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MSRA > Neurology > Flashcards

Neurology Flashcards

1
Q

Treatment for tension headaches (acute, chronic)

A

Acute
1. Paracetamol/ ibuprofen/ aspirin

Chronic
1. Acupuncture

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2
Q

Features of a migraine with aura (4) and without (4,2)

A 
Migraine with aura
At least x2 episodes between 5 ad 60 minutes 
1. Visual sx
2. Change in speech 
3. Sensory sx
4. Fully reversible
Without 
At least x5 attacks lasting 4-72 hours
1. Unilateral
2. Unable to do day to day activities 
3. Throbbing/pulsatile 
4. Mod/severe pain 
AND
At least x1 of:
1. N&V
2. Phonophobia/ photophobia
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3
Q

Management of migraines (acute 2, prophylaxis 4)

A

Acute

  1. Triptan PO +/- paracetamol/ ibuprofen/ aspirin
  2. Metoclopramide/ prochlorperazine

Prophylaxis

  1. Propranalol OR topiramate OR amitryptilline
  2. Behavioural interventions OR riboflavin
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4
Q 
Features of temporal arteritis (6)
Management (1)
Where is it tender?
One or two sides?
Age?
Onset speed
Blood finding
Other symptom
A 
Features
1. Tender/ palpable temporal artery 
2. Unliateral
3. >60yo 
4. Rapid onset <1 month
5. Jaw claudication
6. Raised ESR
Management
Emergency 
1. Prednisolone 60mg PO tapering over 1-2 years
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5
Q

Features (4) and management of trigeminal neuralgia (1)

A 
Features
1. Worse on chewing/ brushing hair/ light touch
2. Lasts a few seconds to minutes
3. Unilateral
4. Severe electric shock like pains
Treatment 
1. Carbamezapine
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6
Q

Features of MS

visual (3), sensory (2), motor (2), cerebellar (2), other (2)?

A 
Visual
1. Optic neuritis 
2. Optic atrophy
3. Uhthoff's phenomenon (worsening of vision on neck flexion)
Sensory
4. Pins and needles 
5. Lhermitte's syndrome (parasthesia in limbs on neck flexion)
Motor
6. Spasticity
7. Weakness 
Cerebellar
8. Ataxia 
9. Tremor 
Other
10. Urinary incontinence
11. Sexual dysfunction
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7
Q 
Name three types of MS 
Diagnosis definition 
Management acute (1), chronic (4)
A

Types

  1. Relapsing-remitting (RR)
  2. Primary progressive - deteriorate from onset
  3. Secondary progressive - deteriorating on BG of RR

Diagnosis
1. x2 relapses with x2 objective clinical evidence
OR
2. x1 objective clinical evidence of lesion with x1 reasonable evidence of prev relapse

Mx
Acute
1. High dose steroids - methylpred for 5/7 (to reduce duration)

Chronic

  1. Beta interferon
  2. Glatiremer acitate
  3. Natalizumab
  4. Fingolimod
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8
Q

Menstrual migraine management (2)

A
  1. Frovatriptan OR

2. Zolmitriptan

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9
Q

Features (6) and treatment acute (2) and prophylaxis (2) of cluster headaches

A 
Features 
1. M>F
2. Smokers
3. Unilateral (always same side), periorbital 
4. Ptosis and miosis
5. Lacrimation/ redness
6. Nasal congestion 
Management 
Acute
1. 100% oxygen
2. SC triptan (sumo)
Prophylaxis
1. Verapamil
2. +/- Prednisolone tapering dose
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10
Q

Symptomatic management of MS
Fatigue (2)
Spasticity (3)
Oscillopsia (1)

A

Fatigue

  1. Amantadine
  2. CBT

Spasticity

  1. Baclofen OR gabapentin
  2. Diazepam/ dantrolene/ tizanidine
  3. Physio

Oscillopsia
1. Gapapentin

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11
Q

Sx of anterior cerebral infarct (1)

