26.5.2013(Neurology) 18 Flashcards
(128 cards)
0
Q
MRI is contraindicated in
A
Bone growth stimulators McGee stapedectomy piston prosthesis Omniphase penile implant Swan ganz catheter Tattooed eyeliner
1
Q
Channel involved in familial hemiplegic migrane
A
Ca
Na
2
Q
Channelopathies involving Ca++ channel
A
Hypokalemic periodic paralysis Familial hemiplegic migrane type 1 SCA 6 Episodic ataxia 2 Cerebellar ataxia Lambert eaton syndrome
Hippo Families have 6th Sense 2 Attack Cattles
3
Q
Cl- channelopathy
A
Myotonia congenita
Mayo Clinic
4
Q
Na+ Channelopathies
A
Paramyotonia congenita
Hyperkalemic periodic paralysis
familial Hemiplegic migrane 2
Generalised epilepsy with febrile convulsions
PNH
5
Q
Most common intracranial bleed
A
Intraparenchymal hemorrhage
6
Q
Hemorrhage in non hypertensives,unusual areas
A
Neoplasm
Hemorrhagic disorders
AV malformation
7
Q
Blood pressure to be reached in intraparenchymal hemorrhages
A
<130mm of Hg
8
Q
Most common cause of CVA
A
Embolism
Artery to artery embolism(carotid)
9
Q
Most common cause of SAH
A
Trauma
10
Q
Second most common cause of SAH
A
Berry aneurysm
11
Q
Common locations of berry aneurysms
A
Terminal ICA
Middle cerebral artery bifurcation
Top of basilar artery
Most common: Anterior communicating artery,anterior cerebral artery communication
12
Q
Mycotic aneurysms
A
Septic emboli from IE
13
Q
Investigation of choice for SAH
A
NON CONTRAST CT
Obtained within 72 hours
14
Q
Second line investigation for SAH
A
LP
15
Q
Xanthochromia peaks at
A
48h
16
Q
Xanthochromia is due to
A
Bilirubin
17
Q
ECG changes in SAH
A
Prolonged QRS
increased QT interval
Peaked or deeply inverted symmetric T waves
18
Q
Lucid interval is seen in
A
EDH(characteristic)
SDH 1/3rd of pts
19
Q
Site of SDH
A
Frontotemporal region
20
Q
Which dangerous and why?
EDH OR SDH
A
EDH
arterial bleed
21
Q
Underlying brain injury is more common in
SDH OR EDH
A
SDH
22
Q
Causes for hemiballismus
A
Lesion in subthalamic nucleus
Non ketotic hyperosmolar coma
23
Q
Most common cause of delayed neurological deterioration in SAH at 1 week
A
Vasospasm
24
Complications of SAH
Vasospasm
Rebleed
Hyponatremia
Hydrocephalus
25
Cerebral salt wasting syndrome cause
BNP
| ANP
26
Lacunar syndromes
```
Pure motor hemiparesis
Pure sensory stroke
Ataxic hemiparesis
Dysarthria and clumsy hand syndrome
Sensorymotor stroke
```
27
Site of lesion in pure motor hemiparesis
Anterior 2/3 of post limb of internal capsule
28
Site of lesion in pure sensory stroke
Thalamus
29
Site of lesion in ataxic hemiparesis
Basis pontis
30
Site of lesion in clumsy hand,dysarthria syndrome
Genu of IC(corticobulbar fibres)
31
Cause of lacunar stroke
Lipohyalinosis of penetrating arteries
32
Size of lacunar stroke
3mm-2cm
33
A decrease in CBF to zero causes death in
4-10 min
34
CBF that causes infarction in an hour
<16-18ml/100g tissue per min
35
Triad of pontine stroke
Pinpoint pupil
Hyperpyrexia
Quadriparesis
36
Single most common finding in aphasic pts
Anomia
37
Type of aphasia common in
Head trauma
Met encephalopathy
Alzheimer's
Anomic aphasia
38
Artery involved in wernicke aphasia
M2 segment
| Inferior branch
39
Artery involved in broca aphasia
M2 segment
| Superior branch
40
Transcortical motor aphasia
Comprehension +
Repetition +
Naming -
Fluency -
41
Transcortical sensory aphasia
Comprehension -
Repetition +
Naming -
Fluency +
42
Isolation aphasia
Comprehension -
Repetition +
Naming -
Fluency -
Echolalia
43
Pure word deafness
Comprehension impaired for spoken language
Repetition -
Naming +
Fluency +
44
Pure alexia
Comprehension impaired only for reading
Repetition +
Naming +
Fluency +
45
Artery involved in global aphasia
MCA. Main trunk
46
Cause of transcortical motor aphasia
Infarct of ant watershed area
47
Cause of transcortical sensory aphasia
Infarct of post watershed area
48
Cause of alexia without agraphia
Lesion of splenium of carpus callosum
49
Cause of pure word deafness
Lesion of superior temporal gyrus
50
Gerstmann syndrome
```
Alexia
Agraphia
Acalclia
Finger Agnosia
Rt lt disorientation
```
51
Amino acids needed for carnitine synthesis
Lysine
Methionine
LEMON
52
Ipsilateral 3rd nerve palsy+contralateral hemiparesis
Weber syndrome
53
Wallenberg syndrome is caused by thrombosis of
VERTEBRAL artery
54
Golden hour of thrombolysis in stroke
<3 hrs
55
Nothnagel syndrome
Ipsilateral or B/L 3rd nerve palsy+ataxia
56
Parinaud syndrome
```
Convergence retraction nystagmus
Supranuclear Upward gaze palsy
Dilated pupil with light near dissociation
Lid retraction(collier sign)
Skew deviation
Spasm/paresis of accommodation
Defective convergence
```
57
Claude syndrome
Benedikt+Nothnagel
3rd nerve palsy
Contralateral ataxia
Rubral tremor
58
Free fatty acid is the preferred fuel for
Cardiac and RED muscle fibres
59
Most common organelle to undergo calcification
Mitochondria
60
Most common organ affected by metastatic calcification
Lung
61
Ca+ deposition in metastatic calcification in kidney occurs in
Basement membrane
62
Benedikt syndrome
3rd nerve palsy
Contralateral tremor
Hemiathetosis
Hemichorea
63
Millard gubler syndrome
7th nerve palsy
6th nerve palsy(not classically included)
Contralateral hemiparesis
64
Foville syndrome
7th nerve palsy
Lateral gaze palsy
Contralateral hemiparesis
65
Raymond syndrome
6th nerve palsy
| Contralateral hemiparesis
66
Wallenberg syndrome
```
Spinal nucleus of V nerve
Descending sympathetics
Inferior cerebellar peduncle
Vestibular nuclei
Nucleus ambigus
Lateral spinothalamic tract
NTS(nucleus tractus solitarius)
```
Rarely: nucleus gracilis,cuneatus,7th nerve nucleus
67
Dejerine syndrome
Medial medullary syndrome
CST
medial lemniscus
Hypoglossal nerve
68
Avellis syndrome
9
10
LST
69
Jackson syndrome
9
10
11
12
70
Schmidt syndrome
9
10
11
71
Cestan chenais syndrome
```
CST
medial lemniscus
ICP
sympathetics
9
10
```
72
Babinski nageotte syndrome
```
CST
ML
+/- 12
9
10
ICP
sympathetics
Spinal tract of 5
Tractus solitarius
```
73
Causes of CVT
```
Contraceptive use
Pregnancy
Postpartum period
IBD
Dehydration
Meningitis
Hypercoagulable states
```
74
Investigation of choice in CVT
MRV
75
Empty delta sign
CVT
76
Rx of CVT
I.V heparin
77
Moya maya disease involves
Large intracranial arteries
| Distal ICA,stem of ACA,MCA
78
In moya moya disease vascular inflammation is
Absent
79
Factors increasing 2,3-BPG
```
GH
T3 T4
Androgens
Alkalosis
Anemia
Chronic hypoxia
High altitude
Exercise
INOSINE
Dihydroxyacetone
Pyruvate
Phosphoenolpyruvate
Phosphate
```
80
CT scan criteria for thrombolysis
No acute bleed
| No Edema >1/3 of MCA territory
81
BP above which thrombolysis in stroke in CI
185/110mm of Hg despite Rx
82
Lab values CI stroke thrombolysis
Plt- 400
83
Contraindications for thrombolysis in stroke
```
Major surgery within 14 days
GI bleed in 21 days
Previous stroke or head trauma within 3 months
Previous hemorrhagic stroke
Recent MI
Rapidly improving symptoms
Minor stroke symptoms
Coma or stupor
```
84
Procedure to be avoided after thrombolysis in stroke
