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Misc. Notes Year 3 > Year 4 Neuro document > Flashcards

Year 4 Neuro document Flashcards

1
Q

Exposure to which chemicals is associated with Parkinson’s disease

A

Pesticide

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2
Q

Which lifestyle habit is thought to be protective for Parkinson’s

A

Smoking??

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3
Q

Which neurones degenerate in Parkinsons disease

A

Dopaminergic neurones of the pars compacta substantia nigra

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4
Q

Is an idiopathic Parkinsons tremor typically symmetrical or asymmetrical

A

Asymmetrical

Suspect drug-induced parkinsonism if bilateral tremor

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5
Q

What is an expression to describe the facial expression of someone with Parkinsons disease

A

Mask-like face

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6
Q

What kind of sleep disorders are seen in Parksinson’s

A

REM sleep disorders

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7
Q

Which reduced special sense can be an early sign of Parkinson’s

A

Hyposmia

Reduced sense of smell

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8
Q

What is the Glabella tap and how will it present in Parkinson’s

A

Tapping on the forehead makes people stop blinking. Blinking will persist in Parkinson’s - Myerson’s sign of frontal release

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9
Q

What is the gold standard treatment of Parkinson’s

A

Levodopa + Carbidopa

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10
Q

Why might different classes of drugs be used in Parkinson’s

A

To delay the use of Levodopa until significant disability

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11
Q

What type of drug is Rasagiline

A

MAO-B inhibitor

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12
Q

What drug should you give for Levodopa associated nausea and why not use metoclopramide

A

Domperidone
Selective to peripheral dopamine receptors so wont prevent activity of levodopa in the brain (metoclopramide isn’t selective)

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13
Q

Which Parkinsons Plus Syndrome has a lack of a tremor and how does it present

A 
Progressive supranuclear palsy
Vertical gaze palsy.
Early postural instability and falls. 
Speech and swallowing problems. 
Symmetrical trunkal rigidity
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14
Q

What is the triad of Multi-System Atrophy

A

Parkinsonism
Autonomic Dysfunction
Cerebellar Dysfunction

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15
Q

What sign is seen on MRI in Multi-System Atrophy

A

Hot Cross Bun sign

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16
Q

Which disease affects the Nucleus Basilis of Meynert

A

Alzheimer’s Disease

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17
Q

Which genetic disease increases your chances of developing Alzheimer’s in the future

A

Down’s Syndrome

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18
Q

Hemiballism as a symptom suggests a lesion where in the brain

A

Subthalamic lesion

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19
Q

Which anti-epileptic drug can cause hyponatraemia

A

Carbamazepine

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20
Q

Which drug can be given for treatment of fatigue in MS

A

Amantidine

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21
Q

A defect in which artery will cause full paralysis except blinking and eye movement

A

Basilar artery

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22
Q

Anti-Musk and Anti-AchR antibodies are associated with which condition

A

Myasthenia Gravis

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23
Q

Which disease can present with renal and hepatic failure as well as Parkinsonism

A

Wilson’s Disease

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24
Q

How is a postural tremor different from a resting tremor

A

postural tremor is a tremor that is absent at rest, present on maintained posture such as holding arms out

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25
Q

What diseases can cause an intention tremor

A 
Cerebellar disease (MS, stroke, hemorrhage) 
Wilsons disease
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26
Q

What is dystonia

A

Involuntary, sustained muscle spasms that result in abnormal posturing and repetitive movements in the context of an associated tremor

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27
Q

What is chorea

A

Non rhythmical irregular purposeless movements that flit and flow from one body part to another

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28
Q

Huntington’s disease shows acceleration- what does this mean

A

Gets worse as it is passed down though the generations

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29
Q

Syndeman’s chorea can develop after what

A

Rheumatic fever

Strep throat infection

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30
Q

What is Myoclonus

A

Sudden, involuntary focal or generalised muscle jerks.

