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Nephrology > Neurology > Flashcards

Neurology Flashcards

1
Q

Optic chiasm tumour superior or inferior

A

Bitemporal hemianopia
More UQ - superior eg pit tumour
More LQ - inferior - craniopharyngioma

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2
Q

Homonymous quadrantopia

A

PITS

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3
Q

Macula sparing

A

Occipital lesion

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4
Q

L homonymous hemianopia

A

R sided stroke

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5
Q

GBS - what is it

A

immune mediated patchy demyelination of the PNS often triggered by an infection (Campylobacter jejuni), viral EBV, CMV.

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6
Q

Miller Fisher syndrome

A

variant GBS
ophthalmoplegia, areflexia and ataxia. The eye muscles are typically affected first
descending paralysis rather than ascending
anti-GQ1b antibodies

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7
Q

Treatment GBS

A

IV immunoglobulins

Plasmapheresis

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8
Q

Features GBS

A

progressive weakness of all 4 limbs- ascending i.e. the lower extremities are affected first
proximal > distal
Sensory symptoms tend to be mild (e.g. distal paraesthesia)
Some patients - back pain initially
Areflexia
cranial nerve involvement e.g. diplopia
autonomic involvement: e.g. urinary retention, diarrhoea
papilloedema: thought to be secondary to reduced CSF resorption

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9
Q

DVLA unprovoked seizure

A

6 months off

Structural abnormalities - 12

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10
Q

DVLA epilepsy

A

12 months, normal liscence if seizure free 5 years

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11
Q

DVLA withdrawal epilepsy meds

A

6 months

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12
Q

DVLA - explained/ unexplained syncope

A

4 weeks

6 months

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13
Q

DVLA - stroke/ TIA

A

1 month, inform in residual neuro deficit

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14
Q

DVLA - craniotomy for meningioma, pit tumour

A

1 year

6 months

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15
Q

DVLA - chronic neuro disorder

A

Tell DVLA

PK1 form - state of health application

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16
Q

Cerebellar Disease causes

A 
M - MS
A - alcohol
V - vascular
I - Inherited - Freidrich's
S - SOL
17
Q

UMN lesion

A

decreased power
increased tone, spasticity
increased reflexes
pyramidal

18
Q

LMN lesion

A

decreased power, tone, reflexes
muscle wasting
fasciculations

19
Q

Bamford Classification

A
  1. unilateral hemiparesis and/or hemisensory loss of the face, arm & leg
  2. homonymous hemianopia
  3. higher cognitive dysfunction e.g. dysphasia
20
Q

Progressive supranuclear palsy

A 
Early postural instability
vertical gaze palsy ± falls
rigidity of trunk > in limbs
symmetrical onset
speech and swallowing problems
little tremor
21
Q

Multiple system atrophy

A

Early autonomic features, eg impotence/incontinence, postural BP
Cerebellar + pyramidal signs
rigidity > tremor

22
Q

MUSK antibodies

A

MG

23
Q

MG pathophysiology

A

antibodies to nicotinic acetylcholine receptors (AChR)

interfering with neuromuscular transmission via depletion of working post-synaptic receptor sites

24
Q

MG tx

A

Anticholinesterase, eg pyridostigmine

25
Q

Lambert–Eaton myasthenic syndrome

A 
paraneoplastic (SCLC) / autoimmune
Gait difficulty before eye signs 
Autonomic involvement 
Hyporeflexia and weakness, improves after exercise
Antibody to pre-synaptic membrane’s voltage-gated Ca2+ channels
anti-P/Q type VGCC antibodies in 85%
Tx: 3,4-diaminopyridine or IV Ig
CXR/ CT regular to check cancer
26
Q

Syringomyelia

A

cape-like’ (neck and arms) loss of sensation to temperature but preservation of light touch, proprioception and vibration
full spine MRI with contrast to exclude a tumour or tethered cord. A brain MRI is also needed to exclude a Chiari malformation.

27
Q

anti-GQ1b antibodies

A

GBS

28
Q

UMN lesion

A

Weak, spastic tone
Hyperreflexia
upward plantars

29
Q

LMN lesion

A

reduced reflexes
plantars down
muscle atrophy, fasciculations
Flaccid tone

30
Q

wernicke’s aphasia

A

left middle side of the brain
difficulty with language comprehension
receptive aphasia
fluent nonsense

31
Q

Broca’s aphasia

A

is a non-fluent type
expressive dyshpasia
Comprehension intact - understands but cannot say sentence
anterior brain

32
Q

Cerebellar signs

A 
DANISH
Dysdiadokinesia / dysmetria.
Ataxia.
Nystagmus.
Intention tremor.
Speech - slurred or scanning.
Hypotonia.
33
Q

Management of TIA

A

See within 24 hours, aspirin 300mg

34
Q

Syringomyelia

A

Collection of CSF in the spinal cord

Chiari malformation etc

Nephrology (26 decks)

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