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Neuro And Special Senses > Neurology > Flashcards

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
Q

Describe the symptoms of GBS?

A 
Distal limbs affected
Paraesthesia
Numbness
Weakness
Pain
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26
Q

What are the causes of GBS?

A

Infection
Vaccination
Surgery

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27
Q

What is the management of GBS?

A

Supportive
IV Ig
Plasmapheresis

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28
Q

What is the inheritance pattern of DMD?

A

X linked recessive

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29
Q

What is the difference between DMD and BMD?

A 
DMD = absence of dystrophin 
BMD = fault production of dystrophin
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30
Q

What are the likely meningitis organisms for the different age groups?

A

Neonates - e.coli, listeria monocytogenes
2-5 years - H. Influenzae type B
5-30 years - N. Meningitidis
>30 years - S. pneumoniae

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31
Q

What do delta waves on an EEG suggest?

A

Deep or dreamless sleep

32
Q

What do theta waves on an EEG suggest?

A

Drowsy, light sleep or thinking

33
Q

What do alpha waves on an EEG suggest?

A

Relaxation/calm

34
Q

What do beta waves on an EEG suggest?

A

Normal waking pattern

High alert, active thinking

35
Q

Which AEDs are hepatic enzyme inducers?

A

Phenytoin
Carbamazepine
Phenobarbital
Topiramate

36
Q

COCP lowers the levels of which AED in the blood?

A

Lamotrigine

37
Q

What are the 2 types of hydrocephalus?

A

Obstructive

Communicating

38
Q

What features on fundoscopy suggest raised ICP?

A

Blurred disc margins

Flame shaped haemorrhages

39
Q

Describe Kernig’s sign

A

A sign used to aid meningitis diagnosis

Pain and resistance of passive knee extension when hips are flexed

40
Q

Define status epilepticus

A

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
Q

Define epilepsy

A

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
Q

What is the definition of a focal/partial seizure?

A

Only occurs in one hemisphere

43
Q

Name the features that suggest a genetic cause to epilepsy

A

Child or teenage onset
Triggered by sleep deprivation and alcohol
Early morning seizures
Short absence seizures

44
Q

What is SUDEP?

A

Sudden unexpected death in epilepsy

Unwitnessed, non-traumatic, non-drowning death of a person with epilepsy. With or without a seizure.

45
Q

Give 2 examples of newer, broad spectrum AEDs

A

Levetiracetam

Topiramate

46
Q

What is MND?

A

Motor neurone disease is a degenerative condition that affects motor neurones, namely the anterior horn of spinal cord and the motor cranial nuclei.

47
Q

At what age is MND more likely?

A

> 50

48
Q

What is the median survival when diagnosed with MND?

A

2-4 years

49
Q

Define multiple sclerosis

A

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
Q

How might MS present in the eyes?

A

Optic neuritis - acute, sometimes painful, decrease in visual acuity and colour vision
INO
Dysfunctional eye movements - Diplopia, horizontal nystagmus, lateral rectus weakness

51
Q

Relapses of MS are treated with …

A

500mg PO methylprednisolone for 5 days

IV if severe

52
Q

Give some causes of a peripheral neuropathy

A 
Alcohol 
Diabetic amyotrophy
Porphyria 
Vit B1/12 deficiency 
Carcinoma
53
Q

What are the causes of facial nerve palsy?

A 
Idiopathic - Bell’s 
Cerebrovascular disease
Iatrogenic
Infective
Neoplastic
54
Q

What is the pathology involved in Syringomyelia?

A

Fluid filled tubular cyst within the central spinal cord

55
Q

What is neuromyelitis optica?

A

Aka Devic’s disease

A rare autoimmune disease affecting the spinal cord and optic nerves

56
Q

Which specific antibody is present in NMO?

A

Anti-aquaporin 4

57
Q

Which cranial nerves supply PNS?

A

Oculomotor
Facial
Glossopharyngeal
Vagus

58
Q

What does the oculomotor nerve supply PNS to?

A

Sphincter pupillae

Ciliary muscle

59
Q

The facial supplies PNS to …

A

Lacrimal gland
Nasopharynx
Sublingual and submandibular glands

60
Q

Where does the glossopharyngeal nerve supply PNS to?

A

Parotid gland

61
Q

What are the 4 PNS ganglion of the cranial nerves?

A

Ciliary ganglion - 3
Pterygopalatine - 7
Submandibular - 7
Otic - 9

62
Q

What is the function of the caudate nucleus?

A

Maintaining body and limb posture

Controlled approach-attachment behaviours

63
Q

How many days a month should a migraine be to classify as chronic?

A

15 days +

64
Q

Describe the presentation of migraine

A

Severe, unilateral headache
Aura
Photophobia and vomiting
Tired, irritable, difficult concentrating

65
Q

What are the preventative treatments for migraine?

A

Amitriptyline
Propranolol
Topiramate

66
Q

What type of headache is a contraindication to the COCP?

A

Migraine with aura

67
Q

What is the classic Parkinson’s triad?

A

Tremor
Rigidity
Bradykinesia

68
Q

Which area is affected in IPD?

A

Zona compacta of the substantia nigra

69
Q

What is the pathophysiology of Alzheimer’s?

A

Widespread cortical atrophy with neurones affected developing amyloid plaques, neurofibrillary tangles and produce less acetylcholine.

70
Q

Name some acetylcholinesterase inhibitors

A

Donepezil
Galantamine
Rivastigmine

71
Q

What causes subacute degeneration of the spinal cord?

A

Vitamin b12 deficiency
Vtaimin E deficiency
Copper deficiency

72
Q

What runs through the cavernous sinus?

A

CN 3, 4, 5a, 5b and 6
ICAs
SNS fibres

73
Q

What are the symptoms of cavernous problems?

A 
Headache - acute, unilateral
Opthalmoplegia, Diplopia 
Seizures
Facial pain
Pulsation proptosis 
Horners syndrome
74
Q

Pituitary adenomas are associated with what cancer syndrome?

A

MEN1

75
Q

What is pituitary apoplexy?

A

Sudden onset hypopituitarism caused by acute infarction of a pituitary adenoma

Neuro And Special Senses (5 decks)

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