Myoclonus can be normal, with abnormal being defined by over 5 of these jerky movements

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31
Q

What is the median age of onset of MND

A

60

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32
Q

Which form of dementia does MND have a link to

A

Frontotemporal Dementia

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33
Q

How can the presentation of MND be differentiated from Myasthenia gravis

A

Doesn’t affect the eyes

Cogan Lid Twitch

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34
Q

What is the mechanism of action of Riluzole

A

Blocks glutamatergic neurotransmission in the CNS

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35
Q

Which connective tissue disease is Myasthenia associated with

A

SLE

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36
Q

Which common cardioprotective drug can worsen Myasthenia symptoms

A

Beta-Blockers

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37
Q

What is the mainstay of treatment for Myasthenia Gravis

A

Pyridostigmine

Anti-Cholinesterase

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38
Q

What is the mainstay of treatment for Lambert Eaton syndrome

A

3,4 - diaminopyridine

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39
Q

What is a Stokes Adams Attack

A

Transient arrhythmias causing reduced cardiac output and loss of consciousness.

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40
Q

What is a Jacksonian march

A

A frontal lobe seizure only occurs on one side of the body; it progresses in a predictable pattern from twitching or a tingling sensation or weakness in a finger, a big toe or the corner of the mouth, then marches over a few seconds to the entire hand, foot or facial muscles

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41
Q

A spike and wave pattern at 3HZ on an EEG suggest which type of seizure

A

Absence seizure

42
Q

Name a newer anti-convulsant which has the adverse effects of mood swings and depression

A

Levetiracetam

43
Q

Which anti-epileptic drug can cause Leucopenia

A

Carbamazepine

44
Q

What is non-epileptic attack disorder

A

Functional seizures that are largely mediated at the subconscious level and have a strong association with past trauma

45
Q

What is an unusual part of the MS epidemiology

A

More common in locations which are higher above sea level

46
Q

What is the diagnostic criteria for MS

A

Two episodes of symptoms suggestive of MS that last at least 1 hour and are at least 30 days apart as this shows dissemination in time and place

47
Q

Name 3 disease modifying drugs used 1st line for MS

A

Beta-interferon
Techfidera
Copaxone

48
Q

What is Mononeuritis Multiplex

A

When two mononeuropathies in distinct locations develop at the same time

49
Q

Which type of fungal meningitis is seen in HIV patients

A

Cryptococcal

50
Q

What is Kernig’s sign

A

Pain and resistance on passive extension of the knee with a flexed hip

51
Q

Which cells will be seen in CSF in Viral, Bacterial and Tb meningitis respectively

A

Viral and TB - Lymphocytes

Bacterial - Neutrophils

52
Q

What is the contact prophylaxis regime for meningitis

A

Rifampicin 4 doses

Ciprofloxacin 1 dose

53
Q

Bilateral temporal lobe oedema or bilateral temporal focal enhancement on MRI suggests what

A

Herpes Simplex encephalitis

54
Q

What causes Progressive multifocal leukoencephalopathy

A

JC virus infection

55
Q

The use of which drug increases risk of JC virus activation

A

Tysabari (MS 2nd line)

56
Q

What is the mechanism of action of triptans

A

5HT (serotonin) agonists

57
Q

How many times should triptan use be limited to, per week, and why

A

Shouldn’t be taken more than twice a week as patient can become dependent and experience rebound headaches.

58
Q

Which gender is Trigeminal Neuralgia more common in and what is the 1st line treatment

A

More common in Men

Carbamazepine

59
Q

What are the two peak ages on onset of Narcolepsy

A

15 and 36??

60
Q

Which arteries are affected in Total Anterior Circulation Syndrome

A

Blockage of both anterior and middle cerebral arteries

61
Q

Which arteries are affected in Partial Anterior Circulation Syndrome

A

Blockage of one of anterior or middle cerebral arteries

62
Q

Which arteries are affected in Posterior Circulation Syndrome

A

Posterior circulation stroke involving vertebral basilar arteries

63
Q

Which arteries are affected in Lacunar Stroke

A

Multiple small vessel infarcts in basal ganglia and thalamus.

