Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Danny's Phase 3A Medicine > Neurology > Flashcards

Neurology Flashcards

1
Q

Describe the typical onset of the various types of Dementia

A

Alzheimers: Gradual, progressive onset

Vascular: Abrupt (after stroke) or gradual

Lewy body: Insidious onset, progressive with fluctuations

frontotemporal: Insidious onset typically in 50s/60s then rapid progression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the difference of symptoms between the various types of Dementia

A

Alzheimer’s: memory,language, visuospatial skills, later behavioural signs

Vascular: Focal neuro signs, signs of vascular disease

Lewy body: Visual hallucinations, Parkinsonism signs (tremors, falls, shuffle gait)

Frontotemporal: Disinhibition, poor judgement, decreased motivation, socially inappropriate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What can be seen on CT/MRI in Alzheimers?

A

1) Beta-amyloid plaques
2) Neurofibrillary tangles
3) Atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What may be seen on imaging of Frontotemporal?

A
  • Frontal/temporal atrophy

- Picks cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What may be seen on imaging of Vascular Dementia?

A

1) changes in blood vessels and vascular infarcts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What may be seen on imaging of Lewy body dementia?

A

Lewy bodies in cortex of midbrain

Generalised atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Treatment of Alzheimers?

A

Donepazil (cholinesterase inhibitors)

Memantine

Treat depression, aggression/agitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Treatment of Lewy body dementia?

A

Cholinesterase inhibitors

Memantine

Levodopa

Physiotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Where do you test sensation in the following dermatomes on the arm?

C5-T2

A

C5 - Over deltoid

C6 - index finger

C7 - middle finger

C8 - little finger

T1 - inside arm

T2 - apex of axilla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where do you test sensation in the following dermatomes on the leg?

L2-S2

A

L2 - anterior medial thigh

L3 - over knee

L4 - medial tibia

L5 - dorsum of foot running to big toe

S1 - lateral heel

S2 - popliteal fossa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Where do you test movement in the following myotomes on the arm?

C5-T1

A

C5 - shoulder abduction

C6 - elbow flexion

C7 - elbow extension

C8 - finger flexion

T1 - finger abduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Where do you test movement in the following myotomes on the leg?

L2-S2

A

L2- Hip flexion

L3- Knee extension

L4- Ankle dorsiflexion

L5- Extension of big toe

S1- Ankle plantar flexion

S2- Knee flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What muscles do the radial nerve innervate?

A

Triceps and finger extensors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What muscles do the median nerve innervate?

A

LOAF

Lateral 2 lumbricals

Oppenens brevis

Abductor pollicis brevis

Flexor pollicis brevis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What muscles do the ulnar nerve innervate?

A

Intrinsic muscles of the hand, lumbricals, hypothenar and interossei

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What nerve is responsible for:

Finger flexion?

Finger extension?

Finger abduction?

A

Median

Radial

Ulnar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the most common winged scapula nerve lesion?

A

Long thoracic nerve (serratus anterior)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What nerve is responsible for the following movements?

knee extension

knee flexion

ankle dorsiflexion

Big toe extension

ankle plantar flexion

A

knee extension - femoral L3

knee flexion - sciatic/tibial L5, S1/2

ankle dorsiflexion - peroneal L4

Big toe extension - peroneal L5

ankle plantar flexion - tibial S1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Name some foot drop differentials?

A

Muscle: myopathy

Nerve: peroneal nerve, sciatic nerve

Root: L4/5

Anterior horn: MND

Brain: parasaggital mengingioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which lobe is Brocas area in and what is its function?

A

region in the frontal lobe of the dominant hemisphere, usually the left, of the brain with functions linked to speech production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which lobe is Wernicke’s area in and what is its function?

A

located in the temporal lobe on the left side of the brain and is responsible for the comprehension of speech

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Difference in signs between Epidural and Subdural Haematoma?

A

Epidural = rapidly expanding with arterial blood (middle meningeal)
LUCID INTERVAL - patient feels better for a small while due to the way it ‘holds’ the blood

extra-dural haematoma is lentiform like a lemon

Subdural = slowly expanding with venous blood (bridging veins), fluctuating consciousness

subdural haematoma is sickle shaped like a banana

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How do subdural and epidural haematomas look on CT?

A

Epidural - lemon (biconvex)

Subdural - banana (biconcave)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are Kernigs and Brudzinkis sign?

