Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neurology > Pastest > Flashcards

Pastest Flashcards

1
Q

This disease is caused by degeneration and inclusion body deposition within the v pars compacta of the substantia nigra

A

Parkinson’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is speech affected in parkinson’s disease?

A
  • monotone pronounciation progressing to slurred dysarthria

- speech may even be lost completely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The following triad is a common presentation of what?

  • Gait disturbance
  • Urinary incontinence
  • Dementia
A

Normal pressure hydrocephalus

usually a disorder of the elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

“A 23 year old man with mild headache, low grade fever and malaise. He has been unwell for 5 days. On examination, you notice facial Molluscum contagiosum”

A

Cryptococcal meningitis

This is an AIDS-defining illness. It occurs in patients with a low CD4 count. It often has a slowly evolving prodromal phase with fever, malaise and headache. Patients may have nausea, vomitting and photophobia and neck stiffness at the time of presentation. Treatment is with IV antifungal agents, amphotericin and/or flucytosine. Molluscum contagiosum is a good indicator of immunosuppression in HIV infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does a subarachnoid haemorrhage classically present?

Also, where is the initial pain often located?

A

Classically presents with a VERY severe headache of sudden onset

The initial pain is often in the occipital region.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How would you diagnose a subarachnoid haemorrhage?

A

CT scan or lumbar puncture if the CT scan is negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Saccular berry aneurysms and AV malformations are associated with this?

A

Subarachnoid haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Drug therapy for bacterial meningitis?

A

Cefotaxime/ceftriaxone !!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Who is most at risk of chronic subdural haematoma?

A

The elderly and alcohol abusers (this is due to the fragility of bridging veins = slow bleeding from vein into the subdural space)
Trauma is a cause in any age group.

Gradually symptoms resulting from haematoma accumulate over a period of days/weeks)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What kind of people suffer from benign intracranial hypertension? Clue you probably don’t like them

A

Overweight women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Conditions particularly associated with visual hallucinations

A
  • Delirium

- Drug intoxication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Orthello syndrome

A

Patient’s believe their partners to be cheating on them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Cotard’s syndrome

A

Patients believe parts of their body to be dead/decaying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Ekbom’s syndrome

A

Patient delusionally thinks that their body is infested by insects or animals
-associated with ‘matchbox sign’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is schizophreniform?

A

Disorder typified by symptoms of schizophrenia of less than 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hebephrenic schizophrenia

A

Predominant affective symptoms causing childish behaviour and prominent thought disorder
e.g. shallow mood, giggling, pranks, disorganised thoughts, rambling speech

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Residual schizophrenia

A

The patient has negative symptoms after previous episodes of delusions and hallucinations:
“predominant social withdrawal with a previous history of marked hallucinations and delusions”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Characterised by rapidly progressive dementia, myoclonus and distinctive electroencephalographic and neuropathologic findings

A

Creutzfeldt Jakob disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Avoidant personality disorder

A

These patients are socially inhibited, sensitive to rejection and timid with overwhelming feelings of inadequacy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Schizoid personality disorder

A

These patients exhibit voluntary social exclusion and limited emotional expression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Schizotypal personality disorder

A

These patients demonstrate odd though patterns, interpersonal awkwardness and can have an odd appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Reaction formation

A

A.k.a 2 faced bitch syndrome

When a person adopts a behaviour opposite to that of their true feelings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Sublimation

A

This is when a patient turns “unacceptable” thoughts or impulses into socially acceptable ones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Best treatment for social phobia

A

Cognitive behaviour therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the name given to seizures that are confined to the limbic structures?

A

Partial complex seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Damage to this part of the brain leads to loss of the capacity for new learning and short-term memory

A

Hippocampus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

This nucleus is where you’ll find lots of adrenergic neurones

A

Locus coeruleus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

This nucleus is the centre for serotonin-containing cell bodies

A

Median raphe nucleus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Triad of ADHD

A

Hyperactivity
Inattention
Impulsiveness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Triad of ASD

A

Social impairment
Lack of imagination
Very limited activities or something

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Features of tremor in Parkinson’s

A
  • most marked at rest
  • 3-5 Hz
  • worse when stressed or tired
  • typically ‘pill-rolling’ i.e. in thumb and index finger
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Differentiating between PD and drug induced parkinsons?

