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Neurology > Neurology - conditions > Flashcards

Neurology - conditions Flashcards

1
Q

Name 6 signs and patient speak phrases for anterior horn cell disorders

A

UMN - increased reflexes and tone, positive babinski
LMN - fasciculations, weakness, wasting
“tripping, problems with buttons”

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2
Q

Name 3 UMN and 3 LMN symptoms in MND

A

UMN - increased reflexes, tone and babinski signs

LMN - fasiculations, muscle wasting, weakness

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3
Q

name a patient speak phrase and cause of parasellar syndrome

A

bashing both wing mirrors, period problems, not needing to shave as much
hypopituitarism

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4
Q

Which are the 4 main mononeuropathies?

A

carpal tunnel
ulnar
radical
axillary

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5
Q

How do patients describe neuropathic pain?

A

“pain wakes them up at night”

“tingling”

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6
Q

What are 3 components of 3rd nerve palsy and how does it occur?

A

fixed dilated pupil, decreased eye movements, ptosis

3rd nerve enters cavernous sinus, it can be compressed onto the apex of petrous of temporal bone

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7
Q

What is the patient speak phrase and test for proximal myopathy?

A

“hair, chair and stair” - struggle on hills

one legged squat, they struggle to lift their own weight

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8
Q

What is radiculopathy?

A

a pinched nerve

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9
Q

What are the most common radiculopathies?

A

C6 - elbow flexion strength, thumb sensation, biceps
C7 - elbow extension, middle finger and triceps
L5 - dorsiflexion, big toe and dorsum sensation
T1 - plantar flexion, little toe and sole and heel, ankle jerk

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10
Q

What are some patient speak phrases for myelopathy?

A

small movements go first

“treacle hands, struggle with buttons, walking on cotton wool, heavy legs which jerk at night” they wear velcro

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11
Q

How would a patient describe pain in radiculopathy and which arethe 4 main nerve roots affected?

A

“sharp and shooting” no on rest

C6, C7, L5, S1

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12
Q

What are the 3 main mononeuropahties and their signs?

A

carpal tunnel - worse at night
radial nerve - wrist drop
common perineal - dorsum loss of sensation

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13
Q

What is the definition of pyramidal weakness?

A

weakness in extensor of upper limb and flexors of lower limb

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14
Q

What are the patient speak phrases for proximal vs. distal muscle weakness?

A

Muscle (proximal) - trouble with chair, hair and stair

nerve (distal) - trouble counting money (loss of fine finger movements), tripping

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15
Q

What is Creuzfeld-Jakob Disease?

A

Human prion disease - neurodegenerative illnesses due to the accumulation of small infectious pathogens containing protein but no nucleic acid
- no cure, from infected meat
myoclonus, visual disturbances, cerebellar, pyramidal and extrapyramidal symptoms

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16
Q

What would weakness, with no abnormal pain or sensation, with increased reflexes and tone be?

A

MND

- also look for fasciculations

17
Q

What would weakness, with no abnormal pain or sensation, without increased reflexes and tone be?

A

Myasthenia gravis

- look out for eye signs

18
Q

What would weakness & abnormal pain and sensation & asymetrical weakness be?

A

MS

- worse in hot shower, multiple episodes, optic neuritis

19
Q

What would weakness & abnormal pain and sensation & symetrical weakness be?

A

Guillan Barre syndrome

- post infective

20
Q

What are some other causes of weakness?

A 
abnormal K or Ca
anaemia 
post-viral 
malignancy
infection 
low cardiac output 
psychogenic
inflammatory myopathy
proximal myopathy
21
Q

What would you assess in cerebellar examination?

A

gait (ataxia), speech (dysarthria), tremor

22
Q

What are some causes of cerebellar disease?

A

inherited - Friedreich’s ataxia (recessive), spinocerebellar ataxia (dominant)
Acquired - toxic (alcohol, lithium), immune mediated (post-infectious cerebellitis), neurodegenerative (MSA-C has hot-cross bun sign on MRI), idiopathic sporadic ataxia

23
Q

What is CIDP and how does it present?

A

chronic inflammatory demyelinating polyneuropathy

fatigue, decreased reflexes, sensory deficits, LMN signs

24
Q

How would you test for CIDP?

A 
EMG and NCS (slowed conduction in NCS)
serum test to exclude autoimmune 
LP - anti-ganglioside antibodies 
nerve biopsy 
US of peripheral nerves
TREAT: IVIG, plasmapheresis, corticosteroids, immunosuppressants
25
Q

What is a drug given for Alzheimer’s disease?

A

anticholinesterase e.g. donepezil, rivastigmine

26
Q

How do you treat giant cell arteritis?

A

steroids e.g. prednisilone
immunosuppressants e.g. azathioprine
biologicals

27
Q

What are some tests for suspected dementia?

A 
6-CIT 
addenbrookes 
MOCA 
MMSE 
CT head
Bloods
28
Q

What is included in a confusion screen?

A 
vital signs 
CT head 
Bloods - FBC, U&E, LFT, coagulation/INR, TFTs, calcium, B12/folate/haematinics, glucose, blood cultures 
CXR 
urinalysis
29
Q

What is giant cell arteritis and its symptoms?

A

aorta and cranial blood vessels become inflamed

scalp tenderness, jaw claudication, headache, acute blindness

30
Q

What are 3 diseases linked to carpal tunnel syndrome?

A

RA, pregnancy, DM, hypothyroidism

31
Q

How would you treat carpal tunnel syndrome?

A

wrist splint, steroid injections, analgesia, surgical decompression

32
Q

What are some symptoms of cauda equina?

A

saddle anaesthetia, bowel and bladder dysfunction, erectile dysfunction, leg weakness, bilateral sciatica, LMN symptoms

33
Q

What is the most common form of MND and its symptoms?

A

ALS - amyotrophic lateral sclerosis
UMN - hyperreflexia, muscle spasm,
LMN - muscular atrophy, fasiculations
progressive weakness (pyramidal), wasting in limbs

34
Q

How would you treat MND?

A

baclofen (GABA agonist) - reduce spasticity

riluzole (Na channel blocker) - slows progression

35
Q

What is the prognosis of MND?

A

5 year survival <10%

Neurology (10 decks)

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