A
  • Kernig’s (inability to straighten knee when hip flexed 90 degrees)
  • Brudzinski’s- neck stiffness - flex neck and knee+hip flex too
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How is MS diagnosed?
presence of multiple CNS lesions, which cause symptoms that: - Last longer than 24 hours - Are disseminated in space (clinically or on MRI) - Are disseminated in time (>1 month apart)
26
What may be the first manifestation of MS?
Optic Neuritis - inflammation of optic nerve - reduced visual acuity
27
What is Lhermitte's phenomenon?
Neck flexion brings on a sudden sensation of an electric shock running down your spine Sign of MS
28
What is Uhthoffs phenomenon?
Temporary worsening of symptoms caused by an increase in temperature (e.g. - MS patient in hot bath)
29
Typical MS symptoms?
``` Visual loss (Optic neuritis) Pyramidal weakness, spastic paraparesis Sensory disturbance Cerebellar symptoms (nystagmus / vertigo / tremor /ataxia / dysarthria) Bladder involvement / sexual dysfunction Lhermitte’s & Uhthoff’s phenomenon Fatigue Cognitive impairment ```
30
Typical Giant Cell Arteritis features?
``` Jaw claudication Scalp/ temporal tenderness Double vision Severe and frequent Headaches Fatigue Weight Loss Anaemia ```
31
How is GCA diagnosed?
Temporal artery biopsy High ESR Temporal tenderness New onset localised headache
32
Types of MS?
1) Clinically isolated syndrome (CIS) 2) Relapsing- remitting 3) Primary progressive 4) Secondary progressive
33
What is Clinically Isolated Syndrome?
First episode of MS characteristics that must last 24 hours. first attack of demyelination A diagnosis of MS can be made afterwards if the MRI shows lesions similar to those of MS
34
What is Secondary Progressive MS?
SPMS follows relapsing remitting. Relapsing remitting will transition into progressive worsening of neurological functioning
35
What is Primary Progressive MS?
Worsening of neurological functioning from the onset of symptoms, without early relapses or remissions 15% of diagnosis
36
What is Relapsing-Remitting MS?
clearly defined attacks of new or increasing neurologic symptoms. These attacks – also called relapses or exacerbations – are followed by periods of partial or complete recovery (remissions). During remissions, there may be no symptoms, and no apparent progression of the disease.
37
What is the Glasgow Coma Scale?
The Glasgow Coma Scale (GCS) is the most common scoring system used to describe the level of consciousness in a person following a traumatic brain injury
38
How is the GCS scored?
1) Eye opening (E) 4 2) Verbal response (V) 5 3) Motor response (M) 6 the score may be expressed as 'GCS 12 = E2 V4 M6'
39
Describe the GCS scoring
Motor response 6. Obeys commands 5. Localises to pain 4. Withdraws from pain 3. Abnormal flexion to pain (decorticate posture) 2. Extending to pain 1. None Verbal response 5. Orientated 4. Confused 3. Words 2. Sounds 1. None Eye opening 4. Spontaneous 3. To speech 2. To pain 1. None
40
Symptoms of Myasthenia Gravis?
1) Droopy eyelids (ptosis) 2) Droopy mouth 3) Double vision (diplopia) 4) Dysphagia 5) Dysarthria (facial muscles) 6) Muscle weakness 7) shortness of breath
41
What are the autoantibodies in myasthenia gravis?
acetylcholine receptor antibodies (AChR) muscle-specific tyrosine kinase (MuSK) antibodies
42
Myasthenia Gravis diagnosis?
Anti- acetylcholine (AchR) receptor anti- muscle specific Kinase (MuSK) antibodies Large thymus/ clusters of immune cells in thymus - Thymomas (tumours)
43
Symptoms of Optic Neuritis?
1) Reduced visual acuity over days 2) Pain on moving eye 3) Exacerbated by heat/exercise 4) Afferent pupillary defect 5) Dyschromatopsia (especially red)
44
Treatment of MS? Acute Chronic?
Acute Episode- Steroids Chronic - 1) Interferon beta (prevents immune activation) 2) glatiramer acetate (similar to myelin) 3) Natalizumab prevents t-lymphocytes crossing blood-brain barrier
45
Signs of Huntingtons?
- Chorea - Dystonia - Lack of co-ordination - Cognitive decline
46
How does Huntingtons occur?
autosomal dominant 1) Chromosome 4 produces Huntingtin protein 2) Mutation to the Huntington gene on chromosome 4 results in CAG nucleotide repeats 3) This leads to an abnormal Huntingtin protein & neurodegenerative disorder
47
Symptoms of Progressive Supranuclear Palsy?
- Falls and balance problems - lack of interest, behaviour change, thought and memory problems - muscle stiffness - Dysarthria / Dysphagia - *difficult eye and eyelid movements, focusing/ looking up/down*
48
Cause of PSP?
PSP occurs when brain cells in certain parts of the brain are damaged as a result of a build-up of a protein called tau.
49
What is the most common cause of head tremor? (titubation)
Essential tremor
50
What may relieve an essential tremor? what Medication can be given?
Alcohol / rest Propanolol
51
