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Flashcards in Exam 2 Deck (26):
1

Drugs which can cause parkinsonism(2)

Anti-emetics e.g. metoclopramide
anti-psychotics

2

Four cardinal symptoms of Parkinsons disease

Resting tremor
Rigitidy
Bradykinesia
Postural/gait impairment

3

Non-motor symptoms of Parkinsons disease (4)

Depression
Constipation
Hyposmia
Dementia

4

Poor levodopa response suggests..

Vascular parkinsonism

5

Postural tremor, symmetrical which improves with alcohol

Essential tremor

6

Causes of a flapping tremor (3)

Liver disease
Renal failure (uraemia)
Hypercapnia

7

Aetiology of an intention tremor

Cerebellar lesion/alcohol

8

Causes of chorea (2)

Huntingtons disease
Sydenhams chorea (post-strep)

9

First-line management of Parkinsons disease (2)

Levodopa+ decarboxylase inhibitor e.g. carbidopa to reduce peripheral metabolism of dopamine

10

Adverse effects of levodopa (3)

On-off effect
Reduced effectiveness with time
Dyskinesia

11

Bromocriptine is an example of what? Give two other drugs in the same class

Dopamine agonist. Cabergoline, ropinorole

12

Adverse effects of dopamine agonists (3)

Excessive daytime somnolence
Impulse control disorders
Fibrosis

13

Inflammatory demyelinating disease of the CNS presenting with focal neurological deficit

Multiple sclerosis

14

Demyelination of the medial longitudinal fasciculus causes...

Internuclear opthalmoplegia- failure of adduction of contralateral eye during lateral gaze with nystagmus in abducting eye

15

Investigations in MS:
a) LP
b) MRI
c) evoked potentials

a) oligoclonal bands in CSF- represents IgG reponse in the CNS
b) high-signal plaques
c) delayed

16

Management of acute exacerbations of MS

Steroids- if severe, admit and give IV

17

In MS, what is a) amantadine and b) modafinil indicated for?

a) fatigue
b) daytime somnolence

18

Disease modifying treatment in MS? (2) What is the aim of this?

Interferon beta
Glitiramer acetate.
Reduce relapse rate in relapsing-remitting MS.

19

Electric-shock like sensation caused by neck flexion? What other conditions is this caused by?

Lhermitte's phenomenon
Cervical spondylosis, SCDC, cord tumours

20

Symptoms/signs of optic neuritis (4)

Blurred vision
Washed-out colours
Eye pain
Relative afferent pupillary defect

21

Commonest brain region affected in stroke and symptoms of this (3)

Middle cerebral artery
Contralateral hemiparesis and sensory loss (upper>lower)
Contralateral homonymous hemianopia
Aphasia

22

How does the hemiparesis/sensory loss in anterior cerebral artery strokes differ from middle?

Affects more the lower limb than the upper

23

Ataxia + disorders of gaze and vision/other cranial nerve lesions: stroke location?

Posterior circulation

24

Indications for thrombolysis (2)

Haemorrhagic stroke excluded on CT
Patient is within 4.5 hours of symptoms

25

Secondary prevention of stroke

Control of blood pressure, cholesterol, diabetes
Clopidogrel as an antiplatelet
Warfarin for cardio-embolic stroke

26

Agent and dose used for thrombolysis

Recombinant tissue plasminogen activator, 0.9mg/kg/hour