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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
Q

Carbamazepine MOA

A

Sodium channel blockade

26
Q

Lacosamide MOA

A

Sodium channel blockade

27
Q

Lamotrigine MOA

A

Sodium channel blockade

28
Q

Phenytoin MOA

A

Sodium channel blockade

29
Q

Topiramate MOA

A

Sodium channel blockade
AMPA antagonist
GABA agonist

30
Q

Vigabatrin MOA

A

GABA agonist

31
Q

Valproate MOA

A

Sodium channel blockade
GABA agonist
T-type calcium channel antagonist

32
Q

Excitatory Seizure Channels

A 
Sodium channel (voltage gated)
Calcium channel (voltage gated)
Potassium channel (voltage gated)
Glutamate (NMDA and AMPA)
33
Q

Inhibitory Seizure Channels

A

GABA

34
Q

Lewy Body Dementia - Clinical signs

A

Visual hallucinations
Fluctuating cognition
RBD
Parkinsonism

35
Q 
Lacunar stroke with
contralateral weakness (upper and lower limb) and contralateral ataxia
A

Ataxic hemiparesis
Posterior limb of external capsule, basis pontis
Small penetrating arteries of MCA

36
Q

Contralateral upper quadrantanopia

+ either receptive aphasia (dominant) or constructional apraxia (non-dominant)

A

Inferior division of MCA infarct

affecting temporal lobe

37
Q

Contralateral hemineglect, hemiparesis (face, arm >leg), expressive aphasia

A

Superior division of MCA infarct

38
Q

Can write but cannot read

A

Alexia without agraphia
PCA stroke - collosal branches
Left occipital region plus splenium of corpus callous

39
Q

Balint syndrome

A

Bilateral posterior cerebral artery stroke affecting parieto-occipital lobes
Bilateral loss of voluntary but not reflex eye movements
Bilateral optic ataxia
Bilateral asimultagnosia

40
Q

Anton syndrome

A

Bilateral posterior cerebral artery stroke affecting occipital lobes
Bilateral visual loss
Unawareness/denial of blindness

41
Q

Weber syndrome

A 
Penetrating PCA arteries to midbrain
Contralateral weakness (upper and lower limb) with ipsilateral lateral gaze weakness (CN III)
42
Q

Wallenberg syndrome

A

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
Q

Dejerine syndrome

Medial medullary syndrome

A

Contralateral pyramidal tract
Contralateral hemisensory loss - vibration/proprioception (medial leminiscus)
Ipsilateral tongue weakness (CN XII)

44
Q

Locked in syndrome

A

Bilateral ventral pons

Bilateral corticospinal, corticobulbar, CN VI weakness

45
Q

Fingolimod (MOA, AE) tablets

A

Singosphine - 1 - phosphate receptors (blocks ability of lymphocytes to leave lymph nodes)
Bradycardia, macular edema, shingles, hepatopathy, PML (rare)

46
Q

Natalizumab (MOA, AE)

A

Alpha 4 subunit of integrin molecules

PML, hypersensitivity

47
Q

Teriflunomide (MOA, AE) tablets

A

Inhibits pyrimidine synthesis

Hepatopathy, lymphopenia, hair loss, GI upset

48
Q

Glatiramer acetate subcut injections (MOA, AE)

A

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
Q

Alemtuzumab (MOA, AE)

A

Anti CD 52
Infections
Autoimmunity - especially thyroid

50
Q

Daclizumab (MOA, AE)

A

Anti CD 25

Injection site reactions, eczema, deranged LFTs

51
Q

Interferons (MOA, AE)

A

Enhancement of suppressor T cell activity

Flu-like symptoms, depression, injection site reactions

52
Q

Radial nerve palsy

A 
Wrist drop, brachioradialis weakness, dorsal hand sensation affected
Can flex wrist
Spares triceps (if above spiral groove)
53
Q

C7 radiculopathy

A

Wrist drop, weak wrist flexion, triceps weakness, spares brachioradialis

54
Q

L4, L5 radiculopathy

A

Weak foot eversion and inversion

Ankle jerk spared

55
Q

Sciatic nerve

A

Weak foot eversion, inversion, ankle jerk

56
Q

Common perineal nerve

A

Weak eversion

Ankle jerk and inversion spared

Basic Physician's Training Monash (16 decks)

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