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NMF: Neurology > GENERAL > Flashcards

GENERAL Flashcards

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1
Q

What is the difference between the autonomic and somatic peripheral nervous system?

A

autonomic = involuntary so does not require dendrites to give that information so it is a unipolar neurone.

somatic = voluntary so requires afferent (sensory) and efferent (motor) neurones

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2
Q

Which neurotransmitters are used in the

a) parasympathetic
b) sympathetic

arms of the autonomic nervous system?

A

a) ACH

b) preganglionic = ACH
postganglionic = noradrenaline (because this will target the fight/flight response on to the organ)

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3
Q

Where are cell bodies found in the autonomic NS?

A

Pre-ganglionic = grey matter of CNS
- usually parasympathetic in the brain, sympathetic in
the spinal cord

Post-ganglionic = autonomic ganglia in the PNS

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4
Q

What is a glial cell?

A

A glial cell is a non-neuronal cell found in CNS and PNS. They help to maintain homeostasis by supporting neurones

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5
Q

Name some glial cells found in the CNS

A
  • astrocytes (blood brain barrier)
  • oligodendrocytes (produce myelin)
  • microglia (immune monitoring)
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6
Q

Name some glial cells found in the PNS

A
  • Schwann cells (produce myelin)

- satellite cells (Regulate external chemical environment same as astrocytes do in CNS)

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7
Q

What is found in the white matter of the brain?

A

axons

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8
Q

What is found in the grey matter of the brain?

A

neuronal cell bodies

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9
Q

What does dorsal mean?

A

posterior ( like the back of your hand)

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10
Q

What does ventral mean?

A

anterior

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11
Q

Which rami is sensory and which is motor?

A

dorsal = sensory

ventral = motor

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12
Q

What is the pyramidal system?

A

system of voluntary movement

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13
Q

Give some pyramidal signs

A

spasticity
hyperactive reflexes
loss of fine hand movements
extensor plantar response (Babinski sign)

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14
Q

What are the important tracts of the pyramidal system?

A

lateral and anterior corticospinal

corticobulbar

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15
Q

Where are the majority of UMN contained?

A

lateral corticospinal tract

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16
Q

When does
a) lateral
b) anterior
corticospinal tract cross?

A

a) at the medulla

b) at the spinal level it synapses at

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17
Q

Cerebellar signs

A 
DANISH
dysdiadochokinesia
ataxia
nystagmus
intention tremor 
scanning dysarthria
hyporeflexia
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18
Q

What is stereognosis?

A

the ability to recognise an object by touch

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19
Q

What is myoclonus?

A

sudden, involuntary focal/general muscle jerks

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20
Q

What is clonus?

A

a series of involuntary, rhythmic, muscular contractions and relaxations

–> sign of UMN lesion

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21
Q

prophylactic treatment for cluster headaches

A

verapamil

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22
Q

At what spinal levels can spinal cord injury cause autonomic dysreflexia?

A

above T6

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23
Q

Treatment of trigeminal neuralgia

A

carbamazepine

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24
Q

syringomyelia causes sensory dysfunction in which distribution

A

cape-like loss of pain and temperature due to involvement with spinothalamic tract