64
Q

What is the timescale within which you can offer thrombolysis to a stroke patient

A

<4.5 hours

65
Q

What should you do if someone presents with a stroke after 4.5hours of onset

A

300mg aspirin

continued for at least 14 days

66
Q

What is the most common cause of Sub-Arachnoid Hemorrhage

A

Rupture of berry aneurysms

67
Q

When do berry aneurysms rupture

A

When they grow greater than 6mm

68
Q

Which 3 disease are associated with the development of berry aneurysms

A

Polycystic Kidney Disease
Coarction of aorta
Ehlers Danlos syndrome

69
Q

What are Charcot-Bouchard aneurysms

A

Micro-aneursyms associated with chronic hypertension

Most commonly occur within basal ganglia

70
Q

Rupture of Charcot-Bouchard aneurysms leads to what

A

Intracerebral haemorrhage

71
Q

Which chemical imbalance can occur after a sub-arachnoid haemorrhage

A

Hyponatraemia

72
Q

Which drug is given to patients following a sub-arachnoid haemorrhage to prevent Delayed Ischaemic Neurological Deficits

A

Nimodipine

73
Q

What type of haemorrhage is associated with fluctuating consciousness and insidious mental/physical slowing

A

Subdural

74
Q

What type of haemorrhage is associated with a head injury followed by a lucid period

A

Extradural

75
Q

What is the most common cause of an extradural haemorrhage

A

Temporal bone fracture

76
Q

What is the most common type of primary brain tumour

A

Astrocytoma (glioma)

77
Q

What is another name for a grade 4 astrocytoma

A

Glioblastoma Multiforme

78
Q

Which tumour is described as having a toothpaste-like morphology

A

Oligodendroma

79
Q

Which malignant tumour of the cerebellum is almost exclusively seen in children

A

Medulloblastoma

80
Q

Which therapy are oligodendromas very sensitive to

A

Chemotherapy

81
Q

Glioblastoma multiforme is sensitive to which drug

A

Temozolomide

82
Q

How is cerebral perfusion pressure calculated

A

MAP - ICP

83
Q

Which type of herniation will present as lower limb weakness

A

Subfalcine

frontal lobe under falx cerebri

84
Q

Which type of herniation will present as ipsilateral 3rd nerve palsy

A

Uncal

Temporal lobe under tentorium cerebelli

85
Q

What is the most common cause of painful 3rd nerve palsy

A

Posterior communicating artery aneurysm

86
Q

Which type of herniation will present as ataxia, 6th nerve palsy and UMN sign

A

Tonsillar

Herniation of the cerebellar tonsils through the foramen magnum

87
Q

What is the triad of normal pressure hydrocephalus

A

Ataxia
Dementia
Urinary incontinence

88
Q

Which spinal tracts are affected in Central Cord Syndrome

A

Corticospinal –> as it lies medially

Spinothalamic –> as the fibres have to cross the ischaemic zone

89
Q

Which gene is associated with MS

A

HLA-DR2

90
Q

How does internuclear ophthalmoplegia present

A

Failure to adduct with nystagmus in other eye

91
Q

Which neural cells undergo gliosis

A

Astrocytes

hyperplasia and hypertrophy

92
Q

What colour are acute MS plaques

A

Yellow/brown

93
Q

What colour are chronic inactive MS plaques

A

Grey

94
Q

What are the two ages in which incidences of Myasthenia Gravis peak

A

Females in the 3rd decade

Males in the 6/7th decade

95
Q

Alzeheimer’s disease causes a loss of cholinergic neurons where in the brain in particular

A

Nucleus basalis of Meynert

96
Q

Which two proteins make up Lewy bodies and which one can be detected by immunochemical staining

A

Alpha- synuclein

Ubiquitin (staining)

97
Q

What is the greatest risk factor for Parkinson’s

A

Age

98
Q

Which drug treatment for Parkinon’s can cause pathological gambling and hyper-sexuality

A

Dopamine Agonists

99
Q

Which chromosome has the abnormality leading to Huntington’s

A

Chromosome 4

100
Q

Which basal ganglion atrophies in Huntington’s

A

Caudate Nucleus

101
Q

What causes xanthochromia in the context of sub-arachnoid haemorrhage

A

Yellow discolouration of CSF indicating presence of bilirubin breakdown

102
Q

Asides from giving Nimodipine, how else can you prevent Delayed Ischaemic Deficit following sub-arachnoid haemorrhage

A

triple H therapy – hypervolaemia, hypertension, haemodilution

Misc. Notes Year 3 (25 decks)

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