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Flashcards in Exam 3 Deck (25):
1

Cause of myasthenia gravis

Auto-Ab against the nicotinic acetylcholine receptor

2

Associations of myasthenia gravis

Thymoma or thymic hyperplasia

3

Distinguishing features of the muscle weakness in myasthenia gravis (4)

Fatiguable and mainly proximal

4

Treatment of myasthenia gravis (3)

Pyridostigmine- acetylcholinesterase inhibitor
Thymectomy
Prednisolone

5

Cause of Lambert-Eaton myasthenic syndrome?

Antibodies to pre-synaptic voltage gated calcium channels

6

Lambert-Eaton is associated with what disease?

Small cell lung cancer

7

Management of myasthenic crisis

IVIG

8

Feature of LEMS which may distinguish it from MG?

Signs of autonomic dysfunction

9

Commonest form of motor neurone disease and associated symptoms

Amytrophic lateral sclerosis. Mix of UMN and LMN signs

10

Subtypes of MND:
a) dyarthria, dysphagia, wasted fasciculated tongue
b) UMN signs exclusively
c) LMN signs exclusively, best prognosis

a) progressive bulbar palsy
b) primary lateral sclerosis
c) progressive musclar atrophy

11

Motor neurone disease never affects...(4)

sensation
sphincters
cerebellum
eye muscles

12

Impairment of cognitive function seen in 10-35% MND patients?

Frontotemporal dementia

13

Drug which has a modest impact on survival in MND

Riluzole- antilgutamergic

14

Gene implicated in 20% of familial cases?

Superoxide dismutase 1 (SOD1)

15

Upper motor neurone signs (2)

Increased tone
Hyper-reflexia

16

Lower motor neurone signs (4)

Decreased tone
Fasciculation
Wasting
Hyporeflexia

17

How can spinal stenosis be differentiated from claudication?

Spinal stenosis tends to get better when walking uphill/cycling, since this causes back flexion

18

Arreflexic flaccid paralysis in reponse to acute cord transection

Spinal shock

19

Brown-Sequard syndrome symptoms?

Ipsilateral dorsal column and corticospinal tract level
Contralateral spinothalamic tract level

20

Patient presentation- "cape-like" pain/temperature loss, with distal upper limb weakness

Central cord syndrome

21

What usually causes central cord syndrome?

Hyper-extension or hyper-flexion to an already stenosed neck

22

Cause of syringomyelia

Expansion of the central cord canal due to CSF blockage

23

Symptoms of syringomyelia

Cape-like spinothalamic loss
LMN signs in upper limbs
UMN signs in lower limbs

24

Malformation commonly associated with syringomyelia

Chiari malformation- extension of the cerebellar tonsils into the spinal cord

25

Back pain red flags (5)

Cauda equina symptoms (urinary retention/incontinence, faecal incontinence, saddle anaesthesia)
Nocturnal pain
Fever/chills
Unexplained weight loss
Past history of cancer