A

Drug induced:

  • motor symptoms generally have rapid onset and BILATERAL
  • rigidity and resting tremor are uncommon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Medications for prophylaxis of migraine?

A

Propanolol or topiramate (propanolol is preferred in women of childbearing age)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is Zolmitriptan used for?

A

Useful for aborting migraine attacks (i.e. I think good when you’re having the attack but not used for prophylaxis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

When should you give prophylaxis for migraine?

A

If patient is experiencing 2 or more attacks per month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Which scoring system is most appropriate to evaluate whether someone has had a stroke or not?

A

The ROSIER score

stroke is likely if >1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What might a patient do to obtain some relief from carpal tunnel syndrome?

A

Shake their hand for relief, classically at night

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

If you suspect someone has subarachnoid haemorrhage, when would you do lumbar puncture?

A

Done after 12 hours to allow time for xanthochromia to develop (xanthochromia - yellow discolouration of CSF due to bilirubin from blood breakdown I think)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Conditions associated with berry anuerysms

A

APCKD
Ehlers-Danlos syndrome
Coarction of the aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Most dreaded early complication of subarachnoid haemorrhage?

A

Re-bleeding

risk greatest within the first 24 hours of rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Bacteria typically causing Guillain Barre

A

Campylobacter jejuni

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Treatment for paroxysmal hemicrania?

A

Indomethacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Which type of motor neurone disease carries the worst prognosis?

A

Progressive bulbar palsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

WHich type of motor neurone disease carries the best prognosis?

A

Progressive muscular atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

When can you give aspirin for stroke?

A

Give as soon as haemorrhagic stroke has been excluded!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Imaging features of normal pressure hydrocephalus?

A

Enlarged fourth ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Management of normal pressure hydrocephalus?

A

Ventriculoperitoneal shunting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

A 41 year old presents with a two week history of headaches around the left side of his face associated with watery eyes. He describes having about 2 episodes a day each lasting around 30 minutes.

A

Cluster headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Features of cluster headache

A

Episodic eye pain
Lacrimation (watery eyes)
Nasal stuffiness
Occurring daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Management of cluster headache

A

acute: 100% oxygen, subcutaneous or a nasal triptan
prophylaxis: verapamil, prednisolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Which artery is involved in a PAINFUL THIRD NERVE palsy?

A

Posterior communicating artery (aneurysm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

A patient is referred due to the development of a third nerve palsy associated with a headache. On examination meningism is present. What diagnosis should you exclude RAPIDLY?

A

Posterior communicating artery aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What is Weber’s syndrome?

A

Ipsilateral 3rd nerve palsy with contralateral hemiplegia - caused by midbrain strokes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

NICE guidance for neuropathic pain?

A

First line: amitryptiline, duloxetine, gabapentin or pregabalin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Most common presentation of multiple sclerosis?

A

Optic neuritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is Uhthoff’s phenomenon?

A

Worsening of vision following rise in body temperature

seen in MS - visual symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What is Lehrmitte’s syndrome?

A

Paraesthesia in limbs on neck flexion (seen in MS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Motor symptoms seen in MS

A

Spastic weakness, most commonly seen in the legs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Fasciculations, what should you think?

A

MND :(

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

A 64-year-old man presents with a eight-month history of generalised weakness. On examination he has fasciculation and weakness in both arms with absent reflexes. Examination of the lower limbs reveal increased tone and exaggerated reflexes. Sensation was normal and there were no cerebellar signs. What is the most likely diagnosis?

A

Motor Neurone disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Chief extensor of the forearm

A

Triceps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Nerve supply to the triceps

A

Radial nerve C7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Klumpke is associated with which syndrome?

A

Horner’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Nerve roots damages in Erb’s palsy

A

C5, C6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Nerve roots damaged in Klumpke’s palsy?