Urethral catheterisation(for 2hrs)
85
Painful cranial structures
```
Falx
Dural sinuses
Scalp
Middle meningeal artery
Proximal segments of large pial arteries
```
86
TPR in isotonic exercises
Decreases(opposite in isometric exercise)
87
Effect of sleep on migrane
Decreased
88
Types of migrane
```
Classical(with aura)
Common(without aura)
Migrane sine migrane- visual disturbance without headache
Ophthalmoplegic migrane- transient 3rd nerve palsy
Basilar migrane
Hemiplegic migrane
Focal migrane
Retinal migrane
```
89
Anticonvulsants used in prophylaxis of migrane
Valproate
Topiramate
Gabapentin
90
Prophylaxis of migrane
```
Betablockers
TCA
anticonvulsants
Methysergide,flunarizine
Pizotifen
```
91
Cluster headache is common in
Males(migrane in females)
92
Alcohol trigger is present in which headache
Cluster
93
Duration of attack of cluster headache
15-180 min
94
Cluster headache is associated with
Autonomic features
| Migrainous features
95
Abortive Rx of cluster headache
Sumatriptan injection
| Oxygen
96
Prophylaxis of cluster headache
Verapamil
Methysergide
Lithium
97
Non selective beta blockers
Propranolol
Timolol
Sotalol
Pindolol
Labetolol,carvedilol
98
postural control in absence seizures
Not impaired
99
Postictal confusion is not seen in
Absence seizures
100
Course of absence seizures
60-70% have spontaneous remission in adolescence
101
OCP failure occurs with concomitant use of all anti epileptics except
Valproate
102
Juvenile Myoclonic epilepsy is
| Focal or generalised
Generalised
103
Depression and suicide ideation is side effect of which anticonvulsant
Phenobarbitone
104
Rx for Lennox gestalt seizures
Lamotrigine(DOC)
Topiramate
Felbamate
Rufinamide
105
Anticonvulsants causing aplastic anemia
Carbamazepine
| Felbamate
106
Adverse effect of rufinamide
Cardiac conduction defect (QT prolongation)
107
Anticonvulsant with least drug interaction and side effects
Levetiracetam
108
Myoclonic seizures can be provoked by
Sleep deprivation
109
Triad of Lennox gastaut syndrome
1. mixture of seizure types
2. 3 Hz spike and dome pattern
3. Cognitive dysfunction
110
Most common disease associated with focal seizures with dyscognitive features
Mesial temporal epilepsy syndrome
111
Electrolyte abnormality associated with carbamazepine
Hyponatremia
112
Tremor is side effect of which anti epileptic
Valproate
113
Thrombocytopenia is seen in which anti epileptic
Valproate
114
Metabolic abnormality with valproate usage
Hyperammonemia
115
Edema is seen with which anti epileptic
Gabapentin
116
Hypohidrosis is caused by which anticonvulsants
Topiramate
| Zonisamide
117
Renal stones are caused by which anticonvulsants
Topiramate
| Zonisamide
118
Weightloss is caused by which anticonvulsant
Topiramate
| Felbamate
119
Glaucoma is caused by which anticonvulsant
Topiramate
120
Psychosis is the adverse effect of which anticonvulsant
Tiagabine
| Zonisamide
121
Anorexia is seen with which anticonvulsant
Clonazepam
| Zonisamide
122
Decreased libido is seen with which anticonvulsants
Phenobarbital
| Primadone
123
Adverse effect of lacosamide
PR interval prolongation
124
Anticonvulsants causing leukopenia
Rufinamide
Levetiracetam
Carbamazepine
125
Anticonvulsants causing hepatic failure
Felbamate
Valproate
Carbamazepine
126
Transient alopecia is side effect of which anticonvulsant
Valproate
127
Painless intracranial structures
```
Brain
Ependyma
Dura over convexities
Pia
Arachnoid
Choroid plexus
```
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