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3 Neurology > Neurology Revision Night > Flashcards

Neurology Revision Night Flashcards

1
Q

what “nucleus” is one of the first parts of the brain affected in alzheimers?

A

nucleus basalis of meynert

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2
Q

pathophysiological cause of the genetic element of huntingtons?

A

genetic anticipation

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3
Q

name the symptomatic triad in parkinson’s

A

rigidity
tremor
bradykinesia

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4
Q

name 2 parkinson’s plus conditions

A

progressive supranuclear palsy

multiple system atrophy

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5
Q

main presentation of multiple system atrophy?

A

parkinsonism PLUS:

autonomic features eg orthostatic hypertension

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6
Q

main presentation of progressive supranuclear palsy?

A

parkinsonism PLUS:

vertical gaze problems

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7
Q

parkinsons plus syndromes respond well to levodopa T or F

A

F

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8
Q

CT sign of an acute MCA infarction?

A

MCA sign (hyperdense MCA (white artery) on CT)

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9
Q

your risk of developing alzheimers is higher in down syndrome T or F

A

T

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10
Q

frequency of the resting tremor in parkinsons?

A

4-6Hz

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11
Q

hemiballism is a form of what movement disorder?

A

chorea

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12
Q

cause of hemiballism?

A

decrease in activity of the subthalamic nucleus of the basal ganglia eg by a lesion

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13
Q

huntington’s presents with chorea T or F

A

T

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14
Q

how is the onset of vascular parkinsonism different to that of PD?

A

its more sudden

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15
Q

how does the presentation of vascular parkinsonism differ from PD?

A

begins in the lower body whereas PD tends to arise in the hands first

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16
Q

who gets sydenham’s chorea?

A

girls and young women (5-15yrs)

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17
Q

cause of sydenham’s chorea?

A

rheumatic fever

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18
Q

main symptoms of sydenham’s chorea

A

widespread chorea

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19
Q

“autosomal, postural tremor” describes what kind of tremor

A

resting tremor

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20
Q

cerebellar lesions cause what kind of tremor

A

intention

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21
Q

describe the findings on CSF on an MS patient

A

presence of oligoclonal bands

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22
Q

opening pressure is/isnt elevated in the CSF of a patient with viral meningitis

A

isnt

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23
Q

what kind of white cells are found in TB meningitis?

A 
mainly lymphocytes (80%)
polymorphs (20%)
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24
Q

opaque CSF that forms a fibrin web when left indicates what type of meningitis?

A

TB meningitis

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25
Q

protein is __ and glucose is __ in TB meningitis

A

high

low

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26
Q

xanthochromia in CSF indicates what condition?

A

SAH

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27
Q

creutzfeldt jakob disease is an example of what group of diseases?

A

prion disease

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28
Q

symptoms of creutzfeldt jakob disease?

A

dementia

myoclonus

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29
Q

presence of what in the CSF indicates creutzfeldt jakob disease?

A

14-3-3 protein

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30
Q

most useful initial investigation for alzheimers?

A

MMSE

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31
Q

what type of dementia is MMSE not recommended for and why?

A

FTD

memory not affected as much

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32
Q

1st line Ix for FTD?

A

MRI

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33
Q

most useful initial investigation for vascular dementia?

A

SPECT

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34
Q

1st line drug for focal seizures?

A

lamotrigine

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35
Q

1st line drug for generalised seizures?

A

sodium valproate

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36
Q

what drug should be given for generalised seizures in young women?

A

lamotrigine

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37
Q

valproate MoA

A

increases Na channel inactivation with increased GABA concentration

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38
Q

1st line Tx for absence seizures?

A

ethosuxamide

valproate can also be used

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39
Q

MoA of ethosuxamide?

A

blocks T type calcium channels

40
Q

uncontrolled hypertension causes what kind of stroke?

A

haemorrhagic

41
Q

Tx of stroke if under 4.5hrs?

A

thrombolysis then aspirin + clopidogrel

42
Q

Tx of stroke if >4.5hrs?

A

give aspirin and hope for the best

43
Q

haemorrhagic stroke management?

A

give mannitol

control hypertension with antihypertensives

44
Q

what should you do if someone with a CVA then has a seizure?

A

give anti-epileptic eg carbamazepine or lamotrigine

45
Q

what is phenytoin and when would you use it?

A

anti-epileptic

status epilepticus only as its v potent

46
Q

prophylactic drugs for cardioembolic stroke?

A

rivaroxaban/warfarin

47
Q

patient with bilateral double vision and ptosis that gets worse throughout the day…

A

myaesthenia gravis

48
Q

most useful Ix for myaesthenia gravis?

