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Flashcards in clinical 6 Deck (100)
1

uses iodine as contrast

CT

2

better for bone

CT

3

Better for soft tissue

MRI

4

T1 hyper intense MRI shows up what

fat and 4 'M's':

- Methemoglobin (subacute hematoma)
- Mineral deposition (Ca, Mg, Mn, etc.)
- Melanin (melanoma)
- “Mush” (highly proteinaceous fluid)

5

different types of T1

hyperintense (bright)
hyopintense (dark)

6

contrast in T1 hyperintense

gadolinium

7

T1 hypo intense will show what

air
cortical bone
high flow: arterial 'flow voids'

8

T2 hyperintense will show up what

water (so more water than tissue)

9

what pathology willa T2 hyper intense show up

oedema, demyelination, fluid collection, some tumours

10

where do you get muscle weakness in duchesses

pelvic and shoulder girdle

11

milder form of duchennes

beckers

12

gene affected in duchennes

dystrophin (deficiency)

13

what has happened to dystrophin gene in duchennes

large scale deletion

14

what will bloods show in duchenes

raise creatine kinase

15

2 signs of duchenes

towers sign
toe walking

16

what will be seen on biopsy of huntinftons brain (macroscopic)

caudate atrophy

17

CAG encodes for what

glutamate

18

chromosome involved in alzheimers that

21

19

plaques in alzheimers had up of what

amyloid beta proteins

20

what other genetic condition associated with alzhimers and why

down syndrome coz gene that encodes for Amyloid precursor protein in on chromo 21 r

21

other than APP mutation, what other genes and chromosomes can cause alzheimers

presenilin 1 (chromo 14)
presenilin 2 (chromos 1)

22

2 chromosomes invloed in alzheimers

1, 14, 21

23

what are triptans

5-HT (1B/1D) agonists

24

what do triptans do

- constrict arteries
- inhibit release of substance P and pro inflamm neuropeptides
- blocks transmission of trigeminal nerve to 2nd order neurones

25

triptans are used to treat

migraine, cluster headaches, subarchnoid heammorhages

26

dorsal column senses

vibration, fine touch and proprioception

27

what is 'dissociated sensory loss'

pattern of neurological damage caused by lesion to a single tract in spinal cord which involves loss of fine touch and proprioception but with out loss of pain and temperature (or vice versa)

28

loss of pain and temperature indicates lesion where

lateral spinothlamic tract

29

in lateral spinothalamic lesions why will you lose sensation of pain and temperature at level of spine but not sensory loss to dermatome

tract of lissauer transmits one or two levels up from lesion, thus bypassing lesion

30

cord hemisection is called

brown-sequard syndrome

31

pyramidal tract include

lateral and anterior corticospinal tracts

32

dorsal column also called

medial lemniscus system

33

2 parts of dorsal column

gracile (most medial)
cuneate (more lateral)

34

what will cause both UMN and LMN symptoms (be specific with answer)

Amyotrophic lateral sclerosis (motor neuron disease)

35

poliomyelitis affect which part of CNS

anterior horn = LMN signs

36

UMN or LMN in polio

LMN

37

Brown-Sequard syndrome: tracts affected

1. Lateral corticospinal tract
2. Dorsal columns
3. Lateral spinothalamic tract

38

Brown-Sequard syndrome will show

1. Ipsilateral spastic paresis below lesion (lateral corticospinal tract)
2. Ipsilateral loss of proprioception and vibration sensation (dorsal column)
3. Contralateral loss of pain and temperature sensation (lateral spinothlamic tract)

39

Combination of motor, sensory and ataxia symptoms

MS

40

neurosyphilis is called

tabes dorsalis

41

tabes dorsalis affects what tract

dorsal column

42

tabes dorsalis symptoms

Loss of proprioception and vibration sensation (dorsal column)

43

faciculatiosn think?

motor neurone disease

44

role of nerve conduction studies in motor neurone disease

results will show normal conduction, therefore ruling out neuropathy and suggesting MND

45

Electromyography in motor neurone disease will show what

reduced number of action potentials with an increased amplitude

46

which features do you NOT get in motor neurone disease that differentiate if from poly neuropathy, MS and myasthenia gravis