How is Hoffmans sign elicited?
Flick the middle finger nail. Flexion of ipsilateral thumb or index = positive sign
52
Best treatment for ALS?
Riluzole
53
Common causes of Chorea?
``` Huntingtons Wilsons ataxic telengiectasia SLE Hypoglycaemia Pregnancy ```
54
Which type of MND has the worst prognosis?
Progressive bulbar palsy - difficulty swallowing / speech / respiratory insufficiency
55
What condition is due to a CAG repeat?
Huntingtons
56
What condition is due to a CCG repeat?
Fragile X syndrome
57
What should be offered between 6-24 hours for a patient with an acute ischaemic stroke + confirmed anterior circulation occlusion demonstrated by CTA or MRA?
Thrombectomy
58
What should be offered within 24 hours for a patient with an acute ischaemic stroke + confirmed posterior circulation occlusion demonstrated by CTA or MRA?
Thrombolysis (IV Alteplase) + Thrombectomy
59
Headache Red Flags?
1) Sudden onset + severe 2) Age >50 3) Neck pain/stiffness, photophobia 4) Fever 5) Papilloedema 6) New onset neuro deficit 7) Vomiting 8) Dizziness and visual disturbances / atypical aura (over an hour)
60
What is Giant Cell Arteritis?
Granulomatous medium/large vessel vasculitis | large vessel vasculitis of the head, scalp, arms, neck
61
Who does GCA tend to affect?
More females than males Common in Scandinavia Over 50 yrs old
62
Common association with GCA?
Polymyalgia Rheumatica - (neck, shoulders,back,hip) 1) Stiffness 2) Aching 3) Pain Jaw/ Tongue claudication Fever Headache
63
What Anaemia is seen in GCA?
Normocytic Normochromic
64
Lab signs for GCA?
Increased ESR Increased LFTs (ALP) Increased IgGs and complements (CK not elevated as no muscle damage)
65
What would be the most common diagnosis of GCA?
Triad of Anaemia, Fever, Headache and high ESR in an elderly female (>50) Confirmed by temporal artery biopsy
66
Treatment of GCA?
Steroids! fast
67
Complications of GCA?
BLINDNESS Aortic aneurysm Heart attack/ stroke (rarer)
68
What is the most likely cause of an Extradural haematoma
Trauma to the head fractures the temporal bone and tears the middle meningeal artery
69
which foramen does the middle meningeal run through?
Foramen Spinosum
70
what is the difference between a facial palsy caused by an upper or lower motor neurone lesion?
Upper motor neurone lesion spares the upper head e.g 'wrinkle forehead/ raise eyebrows'
71
What is Bells Palsy?
Lower motor neurone palsy of the facial nerve (7th) Causing: 1) Facial droop on one side of the face 2) Cant close one eyelid 3) flat wrinkles on one side of forehead
72
At what age are you more likely to get Myasthenia Gravis?
Women: Under 40 Men : Over 60
73
What muscles are weakened in Myasthenia Gravis that is useful for diagnosis?
Weakness of extra-ocular muscles causing: 1) Diplopia 2) Ptosis (droopy eyelid)
74
What is a Myasthenic Crisis?
Weakness of breathing muscle = life threatening
75
What type of hypersensitivity reaction is Myasthenia Gravis and Multiple Sclerosis?
MG - type II (antibody mediated - AChR / MuSK) MS - type IV (cell-mediated- T cell crosses brain barrier, activated by myelin, sends signal to allow more T cells across barrier)
76
MS Risk factors?
Female Vit D deficiency HLA-DR2
77
What is Charcots Neurological Triad?
1) Dysarthria (dysfunctional eating, talking, swallowing) 2) intention tremor (muscle weakness, spasms, ataxia, paralysis) 3) Nystagmus (Optic Neuritis, greying of vision, pain, double vision) Linked to MS
78
What neuro condition is associated with small cell lung cancer?
Lambert-Eaton Syndrome | waddling gait, hyporeflexia
79
Treatment of Myasthenia Gravis?
Pyridostigmine (acetylcholinesterase inhibitor) Steroids Thymectomy
80
What is given to someone if they have confirmed anterior circulation occlusion and their symptoms were within 6 hours?
Thrombolysis and Thrombectomy
81
What is given to someone if they have confirmed anterior circulation occlusion and their symptoms were between 6 and 24 hours ago?
Thrombectomy
82
What is given to someone if they have confirmed posterior circulation occlusion and their symptoms were less than 24 hours ago?
Thrombolysis and Thrombectomy
83
What visual defects are caused by: Temporal lesions?
contralateral superior quadranopia PITS (Parietal-Inferior, Temporal-Superior)
84
What visual defects are caused by: Parietal lesions?
contralateral inferior quadranopia PITS (Parietal-Inferior, Temporal-Superior)
85
What visual defects are caused by: Diabetes Insipidus due to craniopharyngioma
lower bitemporal hemianopia
86
What visual defects are caused by: Pituitary macroadenoma
Upper bitemporal hemianopia
87
What visual defects are caused by: Occipital cortex lesion?
Macula sparing homonymous hemianopia
88
What visual defects are caused by: Optic chiasm?
Bitemporal hemianopia

Danny's Phase 3A Medicine (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions