Neurology causes Flashcards

1
Q

Causes of a high CSF protein in the presence of a normal CSF cell count

A
  • Guillain–Barré syndrome
  • Spinal cord tumour causing spinal block (Froin’s syndrome)
  • Acoustic neuroma
  • Lead encephalopathy
  • Subacute sclerosing panencephalopathy
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2
Q

Aseptic meningitis causes

A

Systemic Diseases:
- Behçet’s Syndrome

Viral Causes:
- Enteroviruses (e.g., Coxsackievirus, Echovirus, Poliovirus)
- Arboviruses (e.g., West Nile Virus)
- Herpes Simplex Virus (HSV)
- Acute HIV infection

Fungal Causes:
- Cryptococcus (especially in patients with AIDS, acute lymphocytic leukemia, and lymphomas)
- Endemic fungi

Bacterial Causes:
- Partially treated bacterial meningitis
- Nocardia
- Mycobacterium Tuberculosis
- Lyme Disease

Parasitic Causes

Drug-Induced:
- Intravenous Immunoglobulin

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3
Q

Peripheral neuropathy causes

A

Drugs:

  • Metronidazole
  • Nitrofurantoin
  • Isoniazid
  • Amiodarone
  • Hydralazine
  • Dapsone
  • Cisplatin
  • Vincristine (Chemotherapeutic agent)
  • Certain antiretrovirals (for HIV)
  • Alcohol (Chronic misuse)

Acute Causes:

  • Guillain-Barre Syndrome (motor)
  • Porphyria (motor)
  • Diphtheria (mixed)

Subacute Causes:

  • Vitamin B12 deficiency (painful sensory, with severe later motor symptoms)

Toxins:

  • Lead (motor)

Chronic Causes:

  • Paraneoplastic syndromes (sensory)
  • Monoclonal gammopathy of undetermined significance (MGUS - related to paraproteinaemia)
  • Connective Tissue Diseases (mixed)
  • Amyloidosis (mixed, with autonomic features and entrapments)
  • Chronic kidney disease (Uraemia - mixed)
  • Hypothyroidism (mixed)
  • Diabetes Mellitus (mixed)
  • Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)
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4
Q

Differential diagnosis of brain ring-enhancing lesions

A
  • Cerebral metastases
  • Histoplasmosis
  • Some primary brain tumours

The differential diagnosis for ring-enhancing lesions in the brain in a patient with HIV includes:

  • Toxoplasmosis
  • Primary CNS lymphoma,
  • Mycobacterial infections,
  • Cryptococcosis
  • Bacterial or fungal abscesses.
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5
Q

Chorea

A
  • Huntington’s disease
  • Wilson’s disease
  • Ataxia telangiectasia
  • SLE, antiphospholipid syndrome
  • Rheumatic fever (Sydenham’s chorea)
  • Pregnancy (chorea gravidarum)
  • Neuroacanthocytosis
  • Thyrotoxicosis
  • Polycythemia rubra vera
  • CVD
  • Drug-induced (oral contraceptive pill, L-dopa, antipsychotics)
  • CO poisoning (can also cause parkinsonism)
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6
Q

Absent ankle jerks, extensor plantars

A
  • Subacute combined degeneration of the cord
  • Motor neuron disease
  • Friedreich’s ataxia
  • Syringomyelia
  • Taboparesis (syphilis)
  • Conus medullaris lesion (cauda equina syndrome)
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7
Q

Causes of stroke in young (≤35 years of age) individuals

A
  • Cerebral haemorrhage
  • Meningoencephalitis
  • Neoplasm
  • Carotid or vertebral dissection
  • Migraine
  • Inflammatory conditions (vasculitis, antiphospholipid syndrome, isolated cranial angiitis, Takayasu’s disease)
  • Structural arterial disease (Fibromuscular dysplasia)
  • Cerebral vein thrombosis
  • Thrombophilic states
  • Cardiac causes (severe hypertension, AF, rheumatic heart disease, mechanical valves, cardiomyopathy, septal defects, PFOs)
  • Haematological (polycythaemia, thrombocythemia, paroxysmal nocturnal haemoglobinuria, sickle cell anaemia)
  • Mitochondrial disease, e.g. MELAS
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8
Q

Causes of dural sinus thrombosis

A
  • Infections of the face, ear, and sinuses
  • Hereditary thrombophilic states
  • Hyperviscosity states
  • Oral contraceptive pill/pregnancy
  • Behçet’s disease
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9
Q

Proximal muscle weakness

A
  • Cushing syndrome
  • Acromegaly
  • Thyroid disease
  • Polymyositis
  • Dermatomyositis
  • Polymyalgia rheumatica
  • Osteomalacia
  • Myasthenia gravis
  • Electrolyte imbalance
  • Drug-induced
  • Muscular dystrophy
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10
Q

Headache

A
  • Nicorandil
  • Amlodipine
  • Sulphasalazine
  • Ivabradine
  • Carbamazepine
  • Isosorbide mononitrate
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11
Q

Confusion

A
  • Amantadine
  • Digoxin
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12
Q

Tremor

A
  • Antipsychotics
  • Lithium
  • Ciclosporin
  • Sodium valproate
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13
Q

Psychosis

A
  • Levodopa
  • Corticosteroids
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14
Q

Parkinsonism

A
  • Metoclopramide
  • Antipsychotics
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15
Q

Slurred speech

A
  • Antipsychotics
  • Phenytoin
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16
Q

May exacerbate myasthenia gravis

A
  • Penicillamine
  • Quinidine, procainamide
  • Beta-blockers
  • Lithium
  • Phenytoin
  • Antibiotics (gentamicin, macrolides, quinolones, tetracyclines)

Link

17
Q

Conditions that cause upper motor neuron (UMN) and lower motor neuron (LMN) signs

A
  • ALS (motor)
  • B12 deficiency with subacute combined degeneration of the cord (motor+ sensory)
  • Cervical myelopathy (motor+ sensory)
  • Syringomyelia (LMN = arms, UMN = legs, motor+ sensory)
  • Friedreich ataxia (ataxia+ motor+ sensory)
  • Syphilis (motor+ sensory)
  • Hyperthyroidism (motor+ sensory)
18
Q

Causes of sensorineural deafness

A

Unilateral:
* Meningioma
* Acoustic neuroma
* Granuloma
* Metastasis

Bilateral:
* Degenerative (presbycusis)
* Aminoglycosides
* Amphotericin
* High-dose loop diuretics
* Mumps
* Rubella

19
Q

Causes of serotonin syndrome

A
  • Monoamine oxidase inhibitors (methylene blue, linezolid)
  • SSRIs
  • Ecstasy
  • Amphetamines

Link

MCQs

20
Q

Causes of abdominal pain and neuropathy

A
  • Acute intermittent porphyria (AIP)
  • Lead poisoning
  • Arsenic poisoning
  • Guillain–Barré syndrome
  • Polyarteritis nodosa
  • Diabetic ketoacidosis
  • Intra-abdominal malignancy
  • Sarcoidosis
  • Alcohol abuse
21
Q

Drugs that can lower seizure threshold

A
  • Antibiotics: Imipenem, penicillins, cephalosporins, metronidazole, isoniazid
  • Antihistamines
  • Antipsychotics
  • Antidepressants: Bupropion, Tricyclics
  • Baclofen
  • Fentanyl
  • Ketamine
  • Lidocaine
  • Lithium
  • Meperidine
  • Propoxyphene
  • Theophylline
22
Q

Most common sites for hypertensive intracranial hemorrhage

A
  • Putamen (part of basal ganglia) (44%)
  • Thalamus (13%)
  • Cerebellum (9%)
  • Pons (9%)
  • Other cortical areas (25%)
23
Q

Causes of autonomic neuropathy

A
  • Diabetes
  • Chronic renal failure
  • AIDS
  • Primary amyloidosis
  • Porphyria
  • Parkinson’s disease
  • Guillain-Barré syndrome
24
Q

Causes of third nerve palsy

A
  • Posterior communicating artery aneurysm
  • Mononeuritis multiplex
  • Myasthenia gravis
  • Multiple Sclerosis
  • Vascular lesions
  • Meningitis
  • Ophthalmoplegic migraine