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Neurology > Year 4 > Flashcards

Year 4 Flashcards

1
Q

What is thoracic outlet syndrome?

A

A condition caused by compression of the brachial plexus, subclavian artery or subclavian vein at the thoracic outlet.

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2
Q

Does thoracic outlet syndrome typically cause neurogenic or vascular symptoms?

A

Neurogenic

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3
Q

How are the GCS points broken down into the 3 main groupings?

A

Motor = 6
Verbal = 5
Eyes = 4

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4
Q

What does a worsening headache despite dosage of opiate being increased suggest?

A

Medication overuse headache

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5
Q

A lesion of which nerve produces weakness of foot dorsiflexion and eversion, alongside reduced sensation on the dorsum of the foot?

A

Common peroneal nerve

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6
Q

Which antibodies are seen in myasthenia gravis?

A

Anti-acetylcholine receptor antibodies

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7
Q

What do pinpoint pupils suggest in stroke?

A

The pons is the site of the injury.

May also be present in an opiate overdose.

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8
Q

What is Cushing’s reflex?

A

The physiological response to raised ICP.

Causes 2 key findings -
Hypertension
Bradycardia

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9
Q

Which nerve is responsible for thumb opposition?

A

Median nerve

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10
Q

What nerve roots are injured in Klumpke’s palsy?

A

C8 + T1

Presents with weakness of the intrinsic muscles of the hand, flexors of the wrist, and flexors of the fingers.

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11
Q

Which palsy presents with a claw hand?

A

Klumpke’s palsy

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12
Q

How should different opiates be given in seizure?

A

Midazolam - mouth
Lorazepam - line (IV)
Diazepam - down below (PR)

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13
Q

Which anti-emetic is given for radiotherapy induced nausea and vomiting?

A

Ondansetron

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14
Q

Haloperidol is given for what forms of nausea and vomiting?

A

Those caused by a brain tumor, or due to raised ICP.

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15
Q

Which anti-emetic is advised in those with vestibular nausea and vomiting?

A

Prochlorperazine

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16
Q

Which anti-emetic is given in GI-related nausea and vomiting?

A

Metoclopramide

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17
Q

A palsy of which cranial nerve produces horizontal diplopia?

A

CNVI (abducens)

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18
Q

Which nerve palsy is suspected in those with a ‘down and out’ eye?

A

CNIII

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19
Q

Palsy of which nerve produces a foot drop?

A

Common peroneal nerve

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20
Q

What condition that produces severe unilateral headaches, may also be accompanied by autonomic features?

A

Paroxysmal hemicrania

Treat with indomethacin

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21
Q

What is subacute degeneration of the spinal cord?

A

Vitamin B12 deficiency which results in impaired function of the dorsal columns, lateral corticospinal tracts and spinocerebellar tracts.

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22
Q

What should a headache linked to valsalva maneouvre raise suspicion of?

A

Raised ICP

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23
Q

Which drugs should be stopped abruptly in medication overuse headache?

A

Paracetamol
NSAIDs
Triptans

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24
Q

In medication-overuse headache, can opiates be withdrawn abruptly?

A

No, taper off over a prolonged period.

25
Q

Alongside steroids, what should be given in Bell’s palsy?

A

Eye drops and eyecare advice.

26
Q

The movement of which muscles is typically spared in motor neurone disease?

A

Ocular muscles

27
Q

Palsy of which nerve results in vertical diplopia?

A

CNIV (trochlear nerve)

28
Q

What is dysarthia?

A

The impairment of phonation secondary to muscular weakness.

29
Q

Why is Alzheimer’s more common in Down’s Syndrome?

A

As the gene responsible for the condition is found on chromosome 21 - hence, trisomy increases risk.

30
Q

Which nerve is tested on protrusion of the tongue?

A

Hypoglossal nerve (CNXII)

31
Q

What does injury to Wernicke’s area result in?

A

Issues comprehending language.

Also known as a receptive aphasia.

32
Q

What does injury to Broca’s area result in?

A

Impaired ability to produce language.

Also known as an expressive aphasia.

33
Q

What function is predominately controlled by the dominant hemisphere?

A

Language

34
Q

Which 3 spinal tracts are ascending?

A

DCML
Spinothalamic
Spinocerebellar

35
Q

Does the gracillus or cuneate tract of DCML supply below T6?

A

Gracillus

This is found medially.

36
Q

Where is deeper meaning of sensation derived?

A

Posterior parietal complex

37
Q

How is MND diagnosed?

A

It is a clinical diagnosis

38
Q

How does transient global amnesia present?

A

Abrupt onset anterograde amnesia, followed by retrograde amnesia.

Cannot lay down new memories from onset.

39
Q

How long does transient global amnesia last?

A

A few hours

Usually a one-off caused by emotion/temperature change.

40
Q

What area of brain is involved in transient global amnesia?

A

Hippocampus

This is where short-term memories are stored.

41
Q

Transient epileptic amnesia is associated with which form of seizures?

A

Temporal lobe epilepsy

42
Q

What should be excluded in a patient presenting with memory issues?

A

Mood disorder

43
Q

What is the most common form of prion disease?

A

Creutzfeldt-Jakob disease

44
Q

What is BSE?

A

Bovine spongiform encephalopathy - a form of CJD, previously known as ‘Mad Cow’ disease.

45
Q

What are common features presenting in Alzheimer’s disease?

A

Apraxia
Forgetfullness

46
Q

Which form of dementia may be associated with visual hallucinations?

A

Lewy body dementia

47
Q

What treatment is used in Alzheimer’s disease?

A

Any therapies which increase acetylcholine levels.

Two forms of this include cholinesterase inhibitors and NDMA receptor blockers.

48
Q

What MUST be present for vascular dementia to be diagnosed?

A

A clear relation between vascular disease and the onset of demential symptoms.

49
Q

What is a DATscan used for?

A

Determining dopamine activity within the brain.
Used in PD and DwLB.

50
Q

What is Cushing’s reflex?

A

Raised systolic BP, reduced HR.

Associated with raised ICP.

51
Q

How does brain surgery impact driving?

A

DVLA needs to be informed.
Cannot drive for 1 year.

52
Q

What does a headache that wakes the patient with nausea and vomiting suggest?

A

CNS tumor

53
Q

Why is LP avoided if signs of raised ICP present?

A

As may lead to herniation of brain tissue.

54
Q

Why should those with raised ICP be kept in bed at 30-45degrees incline?

A

To facilitate venous return

55
Q

What management options exist for IIH?

A

Weight loss +/- bariatric surgery
Carbo-anhydrase inhibitors
Diuretics

56
Q

Which anaesthetic sedative is used in raised ICP?

A

Propofol

57
Q

What should be lowered in raised ICP?

A

CO2 levels

Aim for 4-5kPa. This produces cerebral vasoconstriction, lowering ICP.

58
Q

Can bacterial meningitis present WITHOUT the petechial rash?

A

Yes, it is not common for rash to be present.

59
Q
A

Neurology (22 decks)

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