A

C8, T1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Shoulder abduction (deltoid)

A

Axillary nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What is cabergoline?

A

A dopamine receptor agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Side effects of dopamine agonists?

A

Impulse disorders and excessive daytime somnolence
Bromocriptine and carbergoline can cause pulmonary, cardiac and retropertioneal fibrosis
Dopamine agonists more likely to cause visual hallucinations in the elferly than levodopa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Side effects of amantadine

A 
Ataxia
Slurred speech
Confusion
Dizziness
Livedo reticularis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

This type of haematoma is associated with a lucid interval!! E.g. gets hit on the head, feels fine, collapses later

A

Extradural haematoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Anticoagulation is associated with this type of haematoma?

A

Subdural haematoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

This haematoma is associated with features of raised ICP

A

Extradural haematoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Often results from acceleration-deceleration trauma or a blow to the side of the head

A

Extra-dural haematoma

74
Q

Risk factors for headache

A

Young male smoker with a positive family history

75
Q

Driving regulations for stroke/TIA

A

1 month off driving

76
Q

Driving restrictions for multiple TIA’s over a short period of time?

A

3 months off driving

77
Q

Which other conditions do you have to inform DVLA of?

A

Multiple sclerosis

Motor neuron disease

78
Q

Petit mal seziure

A

Absence seziure

79
Q

Jacksonian seizures arise from which lobe?

A

The temporal lobe

80
Q

Adverse effects of triptans?

A

‘Triptan sensations’

e.g. tingling, heat, tightness (throat and chest), heaviness and pressure

81
Q

Contraindications to triptans

A

patients with a history of, or significant risk factors for, ischaemic heart disease or cerebrovascular disease

82
Q

Medication for acute seizure management

A

Rectal diazepam (10-20mg in adults, max 30 mg.)

83
Q

What is visual agnosia

A

Person can see but cannot recognise or interpret visual information due to a disorder in the parietal lobes

84
Q

Which vessel is involved in a stroke which would cause “locked in syndrome”

A

basilar artery

85
Q

What is cataplexy?

A

Sudden and transient loss of muscular tone caused by strong emotion (e.g. laughter, being frightened)
Features range from buckling knees to collapse

86
Q

Management of Bell’s palsy

A

Prednisolone 1mg/kg for 10 days should be prescribed for patients within 72 hours of onset of Bell’s palsy
Eye care is important - prescription of artificial tears and eye lubricants should be considered

87
Q

Blood pressure and ACUTE stroke management?

A

Elevated blood pressure should not be treated in the acute phase following a stroke (unless complications develop e.g. hypertensive encephalopathy)

Make sure you treat things like blood glucose, oxygen sats, temp etc first

88
Q

Causes of bilateral facial nerve palsy

A
  • Sarcoidosis
  • Guillain Barre
  • Polio, Lyme disease
89
Q

Difference between LMN and UMN lesions of the face?

A

UMN lesions “spare” the upper face i.e. forhead

LMN lesions affect all facial muscles

90
Q

Medication which should be prescribed for someone who is being discharged home who had a stroke

A

Clopidogrel and a statin

91
Q

How does sodium valproate work?

A

Increases GABA activity

92
Q

When should you give prophylaxis for migraine?

A

When pt is experiencing 2 or more attacks per month

93
Q

Side effects of metoclopramide in children and young adults?

A

Extra-pyramidal side effects

94
Q

What is Shy-Drager Syndrome?

A

A type of multiple system atrophy:

  • parkinsonism
  • autonomic features (atonic bladder, postural hypotension)
  • cerebellar signs
95
Q

Which medication can exacerbate absence seizures?

A

Carbamazepine

96
Q

Selegiline mechanism of action

A

MAO-B inhibitor

-inhibits breakdown of dopamine secreted by the dopaminergic neurones

97
Q

Anti-muscarinics and parkinsons?

