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Basic Physician's Training Monash > Neurology > Flashcards

Neurology Flashcards

1
Q

Multiple systems atrophy - clinical features

Pathognomonic MRI finding

A

Cerebellar
Autonomic neuropathy
Parkinsonism

Hot cross bun sign

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2
Q

14-3-3 CSF protein association

A

CJD

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3
Q

Anti VGKC

A

Anti LGI 1 limbic encephalitis

Faciobrachiodystonic seizures

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4
Q

Lacunar stroke patterns

A
  1. Pure Motor- internal capsule/pons
  2. Ataxic hemiparesis- internal capsule/pons/corona radiata
  3. Dysarthria-clumsy hand syndrome- pons/internal capsule
  4. Pure sensory stroke- VPL nucleus of the thalamus
  5. Mixed sensorimotor stroke- Thalamus+internal capsule
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5
Q

4 Midline structures

A

Motor Tract (Cerebrospinal)
MLF
Medial Lemniscus Pathway (Dorsal column)
Motor Nucleus

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6
Q

4 Side structures

A

Spinothalamic Tract
Spinocerebellar tract
Sensory nucleus of CN V
Sympathetic Tract

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7
Q

4 midline motor nuclei

A

III, IV, VI, XII

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8
Q

Cortical Signs- Frontal Lobe

A 
Primary Motor Cortex
Personality
Primitive reflexes
Expressive Dysphasia
Anosmia
Gait Apraxia
Optic Nerve compression
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9
Q

Cortical Signs- Temporal Lobe

A

Receptive Dysphasia
Primary Auditory cortex
Memory
Upper qudrantanopia

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10
Q

Cortical Signs- Parietal Lobe

A 
Sensory Cortex
Attention
Construction and dressing apraxia
Lower qudarantanopia
Gerstmann
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11
Q

Cortical Signs- Occipital Lobe

A

Vision- Homonymous hemianopia
Anton’s Syndrome- cortical blindness with confabulation
Alexia without agraphia

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12
Q

Gerstmann Syndrome

A

Acalculia
Agraphia
L-R disorientation
Fingeragnosia

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13
Q

PSP - clinical features

Pathognomonic MRI finding

A

downgaze palsy
Personality and cognitive change

Hummingbird sign

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14
Q

EEG - Focal prominent intermittent high amplitude slow waves (delta and theta slowing) with occasional periodic lateralised epileptiform discharges in the affected region

A

HSV encephalitis

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15
Q

EEG - Periodic sharp wave discharges (tri-phasic)

A

CJD

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16
Q

EEG - Generalized polyspike and slow wave discharges (4 - 6 Hz) with frontal predominance over normal background activity

