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Year 3 MBChB > Neurology > Flashcards

Neurology Flashcards

1
Q

What are focal seizures?

A

Occur within discrete regions of the brain

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2
Q

What are features of a temporal lobe seizure?

A

Aura
Deja Vu
Affects mentally

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3
Q

What are features of a Jacksonian seizure?

A

Starts proximally

‘Marches down limb’

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4
Q

How are focal seizures managed?

A

Carbamazepine

Lamotrigine

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5
Q

What are side effects of carbamazepine?

A

Can put patients into status epilepticus
Visual disturbances
SIADH
Agranulocytosis

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6
Q

What is the mode of action of carbamazepine?

A

Bines to sodium channels

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7
Q

What is the management of tonic-clonic seizures?

A

Sodium valproate

Lamotrigine

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8
Q

What is an atonic seizure?

A

Sudden loss of muscle tone lasting 1-2seconds with brief loss of consciousness

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9
Q

What is the management of atonic seizures?

A

Sodium valproate

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10
Q

What are absent seizures?

A

Sudden brief lapses of consciousness lasting around 10 seconds - patient doesn’t know anything has happened
3Hz on EEG

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11
Q

What are myoclonic seizures?

A

Sudden and brief muscle contractions

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12
Q

What is the triad of Parkinsonism?

A

Bradykinesia
Resting tremor
Rigidity

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13
Q

What are other features of Parkinsonism?

A 
Shuffling gait 
Reduced arm swing 
Micrographia 
Hypomimia 
Drooling 
REM sleep disorder 
Reduced olfaction 
Depression
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14
Q

What is parkinson’s disease?

A

Degeneration of dopaminergic neutrons in substantia nigra with Lewy Bodies seen

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15
Q

What are the treatments for Parkinsons?

A

Levodopa + carbadopa
Bromocriptine
Cabergoline

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16
Q

What are the side effects of levodopa?

A

Dyskinesia
Psychosis
Postural hypotension

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17
Q

What are the side effects of bromocriptine?

A

Impulse control problems
hallucinations
postural hypotension

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18
Q

What are the features of multi-system atrophy?

A

Parkinsonism
Autonomic features
Cerebellar signs

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19
Q

What are the features of progressive supra nuclear palsy?

A

Parkinsonism
Look down before looking up
Early falls

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20
Q

What drugs can induce parkinsonism?

A

Anti-psychotics: particularly haloperidol + chlorpromazine

metoclopramide

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21
Q

What is the management of drug induced parkinson’s?

A

Remove drug
procyclidine
Benzotropine

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22
Q

What are the features of vascular parkinson’s?

A

predominant affects lower limbs
Spasticity
Hemiparesis
Pseudobulbar palsy

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23
Q

What are features of type 1 neurofibromatosis?

A

Cafe au lait spots
Axillary freckling
Dermal neurofibromas
Lisch nodules on iris

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24
Q

What are the features of type 2 neurofibromatosis?

A

Bilateral vestibular schwannomas - tinnitus, vertigo, SN hearing loss

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25
Q

What are the features of a cord hemisection?

A

Ipsilateral spastic paresis below lesion
Ipsilateral loss of proprioception and fine touch
Contralateral loss of pain and temp

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26
Q

What are the features of Friedrich’s ataxia?

A

Bilateral spastic paresis
bilateral loss of proprioception and fine touch
Bilateral limb ataxia

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27
Q

What are the features of an anterior spinal artery occlusion?

A

Bilateral spastic paresis

Bilateral loss of pain and temp

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28
Q

What is MS?

A

Demyelination in CNS causing plaques disseminated in time and place

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29
Q

When does MS commonly present?

A

30s and 40s

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30
Q

What are the features of MS?

A 
Optic neuritis 
Pyramidal dysfunction 
Sensory syndrome 
Cerebellar features 
Cognitive impairment 
Fatigue 
Symptoms that come and go
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31
Q

How is MS diagnosed?

A

At least 2 clinical episodes

MRI - difficult as needs to be during the episode

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32
Q

How is MS managed?

A

Interferon B
Tectafira
Monoclonal antibody
Symptomatic management

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33
Q

What is L’hermitte’s sign?

A

Sudden electric shock passing down neck and back

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34
Q

What is Uhthoff’s sign?

A

increasing temperature worsens neuro symptoms

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35
Q

What are features of space occupying lesions?

A 
Headache worse on waking, lying down, bending forward, and coughing 
Vomiting 
Papilloedema 
Seizures 
Focal neuro signs
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36
Q

What investigations are done in space occupying lesions?

A

CT, MRI

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37
Q

What masses is a brain MRI good for?

A

Posterior fossa masses

38
Q

How is cerebral oedema managed?

A

Dexamethasone, mannitol if acute

39
Q

If there is preservation, where is the brain tumour likely to be?

A

Frontal lobe

40
Q

If there is dyspraxia and neglect, where is the brain tumour likely to be?

A

Parietal lobe

41
Q

What is Guillian Barre?

A

Symmetrical ascending weakness starts a few weeks after an infection that lasts approx 4 weeks

42
Q

How is Charcot-Marie-Tooth passed on?

A

Autosomal dominant - myelin gene

43
Q

What are the features of Charcot-Marie-Tooth?

A

Pes cavus
Foot drop
Claw toes
Weakness

44
Q

What is the management of C-M-T?

A

Physio

Splints

45
Q

What is Huntingtons?

A

Autosomal dominant inherited neurodegenerative condition

46
Q

What are the features of Huntingtons?

A

Chorea
progressive behaviour disturbance
Dementia
Eye movement abnormalities

47
Q

What is the genetic abnormality in Huntingtons?

