DPD Amir Sam 4 Flashcards Preview

Year 3 DPD > DPD Amir Sam 4 > Flashcards

Flashcards in DPD Amir Sam 4 Deck (44)
Loading flashcards...
1

What are the associated symptoms you should ask for in a neuro history?

Top to toe:
Headache
Visual changes
Hearing changes
Swallowing changes
Neck stiffness
Limb weakness/paraesthesia
Bowels and bladder

2

What are the two things you should think about when taking a neuro history?

Anatomy and pathology

3

What are the different anatomical areas in which a lesion may occur?

Brain
Spinal cord
Nerve root
Peripheral nerve
Neuromuscular junction

4

How may a brain lesion present as a sensory defect?

Hemiparesis

5

How may a spinal cord lesion present as a sensory defect?

Paraparesis

6

How may a nerve root lesion present as a sensory defect?

Dermatomal paraesthesia

7

How may a peripheral nerve lesion present as a sensory defect?

Specific area/s (mono/polyneuropathy)

8

How may a NMJ lesion present as a sensory defect?

Generalised, systematic

9

What are the different pathologies that help differentiate a presentation?

Vascular
Infection
Inflammation/autoimmune
Toxic/metabolic
Tumour/metastases

10

What are the signs in the limbs of an upper motor lesion?

Spastic tone
Decreased power
Brisk reflexes
Upgoing plantars

11

What are the signs in the limbs of a lower motor lesion?

Flaccid tone
Decreased power
Decreased reflexes

12

What are the signs of cerebellar dysfunction?

DANISH
Dysdiodochokinesia
Ataxia
Nystagmus
Intention tremor
Staccato speech
Hypotonia/Heel-shin test positive

13

What type of lesion does a glove and stocking distribution imply?

Polyneuropathy

14

What is the management for diabetic neuropathy?

Duloxetine

15

What are the causes of peripheral neuropathy?

V DUA LIPA

Vit B12 deficiency
Diabetes
Uraemia
Alcohol
Low T4 (hypothyroidism)
Iatrogenic- drugs
Paraneoplasm
Amyloidosis (Hx of myeloma/chronif infx/inflammation)

16

What is the likely cause of a sudden loss of vision?

A. Amaurosis fugax
B. Anterior uveitis
C. Papilloedema
D. Papillitis
E. Vitreous haemorrhage

E. Vitreous haemorrhage

17

What is the likely diagnosis in a female with blurred vision who had limb paraesthesia 2 weeks ago?

A. Amaurosis fugax
B. Anterior uveitis
C. Papilloedema
D. Papillitis
E. Vitreous haemorrhage

D. Papillitis

This Pt has MS, which commonly presents with optic neuritis aka papillitis

18

What is the likely cause of a gradual loss of vision, like curtains are closing across the eyes?

A. Amaurosis fugax
B. Anterior uveitis
C. Papilloedema
D. Papillitis
E. Vitreous haemorrhage

A. Amaurosis fugax

19

What is the likely cause of a Pt's blurred vision who has had 2 months of a gradually increasing headache?

A. Amaurosis fugax
B. Anterior uveitis
C. Papilloedema
D. Papillitis
E. Vitreous haemorrhage

C. Papilloedema

20

What is the likely cause of a Pt with a red itchy eye?

A. Amaurosis fugax
B. Anterior uveitis
C. Papilloedema
D. Papillitis
E. Vitreous haemorrhage

B. Anterior uveitis

21

What are the causes of spastic paraparesis?

V- (can't think of one)
I- HIV
I- transverse myelitis, MS
T- B12 deficiency
T- paraneoplasm

22

What is meralgia paraesthetica?

Compression of the lateral femoral cutaneous nerve

23

What is the management for meralgia paraesthetica?

Assure the Pt
Advise weight loss
Give carbemazepine/gabapentin if persistent

24

What are the signs of a median nerve lesion?

Weak abductor pollicis brevis
Weak opposition
Paraesthesia in the palmar lateral 3 1/2 fingers

25

What are the signs of a radial nerve lesion?

Wrist drop
Paraesthesia in the dorsal medial half

26

What are the signs of a ulnar nerve lesion?

Paraesthesia in the dorsal lateral half + medial 1 1/2 fingers

27

What are some causes of sciatica?

Disc herniation
Spinal cord stenosis
Malignancy- eg. prostatic met compression

28

What condition causes Parkinsonism with an upgaze abnormality?

Progressive supranuclear palsy

29

What condition causes Parkinsonism, Alzheimer's, and hallucinations?

Lewy body dementia

30

55 M confusion and chest pain
No headache/neck stiffness
Recently moved house with malfunctioning heating system
Temp 37C, HR 110, BP 120/60
Normal examinations
ECG- sinus tachy, widespread ST depression
Urinalysis- NAD
Blood glucose- 7.0mmol/L
WCC- 7 CRP- <5 CT Head- NAD

What is the most likely cause (from VIITT)?

V- no mention of acute presentation
I- WCC and temperature is normal
I- CRP is normal
T- potentially a toxic/metabolic cause
T- CT head is clear