Neuro Flashcards Preview

Nick's MD2 > Neuro > Flashcards

Flashcards in Neuro Deck (62)
Loading flashcards...
1
Q

What are 2 signs and 2 symptoms of optic neuritis?

A

Pain on moving eye,
Loss of central vision,
Relative afferent pupillary defect
Papilloedema

2
Q

What pattern of weakness is expected in the upper limb with an UMN lesion?

A

Extensors weaker in the upper limb

3
Q

What pattern of weakness is expected in the lower limb with an UMN lesion?

A

Flexors weaker in the lower limb

4
Q

How do you calculate risk of stroke in AF?

A
CHADSVASC
CCF
HTN (140/90 or on treatment)
Age 75 or older (1 point)
DM
Stroke or TIA (2 points)
Vascular disease
Age 65-74 (1 point)
Sex category (f=1)
5
Q

What is the immediate management plan for meningitis?

A
1 blood cultures
2 dexamethasone
3 ceftriaxone + benzylpenicillin
4 (?CTB if needed)
5 LP
6
Q

What is the drug treatment of choice for generalised epilepsy?

A

Sodium valproate

7
Q

What is the drug treatment of choice for focal epilepsy?

A

Carbemazepine

8
Q

What is the most common type of brain tumour?

A

Astrocytoma

9
Q

What are 3 characteristic features from headache due to raised ICP?

A

Worse in the morning
Worse with coughing
Better after vomiting

10
Q

What is a surgical third nerve palsy?

A

Compression - parasymapthetic fibres more affected - dilated pupil (EOM intact)
Often due to PCom aneurysm

11
Q

What is a medical third nerve palsy?

A

Often due to diabetes - somatic motor fibres more affected - ophthalmoplegia (but pupillary reflex intact)

12
Q

Principles of treatment for an astrocytoma

A
  • dexamethasone
  • resection of as much of the tumour as safely possibly
  • adjuvant CTx and RTx therapy
13
Q

What is the typical pattern for a low grade glioma on T1 weighted MRI with contrast?

A

non enhancing mass with minimal mass effect

14
Q

Most common symptom of low grade glioma?

A

Seizures

15
Q

Principles of treatment of a low grade glioma

A
  • removal of as much as the tumour as safely possible

- defer RTx and CTx until tumour progression

16
Q

What are the 4 signs of Gerstmann syndrome?

A

dysgraphia/agraphia
dyscalculia/acalculia
finger agnosia
left-right disorientation

17
Q

which primary tumours commonly metastasise to the brain?

A

lung, breast, melanoma, kidney, GI

18
Q

principles of treatment of brain metastases

A
  • dexamethasone
  • If 1 met: surgery
  • for 1-3 mets: stereotactic radiotherapy
  • for multiple mets: whole brain RTx
19
Q

The level of sensory deficit tells you what about the level of injury?

A

the lowest possible level of injury (could be anywhere higher than this)

20
Q

most common cause of nerve root injury?

A

herniated intervertebral disk

21
Q

Claw hand implies a lesion of which nerve?

A

Ulnar

22
Q

Wrist drop implies a lesion of which nerve?

A

Radial

23
Q

Define oscillopsia

A

sensation that the visual world is moving

24
Q

What is the difference in presentation between peripheral and central nystagmus?

A

Peripheral - may not be seen unless you remove the fixation of the eye
Central - will see it all the time

25
Q

What does a positive head impulse test imply?

A

Vestibular involvement (not central)

26
Q

how do you diagnose myasthenia gravis?

A
  • tensilon test with short acting ACh antagonist (edrophonium)
  • blood test for autoantibodies -ACh R, MuSK
  • CT chest (for thymoma)
  • EMG studies
27
Q

treatment of myasthenia gravis

A

ACh antagonists
plasma exchange
IV immunoglobulin immunosuppression - steroids, azathioprine
thymectomy

28
Q

major diagnostic finding to diagnose myopathy

A

CK >1000

29
Q

treatment for encephalitis

A

Acyclovir

30
Q

safest seizure medication in pregnanct

A

Tegretol (carbamazepine)

31
Q

when is the greatest risk of rebleed of a subarachnoid haemorrhage?

A

First 24-48 hours

32
Q

What is a normal ICP?

A

10-15mmHg

33
Q

When grading power, what does 5 indicate?

A

5 normal power

34
Q

When grading power, what does 4 indicate?

A

4* active movement against gravity and resistance

35
Q

When grading power, what does 3 indicate?

A

3 active movement against gravity

36
Q

When grading power, what does 2 indicate?

A

2 active movement with gravity eliminated

37
Q

When grading power, what does 1 indicate?

A

1 flicker or trace of contraction

38
Q

When grading power, what does 0 indicate?

A

0 no contraction

39
Q

what is dysmetria?

A

overshooting (in finger-nose test)

40
Q

the head impulse test can help you differentiate between which two diagnoses

A

vestibular neuritis - head impulse test positive

posterior fossa stroke - head impulse test normal (when you have acute onset severe gait ataxia, nausea, vomiting, continuous)

41
Q

When grading reflexes, what does 0 indicate?

A

0 absent

42
Q

When grading reflexes, what does 1 indicate?

A

1+ hypoactive

43
Q

When grading reflexes, what does 2 indicate?

A

2+ normal

44
Q

When grading reflexes, what does 3 indicate?

A

3+ hyperactive without clonus

45
Q

When grading reflexes, what does 4 indicate?

A

4+ hyperactive with clonus

46
Q

Cerebral infarction typically shows which type of necrosis?

A

Licquefactive

47
Q

At what vertebral level does the spinal cord stop?

A

L1/2

48
Q

Erector spinae muscles:
How would you identify them by palpation?
What movements do they support?

A

Between spinous process and ribs

Extension/flexion of the back

49
Q

What is endangered with a fracture of the medial epicondyle of the elbow?

A

Ulnar nerve

50
Q

Hypometric saccades… where is the pathology?

A

Cerebellum

51
Q

GCS motor scale

A
6 Obeys commands
5 Localises to pain
4 Withdraws to pain
3 Abnormal flexion to pain
2 Abnormal extension to pain
1 No response
52
Q

GCS verbal scale

A
5 Oriented
4 Confused
3 Inappropriate words
2 Incomprehensible
1 No response
53
Q

GCS eye opening scale

A

4 Spontaneous
3 To voice
2 To pain
1 None

54
Q

Which action reliably tests the function of the ulnar nerve in the hand?

A

Finger abduction

55
Q

What is the sensory deficit with a lesion of the ulnar nerve at the wrist?

A

Palmar surface of the medial 1.5 fingers and palm

Dorsal 1.5 fingers are supplied by the posterior cutaneous branch that arises in the forearm

56
Q

Why is benzylpenicillin given in empirical treatment of meningitis?

A

To cover Listeria monocytogenes

57
Q

Acute management of ischaemic stroke

A

Alteplase (tPA) within 4.5 hours of onset

If >4.5 hours or tPA contraindicated, aspirin 150-300mg

58
Q

After how much time will blood appear isodense to brain on CT?

A

2 weeks

59
Q

What is the triad of Menierre’s disease?

A

1) Tinnitus
2) Vertigo
3) Hearinig loss

60
Q

What does the superior branch of the occulomotor nerve supply?

A

Superior rectus and levator palpebrae

61
Q

What does chadsvasc measure?

A

Risk of stroke from AF

62
Q

How do you differentiate vasogenic oedema from cytotoxic oedema on MRI?

A

Vasogenic oedema doesn’t cross border from grey matter to white matter