Neurology Flashcards
How do you differentiate T1 and T2 MRIs?
T1 - 1 media is bright (fat)
T2 - 2 media are bright (fat and water)
What is the role of the hippocampus?
Consolidation of information to long-term memory
Spatial memory that enables navigation
What are the features of progressive supranuclear palsy?
Postural instability
Frontal lobe abnormalities
Vertical gaze palsy, especially of downward gaze
What are the features of Lewy body dementia?
Attention and executive function deficits
Hallucinations
Parkinsonism
Sensitivity to antipsychotics
What are the features of corticobasal syndrome?
Dementia
Alien limb phenomenon
Asymmetric motor abnormalities, often initially affecting only one limb
What is the most common cause of spontaneous intracerebral haemorrhage?
Hypertension
(hypertension is a more significant risk factor for stroke than it is cardiac events)
What is the most common cause of spontaneous cerebral haemorrhage in the elderly?
Cerebral amyloid angiopathy (amyloid deposits form in blood vessels of the CNS)
What is the most common cause of spontaneous intracerebral haemorrhage in children?
Ruptured arteriovenous malformations
What causes amaurosis fugax?
TIA of the internal carotid artery
What is Wallenberg syndrome?
Lateral medullary syndrome
Occlusion of the PICA or branches of the vertebral artery
Symptoms include ipsilateral Horner syndrome, palate weakness, hemiataxia, and contralateral sensory disturbances.
What is a cryptogenic stroke?
Brain infarction not attributable to a source of definite cardioembolism, large artery atherosclerosis or small artery disease despite thorough vascular, cardiac and serologic evaluation
What is Todd’s paralysis?
Postictal weakness or paralysis
What is the difference between anterograde and retrograde amnesia?
Anterograde - difficulty forming new memories (hippocampus)
Retrograde - difficulty retrieving old memories (hippocampus, temporal lobe and surrounding structures)
Encephalitis involving the temporal lobe is strongly associated with which pathogen?
Herpes simplex meningitis
Also other herpes viruses
Name two ergot-derived dopamine agonists
- Cabergoline
- Pergolide
- Bromocriptine
* Associated with pulmonary and valvular fibrosis*
Name two non-ergot derived dopamine agonists
- Pramipexole
- Rotigotine
- Ropinirole
- Apomorphine
Name two MOA-B inhibitors
- Selegiline
- Rasagiline
Name and catechol-O-methytransferase inhibitor
Entacapone
What is the mechanism of catechol-O-methytransferase inhibitors? (entacapone)
Inhibit peripheral breakdown of levodopa
Helps with motor fluctuations associated with levodopa use
What is the mechanism of MAO-B inhibitors?
Reduce the breakdown of dopamine
What is the most common human prion disease?
Creutzfeldt-Jakob disease
Where is pain from fibromyalgia predominantly experienced?
“Tender points”, usually where muscles and tendons attach to bone
No notable swelling, deformity or erythema
Laboratory tests are normal as there is no inflammation
What are the three prodromal symptoms in Parkinson’s disease?
- Constipation
- REM sleep disturbance
- Anosmia
What is the classic triad of Parkinson’s disease?
- Decrementing bradykinesia
- Tremor
- Rigidity
What is dysarthria?
Disorder of speech - poor articulation and pronunciation
What is dysphasia?
A disorder of language - impaired selection of words and formulation of sentences
Can be expressive (Broca) or receptive (Wernicke)
What is a Jacksonian march?
Spread of a focal seizure through the ipsilateral side of the body
What is the major adverse effect of vigabatrin?
Permanent visual field defects
Perform regular visual testing while on treatment
Is pseudobulbar palsy an UMN or LMN lesion?
UMN
What is affected in pseudobulbar palsy?
Corticobulbar tracts
Stroke, neurodegenerative diseases, injury, malignancy
If a patient has saccades, where is the lesion?
Midline cerebellum
How can the C4 myotome be tested?
Shoulder shrug
How can the C5 myotome be tested?
Elbow flexion
Shoulder abduction and external rotation
How can the C6 myotome be tested?
Wrist extension
How can the C7 myotome be tested?
Elbow extension and wrist flexion
How can the C8 myotome be tested?
Thumb extension and finger flexion
How can the T1 myotome be tested?
Finger abduction
How can the L2 myotome be tested?
Hip flexion
How can the L3 myotome be tested?
Knee extension
How can the L4 myotome be tested?
Ankle dorsiflexion
How can the L5 myotome be tested?
Great toe extension
How can the S1 myotome be tested?
Ankle plantarflexion
How can the S4 myotome be tested?
Bladder and rectum motor supply
Which drugs are associated with hyperprolactinemia?
1st generation antipsychotics
Risperidone
Metoclopramide/domperidone
Methyldopa
Why do dopamine antagonists cause hyperprolactinemia?
Dopamine inhibits prolactin
What is a decorticate posture?
What is a decerebrate posture?
What is the empirical treatment for bacterial meningitis?
Ceftriaxone IV
PLUS
Dexamethasone IV
