pastest 3 Flashcards
thiamine is what vitamin
B1
which cranial nerve has the longest course
6th abducens
cranial nerve in bells palsy
lower motor of 7th (facial)
treatment for cluster headache
sumatriptan and high flow oxygen
drug given to reduce ICP
mannitol (diuretic)
which cranial nerve has the longest course
6th abducens
cranial nerve in bells palsy
lower motor of 7th (facial)
treatment for cluster headache
sumatriptan and high flow oxygen
winged scapula: nerve and muscle
long thoracic nerve, serratus anterior
weakness in elblow flexion (nerve?)
musculocutaneous nerve
epidural haematomma crosses suture line?
no (dura mater there to it)
sentinel headache
precedes sub arachnid haemorrhage
lens shape on CT
extra dural
what will be seen in perineal nerve damage
dorsiflexion weakness/foot drop
weakness in eversion
loss of sensation to dorm of foot and medial aspect of leg
weak extensor hallicus longus
loss of knee reflex, what nerve
femoral
femoral nerve lesion will show what
loss of knee reflex
weakness in hip flexors and knee extensors
weakness in hip flexors and knee extensors - nerve
femoral
sciatic nerve made up of what roots
L4 - S2
loss of ankle reflex - nerve?
sciatic nerve
weakness in muscles below knee - nerve?
sciatic nerve
loss of sensation over foot and posterolateral lower leg
sciatic
shoulder shrugging, what nerve
spinal accessory
spinal accessory arise from
C1-C5
pathway of spinal accessory
arise from C1-C5, ascend through foramen magnum, descent through jugular, crosses 1/3 down sternocleidomastoid (which it innervates)along the posterior triangle , then onto trapezius (which it innervates)
innervates skin over deltoid
axillary nerve
myasthenia gravis age of onset
~ 20
treatment for myasthenia gravis
acetylecholine esterase inhibitors
who get duchesses
only boys (x-linked)
myasthenia gravis is Ab to what
Ach receptors
which tracts crosses in spinal cord
spinalothalamic (pain and temp) quick to cross
hyperreflexia: UMN or LMN
UMN
positive babinski sign: UMN or LMN
UMN
sensorimotor to lower limb is via which 3 nerves
femoral, sciatic, obturator
femoral and obturator arise from same level, this is where
L2-L4
right sided extradural haematomma leading to herniation of temporal uncus can present with what neurological signs
weakness in both upper and lower LEFT limbs, dilated pupil in RIGHT eye
nerves for afferent and efferent of corneal reflex
afferent: ophthalmic division of trigeminal (sensory)
efferent: facial (blink - motor)
puffing of cheeks tests what nerve
facial nerve
clenching jaw is what nerve
mandibular division of trigeminal
what nerve passes along cavernous sinus in brain
ophthalmic division of trigeminal
pathology affecting cavernous sinus will show what sign
absent corneal reflex
upper limbs wlil be spared as long as a spinal injury is below what level
T1
all lower limb nerve arise from where
above the 5th the sacral segment
indian ink staining of CSF
Cryptoccosus meningiti
viral meningitis profile
opening pressure: normal
WBC: lymphocytes predominant
protein: increased
glucose: normal
bacterial meningitis profile
opening pressure: Increased
WBC: neutrophil predominant
protein: increased
glucose: decreased
cryptococcus meningite profile
opening pressure: increased
WBC: lymphocytes predominant
protein: increased
glucose: normal/decreased
14-3-3 protein in CSF
prion disease
EEG shows triphasic spikes
prion disease
histology in prion disease will show what changes in brain tissue
instead of alpha helical protein get beta sheets
numbness of lateral thigh, what nerve
lateral femoral cutaneous nerve
numbness of medial thigh, medial leg and medial ankle
femoral nerve
weakness in hip flexion and knee extension
femoral nerve
weakness of knee flexion
sciatic
weakness in adduction and internal rotation of hip
obturator
what will be seen in brain tissue of someone with alzheimers
amyloid plaques and tau proteins neurofiblary tangles
what typer of dementia will have frontal lobe features
picks disease
complete loss of vision in one eye
optic nerve of ipsilateral eye
bitemporal heminopai
optic chasm
right homonymous hemianopia
left optic tracts/radiation
left homonymous hemianopia
right optic tract/radiation
3 categories of glasgow comma score
eyes response (4) verbal response (5) motor response (6)
GCS: eye response if out of how many?
4
GCS: verbal response if out of how many?
5
GCS: motor response if out of how many?
6
what drugs cane given to stop a fit and by what route
lorazepam - IV
diazepam - rectal
drug you can give in several consecutive fits/status epileptics that have already had diazepam/lorazipam
IV phenytoin
other pathology associated with myasthenia gravis
thymus disease
first line treatment for bacterial meningitis
cephalosporin (cefotaxime)
what drugs do you give for alcohol withdrawal
chlordiazepoxide and thiamine
polymorph leucocytosis =
neutrophils
CSF in TB meningitis is have what 2 particular features
very high protein and very low glucose
viral meningotis protein level will be
slightly elevated
non hospital treatment of suspected bacterial meningitis
IM/IV benzylpenicillin
hospital treatment of bacterial meningitis of unknown organism
IV cefotaxime
hospital treatment of bacterial meningitis of unknown organism > 55 yrs
Iv cefotaxime + ampicillin
why do you also give ampicillin to > 55 yrs in bacterial meningitis where organism is not know
incase of listeria also if immunocompromisedn
viral meningitis also called
aseptic meningitis
most common cause of viral meningitis
enteroviruses (echoviruses)
treatment for viral encephalitis
aciclovir
appearance of CSF in bacterial meningitis
turbid/cloudy
appearance of CSF in viral meningitis
clear
appearance of CSF in TB meningitis
fibrin web
glucose in bacterial
glucose in TB
glucose in viral
> 50% of plasma
how do you differentiate TB from viral
TB will have
vessels involved in sub dural
bridging veins
what might indicate encephalitis rather than meningitis
confusion, seizures, increased signal in temporal lobes on MRI
what type of meningitis do you see nerve palsy
TB
Oligoclonal bands =
MS (Ab’s that indicate inflammation of CNS)
gait seen in normal pressure hydrocephalus
broad based, small stepping, difficulty initiating
homonymous hemianopia occurs in infarct in what part of brain
occipital
expressive dysphagia = what area
broca’s
receptive dysphagia = what are
wernickes
fluent nonsensual speech
receptive (wernickes) dysphagia
injury to elbow or shaft of humorous usually damages what nerve
radial
fingers innervated by median nerve
thumb, index and middle
shoulder dislocation usually results in damage to what nerve
axillary
what tract carries fine touch
dorsal column
dorsal column carries what sensations
fine touch
2 point discrimination
vibration
proprioception
anterior spinothalamic tract senses what
crude touch
lateral spinothalamic senses what
pain and temp
pain and temp
lateral spinothalamic
crude touch
anterior spinothalamic tract senses what
vibration
dorsal column
what can cause neuritis
MS
connective tissue disease
diabetes
lead poisoning
headache + stiff neck but no fever
subarachnoid haemorrhage
increased pain on bending forward indicates what
raised ICP
dilated ventricles + increased opening CSF pressure
benign intracranial hypertension
treatment for benign intracranial hypertension
stop COCP if on it lose weight acetazolamide or dexamethasone repeated therapeutic lumbar puncture ventriculo-peritoneal shunt
drugs you can give in benign intracranial hypertension
acetazolamide (diuretic) or dexamethasone (steroid)
what gives you a headache in the morning
raised ICP (SOL, benign intracranial pressure, chronic bleeds)
which haematomma DOES cross sutures
sub dural (extradural does not)
which haematomma DOES cross the midline
extradural (sub dural does not)