A

CAG repeat affecting Huntington gene on chromosome 4 leading to aggregation of mutated proteins in cells
Affects earlier and earlier through generations

48
Q

How many CAG repeats are needed in Huntingtons?

A

More than 40

49
Q

What cranial nerves does a bulbar palsy affect?

A

CN: VII - XII

50
Q

What are the features of bulbar palsy?

A

Weak and wasted tongue with fasciculations
Drooling
Dysphagia
Raspy voice + slurred speech

51
Q

What is pseudo bulbar palsy?

A

Disease of corticobulbar palsy

52
Q

What are the features of pseudo bulbar palsy?

A 
Unable to protrude tongue 
Donald duck speech 
Dribbling 
Dysphagia
Exaggerated reflexes
53
Q

What are cerebellar signs?

A 
Dysdiadochokinesis
Ataxia 
Slurred speech 
Hypotonia and reduced power 
Intention tremor 
Nystagmus 
Gait: broad based
54
Q

What does a midline cerebellar lesion cause?

A

Disturbance of postural control

55
Q

What are the 3 layers of cerebellum from outer to inner?

A

Purkinje
Molecular
Granular

56
Q

What are the features of Horner’s syndrome?

A

Miosis
Ptosis
pseudo-enophthalmos
Anhydrosis

57
Q

What are the causes of Horner’s syndrome?

A 
Pancoast's tumour 
Thyroidectomy 
Trauma 
Cervical rib 
Congenital
58
Q

What is the typical onset of juvenile myoclonic epilepsy?

A

Teenage girls

59
Q

What is the presentation of juvenile myoclonic epilepsy?

A

Bilateral myoclonic jerks often in the morning and provoked by sleep deprivation

60
Q

What is the management of juvenile myoclonic epilepsy?

A

Sodium valproate

61
Q

What does the EEG show in West’s syndrome?

A

Hypsarrhythmia

62
Q

What is the presentation of West’s syndrome?

A

Flexion of head, trunk, limbs –> arm extension
Lasts 1-2 seconds, up to 50 times
Progressive mental handicap

63
Q

What is Lennox-Gustaut syndrome defined by?

A

Multiple seizure types
EEG showing slow spike-and-wave discharges
Impaired cognitive function

64
Q

What is myasthenia gravis?

A

Autoimmune disorder resulting in insufficient functioning ACh receptors

65
Q

What are the features of myasthenia gravis?

A 
Fatigability of muscles 
Diplopia 
Proximal weakness 
Ptosis 
Dysphagia
66
Q

What investigations are used for myasthenia gravis?

A

Single fibre EMG
Normal CK
Autoantibodies
Tension test

67
Q

What is the management of myasthenia gravis?

A

Pyridostigmine
Prednisolone
Thymectomy

68
Q

What is the peak incidence of Bell’s palsy?

A

20-40 year olds

69
Q

What are the features of Bell’s palsy?

A 
Lower MN facial nerve palsy - forehead affected 
Post-auricular pain 
Altered taste 
Dry eyes 
Hyperacusis
70
Q

What is the management of Bell’s palsy?

A

eye care

Prednisolone

71
Q

What is an extradural haematoma?

A

Bleeding into space between dura mater as a result of trauma

72
Q

Which vessel is most commonly damaged in an extradural haematoma?

A

MMA

73
Q

What are the features of an extradural haematoma?

A

Raised ICP

May exhibit lucid interval (concussion superimposed on injury)

74
Q

What does an extradural look like on CT?

A

Apple shaped

75
Q

What is a subdural haematoma?

A

Bleeding into outermost meningeal layer mostly around frontal and parietal lobes

76
Q

What are risk factors for subdural haematoma?

A

Old age and alcoholism

77
Q

What vessels are commonly damaged in subdural haemorrhage?

A

Bridging veins

78
Q

What are features of a subarachnoid haemorrhage?

A

Sudden onset severe headache
Photophobia
Xanthochromia on LP
Neck stiffness

79
Q

What is dementia?

A

Progressive deficits in several cognitive domains

80
Q

What is Alzheimers?

A

Enduring, progressive and global cognitive impairment

81
Q

What is the pathophysiology of Alzheimers?

A

Accumulation of beta amyloid and tau protein aggregation

82
Q

Where does damage in Alzheimers commonly occur?

A

Nucleus basalis of Meynert, hippocampus, amygdala

83
Q

What are the risk factors for Alzheimer’s?

A

Family history, Down’s, vascular Res, depression

84
Q

What is the management of Alzheimer’s?

A

Donepezil
Rivastigmine
BP control

85
Q

What is the progression of vascular dementia?

A

Sudden, step-wise

86
Q

What are the features of Lewy body dementia?

A

Fluctuating cognitive impairment
Visual hallucinations
Parkinsonism

87
Q

What are the features of Pick’s dementia?

A

Executive impairment
Behavioural change
Disinhibition
Emotional unconcern

88
Q

What are mononeuropathies?

A

Lesions of individual peripheral/CN nerves

89
Q

What are the causes of mono neuritis multiplex?

A 
Wegeners
AIDS 
RA
Diabetes 
Sarcoidosis 
Leprosy
90
Q

What are the spinal branches of the median nerve?

A

C6 - T1

91
Q

What muscles does the median nerve supply?

A 
LOAF 
Lumbricals 
Opponens pollicis 
Abductor pollicis brevis 
Flexor pollicis brevis
92
Q

What are the spinal branches of the ulnar nerve?

A

C7 - T1

Year 3 MBChB (4 decks)

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