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Neurology Flashcards

1
Q

What are the cerebellar signs?

A 
Dysdiadochokinesia
Ataxia 
Nystagmus
Intention tremor
Slurred speech
Hypotonia
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2
Q

What are UMN signs?

A

Hyperreflexia
Hypertonia
Babinski positive

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3
Q

What are the LMN signs?

A 
Hypotonia
Hyporeflexia
Weakness
Wasting
Fasciculations
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4
Q

What are the extrapyramidal signs?

A 
Bradykinesia
Shuffling gait
Pill rolling tremor
Lead pipe rigidity 
Cogwheeling
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5
Q

What would you find in a Parkinson’s examination?

A 
Shuffling gait
Slow on block turning
Stupor - leanforward 
Pill rolling, resting tremor. 3-5 hz frequency
Lead pipe rigidity
Cog wheeling
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6
Q

Give 4 likely causes of collapse

A

Vasovagal
Postural hypotension
Hypoglycaemia
Seizures

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7
Q

What is the difference between MRI T1 and T2 weighted?

A

T1 - CSF is black

T2 - CSF is white

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8
Q

Which MRI should be used for MS?

A

T2 weighted flare sequence

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9
Q

Chronic glaucoma gives what kind of scotoma?

A

Arcuate

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10
Q

What are the worrying diagnoses of a painful 3rd nerve palsy?

A

Posterior communicating artery aneurysm

Carotid artery dissection

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11
Q

Name some causes of Horner’s syndrome

A

Congenital
Brainstem stroke or tumour
Carotid dissection
Pancoast tumour

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12
Q

Describe Brown Sequard syndrome

A

Hemisection of the spinal cord leading to ipsilateral loss of fine touch, vibration sense and motor function but contralateral loss of pain and temperature sensation at the level of the lesion and below.

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13
Q

Syringomyelia gives what classical sign?

A

Cape like distribution of sensory loss

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14
Q

What are the causes of primary headache?

A

Migraine
Tension
Cluster

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15
Q

What are the red flags for headaches?

A 
Thunderclap
Worse on coughing/bending forwards
Meningism 
Associated N+V 
Rash 
Neurological signs
Associated fever
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16
Q

What investigations should be done and when for SAH?

A

CT head - immediate, good for fresh blood
LP - 12 hours after symptom onset
MRI - if sx have been for longer than 1 week

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17
Q

What is the commonest cause of SAH?

A

Berry aneurysm

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18
Q

What factors increase risk of venous sinus thrombosis?

A

Thrombophilia
Pregnancy
Malignancy

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19
Q

Which investigation is gold standard for suspected venous sinus thrombosis?

A

Venogram

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20
Q

What diseases can cause chorea?

A 
Huntington’s 
Chorea gravidum 
Drug induced
Wilson’s
Thyroid disease
Vasculitis
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21
Q

What is the pathogenesis of myasthenia gravis?

A

Autoimmune

Antibodies directed against the acetylcholine receptors at the neuromuscular junctions

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22
Q

What is the management of myasthenia gravis?

A

Steroids, Azathioprine
Plasma exchange
Thymectomy
Acetylcholinesterase inhibitors

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23
Q

What vessel supplies the anterior limb of the internal capsule?

A

Anterior choroidal

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24
Q

Which muscles raise the eyelid and what is their innervation?