A

Contralateral hemiparesis and sensory loss of lower extremities > upper

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12
Q

Sx of middle cerebral artery infarct (3)

A

Contralateral hemiparesis and sensory loss upper extremities > lower
Contralateral homonomous hemianopia
Aphasia

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13
Q

Posterior cerebral artery infarct (2)

A

Contralateral homonomous hemianopia with macular sparing

Visual agnosia

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14
Q

Basilar artery infarct (pons) (1)

A

Locked in syndrome

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15
Q

Weber’s syndrome (branches of PCA that supply the midbrain) (2)

A

Ipsilateral CN III palsy

Contralateral hemiparesis of upper and lower extremity

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16
Q

Posterior inferior cerebellar artery (lateral medullary syndrome) (4)

A
  1. Ipsilateral face pain and temperature loss
  2. Contralateral torso and trunk pain and temperature loss
  3. Ataxia
  4. Nystagmus
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17
Q

Anterior inferior cerebellar artery (lateral pontine syndrome) (4)

A
  1. Ipsilateral facial paralysis deafness
  2. Contralateral torse/ trunk pain and temperature loss
  3. Nystagmus
  4. Ataxia
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18
Q

Lacunar (2)

A
  1. Isolated hemiparesis/ hemisensory loss/ hemiparesis with limb ataxia
  2. Strong assoc HTN
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19
Q

Retinal/ Ophthalmic Artery

A

Amaurosis fugax (painless total loss of vision)

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20
Q

Oxford Stroke Classification/ Bamford (3)

A
  1. Hemiparesis/ hemisensory loss
  2. Homonomous hemianopia
  3. Congnitive dysfunction

TACI, PACI, POCI, LACI

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21
Q

TACI - total anterior circulation infarct

A

Involves MCA + ACA (all 3)

  1. unilateral hemiparesis and/or hemisensory loss of the face, arm & leg
  2. homonymous hemianopia
  3. higher cognitive dysfunction e.g. dysphasia
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22
Q

PACI - partial anterior circulation infarct

A

Small arteries of anterior circulation (MCA+ACA)
2 of 3 criteria
1. unilateral hemiparesis and/or hemisensory loss of the face, arm & leg
2. homonymous hemianopia
3. higher cognitive dysfunction e.g. dysphasia

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23
Q

LACI lacunar infarcts

A

Involves perforating arteries around internal capsule, thalamus, basal ganglia
1 of below
1. unilateral weakness (and/or sensory deficit) of face and arm, arm and leg or all three.
2. pure sensory stroke.
3. ataxic hemiparesis

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24
Q

POCI posterior circulation infarct
Which artery?
Features (3)

A 
Vertebrobasilar artery
1 of following
1. cerebellar or brainstem syndromes
2. loss of consciousness
3. isolated homonymous hemianopia
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25
Q

Features of haemorrhagic stroke (4)

A
  1. Decreased level of consciousness
  2. Headache
  3. N+V
  4. Seizures
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26
Q

Criteria for thrombolysis for ischaemic stroke (2)

A
  1. Within 4.5hrs of onset of symptoms

2. Nil hx of preeclampsia/ pregnancy/ intracranial haemorrhage

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27
Q 
Acute stroke investigation and management
If ischaemic --> 
If secondary to AF --> 
If cholesterol raised --> 
Offer thrombectomy -->
A

CT to rule out haemorrhagic stroke
If ischaemic - 300mg aspirin
If secondary to AF - anticoagulation not to be started for 2 weeks, 300mg aspirin in the interim
If cholesterol >3.5 start on statin
Offer thrombectomy if:
1. confirmed occlusion of the proximal anterior circulation demonstrated by CTA/MR within 6 hours of onset
OR
2. confirmed occlusion of the proximal anterior circulation demonstrated by CTA/ MR AND potential to salvage brain tissue if within 24 hours of onset

For all other locations consider if within 24 hours

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28
Q

Stroke

Secondary prevention treatment (4)

A
  1. Clopidogrel 75mg OD
    If contrainidicated
  2. MR dipyridamole + aspirin

