Neurology Flashcards

1
Q

Symptoms from B12 deficiency

A

Parasthesia

Personality changes

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2
Q

Symptoms from Folate deficiency

A

peripheral neuropathy

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3
Q

Features on EEG of childhood absence epilepsy?

A

3 per second spike and wave discharges

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4
Q

Features on EEG of tonic clonic seizure?

A

10 Hz activity during tonic phase

Slow waves during clonic phase

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5
Q

Treatment of status epilepticus?

A
  1. ABC , IV glucose, IV thiamine
  2. IV Benzodiazepines (lorazepam)
    - x2
  3. Phosphenytoin OR phenytoin
  4. ICU with infusion of midazolam/propofol/phenobarbitol
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6
Q

Indication for starting anti epileptics ?

A
EEG: abnormal spine, poly spike discharge, spike wave complex 
Abnormal neuro exam 
Findings on MRI 
Nocturnal seizure 
Unprovoked recurrent seizures
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7
Q

What is atonic seizure?

Treatment of atonic seizure?

A

No LOC
No Tone

Valproate

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8
Q

Treatment of absence seizure?

A

ethosuxamide

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9
Q

Treatment trigenimal neuralgia?

A

Carbamazepine

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10
Q

Investigations for myasthenia gravis?

A

Tensilon test

Anti Acetylcholine R assay Ab

Icepack over eyelids

MRI/CT for thymoma

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11
Q

Symptoms of myasthenia gravis

A

Ptosis
Double vision
Fatigue
Weakness

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12
Q

Treatment myasthenia gravis ?

A

pyridostigmine

acethylcholine esterase inhibitor

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13
Q

What is lambert-eaton?

A

Ab against Ca channels

Mostly paraneoplastic cause from SCC

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14
Q

Symptoms of lamberton eaton?

A

Proximal muscle weakness

Reduced reflexes

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15
Q

Diagnosis of Gillian Barre?

A

Protein +++ in LP

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16
Q

Cause of Gillian Barre?

A

Campylobacter
EBV
other infection

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17
Q

Treatment of Gillian Barre?

A

IVIG

18
Q

Findings on LP for Multiple Sclerosis?

A

Oligoclonal bands on LP

MRI: Periventricular white matter plaques

19
Q

What is Lhermitts phenomenon?

A

Flexion of the neck causes shock waves sensation down the leg

20
Q

What is Uhthoff’s Phenomenon?

A

Worsening of symptoms in the heat

21
Q

What is the acute treatment of MS?

A

IV prednisolone

22
Q

What are disease modifying agents for MS?

A

Teriflunomide
Interfuron beta

Symptomatic treatment for spasticity, bladder dysfunction, pain, fatigue, depression, constipation, sexual dsfxn

Education, counselling g

23
Q

Indication for good prognosis?

A
Young 
Female 
Relapse/Remitting 
Optic neuritis 
Low burden of disease on MRI
24
Q

Acute stroke treatment?

A
  1. rtPA - recombinant tissue plasminogen activator
    - if within 4.5 hours of onset of symptoms
  2. Aspirin if did not get rtPA
  3. Withhold antihypertensive therapy
  4. Avoid hyperglycaemia
  5. lower temperature if febrile
  6. DVT prophylaxis
  7. NPO if dysphagia
25
Q

Secondary stroke prevention treatment?

A
Antiplatelet agent (aspirin, if happened while on aspirin, clopidogrel)
Anticoagulant if found to have AF 
HTN control 
Diabetes control 
Commence statin 
Cease smoking 
Exercise 
Carotid endarterectomy if > 70 w/ sx surgery or > 80% occlusion
26
Q

Contraindications to rtPA

A
Prior SAH 
Pregnant 
Recent GI or urinary hemorrhage 
Recent LP or arterial function 
Recent major surgery (14 days)
Minor sx
27
Q

Features of an MCA stroke?

A

Contralateral UL + Face
Motor + sensory

If L side: aphasia (dominant )
If R side: neglect

28
Q

Features of an ACA stroke?

A

Contralateral LL

Motor + sensory

29
Q

Features of PCA stroke?

A

Homonymous hemianopia / Quandrantanopia

30
Q

Features of Posterior Internal Capsule Infarct?

A

Pure motor hemiparesis

31
Q

Features of a thalamic infarct?

A

Pure sensory deficit

32
Q

Opening pressure in idiopathic intracranial HTN

A

> 20 mmhg

33
Q

Features of anterior pons infarct?

A

Dysarthrria
Facial weakness
Dysphagia
Mild hand weakness/clumsiness

34
Q

Which areas are lacunar?

A
Internal Capsule 
Pons 
Thamalus 
Deep MCA 
Basilar 
Vertebral arteries
35
Q

Syndrome of of posterior inferior cerebellar artery infarct?

A

Wallenberg Syndrome

36
Q

What’s Wallenberg syndrome?

A

Ipsilateral ataxia
Nystagmus
Ipsilateral Horner
Sensory: ipsilateral face, contralateral body to pain and temp

37
Q

Syndrome of Vertebral artery infarct?

A

Medial medullary syndrome

38
Q

Features of medial medullary syndrome?

A

Contralateral motor
Contralateral discriminative touch deficit (intact temp/pain)
CN XII lesion

39
Q

Features of proximal basilar artery stroke?

A

CN VI palsy
Impaired horizontal EOM
Vertical nystagmus
Miosis

40
Q

What causes locked in Syndrome?

A

Basilar artery clot

41
Q

Features of distal basilar artery stroke?

A

Reduced LOC

CN III Palsy