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Year 4 Neurology > Pass Medicine Neurology > Flashcards

Pass Medicine Neurology Flashcards

1
Q

Treat an acute ischaemic stroke who presents within 4.5 hours

A

Thrombolysis and thrombectomy

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2
Q

Treat an acute ischaemic stroke who presents within 6 hours

A

Thrombectomy

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3
Q

What is the new definition of TIA

A

Transient episode of neurological dysfunction caused by focal brain spinal cord or retinal ischaemia without acute infarction

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4
Q

Where is the chemo trigger zone area

A

Medulla oblongata

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5
Q

What is the most common complication following meningitis

A

Sensorineural HL

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6
Q

What is the management of myasthenia crisis

A

IVIG and plasma electrophoresis

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7
Q

Why drugs are common precipitates of myasthenia crises

A

Beta blockers

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8
Q

DVLA rules on provoked seizure

A

Don’t drive

Inform DVLA and wait for their response

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9
Q

What is wernickes dysphagia and where is it

A

Receptive
Can’t understand
Superior temporal gurus

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10
Q

Where is brocas dysphagia and what is it

A

Understand but can’t vocalise

Inferior frontal gurus

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11
Q

Damage to what tract is responsible for cape like loss of sensation

A

Anterior white commodore of the spinothalamic tract

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12
Q

Vertigo hearing loss tinnitus and absent corneal reflex

A

Vestibular schwannoma

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13
Q

Roughened patches of skin over the lumbar spine

A

Shagreen patches seem in Tiberous sclerosis

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14
Q

Weakness improves with exercise

A

Lambert Eaton

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15
Q

Weakness worsens with exercise

A

Myasthenia

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16
Q

LE effects what receptors

A

Calcium

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17
Q

Myasthenia affects what receptors

A

Ach

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18
Q

Autonomic dysreflexia occurs if the injury is above what spinal level

A

T6

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19
Q

Axillary freckling

A

NF1

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20
Q

Bilateral vestibular schwannoma

A

NF2

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21
Q

Neuroleptic malignant syndrome is typically seen when

A

In patients who have just commenced treatment

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22
Q

Treat degenerative cervical myelopathy

A

Cervical decompressive surgery

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23
Q

Glaucoma causes what visual field loss

A

Peripheral

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24
Q

In a bitemporal haemianopia due to a pituitayrbtimour would the upper or lower quadrant be affected

A

Upper

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25
Q

If a Parkinson’s patient has been placed NBm how do they get their meds

A

Via dopamine agonist patch

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26
Q

What are the risk factors for Ms

A

Smoking previous mumps genetics and low vitD

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27
Q

What are the triggers of a migraine

A

CHoCoLate

Chocolate hangovers orgasms cheese/caffeine COC lie ins alcohol travel exercise

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28
Q

First line early status epilepticus

A

IV lorazepam

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29
Q

What type of airway would you choose to intubage if the patients GCs or less tha. 8

A

Cuff endotracheal tube

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30
Q

What is Todd’s paresis

A

Post ictal weakness like a stroke

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31
Q

Lip smacking and post ictal dysphagia are associated with

A

Temporal lobe seizures

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32
Q

What spinal condition is associated with UMN signs

A

Degenerative cervical myelopathy

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33
Q

What is Hoffman’s sign

A

Flick the distal phalanx of the middle finger causes momentary flex ion normally however a positive result would be an exaggerated flexion of the terminal phalanx of the thumb

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34
Q

What is the rosier score

A

Recognising strike in the emergency room

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35
Q

What is the ABCd2 tool

A

Stroke risk after TIA

36
Q

Bitemporal haemianopia with upper quadrant defect

A

Pituitary tumour

37
Q

Bitemporal haemianopia with a lower quadrant defect

A

Craniopharyngioma

38
Q

Treat restless leg

A

Dopamine agonist such as ropinorole

39
Q

Poor response to levodopa impotence and urinary retention

A

Multiple system atrophy

40
Q

How long is a patient on aspirin and clopidogrel following a stoke

A

Aspirin daily for 2 weeks

Clopidogrel daily long term

41
Q

In trauma to test to see if the fluid draining from the ear or nose is CSF you

A

Check for glucose as mucous would not have glucose in it

42
Q

Which dementia is associated with MND

A

Fro to temporal dementia

43
Q

What bacteria is associated with Gillian Barr

A

Campylobacter

44
Q

How would you treat a low pressure headache following a LP

A

Caffeine and fluids

45
Q

Describe the tremor seen in Parkinson’s

A

Unilateral tremor that improves with voluntary movement

46
Q

Hold standard for venous sinus thrombosis diagnosis

A

MR Venogram

47
Q

Treat a cluster headache

A

High flow o2 and triptans (contraindicated in CVd history)