PLUS

  1. Statin
  2. Antihypertensives
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29
Q

Criteria for carotid artery endarterectomy for stroke treatment (2)

A
  1. Not severely disabled

2. Carotid stenosis must be >70% (or 50% in different source)

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30
Q

TIA management
Acute (1)
TIA <1 week
TIA >1 week

A
  1. Aspirin 300mg
  2. If has had TIA within 1 week, refer for urgent specialist assessment within 24 hours
  3. If has had TIA >1 week ago, refer for specialist assessment within a week
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31
Q

Blood supply to cranial nerves
Midbrain
Pons
Medulla

A

Midbrain
III, IV

Pons
V, VI, VII, VIII

Medulla
IX, X, XI, XII

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32
Q

Management of epilepsy
Generalised tonic clonic
1. (1)
2. (2)

A
  1. Sodium valproate
  2. Lamotrogine/ carbamezapine

TLC

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33
Q

Management of epilepsy
Absence seizures
1. (2)

A
  1. Sodium valproate/ ethosuximide

AbScencE

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34
Q

Management of epilepsy
Myoclonic
1. (1)
2. (2)

A
  1. Sodium valproate
  2. Clonazepam, lamotrogine
    MyoCLonic
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35
Q

Management of epilepsy
Focal seizures
1. (2)
2. (3)

A
  1. carbamazepine/ lamotrigine

2. levetiracetam/ oxcarbazepine/ sodium valproate

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36
Q

Carbamazepine can exacerbate which two types of seizures

A
  1. Myoclonic

2. Abscence

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37
Q

Myoclonic and abscence seizures are exacerbated by which antiepileptic?

A

Carbamazepine

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38
Q

Commonest causes/type of dementia (3)

A
  1. Alzheimers
  2. Vascular
  3. Lew body
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39
Q

Creutzfeldt-Jakob disease
Symptoms (4)
Caused by build up of ____ (1)
Variant caused by ______ (1)

A
  1. loss of intellect and memory
  2. changes in personality
  3. loss of balance and co-ordination
  4. progressive loss of brain function and mobility

Caused by build up of prions
Variant CJD - caused by contamination of meat

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40
Q 
Vascular dementia 
Sub types (3)
A
  1. Stroke related VD - multi or single infarct
  2. Subcorticol VD - small vessel disease
  3. Mixed (AD +VD)
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41
Q

Vascular dementia

Features (8)

A
  1. Stepwise deterioration
  2. Seizures
  3. Mood changes
  4. Reduced attention/ concentration
  5. Motor/ sensory loss
  6. Memory disturbance
  7. Speech disturbance
  8. Gait disturbance
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42
Q

Diagnosis for VD using NINDS-AIREN criteria (3)

A
  1. Cognitive decline
    - using clinical examination and neuropsychological testing
  2. CVD
    - through neuro exam OR
    - imaging (MRI)
  3. Association between the above two
    - onset of symptoms within three months following stroke
    - stepwise progression
    - abrupt deterioration in cognitive functions
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43
Q

Management of VD
Non pharmacological (1)
Pharmacological (1)

A

Non pharma
1. Musical/ art therapy
Pharma
1. Memantine or ACE inhibitors if mixed with AD, PD or Lewy body dementia

44
Q 
Lewy Body Dementia 
Features (4) 
Diagnosis (2)
Mx (2) 
What drugs to avoid? (1)
A

Features

  1. Cognitive impairment, fluctuating
  2. Attention and executive function seen early
  3. Parkinsonism
  4. Visual hallucinations

Dx

  1. Clinical
  2. SPECT

Mx

  1. As AD, donepezil/ / galantamine/ rivastigmine (AChEi) mild to mod
  2. Memantine severe (NMDA antag)

Avoid
1. Antipsychotics - risk of irreversible Parkinsonism

45
Q 
Alzheimer's disease
Management 
Mild-moderate (3) 
Mod-severe (1) 
Severe (1)
A 
Mild-mod
1. Donepazil (AChEin) (CI if bradycardia) 
2. Rivastigmine 
3. Galantamine
Mod-severe
1. Combi
Severe
1. Memantine (NMDA)
46
Q