A

Now used more to treat drug-induced parkinsonism rather than idiopathic parkinson’s disease

98
Q

Name 2 epilepsy medications that are P450 enzyme inducers

A

Carbamazepine

Phenytoin

99
Q

This epilepsy medication can cause agranulocytosis

A

Carbamazepine

100
Q

This epilepsy medication can cause SIADH

A

Carbamazepine

101
Q

This epilepsy medication can cause gingival hyperplasia

A

Phenytoin

102
Q

This epilepsy medication can cause coarsening of facial features

A

Phenytoin

103
Q

A 23-year-old woman is referred to the neurology clinic after developing a unilateral hand tremor. Over the past 12 months her family report changes in her behaviour and mood associated with some speech problems. On examination a tremor is noted in the right-hand at rest. There also appears to be paucity of movement and some bradykinesia. Dark circular marks are also noted around the iris. The patient reports that her uncle died of liver cirrhosis at the age of 40 years. What is the most likely diagnosis?

A

Wilson’s disease

104
Q

Wilson’s inheritence

A

Autosomal recessive

105
Q

Onset of Wilson’s disease symtposm

A

Between 10 and 25

106
Q

Features of Wilson’s disease

A

Features result from excessive copper deposition in the tissues, especially the brain, liver and cornea:
liver: hepatitis, cirrhosis
neurological: basal ganglia degeneration, speech and behavioural problems are often the first manifestations. Also: asterixis, chorea, dementia
Kayser-Fleischer rings
renal tubular acidosis (esp. Fanconi syndrome)
haemolysis
blue nails

107
Q

Diagnosis of Wilson’s disease

A

Reduced serum caeruloplamsmin

Increased 24hr urinary copper excretion

108
Q

Management of Wilson’s disease

A

Penicillamine (chelates copper)

109
Q

Patients with sub-arachnoid haemorrhage may suffer from cerebral vasospasm, how can you minimise the chances of this?

A

Prescribe a calcium channel blocker e.g. Nimodopine

110
Q

Why don’t you want to decrease blood pressure acutely following a stroke?

A

Because higher blood pressure may be required to drive the same cerebral perfusion pressure

111
Q

Ptosis + dilated pupil

A

Third nerve palsy

112
Q

Ptosis + miosis

A

Horner’s syndrome

113
Q

Which features are more common in children with migraines?

A

GI disturbance (nausea, vomiting, abdominal pain)

114
Q

Most likely congenital heart defects to be found in adulthood

A

Atrial septal defects
(two types are recognised: ostium secundum and ostium primum)

Ostium secundum is the most common

115
Q

Features of ASD

A

Ejection systolic murmur, fixed splitting of S2

-Embolism may pass from the venous system to the left side of the heart causing a stroke

116
Q

Most common ASD?

A

Ostium secundum

associated with Holt-Oram syndrome

117
Q

ECG findings of ostium secundum

A

RBBB with right axis deviation

118
Q

How is Ostium primum different from ostium secundum?

A
  • usually presents earlier than ostium secundum
  • associated with abnormal AV valves
  • ECG: RBBB with LEFT axis deviation, PROLONGED PR interval
119
Q

ECG findings ostium primum?

A
  • RBBB with LEFT axis deviation

- prolonger PR interval

120
Q

What is conveyed in the dorsal column?

A

Fine touch, vibration and proprioception

121
Q

Which part of the spinal cord does poliomyelitis affect?

A

Affects anterior horns, resulting in lower motor neurone signs

122
Q

Which tracts are affected in subacute degeneration of the cord and what symptoms does this result in?

A
  • Lateral corticospinal tracts
  • Dorsal columns
  • Spinocerebellar tracts

=bilateral spastic paresis

  • bilateral loss of proprioception and vibration sensation
  • Bilateral limb ataxia
123
Q
  1. Bilateral spastic paresis
  2. Bilateral loss of proprioception and vibration sensation
  3. Bilateral limb ataxia
A

Subacute degeneration of the cord

124
Q

Which deficiencies result in subacute degeneration of the cord?

A

Vitamin B12 and E

125
Q

Which tracts are affected in neurosyphilis?

A

Dorsal columns

-loss of vibration and proprioception sensation

126
Q

Most common type of MS?