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25
acute treatment of cluster headache
o2 + triptan
26
Is GABA or glutamate inhibitory?
GABA
27
How do you manage myasthenia gravis?
pyridostigmine (anticholinesterase inhibitor) + prednisolone
28
treat drug-induced parkinsonism
antimuscarinics eg procyclidine
29
What nerve can be injured by fracture to surgical neck of humerus?
axillary nerve
30
What nerve can be injured by fracture to humeral shaft?
radial nerve
31
treat delirium in parkinsons
lorazepam
32
Cause of a) unilateral high-stepping gait b) bilateral high-stepping gait
cause = foot drop a) common peroneal nerve lesion b) peripheral neuropathy l4/5 disc herniation compressing l5
33
treat nausea in parkinson's
domperidone
34
When shingles affects facial nerve
Ramsay Hunt syndrome | - vesicular rash around ear
35
Features of CRPS
- disproportiante symptoms - allodynia - temperature and skin colur changes - oedema and swelling - motor dysfunction
36
How does a) Klumpe's palsy b) Erb's palsy present?
a) weak intrinsic hand muscles | b) waiter's tip: elbow flexion and forearm supination lost
37
What nerve roots does a) Klumpe's palsy b) Erb's palsy affect?
a) C8-T1 | b) C5-6
38
In which type of meningitis are steroids used? Why?
bacterial to reduce inflammation which is a major cause of morbidity
39
True or false "There is no effective vaccine against some of the common strains of meningococcal infection seen in the UK"
false
40
Which of the following statements is TRUE? A. Aciclovir is useful for treating most causes of viral meningitis B. Listeria is a small Gram negative bacillus C. Gentamicin has good penetration into CSF and is useful for treating some types of meningitis D. Listeria infection is associated with the consumption of soft cheese E. Listeria meningitis is commonest in older children and young adults
D
41
Why is ceftriaxone chosen for empirical treatment for suspected bacterial meningitis instead of penicillin? A. Ceftriaxone has a longer half-life than penicillin B. Ceftriaxone penetrates better than penicillin into CSF C. Most bacteria that cause meningitis are now penicillin resistant. D. Resistance is less likely to emerge during therapy if ceftriaxone if used E. Ceftriaxone also has activity against Listeria infection
A: more effective to give a less amount of times
42
Which area of the brain is responsible for nominal aphasia?
suggests an inferior parietal lesion, and area known as the angular gyrus.
43
What is the mode of inheritance in a) Wilson's disease? b) Becker's muscular dystrophy? c) Myoclonic epilepsy with ragged red fibers?
a) autosomal recessive b) x-linked recessive c) mitochondrial
44
When do you see xanthochromic CSF?
sub-arachnoid haemorrhage
45
What does CSF look like in a) viral meningitis? b) bacterial meningitis?
a) clear | b) cloudy
46
When is protein most raised in CSF?
viral meningitis
47
In which case would CSF have low glucose and increased neutrophils?
bacterial meningitis
48
What is the first area of the brain affected by Alzheimer's?
The nucleus basalis of Meynert (main source of cholinergic projections)
49
MOA of lamotrigine
Lamotrigine antagonises voltage sensitive sodium channels and this reduces the release of glutamate, the main excitatory neurotransmitter.
50
First-line management of Alzheimers
acetylcholinesterase inhibitor | eg. rivastigmine, donezapil and galantamine
51
When can memantine be used?
add-on therapy in moderate alzheimer's | monotherapy in severe
52
What is memantine?
NMDA receptor blocker
53
Weber test in a) sensorineural hearing loss b) conductive
a) localises to contralateral side | b) localises to same side
54
Is bell's palsy an UMN or LMN lesion ?
LMN so forehead not involved
55
In which type of meningitis do you see a rash?
meningococcal (bacteria)
56
What is the empirical treatment for bacterial meningitis?
IV ceftriaxone and dexamethasone
57
Features of Bell's palsy
paralysis of facial muscles loss of lacrimation hyperacusis
58
Is sensation affected in Bell's palsy?
no | sensory fibres carried by trigeminal nerve
59
Which nerve is injured in wrist drop?
radial
60
numb superior upper arm and weak shoulder abduction
axillary nerve
61
first 15 degrees of shoulder abduction is done by which muscle?
supraspinatous
62
Which cranial nerve supplies laryngeal muscles eg cricothyroid?
vagus
63
acute, ascending paralysis with glove and stocking weakness
guillain-barre
64
Lesion in a spinal tract would cause an UMN or LMN sign?
UMN
65
Which blood test is raised in temporal arteritis?
ESR
66
Signs of spinal injury
mixed UMN and LMN signs above the lesion | UMN signs below the lesion
67
Psychiatric disorder + cerebellar dysfunction + parkinsonism
Wilson's disease
68
Which organism is Guillain-Barre particularly associated with?
Campylobacter jejuni
69
Alcoholic encephalopathy is caused by deficiency of what?
vitamin B1 (thiamine)
70
bilateral leg weakness, pes cavus + high-stepping gait
Charcot-Marie-Tooth
71
A 60yr old woman has difficulty with speech. Her sentences are fluid but don't make sense and she is unaware of this. She can follow simple commands.
Receptive aphasia --> Wernicke's area (Superior temporal gyrus)
72
A 70yr old man with slow speech and frequent pauses while he tries to remember words. He often resorts to saying " the thing"
Expressive aphasia --> Broca's area (Inferior frontal gyrus)
73
Which medications cause impulsiveness in Parkinson's treatment?
dopamine agonists eg ropinorole
74
Stroke in which territory of the brain would cause weakness and sensory deficit for a) lower limbs? b) upper limbs? c) both?
a) medial frontal and parietal lobes - forebrain - anterior cerebral artery b) lateral frontal, parietal and temporal lobes - middle cerebral artery c) occipital lobe - posterior cerebral artery
75
Which cranial nerve is carried through the cavernous venous sinus?
ophthalmic division of trigeminal (V1)
76
causes of Bell's palsy
``` idiopathic mononeuritis multiplex parotid inflammation herpes zoster pontine tumour or stroke ```
77
What is Creutzfeldt-Jakob disease?
a fatal, degenerative brain disease where prion proteins (misfolded) cause degeneration and death of brain tissue resulting in a spongiform brain
78
How is Creutzfeldt-Jakob disease transmitted?
exposure to infected brain tissue eg. cannibalism | rarely Autosomal dominant inheritance
79
How does Creutzfeldt-Jacob disease present?
rapid onset dementia myoclonus personality changes hallucinations
80
What is mononeuritis multiplex?
a peripheral nerve disorder that affects 2+ random nerves
81
How does mononeuritis multiplex present?
painful, asymmetrical sensory and motor features
82
What causes mononeuritis multiplex?
axons are damaged by a systemic process eg. diabetes mellitus, rheumatoid arthritis, vasculitis
83
Diagnose delirium
acute onset inattention with fluctuating course plus one of: disorganised thinking or altered level of consciousness
84
Which type of chorea is caused by GBS infection in children?
synderham's
85
Which drug can slow progression of MND? | mechanism?
riluzole | anti-glutamate
86
How does wilsons disease present in a) children? b) young adults?
a) liver problems | b) CNS problems eg. ataxia, tremor, slow movement, inc tone
87
Differentiate multi system atrophy from other causes of Parkinsonism
early autonomic disturbance | eg. bladder/bowel problems, postural hypotension, erectile dysfunction
88
Which cause of Parkinsonism presents with eye problems?
progressive supranuclear palsy
89
treat SAH
nimodipine and surgical clipping
90
what causes holmes tremor?
demyelination in the mid-brain
91
What organism causes meningitis in neonates?
Group B strep
92
What organism causes meningitis in children over 3 months + adults?
neisseria meningitidis
93
What organism causes meningitis in >60?
listeria meningitis
94
Which lobe is responsible for short term memory?
temporal

NMF: Neurology (9 decks)

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