Normal pressure hydrocephalus
Triad (3)
Imaging findings (2)
Management (1)

A

Triad

  1. Shuffling gait/ gait abnormality
  2. Urinary incontinence
  3. Dementia + bradyphenia (slowness of thought)

Imaging CT/MRI

  1. Hydrocephalus with ventriculomegaly
  2. Absence of sulcal atrophy

Management
1. Ventriculoperitoneal shunt

47
Q 
Parkinson's disease
Triad
Gender, age 
Other features (6) 
Drug induced features (3) 
Ix (2)
A 
Triad
1. Bradykinesia (slowness of movement) 
2. Tremor (resting, pill rolling)
3.  Rigidity (cog wheel+lead pipe)
M>F, median age 65yo

Features

  1. Mask like face
  2. Depression/ psychosis
  3. Asymmetrical
  4. Micrographia
  5. Salivation
  6. Flexed position

Drug induced features

  1. Bilateral
  2. Rapid onset
  3. Rigidity and tremor not present

Ix

  1. Clinical
  2. SPECT
48
Q

Parkinson’s Disease
Mx
First line (3)
Second line (3)

A

First line, given in early PD with sx impacting daily lives

  1. Levodopa with dopa decarboxylase inhibitor (co-beneldopa)
  2. Dopamine agonist
  3. MAO-B inhib

Second line

  1. COMT inhibitors
  2. Amantadine
  3. Deep brain stimulation
49
Q

Investigations needed prior to starting dopamine agonists (4)

A
  1. CXR
  2. ECHO
  3. ESR
  4. Creatinine
50
Q

Name 8 causes of Parkinsonism

A
  1. Drug induced (antipsychotics + antiemetics)
  2. Parkinson’s disease
  3. Wilson’s disease
  4. Dementia pugillistica (boxers dementia)
  5. Post encephalitis
  6. Progressive supranuclear palsy
  7. Multiple system atrophy
  8. Toxins e.g CO, MPTP
51
Q

Acoustic neuroma (aka vestibular schwannoma)
Features (4)
Bilateral vestibular schwannomas are seen in _______
Ix (1)
Mx (4)

A
  1. Vertigo
  2. Tinnitus
  3. Absent corneal reflex
  4. Hearing loss

Bilateral vestibular schwannomas are seen in: Neurofibromatosis type 2

Ix MRI

Mx

  1. Refer to ENT
  2. Surgery
  3. RT
  4. Observation
52
Q

Parietal lobe lesions (4)

A

Integrating sensory information, including touch, temperature, pressure and pain

  1. Apraxia (difficulty with the motor planning to perform tasks or movements when asked)
  2. Sensory inattention (neglect)
  3. Astereognosis (unable to recognise object in hand with eyes closed)
  4. Inferior homonomous quadrantanopia
53
Q

Cerebellum lesions (5)

A
  1. Dysdiadokinesis
  2. Past pointing
  3. Intention tremor
  4. Nystagmus
  5. Gait and truncal ataxia
54
Q

Temporal lobe lesions (4)

A
  1. Wernicke’s receptive aphasia
  2. Superior homonymous quadrantanopia
  3. Prosopagnosia (face blindness)
  4. Auditory agnosia
55
Q

Frontal lobe lesion (5)

A
  1. Personality change
  2. Expressive (Broca’s) aphasia
  3. Perseveration
  4. Anosmia
  5. Disinhibition
56
Q

Kluver-Bucy syndrome
Lesion in which location (1)
Name 3 features

A
  1. Amygdala
    Features
  2. Hypersexuality
  3. Hyperorality (excessive chewing, lip smacking)
  4. Hyperphagia (excessive eating/ desire of food)
57
Q

Bell’s Palsy - facial nerve paralysis
Age range
Features (2)
Rx (3)