A

Relapsing remitting

127
Q

Percentage of people with relapsing-remitting MS who go on to develop secondary progressive MS?

A

About 65%

128
Q

Drugs used in acute relapse of MS

A

High dose steroids

129
Q

Drug used to prevent relapses and new lesion formation in MS

A

High dose steroids

130
Q

What is natalizumab? (MS)

A

A monoclonal antibody (prevents white blood cells crossing the BBB where I guess they would cause damage/inflammation or something)

131
Q

Treatment for fatigue in MS?

A

Mindfulness training, CBT

132
Q

Treatment for spasticity in MS?

A

Baclofen and gabapentin are first line
Physiotherapy is important
Cannabis and botox are undergoing evaluation

133
Q

Treatment for Oscillopsia (visual fields appear to oscillate)

A

Gabapentin

134
Q

Treatment for bladder dysfunction in MS?

A

Intermittent self catheterisation/anticholinergics

Bladder dysfunction
may take the form of urgency, incontinence, overflow etc
guidelines stress the importance of getting an ultrasound first to assess bladder emptying - anticholinergics may worsen symptoms in some patients
if significant residual volume → intermittent self-catheterisation
if no significant residual volume → anticholinergics may improve urinary frequency

135
Q

Side effects of dopamine agonists e.g. bromocriptine/cabergoline

A
  • pulmonary fibrosis, retroperitoneal and cardiac fibrosis
  • impulse control disorders
  • excessive daytime somnolence
136
Q

Side effects of Levodopa

A 
Movement disorders
Palpitations
Postural hypotension
Dry mouth
Anorexia
Psychosis
Drowsiness
137
Q

Side effects of Amantadine

A 
Ataxia
Slurred speech
Livedo reticularis
Confusion
Drowsniess
Dizziness
138
Q

What does anticipation mean in genetics counselling?

A

Anticipation = earlier onset of disease

139
Q

Give an example of a disease which shows anticipation?

A

Huntington’s (anticipation in trinucleotide repeat disorders - earlier onset in successive generations)

Fragile X
Myotonic dystrophy
Spinobulbar muscular atrophy

140
Q

Someone with parkinson’s has bad nausea, what drug could you give them?

A

Domperidone
-domperidone doesn’t cross the BBB so does not cause extra-pyramidal side effects

(do not give metoclopramide!!! it causes parkinson’s)

141
Q

Drugs which could cause parkinson’s

A

Metoclopramide
Haloperidol
Chlorpromazine

142
Q

Why can you give domperidone for nause in parkinson’s?

A

Doesn’t cross BBB so doesn’t cause extra-pyramidal side effects

143
Q

What is syringomyelia and which tracts are affected?

A

a chronic progressive disease in which longitudinal cavities form in the cervical region of the spinal cord. This characteristically results in wasting of the muscles in the hands and a loss of sensation

Ventral horn and lateral spinothalamic horns affected
(cyst forms in the spinal cord)
Also seen in Horner syndrome

144
Q

When can you stop your anti-epileptic medication?

A

If you have been seziure free for >2 years

-stop the medication over 2-3 months

145
Q

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

A

Temporal arteritis

146
Q

What is Lehrmitte’s sign?

A

When you flex your neck and you get tingling in your hands

  • indicated disease near the dorsal column of the spinal cord
  • also seen in cervical stenosis and subacute degeneration of the cord
147
Q

A 23-year-old man is admitted following the sudden onset of an occipital headache. On examination GCS is 15/15, neurological examination is unremarkable but neck stiffness is noted. A subarachnoid haemorrhage is suspected but the CT scan is normal. At what time should a lumbar puncture be done to exclude the diagnosis?

A

12 hours

148
Q

A 24-year-old woman with Charcot-Marie-Tooth disease (type 1) asks how likely it is that any future children will have the disease. What is the most accurate answer?

A

50%

149
Q

When do features of charcot marie tooth usually appear?

