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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
If a Parkinson’s patient has been placed NBm how do they get their meds
Via dopamine agonist patch
26
What are the risk factors for Ms
Smoking previous mumps genetics and low vitD
27
What are the triggers of a migraine
CHoCoLate Chocolate hangovers orgasms cheese/caffeine COC lie ins alcohol travel exercise
28
First line early status epilepticus
IV lorazepam
29
What type of airway would you choose to intubage if the patients GCs or less tha. 8
Cuff endotracheal tube
30
What is Todd’s paresis
Post ictal weakness like a stroke
31
Lip smacking and post ictal dysphagia are associated with
Temporal lobe seizures
32
What spinal condition is associated with UMN signs
Degenerative cervical myelopathy
33
What is Hoffman’s sign
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
34
What is the rosier score
Recognising strike in the emergency room
35
What is the ABCd2 tool
Stroke risk after TIA
36
Bitemporal haemianopia with upper quadrant defect
Pituitary tumour
37
Bitemporal haemianopia with a lower quadrant defect
Craniopharyngioma
38
Treat restless leg
Dopamine agonist such as ropinorole
39
Poor response to levodopa impotence and urinary retention
Multiple system atrophy
40
How long is a patient on aspirin and clopidogrel following a stoke
Aspirin daily for 2 weeks | Clopidogrel daily long term
41
In trauma to test to see if the fluid draining from the ear or nose is CSF you
Check for glucose as mucous would not have glucose in it
42
Which dementia is associated with MND
Fro to temporal dementia
43
What bacteria is associated with Gillian Barr
Campylobacter
44
How would you treat a low pressure headache following a LP
Caffeine and fluids
45
Describe the tremor seen in Parkinson’s
Unilateral tremor that improves with voluntary movement
46
Hold standard for venous sinus thrombosis diagnosis
MR Venogram
47
Treat a cluster headache
High flow o2 and triptans (contraindicated in CVd history)
48
Kids with difficult to control epilepsy can try
A ketogenic diet (high fat low carb controlled protein)
49
When can you extend the target time of thrombectomy to 6-24 hours
If Ct perfusion or MRI shows limited infarct core volume meaning there is the potential to salvage brain tissue
50
What is a pontine haemorrhage
Complication of hypertension reduced GCS quadriplegia miosis and absent horizontal eye movements
51
What is hyperacusis
Noise sensitivity
52
Treat chemo induced nausea
Ondansetron
53
Treat intracranial induced nausea such as raised IcP or tumour
Haloperidol
54
Treat vestibular nausea
Prochlorperazine
55
Treat GI caused nausea
Metoclopramide
56
What are the 4 big clues that would point you to the diagnosis of MND?
Fasciculations The absence of sensory signs Mix of LMN and UMN signs Wasting of small muscles in the hands
57
Treat Bell’s palsy
Prednisalone and eye drops
58
What is an ataxic gait
Wide based gait with loss of heel toe walking
59
What are the causes of an ataxic gait
``` Posterior fossa tumour Alcohol MS Trauma Rare causes Inherited Epilepsy treatments Stroke (Pastries) ```
60
Which eye nerve is susceptible to damage in raised ICP
Abducens
61
What is a RAPD and what nerve is affecte d
Optic nerve | Defect in the pupils direct response to light
62
What is the most appropriate way of stopping anti epileptics
Can be considered of seizure free for >2 years with anti epileptic drugs being stopped over 2-3 months
63
What nerve is at risk during a humerus fracture
Axillary nerve
64
Involvement of which spinal nerve may cause a horners syndrome
T1
65
Pronated and medically rotated arm
Erbs palsy affecting c5-6
66
Double vision for two weeks worse at night
Ocular myasthenia gravis | Treat with pyridostigmine
67
First line focal seizures
Lamotrigine and carbamazepine
68
Which nerve is damaged of weakness of foot doesiflexion and foot wversion
Common perineal
69
Which opioid would be useful in neuropathic pain if all else fails to help
Tramadol
70
Parkinsonism with associated autonomic disturbance (atonic bladder, postural hypotension) points towards a diagnosis of
Multiple system atrophy
71
What blood test can be used to differentiate between a true seizure and a pseudo seizure
Prolactin
72
Why does a high stepping gait develop
To compensate for foot drop
73
Treat neuroleptic malignant syndrome
Bromocriptine
74
In a seizure with clonic movements moving proximally indicates what
Frontal lobe epilepsy
75
What do you need to do before giving phenytoin
Link up to cardiac monitoring
76
What is grade 0 on the MRC grading system for muscle power
No muscle movement
77
What is grade 1 on the MRC grading system for muscle power
Trace of contraction
78
What is grade 2 on the MRC grading system for muscle power
Movement at the joint with gravity eliminated
79
What is grade 3 on the MRC grading system for muscle power
Movement against gravity but not against added resistance
80
Grade 4 muscle movement
Movement against an external resistance with reduced strength
81
What is grade 5 on the MRC grading system for muscle power
Normal strength
82
What is the Barthel index
Scale that measures disability or dependence of activities of daily living in stroke patients
83
If clopidogrel is contraindicated or not tolerated give what for the prevention following stroke
Aspirin and modified release dipyramidole
84
DVLA and TIA
Continue driving after 1 month if symptom free and no need to inform DVLA
85
A patient who presents to their GP within 7 days of suspected TIA should have what immediately
300mg aspirin
86
What can be used in Ms for acute relapse
Steroids

Year 4 Neurology (18 decks)

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