A 
Age range 20-40yo 
Features
1. LMN 
2. Affects forehead
Mx
1. If within 72 hours of onset, for prednisolone 50mg 
2. +/- acyclovir
3. Eye lubrication
58
Q 
Syringomelia 
What is it? 
Causes (4) 
Symptoms (3) 
Ix (1) 
Mx (2)
A 
Increased CSF at segmental level (in the spinal cord) 
Causes
1. Trauma
2. Tumour
3. Chiari malformation 
4. Idiopathic 
Sx 
1. Bilateral loss of pain and temp 
2. Cape like distribution (neck, back and arms) 
3. Spastic weakness of upper limbs (due to impact on corticospinal)
4. Horners
Ix 
1. MRI 
Mx
1. Treat underlying cause 
2. Shunt
59
Q

Neuroanatomy

Name three tracts and features

A
  1. Corticospinal - motor, muscles weakness
  2. Spinothalamic - sensory, pain and temperature, crosses at the level of the spinal cord
  3. DCML - sensory, light touch
60
Q

Brainstem Strokes (3)

A
  1. Midbrain - Weber’s
  2. Pons - Locked in
  3. Medullary - Wallenburg/ lateral medullary
61
Q

What is cataplexy?

A

Sudden and transient loss of muscular tone caused by strong emotion.
Common in narcoplexy
E.g ranging from buckling kness to collapsing

62
Q

Idiopathic intracranial hypertension

RF (4, 4 -5)

A

RF

  1. Female
  2. Obese
  3. Pregnancy
  4. Drugs e.g COCP, steroids, tetracycline, lithium, vit A
63
Q

Idiopathic intracranial hypertension
Features (5)
Mx (5)

A

Features

  1. Papilloedema
  2. Large blind spot
  3. Headache
  4. Blurred vision
  5. CN V1 palsy

Mx

  1. Weight loss
  2. Acetozolamide
  3. Topiramate
  4. Repeat LP
  5. Surgery optic nerve sheath decompression and fenestration or shunt
64
Q 
Mononeuropathies 
Ulnar nerve
Nerve Roots 
Sensory (1)
Motor (3)
Damage
A

C8, T1
Medial 1.5 fingers
Adductors, interossei, hypothenar
Claw hand

65
Q 
Mononeuropathies 
Radial nerve
Nerve Roots 
Sensory
Motor 
Damage
A

C5-T1, lateral epicondyle
Proximal phalanges on the dorsal aspect of the hand
Extensors, abductor pollicis longus, supinator
Wrist drop

66
Q 
Mononeuropathies 
Median 
Nerve Roots 
Sensory
Motor 
Damage
A

C6, C8, T1
Fingers 1-3.5
LOAF muscles, lumbricals, opponens pollicis, abductor pollicis brevis, flexor pollicis brevis, pronation
Carpal tunnel

67
Q

Carpal Tunnel
Signs (4)
Treatment (3)

A

Features

  1. Phalens (prayer)
  2. Tillens (tapping over median causes sx)
  3. Thenar wasting
  4. Weakness of thumb adduction

Treatment

  1. Steroid injection
  2. Wrist splint
  3. Surgical decompression
68
Q

Carpal Tunnel

Causes

A 
Causes 
MEDIAN TRAPS 
Myxoedema 
Enforced flexion (Colle's fracture) 
Diabetic neuropathy 
Idiopathic
Acromegaly
Neoplasms
Tumour (benign) 
Rheumatoid arthritis
Amyloidosis
Pregnancy 
Sarcoidosis
69
Q

Meralgia paraesthetica which nerve?
Nerve roots
Is it more common in men or women?
Average age group

A

Lateral cutaneous nerve of the thigh
L2 L3
Men
30-40

70
Q 
Meralgia paraesthetica
Features (4) 
Type of pain (3) 
Aggravated by?
Relieved by?

Ix (1)

A

Features

  1. Aggravated by standing, and relieved by sitting
  2. Burning, tingling, coldness, or shooting pain
  3. Numbness
  4. Deep muscle ache

Ix
1. Pelvic compression test

71
Q
  1. Foot drop is caused by what nerve?
  2. Name two muscles that are weakened in foot drop
  3. What is the sensory loss?
  4. Nerve roots
A
  1. Sciatic nerve
  2. Hamstrings, calf muscles
  3. Reduced sensation below knee
  4. L4-S3
72
Q

Wernicke’s encephalopathy
Triad of symptoms (3)
Treatment (1)
Korsakoff’s features (2)

A
  1. Ophthalmoplegia (paralysis of eye muscles)/ nystagmus
  2. Ataxia
  3. Confusional state

Rx - thiamine

  1. Antero + retrograde amnesia
  2. Confabulation
73
Q
  1. Cafe au lait spots
  2. Axillary and groin freckles
  3. Iris haematomas (Lisch nodules)
    = which condition?

Type 1 –> common in, chrm
Type 2 –> common in, chrm

A

Neurofibromatosis

NF1 von Recklinghausen’s syndrome, chrm 17

NF2 bilateral vestibular schwannomas (acoustic neuromas), chrm 22

74
Q
  1. Epilepsy
  2. Ash leaf spots
  3. Shagreen patches
  4. Angiofibromas - butterfly distribution on nose
  5. Developmental delay + intellectual impairment
A

Tuberous Sclerosis

75
Q

Huntington’s
Age
Chrm
Features (4)

A

> 35yo
AD, chrm 4

Features

  1. Chorea
  2. Dystonia (muscles contract uncontrollably)
  3. Saccadic eye movements
  4. Personality changes
76
Q

MND - what is it?

Name three types

A

Causes upper or lower motor neuron signs, nil sensory symptoms.

  1. Amyotrophic lateral sclerosis
  2. Progressive muscular atrophy
  3. Bulbar palsy
77
Q

MND
Features (4)
Treatment for amyotrophic lateral sclerosis

A

Features

  1. Upper and lower motor neuron signs
  2. Fasciculations
  3. Nil sensory signs
  4. Wasting of lumbricals, interossei and tibialis anterior

Tx

  1. Riluzole
  2. BIPAP
78
Q

What is bulbar disease?
What cranial nerves does it affect?
What is corticobulbar palsy?
UMN or LMN signs?

A

An MND that affects CN IX-XII and causes LMN signs

An MND that affects CN IX-XII and causes UMN signs

79
Q

What is progressive muscular atrophy

A

A type of MND
Anterior horn lesion
Nil UMN signs

80
Q

Myasthenia Gravis
What is it?
Antibodies against?
Features (4)

A

Autoimmune disease, antibodies against acetylcholinesterase receptors

Features

  1. Muscle fatigueability (worse over day)
  2. Proximal muscle weakness: face, neck, limb girdle
  3. Dysphagia
  4. Ptosis
81
Q

An inherited myopathy affecting skeletal, cardiac and smooth muscle.
Average age 20-30

Features

  1. Haggard, long face
  2. Dysarthria
  3. Frontal balding
  4. Bilateral ptosis
  5. Cataracts
A

Myotonic dystrophy

82
Q

Myasthenia Gravis

Treatment (3)

A
  1. AchR inhib - pyridostigmine
  2. Prednisolone
  3. Thymectomy
83
Q

Guillian Barre
What is it?
What is it normally caused by?