A

anti-AchR antibodies

49
Q

if the thymus is suspected to be involved in MG what should be done?

A

CT

50
Q

carbemazepine is teratogenic T or F

A

T

51
Q

side effects of carbemazepine?

A

hyponatraemia
ataxia
blurred vision
vertigo

52
Q

3Hz spike waves on EEG…

A

absence seizures

53
Q

when should you remove the pill in a woman who has migraines and why?

A

if they have aura

at an increased risk of stroke

54
Q

pharmacological Tx of migraine?

A

sumatriptan
NSAID
anti-emetic

55
Q

triptans are contraindicated in what condition?

A

heart problems

56
Q

right supra/retroorbital pain with ipsilateral ptosis and miosis that lasts over 30 mins..

A

cluster headache

57
Q

when are cluster headaches worse?

A

at night

58
Q

left supraorbital pain with ipsilateral nasal congestion about 20 times a day lasting 10-30mins

A

paroxysmal hemicrania

59
Q

why should you avoid metaclopramide in parkinson’s?

A

crosses the BBB fast so can cause more side effects

60
Q

what anti-emetic should be used in PD and why?

A

domperidone

doesn’t enter the CNS as fast as metoclopramide

61
Q

what anti-psychotic causes extrapyramidal side effects?

A

haloperidol

62
Q

what drug should be given in acute psychosis from parkinson’s?

A

quetiapine

63
Q

gram positive flagellated rod on gram stain in a patient with suspected meningitis?

A

listeria

64
Q

name the 3 groups at risk of listeria?

A

pregnant women
elderly
children

65
Q

most common meningitis bacteria in young people?

A

neisseria

66
Q

neisseria is gram ___

A

negative

67
Q

what bacteria is common in infection from cribriform plate injuries?

A

strep pneumoniae

68
Q

number 1 bacterial cause of meningitis in neonates

A

group b strep

69
Q

main bacterial causes of meningitis in infants?

A

meningococcus

haemophilus

70
Q

main bacterial causes of meningitis in teens?

A

meningococcus

71
Q

what neurotransmitter has a sedetary effect

A

GABA (it is an INHIBITORY neurotransmitter)

72
Q

drug of choice for spasticity in MS? why is this?

A

baclofen

is a GABA derivative so works as a sedative

73
Q

drug of choice for fatigue in MS? what kind of drug is it?

A

amantadine

dopamine agonist

74
Q

amantadine should be avoided in what condition?

A

epilepsy

75
Q

1st line treatment for trigeminal neuropathic pain?

A

carbemazapine

76
Q

what is the internal capsule of the brain and what does it do?

A

bunch of projection fibres that help the cerebral cortex communicate with the rest of the brain

77
Q

will damage to the internal capsule of the brain cause sensory or motor symptoms?

A

BOTH!! (contains both types of fibres)

78
Q

a lesion in what structure would cause full body paralysis except eye movement? why is this?

A

basilar artery

branches supply the pons and medulla so only midbrain cranial nerves would work

79
Q

what investigation confirms diagnosis of guillain barre?

A

neurophysiology

80
Q

patient presents with deteriorating paralysis after a campylobacter infection….

A

GBS

81
Q

what kind of paralysis does GBS present with?

A

ascending sensorimotor

82
Q

what should be done if anti-AchR antibodies are negative in suspected MG?

A

test anti-musk

83
Q

lambert eaton syndrome is __synaptic

A

pre

84
Q

MG is __synaptic

A

post

85
Q

Ix for lambert eaton syndrome?

A

anti-BGCC

86
Q

symptoms improve/worsen with exercise in LES?

A

improve

87
Q

what muscles are mainly involved in LES?

A

lower limb big muscles

88
Q

associated condition with MG?

A

thymoma

89
Q

associated condition with LES?

A

small cell lung cancer

90
Q

Tx of LES?

A

3,4-diaminopyridine

91
Q

4 main symptoms of LBD?

A

dementia
fluctuating conscious levels
recurrent visual hallycinations
parkinsonian features -> falls

92
Q

triad of symptoms in NPH?

A

incontinence, ataxia, dementia

93
Q

patient presents with visual/auditory hallucinations, seizures and meningism?

A

herpes simplex encephalitis

94
Q

why do you get hallucinations in HSV encephalitis?

A

tends to affect the temporal lobe which contains the meyers loop for superior vision (visual hallucinations) and middle ear (auditory)

95
Q

what symptoms are more prominent in encephalitis and not in meningitis

A

headache
fever
altered consciousness
hallucinations

3 Neurology (41 decks)

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