and then sent for an URGENT CT HEAD

36
Q

What is subacute combined degeneration of the spinal cord?

A

Results from B12 DEFICIENCY

Peripheral neuropathy –> burning sensation in hands a feed + GLOVE and STOCKING sensory/vibratory loss

Spinal involvement –> demyelination of posterior columns and corticospinal tracts = UMN signs of weakness, increased tone, hyperreflexia, Babinski’s sign

Treat w/ IM B12

37
Q

What will the CSF findings be with TUBERCULAR meningitis?

A

Low glucose with HIGH protein

Lymphocytes +++ predominant

Negative India ink stain

38
Q

Wernicke-Korsakoff syndrome

A

A-NO!

Ataxia, nystagmus, opthalmoplegia

Due to chronic thiamine deficiency

39
Q

Meningitis - bacterial (young)

A

Haemophilus influenzae

Benzylpenicillin

JG EMQ revision (14 decks)

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