A

Immune mediated demyelination
Progressive, symmetrical weakness of all the limbs ascending in nature
Campylobacter jejuni

84
Q

Third nerve palsy features (3)

A
  1. Down and out
  2. Ptosis
  3. Dilated pupil
85
Q

Subdural haemorrhage on CT findings

Chronic subdural haemorrhage more common in? (2)

A

Crescenteric

Chronic subdural haematoma common in elderly and ETOH excess

86
Q

Reye’s syndrome features (5)

A
  1. Age 2
  2. Progressive encephalopathy
  3. Fatty infiltration of liver, kidneys and pancreas
  4. Following viral infection
  5. Low glucose
87
Q 
Reflexes nerve roots
Ankle	
Knee	
Biceps	
Triceps
A

Ankle S1-S2
Knee L3-L4
Biceps C5-C6
Triceps C7-C8

88
Q

Neuroleptic malignant syndrome features (4)

A

Following antipsychotics

  1. Fever
  2. Autonomic lability (tachy, HTN, high RR)
  3. Muscle rigidity
  4. Confusion
89
Q

Multiple system atrophy features (5)

A
  1. Parkinsonism
  2. Cerebellar signs
  3. Atonic bladder
  4. Erectile dysfunction
  5. Postural hypotension
90
Q

Degenerative cervical myelopathy
Ix
What sign can be seen O/E

A

MRI of the cervical spine is the gold standard test
Hoffman’s Flicking one finger on a patient’s hand +ve if results in reflex twitching of the other fingers on the same hand in response

91
Q

Duchenne Muscular Dystrophy

Features (4)

A
  1. Gower’s sign
  2. Progressive proximal muscle weakness from 5 years
  3. Calf pseudohypertrophy
  4. Intelectual disability
  5. X linked
92
Q

Becker muscular dystrophy (2)

A
  1. develops after the age of 10 years

2. intellectual impairment much less common

93
Q
  1. absent ankle jerks/extensor plantars
  2. cerebellar ataxia
  3. optic atrophy
  4. spinocerebellar tract degeneration
  5. cardiomyopathy

AD/AR
Age

A

Friedreich’s ataxia

  1. Autosomal recessive
  2. 10-15yo
94
Q
  1. cerebellar symptoms
  2. spider angiomas
  3. IgA deficiency resulting in recurrent chest infections
  4. risk of developing malignancy, lymphoma or leukaemia, but also non-lymphoid tumours

AD or AR
Age of onset

A

AR
1-5yo

Ataxia telangiectasia

95
Q

GCS

A

Motor response

  1. Obeys commands
  2. Localises to pain
  3. Withdraws from pain
  4. Abnormal flexion to pain (decorticate posture)
  5. Extending to pain
  6. None

Verbal response

  1. Orientated
  2. Confused
  3. Words
  4. Sounds
  5. None

Eye opening

  1. Spontaneous
  2. To speech
  3. To pain
  4. None
96
Q

Sodium valproate SE

A 
WHATT PLANT 
Weight gain 
Hepatotoxicity
Alopecia
Teratogenic
Tremor
Pancreatitis
Low sodium 
Ataxia
Nausea
Thrombocytopenia
97
Q

CN3 palsy

A

down and out
ptosis
four extraocular muscles

98
Q

CN6 palsy finding

A

horizontal diplopia

99
Q

CN 4 palsy finding

A

vertical diplopia

100
Q

Name 4 DA
Name 2 MAOB
Name 2 COMT

A

DA: Bromocriptine Ropinerole Apomorphine Cabergoline Pramipexole
MAOB: selegilene, rasigiline
COMT: entacapone, tolcapone

101
Q

Name x3 drugs should not be used as first-line treatment in epilepsy due to the risk of cardiac fibrosis, what type of drug are they

A

bromocriptine, cabergoline and pergolide

DA

102
Q

Ergot derived DA name three

Non ergot derived DA name three

A

bromocriptine, cabergoline, pergolide

ropinerole, pramipexole, rotogotine

103
Q

infantile spasms, three-eight months, drawing up of the legs (Salaam attacks)

A

West syndrome

104
Q

Janz syndrome
AKA
Triad

A

aka juvenile myoclonic epilepsy

  1. Infrequent generalised seizures
  2. Absence
  3. Myclonic jerks
105
Q

What is Kernig’s sign?

Which two diseases is it positive in?

A

positive when the thigh is flexed at the hip and knee at 90 degree angles, and subsequent extension in the knee is painful

SAH + meningitis

MSRA (22 decks)

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