A

JME

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17
Q

AED - visual field defect

A

Vigabatrin

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18
Q

AED - zero order kinetics, hirsutism, gingival hyperplasia

A

Phenytoin

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19
Q

AED - Steven Johnson syndrome

A

Carbamazepine
HLA B 15:02 Chinese
HLA B 31:01 Caucasians

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20
Q

AED - weight loss

A

Topiramate

Also causes renal stones and glaucoma

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21
Q

AED - irritability & psychiatric symptoms

A

Levetiracetam

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22
Q

Levetiracetam MOA

A

SV2A-mediated neurotransmitter release

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23
Q

Ethosuximide MOA

A

Calcium channel blockade - T - type

24
Q

Gabapentin MOA

Pregabalin MOA

A

Alpha-2 Delta subunit of calcium channel

25
Carbamazepine MOA
Sodium channel blockade
26
Lacosamide MOA
Sodium channel blockade
27
Lamotrigine MOA
Sodium channel blockade
28
Phenytoin MOA
Sodium channel blockade
29
Topiramate MOA
Sodium channel blockade AMPA antagonist GABA agonist
30
Vigabatrin MOA
GABA agonist
31
Valproate MOA
Sodium channel blockade GABA agonist T-type calcium channel antagonist
32
Excitatory Seizure Channels
``` Sodium channel (voltage gated) Calcium channel (voltage gated) Potassium channel (voltage gated) Glutamate (NMDA and AMPA) ```
33
Inhibitory Seizure Channels
GABA
34
Lewy Body Dementia - Clinical signs
Visual hallucinations Fluctuating cognition RBD Parkinsonism
35
``` Lacunar stroke with contralateral weakness (upper and lower limb) and contralateral ataxia ```
Ataxic hemiparesis Posterior limb of external capsule, basis pontis Small penetrating arteries of MCA
36
Contralateral upper quadrantanopia | + either receptive aphasia (dominant) or constructional apraxia (non-dominant)
Inferior division of MCA infarct | affecting temporal lobe
37
Contralateral hemineglect, hemiparesis (face, arm >leg), expressive aphasia
Superior division of MCA infarct
38
Can write but cannot read
Alexia without agraphia PCA stroke - collosal branches Left occipital region plus splenium of corpus callous
39
Balint syndrome
Bilateral posterior cerebral artery stroke affecting parieto-occipital lobes Bilateral loss of voluntary but not reflex eye movements Bilateral optic ataxia Bilateral asimultagnosia
40
Anton syndrome
Bilateral posterior cerebral artery stroke affecting occipital lobes Bilateral visual loss Unawareness/denial of blindness
41
Weber syndrome
``` Penetrating PCA arteries to midbrain Contralateral weakness (upper and lower limb) with ipsilateral lateral gaze weakness (CN III) ```
42
Wallenberg syndrome
Lateral medullary syndrome PICA artery (arises from vertebral artery) ipsilateral CN V (pain/temperature) ipsilateral ataxia, vestibular dysfunction, dysphagia, Horner's Contralateral loss of pain/temperature of body (spinothalamic tract)
43
Dejerine syndrome | Medial medullary syndrome
Contralateral pyramidal tract Contralateral hemisensory loss - vibration/proprioception (medial leminiscus) Ipsilateral tongue weakness (CN XII)
44
Locked in syndrome
Bilateral ventral pons | Bilateral corticospinal, corticobulbar, CN VI weakness
45
Fingolimod (MOA, AE) tablets
Singosphine - 1 - phosphate receptors (blocks ability of lymphocytes to leave lymph nodes) Bradycardia, macular edema, shingles, hepatopathy, PML (rare)
46
Natalizumab (MOA, AE)
Alpha 4 subunit of integrin molecules | PML, hypersensitivity
47
Teriflunomide (MOA, AE) tablets
Inhibits pyrimidine synthesis | Hepatopathy, lymphopenia, hair loss, GI upset
48
Glatiramer acetate subcut injections (MOA, AE)
Contains 4 amino acids that are similar to myelin basic protein - induce and activate T-lymphocyte suppressor cells specific for a myelin antigen Joint pain, injection site idiosyncratic reactions
49
Alemtuzumab (MOA, AE)
Anti CD 52 Infections Autoimmunity - especially thyroid
50
Daclizumab (MOA, AE)
Anti CD 25 | Injection site reactions, eczema, deranged LFTs
51
Interferons (MOA, AE)
Enhancement of suppressor T cell activity | Flu-like symptoms, depression, injection site reactions
52
Radial nerve palsy
``` Wrist drop, brachioradialis weakness, dorsal hand sensation affected Can flex wrist Spares triceps (if above spiral groove) ```
53
C7 radiculopathy
Wrist drop, weak wrist flexion, triceps weakness, spares brachioradialis
54
L4, L5 radiculopathy
Weak foot eversion and inversion | Ankle jerk spared
55
Sciatic nerve
Weak foot eversion, inversion, ankle jerk
56
Common perineal nerve
Weak eversion | Ankle jerk and inversion spared

Basic Physician's Training Monash (16 decks)

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