A

Superior tarsal - SNS

Levator palpebrae superioris - oculomotor nerve

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25
Describe the symptoms of GBS?
``` Distal limbs affected Paraesthesia Numbness Weakness Pain ```
26
What are the causes of GBS?
Infection Vaccination Surgery
27
What is the management of GBS?
Supportive IV Ig Plasmapheresis
28
What is the inheritance pattern of DMD?
X linked recessive
29
What is the difference between DMD and BMD?
``` DMD = absence of dystrophin BMD = fault production of dystrophin ```
30
What are the likely meningitis organisms for the different age groups?
Neonates - e.coli, listeria monocytogenes 2-5 years - H. Influenzae type B 5-30 years - N. Meningitidis >30 years - S. pneumoniae
31
What do delta waves on an EEG suggest?
Deep or dreamless sleep
32
What do theta waves on an EEG suggest?
Drowsy, light sleep or thinking
33
What do alpha waves on an EEG suggest?
Relaxation/calm
34
What do beta waves on an EEG suggest?
Normal waking pattern | High alert, active thinking
35
Which AEDs are hepatic enzyme inducers?
Phenytoin Carbamazepine Phenobarbital Topiramate
36
COCP lowers the levels of which AED in the blood?
Lamotrigine
37
What are the 2 types of hydrocephalus?
Obstructive | Communicating
38
What features on fundoscopy suggest raised ICP?
Blurred disc margins | Flame shaped haemorrhages
39
Describe Kernig’s sign
A sign used to aid meningitis diagnosis | Pain and resistance of passive knee extension when hips are flexed
40
Define status epilepticus
A seizure that lasts longer than 30 mins or when seizures occur one after another without recovery between However treatment usually starts after 5
41
Define epilepsy
The transient occurrence of signs and symptoms due to abnormal electrical activity in the brain. Must have at least 2 unprovoked seizures occurring more than 24 hours apart or one unprovoked seizure with a probability of further seizures suspected.
42
What is the definition of a focal/partial seizure?
Only occurs in one hemisphere
43
Name the features that suggest a genetic cause to epilepsy
Child or teenage onset Triggered by sleep deprivation and alcohol Early morning seizures Short absence seizures
44
What is SUDEP?
Sudden unexpected death in epilepsy | Unwitnessed, non-traumatic, non-drowning death of a person with epilepsy. With or without a seizure.
45
Give 2 examples of newer, broad spectrum AEDs
Levetiracetam | Topiramate
46
What is MND?
Motor neurone disease is a degenerative condition that affects motor neurones, namely the anterior horn of spinal cord and the motor cranial nuclei.
47
At what age is MND more likely?
>50
48
What is the median survival when diagnosed with MND?
2-4 years
49
Define multiple sclerosis
A cell mediated autoimmune condition characterised by repeated episodes of inflammation in the CNS which causes demyelination. This slows/blocks the transmission of signals along nerves.
50
How might MS present in the eyes?
Optic neuritis - acute, sometimes painful, decrease in visual acuity and colour vision INO Dysfunctional eye movements - Diplopia, horizontal nystagmus, lateral rectus weakness
51
Relapses of MS are treated with ...
500mg PO methylprednisolone for 5 days | IV if severe
52
Give some causes of a peripheral neuropathy
``` Alcohol Diabetic amyotrophy Porphyria Vit B1/12 deficiency Carcinoma ```
53
What are the causes of facial nerve palsy?
``` Idiopathic - Bell’s Cerebrovascular disease Iatrogenic Infective Neoplastic ```
54
What is the pathology involved in Syringomyelia?
Fluid filled tubular cyst within the central spinal cord
55
What is neuromyelitis optica?
Aka Devic’s disease | A rare autoimmune disease affecting the spinal cord and optic nerves
56
Which specific antibody is present in NMO?
Anti-aquaporin 4
57
Which cranial nerves supply PNS?
Oculomotor Facial Glossopharyngeal Vagus
58
What does the oculomotor nerve supply PNS to?
Sphincter pupillae | Ciliary muscle
59
The facial supplies PNS to ...
Lacrimal gland Nasopharynx Sublingual and submandibular glands
60
Where does the glossopharyngeal nerve supply PNS to?
Parotid gland
61
What are the 4 PNS ganglion of the cranial nerves?
Ciliary ganglion - 3 Pterygopalatine - 7 Submandibular - 7 Otic - 9
62
What is the function of the caudate nucleus?
Maintaining body and limb posture | Controlled approach-attachment behaviours
63
How many days a month should a migraine be to classify as chronic?
15 days +
64
Describe the presentation of migraine
Severe, unilateral headache Aura Photophobia and vomiting Tired, irritable, difficult concentrating
65
What are the preventative treatments for migraine?
Amitriptyline Propranolol Topiramate
66
What type of headache is a contraindication to the COCP?
Migraine with aura
67
What is the classic Parkinson’s triad?
Tremor Rigidity Bradykinesia
68
Which area is affected in IPD?
Zona compacta of the substantia nigra
69
What is the pathophysiology of Alzheimer’s?
Widespread cortical atrophy with neurones affected developing amyloid plaques, neurofibrillary tangles and produce less acetylcholine.
70
Name some acetylcholinesterase inhibitors
Donepezil Galantamine Rivastigmine
71
What causes subacute degeneration of the spinal cord?
Vitamin b12 deficiency Vtaimin E deficiency Copper deficiency
72
What runs through the cavernous sinus?
CN 3, 4, 5a, 5b and 6 ICAs SNS fibres
73
What are the symptoms of cavernous problems?
``` Headache - acute, unilateral Opthalmoplegia, Diplopia Seizures Facial pain Pulsation proptosis Horners syndrome ```
74
Pituitary adenomas are associated with what cancer syndrome?
MEN1
75
What is pituitary apoplexy?
Sudden onset hypopituitarism caused by acute infarction of a pituitary adenoma

Neuro And Special Senses (5 decks)

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