48
Q

Kids with difficult to control epilepsy can try

A

A ketogenic diet (high fat low carb controlled protein)

49
Q

When can you extend the target time of thrombectomy to 6-24 hours

A

If Ct perfusion or MRI shows limited infarct core volume meaning there is the potential to salvage brain tissue

50
Q

What is a pontine haemorrhage

A

Complication of hypertension reduced GCS quadriplegia miosis and absent horizontal eye movements

51
Q

What is hyperacusis

A

Noise sensitivity

52
Q

Treat chemo induced nausea

A

Ondansetron

53
Q

Treat intracranial induced nausea such as raised IcP or tumour

A

Haloperidol

54
Q

Treat vestibular nausea

A

Prochlorperazine

55
Q

Treat GI caused nausea

A

Metoclopramide

56
Q

What are the 4 big clues that would point you to the diagnosis of MND?

A

Fasciculations
The absence of sensory signs
Mix of LMN and UMN signs
Wasting of small muscles in the hands

57
Q

Treat Bell’s palsy

A

Prednisalone and eye drops

58
Q

What is an ataxic gait

A

Wide based gait with loss of heel toe walking

59
Q

What are the causes of an ataxic gait

A 
Posterior fossa tumour 
Alcohol 
MS 
Trauma 
Rare causes 
Inherited 
Epilepsy treatments 
Stroke 
(Pastries)
60
Q

Which eye nerve is susceptible to damage in raised ICP

A

Abducens

61
Q

What is a RAPD and what nerve is affecte d

A

Optic nerve

Defect in the pupils direct response to light

62
Q

What is the most appropriate way of stopping anti epileptics

A

Can be considered of seizure free for >2 years with anti epileptic drugs being stopped over 2-3 months

63
Q

What nerve is at risk during a humerus fracture

A

Axillary nerve

64
Q

Involvement of which spinal nerve may cause a horners syndrome

A

T1

65
Q

Pronated and medically rotated arm

A

Erbs palsy affecting c5-6

66
Q

Double vision for two weeks worse at night

A

Ocular myasthenia gravis

Treat with pyridostigmine

67
Q

First line focal seizures

A

Lamotrigine and carbamazepine

68
Q

Which nerve is damaged of weakness of foot doesiflexion and foot wversion

A

Common perineal

69
Q

Which opioid would be useful in neuropathic pain if all else fails to help

A

Tramadol

70
Q

Parkinsonism with associated autonomic disturbance (atonic bladder, postural hypotension) points towards a diagnosis of

A

Multiple system atrophy

71
Q

What blood test can be used to differentiate between a true seizure and a pseudo seizure

A

Prolactin

72
Q

Why does a high stepping gait develop

A

To compensate for foot drop

73
Q

Treat neuroleptic malignant syndrome

A

Bromocriptine

74
Q

In a seizure with clonic movements moving proximally indicates what

A

Frontal lobe epilepsy

75
Q

What do you need to do before giving phenytoin

A

Link up to cardiac monitoring

76
Q

What is grade 0 on the MRC grading system for muscle power

A

No muscle movement

77
Q

What is grade 1 on the MRC grading system for muscle power

A

Trace of contraction

78
Q

What is grade 2 on the MRC grading system for muscle power

A

Movement at the joint with gravity eliminated

79
Q

What is grade 3 on the MRC grading system for muscle power

A

Movement against gravity but not against added resistance

80
Q

Grade 4 muscle movement

A

Movement against an external resistance with reduced strength

81
Q

What is grade 5 on the MRC grading system for muscle power

A

Normal strength

82
Q

What is the Barthel index

A

Scale that measures disability or dependence of activities of daily living in stroke patients

83
Q

If clopidogrel is contraindicated or not tolerated give what for the prevention following stroke

A

Aspirin and modified release dipyramidole

84
Q

DVLA and TIA

A

Continue driving after 1 month if symptom free and no need to inform DVLA

85
Q

A patient who presents to their GP within 7 days of suspected TIA should have what immediately

A

300mg aspirin

86
Q

What can be used in Ms for acute relapse

A

Steroids

Year 4 Neurology (18 decks)

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