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Anatomy: several systems (Jenna Goff) > Passmedicine > Flashcards

Passmedicine Flashcards

1
Q

What is Weber’s syndrome?

A

Ipsilateral third nerve palsy with contralateral hemiplegia -caused by midbrain strokes

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2
Q

Brocas area

A

Involved in producing coherent speech

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3
Q

Wernickes area

A

Involved in speech processing and understanding language

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4
Q

Driving rules if you are withdrawing from epilepsy medication?

A

Cannot drive till 6 months after last dose (ie stop meds and wait six months)

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5
Q

Driving and fainting

A

No restriction

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6
Q

Driving and syncope? (explained and non-explained)

A

Explained - 4 weeks off
Non-explained - 6 months off
Two or more episodes - 12 months off

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7
Q

Stroke/TIA and driving?

A

1 month off driving, may not need to inform DVLA if no neurological deficit
Multiple TIAs - 3 months off driving and inform DVLA

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8
Q

Gold standard marker for CSF?

A

Beta-2 transferrin
If not, then just check for glucose :)

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9
Q

How does phenytoin work?

A

Binds to sodium channels and increases the refractory period

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10
Q

What do you need to be careful of when starting a phenytoin infusion?

A

Need to monitor heart because it is unpredictable and can cause arrhythmias

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11
Q

Which muscles are likely to waste in motor neurone disease?

A

Small hand muscles
Tibialis anterior

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12
Q

When might the symptoms of carpal tunnel syndrome be worse?

A

At night e.g. “might wake patient during the night”

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13
Q

Which hand muscles are supplied by the median nerve?

A

LOAF muscles

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14
Q

Someone has a painful third nerve palsy, what should you be worried about?

A

Posterior communicating artery aneurysm

(pupil dilated)

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15
Q

What is Weber’s syndrome? Which part of the brain does it occur in?

A

Caused by midbrain stroke
Ipsilateral third nerve palsy with contralateral hemiplegia

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16
Q

Treatment for cluster headache? and prophylaxis?

A

100% oxygen and triptan
Prophylaxis: verapamil

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17
Q

Which nerve wraps around the humerus and may be damaged in shoulder dislocation?

A

The axillary nerve

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18
Q

Which level is affected in Klumpkes palsy, and which other syndrome might occur?

A

Klumpke’s palsy is C8-T1
Involvement of T1 may also cause Horner’s syndrome

In Klumpke’s paralysis, there is typically weakness of the hand intrinsic muscles

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19
Q

Which level is affected in Erb’s palsy?

A

C5 and C6
(brachial trunks)

20
Q

Obese young females with headaches/blurred vision, what should you think

A

Idiopathic intracranial hypertension

21
Q

Which nerve palsy might be present in idiopathic intracranial hypertension?

A

Sixth nerve palsy

22
Q

Which medications can increase risk of idiopathic intracranial hypertension?

A

Tetracyclines
Isotretinoin
Contraceptive pill
Steroids
Levothyroxine
Lithium

23
Q

Management of idiopathic intracranial hypertension?

A

Weight loss
Repeated lumbar puncture
Acetazolomide

(might need to do optic nerve sheath decompression and fenestration to prevent damage to the optic nerve)
-remember idiopathic intracranial hypertension can cause blindness if not treated promptly

24
Q

Which nerve supplies the extensors of the arm/hand

A

The radial nerve

25
Q

Which muscle supplies the interosseous muscles of the hand?

A

The ulnar nerve

26
Q

Which rami make up the brachial plexus?

A

C5 - T1

27
Q

Real Teenagers Drink Cold Beer

A

Roots
Trunks
Divisions
Cords
Branches

28
Q

Normal pressure hydrocephalus triad

A

Incontinence
Dementia
Gait

29
Q

Why do you have to be careful when combining sodium valproate and lamotrigine?

A

Combining sodium valproate and lamotrigine can cause serious skin rashes, such as Steven-Johnson’s syndrome

30
Q

Which test should you perform if you suspect degenerative cervical myelopathy?

A

You should perform Hoffman’s test (flick the patients middle finger, and you are looking for abnormal flexion in the thumb)

A positive Hoffman’s sign is a sign of motor neurone dysfunction and points to a disease of the CNS

31
Q

When should you give someone migraine prophylaxis?

A

When someone is experiencing more than 2 migraines per month

32
Q

Migraine prophylaxis for pregnant women?

A

Give them propanolol
(acute treatment - paracetamol)

33
Q

Why should you avoid using topiramate as migraine prophylaxis in pregnant women?

A

Associated with cleft lip and palate if used in the first trimester of pregnancy

(although used in migraine prophylaxis, topiramate is an anticonvulsant)

Not much evidence about triptans in pregnancy so usually avoided

34
Q

Medication particularly useful for prophylaxis of menstrual migraines?

A

Triptans

35
Q

What is CADASIL syndrome?

A

Cerebral autosomal dominant ateriopathy with subcortical infarcts

(type of genetic condition where you get strokes)

36
Q

Someone develops a foot drop, which nerve might be involved?

A

Common peroneal

37
Q

Someone develops a foot drop and then a wrist drop, which condition should you consider?

A

Mononeuritis multiplex

38
Q

What arteries are involved in a posterior circulation infarct?

A

The vertebrobasilar arteries

39
Q

When is essential tremor more noticeable?

A

When arms are stretched out

40
Q

What makes essential tremor better?

A

Propanol and alcohol

(i guess remember the “ol’s”)

41
Q

A 69 year old woman presents with a 3 week history of headache, which is worse on the right side. She is generally unwell and feels “weak”, noting particular difficulty in getting up from a chiar

A

Temporal arteritis

42
Q

What type of seizure is Carbamazepine of no use in?

A

Absence seizure

43
Q

Most common presenting feature of MS

A

Optic neuritis

44
Q

A 32 year-old female presents with a 3 day history of altered sensation on her left foot and right forearm. On examination she has clonus in both legs and has hyperreflexia in all limbs.

A

Multiple sclerosis

45
Q

First line treatment for trigeminal neuralgia

A

Carbamazepine

46
Q

Migraines and hormone replacement therapy?

A

Safe to prescribe hormone replacement therapy however might make migraines worse

47
Q

Which nerve is associated with a wrist drop

A

Radial nerve

Anatomy: several systems (Jenna Goff) (23 decks)

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