- no ocular involvement
- no spinster involvement
- no sensory loss

47

which features will suggest motor neurone disease

- wasting of small muscle of hand
- UMN signs in legs
- LMN signs in arms

48

UMN lesion features

weakness
increased tone (velocity dependent)
hyperreflexia

49

LMN lesion features

wasting
fasciculations
hypotonia/flaccidity
reduced reflexes

50

what do fat ladies get that can cause headache and visual defect

idiopathic intracranial hypertension

51

drugs that can cause idiopathic intracranial hypertension (4)

steroids
tetracycline antibiotics
contraceptives
lithium

52

tuberous sclerosis inheritance

autosomal dominant

53

tuberous sclerosis or neurofibromatosis may present with seizures

tuberous sclerosis

54

axillary and groin freckles seen in

neurofibromatosis

55

ash leaf macule seen in

tuberous sclerosis

56

curtain descending over eye

amaurosis fugal

57

protocol if ABCD2 score 4+

300mg aspirin immediately
investigations within 24 hrs

58

protocol if ABCD2 score 3 or less

- specialist assessment within 1 week of symptom onset, including decision on brain imaging
- if vascular territory or pathology is uncertain, refer for brain imaging

59

given to patients who cannot tolerate clopidogrel

aspirin + dipyridamole

60

antithrombotic drug given post stroke

clopidogrel

61

how may "attacks" required to diagnose migraine

at least 5

62

criteria for migraine diagnosis

- Minimum of 5 attacks
- Headache attacks lasting 4-72 hours with nausea/vomitong or photophobia/phonophobia
- Plus at least 2 of:
1. unilateral location*
2. pulsating quality (i.e., varying with the heartbeat)
3. moderate or severe pain intensity
4. aggravation by or causing avoidance of routine physical activity

63

nerve an nerve root in tricep reflex

radial and C7

64

radial nerve arises from which levels

C5 - C8

65

waiters tip (erbs palsy) is due to damage where

upper brachial plexus C5-C6

66

when is waiters tip (erb palsy) common

shoulder dystocia in babies

67

internal rotation and extension of upper limb and

waiter tip (erb palsy)

68

Bromocriptine, ropinirole, cabergoline, apomorphine are

dopamine agonists

69

what must be given with L-dopa

decarboxylase inhibitor (e.g. carbidopa)

70

decarboxylase inhibitor (e.g. carbidopa) do what

prevent peripheral metabolism of levodopa to dopamine

71

dopamine agonist side effects

pulmonary, retroperitoneal and cardiac fibrosis

72

what is Selegiline

MAO-B (Monoamine Oxidase-B) inhibitors

73

MAO-B (Monoamine Oxidase-B) inhibitors do what

inhibits the breakdown of dopamine secreted by the dopaminergic neurons

74

what are Entacapone, tolcapone

COMT (Catechol-O-Methyl Transferase) inhibitors

75

COMT (Catechol-O-Methyl Transferase) inhibitors do what

COMT is an enzyme involved in the breakdown of dopamine, and hence may be used as an adjunct to levodopa therapy

76

Antimuscarinics block ______ receptors

cholinergic

77

nerve root for small toe

S1 = S for small one

78

nerve root for big toe

L5 = Largest of the 5 toes

79

nerve root for middle finger + palm of hand

C7

80

nerve root ring finger + pinky

C8

81

nerve root for knee caps

L4

82

nerv root for thumb and index

C5, C6

83

time off driving for TIA

1 month

84

time off driving for multiple TIAs over short period of time

3 months

85

time off driving for a single seizure without an epilepsy diagnosis

6 months

86

seizure with lip smacking

complex partial seizure

87

how do simple and complex partial seizure differ

in complex you lose consciousness/awareness

88

who can't you give triptans to

heart conditions

89

triptan are

5-HT agonists, vaso construction and reduce inflammatory peptide release

90

triptans used to treat what

migrane and cluster headaches

91

dose of diazepam give PR in adult having a prolonged fit

10 - 20mg max 30

92

Stroke: Contralateral hemiparesis and sensory loss, lower extremity > upper

Anterior cerebral artery

93

Stroke: Contralateral hemiparesis and sensory loss, upper extremity > lower
Contralateral homonymous hemianopia
Aphasia

Middle cerebral artery

94

Stroke: Contralateral homonymous hemianopia with macular sparing

Posterior cerebral artery

95

Stroke: Amaurosis fugax

retinal/opthalmic artery

96

Stroke: locked in syndrome

basillary artery

97

what is cataplexy

sudden and transient loss of muscular tone caused by strong emotion (e.g. laughter, being frightened)

98

bells palsy: forehead affected? UMN or LMN

yes forehead affected, LMN

99

treatment for bells palsy

prednisolone within 72 hours of onset, for 10 days

100

what nerve in unilateral 'high stepping gait'

peroneal nerve