A

Appear at puberty:

  • motor symptoms predominate
  • FOOT DROP and LEG WEAKNESS are often the first features
  • distal muscle weakness, high arches, clawed toes
150
Q

A 67-year-old man is reviewed in the neurology clinic due to concerns about increasing clumsiness. Examination reveals an ataxic gait and increased upper limb tone with cog-wheel rigidity. Blood pressure is 135/80 lying and 95/70 standing. What is the most likely diagnosis?

A

Multiple System Atrophy

151
Q

First line treatment for neuropathic pain

A

Amitryptiline, pregabalin, gabapentin, duloxetine

152
Q

First line treatment for trigeminal neuralgia

A

Carbamazepine

153
Q

First line for MS spasticity

A

Baclofen and gabapentin

154
Q

Adverse effects of triptans

A

‘triptan sensations’

Tingling, heat, tightness (e.g. throat and chest), heaviness, pressure

155
Q

Contraindications to triptans

A

Patients with a history of/signifcant risk factors for ischemic heart disease or cerebrovascular disease

156
Q

Migraine and pregnancy

A

1st line: paracetemol

2nd line: aspirin/ibuprofen (can be used in 1st and 2nd trimester)

157
Q

Migraine and menstruation

A

Mefanamic acid or combination of aspirin, paracetemol and caffeine
Triptans are also recommended in the acute situation

158
Q

Which type of dementia is extremely sensitive to neuroleptic agents (anti-psychotic drugs)?

A

Lewy Body dementia

159
Q

Why should you avoid neuroleptics in Lewy body dementia?

A

Patients are extremely sensitive and may develop irreversible parkinsonism

160
Q

Features of Lewy Body dementia

A
  • progressive cognitive impairment
  • parkinsonism
  • visual hallucinations (other features such as delusions and non-visual hallucinations may be seen)
161
Q

Difference between drug induced PD and PD?

A

Rigidity and rest tremor are uncommon in drug induced parkinsonism

162
Q

Causes of bilateral facial nerve palsy?

A

Sarcoidosis
Guillain-Barre syndrome
Polio
Lyme disease

163
Q

What group of people are most likely to get cluster headaches?

A

Men (5:1) and smokers

164
Q

Long term preventative management of cluster headaches

A

Verapamil

165
Q

First line treatment for a migraine?

A

Offer a combination of oral triptan and an NSAID (or an oral triptan and paracetemol)

166
Q

Migraine prophylaxis?

A

Topiramate or propanolol (propanolol favoured in women of child-bearing age)

167
Q

What makes an essential tremor worse/better?

A

Worse when arms are outstretched

Better by alcohol and propanolol

168
Q

Treatment for essential tremor?

A

Propanolol

169
Q

Which bacteria is most strongly associated with the development of Guillain-Barre syndrome?

A

Campylobacter jejuni

170
Q

Normal pressure hydrocephalus imaging

A

Enlarged 4th ventricles

171
Q

Management of normal pressure hydrocephalus

A

Ventriculoperitoneal shunting

172
Q

NF II has a defect on which chromosome?

A

22

173
Q

NF I, which chromosome has a defect?

A

17

174
Q

Von Hippel Lindau, which chromosome has a defect?

A

3

175
Q

Tuberose sclerosis, which chromosome has defect?

A

16

176
Q

Treatment for restless legs syndrome?

A

Dopamine agonists such as ROPINIROLE

177
Q

Medication for tremor in drug induced PD tremor?

A

Procyclidine (an antimuscarinic)

178
Q

Role of antimuscarinics in parkinsons disease?

A

Now used for drug-induced PD rather than idiopathic

179
Q

Management of MND

A
  • Riluzole (used mainly in ALS, prolongs life by about 3 months)
  • Respiratory care (non-invasive ventilation at night, survival benefit of about 7 months)
180
Q

You are 3 times more likely to develop Bell’s palsy if ____

A

If you are pregnant!!

181
Q

Treatment for Bell’s palsy?

A

NICE recommend prednisolone 1mg/kg for 10 days for patients who present within 72 hours of onset

182
Q

When can you give thrombolysis for stroke?

A
  • when haemorrhagic stroke has been excluded

- within 4.5 hours of onset of stroke symptoms

Neurology (56 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions