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YEAR 4 > Neurology > Flashcards

Neurology Flashcards

1
Q

Thunderclap headache

A

subarachnoid haemorrhage

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2
Q

Risk factors for berry aneuryms?

A 
Smoking
Hypertension
Aduld PKCD
Marfans
Ehlers danlos
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3
Q

What is xanthochromic CSF?

A

yellow coloured metabolised and broken down RBCs that forms several hours after a bleed

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4
Q

Why is fresh blood on LP not always indicative of SAH?

A

it can be blood from inserting the needle (traumatic tap)

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5
Q

Lucid period after head trauma followed by sudden collapse or deterioration?

A

extradural haemorrhage (between skull and dura mater)

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6
Q

lentiform appearance

A

extradural haemorrhage

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7
Q

Cogwheel rigidity

A

Parkinsons Disease

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8
Q

Woody texture muscle swelling with raised CK

A

duchenne or becker MD

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9
Q

Toe walker or positive gowers sign

A

MD

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10
Q

Mask-like expression

A

PD

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11
Q

Fluctuating cognitive defecit

A

LB dementia or delirium

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12
Q

REM distrubance

A

LB dementia or PD

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13
Q

Vivid visual hallucination normally of children and non-threatening

A

LB dementia

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14
Q

Acute onset cognitive disturbance that fluctuates

A

delirium

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15
Q

Personality/behaviour changes then dementia

A

frontotemporal dementia (picks disease)

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16
Q

memory and personality problems in someone with a history of CVD

A

vascular dementia

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17
Q

Stepwise deterioration

A

vascular dementia (small strokes affecting some functions and not others)

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18
Q

Pain on loud noise

A

facial nerve palsy

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19
Q

Painful third nerve palsy (reduced eye movements, pupil dilation)

A

posterior communicating artery aneurysm

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20
Q

myalgia, myositis and myoglobinaemia/uria

A

rhabdomyolysis

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21
Q

Complications of rhabdomyolysis?

A

DIC

acute renal failure

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22
Q

Inflammatory myopathy with poor response to steroids

A

inclusion body myositis

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23
Q

What is inclusion body myositis?

A

disease of muscle cells characterised by abnormal protein inclusions (misfolded proteins that aggregate and accumulate)

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24
Q

Symptoms of inclusion body myositis?

A

slowly progressive muscle weakness and wasting in distal and proximal muscles

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25
Q

Weakness, frontal balding, cataracts, ptosis

A

myotonic dystrophy (onset 30s, +ve FH)

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26
Q

What are nerve cell bodies called?

A

PNS: ganglion
CNS: nucleus

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27
Q

What are bundles of axons called?

A

PNS: nerve
CNS: tract

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28
Q

Where is level of T4?

A

male nipple

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29
Q

Where is level of T10?

A

umbilicus

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30
Q

Cervical plexus

A

C1 - C4

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31
Q

Brachial plexus

A

C5 - T1

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32
Q

Lumbar plexus

A

L1 - L4

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33
Q

Sacral plexus

A

L5 - S4

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34
Q

Sympathetic outflow (thoracolumbar)

A

T1 - L2 (extra lateral horn in grey mater of spinal cord)

travels to sympathetic chains and then passes into all spinal nerve anterior and posterior rami

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35
Q

Parasympathetic outflow (craniosacral)

A

CN 3, 7, 9, 10

pelvic splanchic nerve S2-4

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36
Q

How do APs relay sensory information?

A

Duration of firing of APs is duration of stimulus
Frequency of AP firing is proportional to the amplitude of stimulus
release of neurotransmitter is proportional to frequency of APs

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37
Q

afferent meaning

A

conducting inwards

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38
Q

Spinal damage to dorsal column?

A

ipsilateral loss of fine touch and vibration below the level (e.g. left side damage to dorsal column causes left sided symptoms as the fibres haven’t crossed yet)

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39
Q

Spinal damage to spinothalamic tract?

A

contralateral loss of crude touch, pressure, pain and temperature (e.g. left side damage to spinothalamic tract causes right sided symptoms right sided symptoms because fibres have crossed)

40
Q

sensory cortex damage?

A

contralateral loss of fine touch, vibration, crude touch, pain and temperature
(both tracts have crossed)

41
Q

When does a resting tremor occur?

A

when the muscle is relaxed

42
Q

When does an action tremor occur and give some examples

A 
occurs with muscle contraction
postural (maintaining a position against gravity)
intention (purposeful movement towards a target)
task specific (when performing certain tasks, writing, speaking)
43
Q

action tremor that gradually worsens, FH, no associated disease, improved with alcohol

A

essential tremor

44
Q

Lesion of optic nerve

A

ipsilateral monocular visual loss

45
Q

Lesion of optic chiasm

A

bitemporal haemianopia

46
Q

Lesion at optic tract

A

contralateral homonymous hemianopia

47
Q

Lesion at parietal upper optic radiation

A

contralateral homonymous inferior quadrantanopia

48
Q

Lesion at temporal lower optic radiation

A

contralateral homonymous superior quadrantanopia

49
Q

lesion at occipital visual cortex

A

contralateral homonymous hemianopia with central sparing

50
Q

Ankle jerk

A

S1

51
Q

Knee jerk

A

L4

52
Q

Biceps

A

C5

53
Q

Brachradialis

A

C5

54
Q

Triceps

A

C7

55
Q

Babinski positive

A

toe extension (indicates UMN lesion)

56
Q

What causes myasthenia gravis?

A

autoimmune ABs to nicotinic Ach receptors at neuromuscular junction (prevents Ach from LMN from binding to receptors on muscle cells)

57
Q

Treatment of essential tremor?

A

propanolol

primidone

58
Q

Parkinsons tremor

A

resting tremor (pill rolling)

59
Q

Cerebeller tremor

A

slow easily visible tremor of extremities, intention tremor, past pointing

60
Q

What is myasthenia gravis associated with?

A

hyperplasia of thymus or thymoma

61
Q

Treatment of myasthenia gravis?

A

pyridostigmine (anticholinesterase inhibitor)
steroids
thymectomy

62
Q

What happens in myasthenia gravis?

A

inflammation and destruction of muscle cells

skeletal muscle weakness (extraocular muscles commonly affected first)

63
Q

What separates the hemispheres of the brain?

A

medial longitudinal fissure

64
Q

Where are the primary sensory and primary motor cortex located?

A

primary motor: precentral gyrus

primary sensory: postcentral gyrus

65
Q

Function of the frontal lobe?

A

movement, personality, executive functions (making decisions)

66
Q

Function of temporal lobe?

A

primary auditory cortex, smell, memory, facial recognition, language

67
Q

Function of parietal lobe?

A

processes sensory information (regarding the body in 3D space, interpreting visual information, processing language and maths

68
Q

Function of occipital lobe?

A

primary visual cortex

69
Q

Where are broca and wernickes areas and function of each?

A

Broca’s area: anterior, production of speech

Wernike’s area: posterior, understanding speech

70
Q

Function of the cerebellum

A

coordinates skeletal muscle contraction, balance and fine motor control

71
Q

Function of brainstem?

A

essential functions of life (HR, BP, breathing, GI function, consciousness)
receives info from thalamus

72
Q

What is the corpus collosum?

A

thick band of nerve fibres, communication between hemispheres

73
Q

Leg symptoms + midline shift

A

Falcine herniation (brain herniation due to high ICP)

74
Q

Back pain worse on coughing?

A

slipped disc

75
Q

Headache worse on coughing?

A

lesion in posterior fossa

76
Q

Bilateral sciatica, male sexual dysfunction, bowel and bladder symptoms?

A

cauda equina

77
Q

Pleocytosis

A

increased WBC’s in CSF

78
Q

Migraine prophylaxis

A

propanolol, topiramate or amitryptaline

valproate, pisotifen, gabapentin, pregabalin (if one doesn’t work by 4months, try another)

79
Q

Injury to upper brachial plexus

A

(C5 - C6) erbs palsy (waiters tip, paralysis of the arm)

80
Q

When does erbs palsy commonly occur?

A

shoulder dystocia (should fails to deliver after fetal head)

81
Q

Injury to lower brachial plexus?

A

(C8 - T1) Klumpke’s palsy (claw hand)

82
Q

Simmond’s test positive

A

(no planter flexion when squeezing calf)

achilles tendon rupture

83
Q

Anti acetylcholine receptor antibody?

A

myasthenia gravis

84
Q

purely motor symptoms with ocular sparing

A

motor neuron disease

85
Q

Where do signals come from that make up the extrapyramidal system?

A

cerebellum

basal ganglia

86
Q

Where do signals come from that make up pyramidal system?

A

motor cortex (cerebrum)

87
Q

What causes internuclear ophthalmoplagia?

A

damage to medial longitudinal fasiculus (in brainstem)

88
Q

What happens in internuclear ophthalmoplagia?

A

affected eye cant adduct and other eye will nystagmus on abduction

89
Q

What is MS?

A

demyelinating disorder of CNS

T4HS causing inflammation and damage to oligodendrocytes

90
Q

What is the common trio in MS?

A

Nystagmus
Dysarthria
intention tremor

91
Q

What the immunomodulators used in MS?

A

IFN beta
copaxone
tecfidera

92
Q

How are acute exacerbations of MS treated?

A

symptomatically

with oral or IV steroids

93
Q

Drugs used in MS for urinary symptoms?

A

oxybutynin (anti-cholinergic)
desmopressin (synthetic ADH)
catheter

94
Q

Cerebeller lesion symptoms?

A

Ataxia (affected balance, coordination (gait wobbily, wide based) and speech/dysarthria)
intention tremor, past pointing
Dysdiadochokinesia (impaired ability to perform fast movements)
pendular reflex

95
Q

Drugs used in MS for spasticity?

A

baclofen
tizanidine
botox

96
Q

Drugs used in MS for sensory pain?

A

gabapentin, amitriptyline

YEAR 4 (27 decks)

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