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3MB EXAM NOTES > Neurology > Flashcards

Neurology Flashcards

1
Q

Name the ascending tracts that convey SENSORY information to the brain

A

DCML
Anterolateral system which is also called spinothalamic
Spinocerebellar tracts

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2
Q

Name the descending tracts that convey MOTOR information to the brain

A

Pyramidal tract which is also called corticospinal tract
Cortcicobulbar tract
Extrapyramidal tracts

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3
Q

Which sensory information does the DCML convey?

A

Fine touch, proprioception

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4
Q

Which sensory information does the Anterolateral system convey?

A

Crude touch, temperature, pain

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5
Q

Where does the DCML fibres decussate?

A

Medulla

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6
Q

Where does the anterolateral fibres decussate?

A

Segmentally

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7
Q

For which cranial nerves’ motor nuclei does the corticobulbar fibres supply?

A

V, VII, X, XII

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8
Q

What is Parkinson’s triad?

A

Akinesia/Bradykinesia
Rigidity
Resting Tremor

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9
Q

TACS

A

3/3 of
Homonymous hemianopia
Neurological deficit
motor OR sensory loss in 2/3 of face/arms/legs

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10
Q

PACS

A

2/3 of
Homonymous hemianopia
Neurological deficit
motor OR sensory loss in 2/3 of face/arms/legs

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11
Q

POCS

A 
Brainstem effects: cranial nerve palsy, BILATERAL motor/sensory deficit
Cerebellar dysfunction
Homonymous hemianopia (occipital lobe dysfunction)
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12
Q

LACI

A

Any one of:
motor OR sensory loss in 2/3 of face/arms/legs
Motorsensory loss in 2/3 of face/arms/legs
Ataxic hemiparesis in 2/3 of face/arms/legs

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13
Q

Erb’s / Klumpke’s nerves

A

Erb’s C5 - C6

Klumpke’s C8 - T1

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14
Q

Give some examples of acetylcholinesterase inhibitors

A

Memantine
Donepezil
Rivastigmine
Galantamine

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15
Q

What are Pick’s cells and what are they pathognomic of?

A

Swollen neurons secondary to abnormal protein deposition & neuronal loss & gliosis.
Frontotemporal dementia

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16
Q

What are Lewy Bodies and what are they pathognomic of?

A

Intracellular eosinophilic structures with dense cores & pale halo of protein aggregates
Lewy Body Dementia (assoc parkinson’s)

17
Q

Which dementias are primarily managed using acetylcholinesterase inhibitors?

A

Dementia with Lewy Bodies
Alzheimer’s
Vascular dementia (plus assessment of cardiac risk factors)

18
Q

acetylcholinesterase inhibitors work by slowing cognitive decline T/F

A

True

19
Q

What are the contraindications for acetylcholinesterase inhibitors?

A

Severe asthma/ COPD, active peptic ulcer disease

20
Q

What is the first line management for Parkinson’s?

A

Levodopa (dopamine replacement agent)

21
Q

Principles of using Levodopa?

A

DO NOT ACUTELY STOP due to risk of neuroleptic malignancy syndrome.
Effectiveness reduces with time (2yrs.)
Causes motor complications in the long run.

22
Q

What are the side effects of Levodopa?

A

Dyskinesia - involuntary writhing movements
Psychosis
Dry mouth, anorexia, palpitations, postural hypotension, drowsiness

23
Q

When should use of Levodopa be avoided?

A

Personality disorders - risk psychosis

24
Q

If Levodopa is not tolerated, what are the alternatives for managing parkinson’s?

A 
Dopamine agonists (Bromocriptine, Cabergoline)
MAO-B inhibitors (Selegilinw)
25
Q

Which part of the motor neurone system is affected in each form of motor neurone disease?

A

Amytrophic lateral sclerosis - both UMN & LMN
Progressive muscular atrophy - LMN only
Primary lateral sclerosis - UMN only
Bulbar palsy - CN IX, X, XI, XII

26
Q

What is the mainstay of medical management for motor neurone disease?

A

Riluzole - this works by preferentially blocking the sodium channels asociated with damaged neurones

27
Q

Incidence of each form of motor neurone disease?

A

Amytrophic lateral sclerosis - most common. 50%
Progressive muscular atrophy - 10%
Primary lateral sclerosis - 2%
Bulbar palsy - 2%

28
Q

Which form of motor neurone disease has the best prognosis

A

Primary lateral sclerosis (UMN sx)

29
Q

In Brown Sequard Syndrome, which tracts would present with ipsilateral sx & which would present with contralateral sx?

A

Ipsilateral: ALL motor symptoms & DCML symptoms (fine touch, vibration, pressure)
Contralateral: Anterolateral (pain, crude touch, temperature)

30
Q

Which tracts are affected in anterior cord syndrome?

A

Anterolateral (pain, crude touch, temperature)

Pyramidal/corticospinal (voluntary control of muscles of body & face)

31
Q

Band-like sensory symptoms plus motor symptoms primarily in upper limb suggests?

A

Central cord syndrome

32
Q

Hoffmann’s sign tests for?

A

Hyperreflexia

33
Q

UMN signs, loss of digital dexterity & loss of autonomic function (urinary/faecal incontinence/impotence) in an older individual suggests what?

A

Cervical myelopathy

34
Q

Driving regulations & seziures?

A 
1st unprovoked (car) - 6 months seizure free
Established epilepsy (car) - 1 yr seizure free
1st unprovoked (truck) - 10yrs seizure free

3MB EXAM NOTES (11 decks)

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