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Neuro - C.U > General facts > Flashcards

General facts Flashcards

(102 cards)

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1
Q

Subdural haematoma is a bleed in?

A

Veins of the brain

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2
Q

What is kernigs sign?

A

Kernigs sign is positive when the thigh is flexed at the hip and knee at 90 degree angles, and subsequent extension in the knee is painful

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3
Q

What is GCA associated with?

A

Polymyalgia rheumatica

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4
Q

Liehthem’s disease is?

A

Degeneration of the posterior and lateral columns of the spinal cord.

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5
Q

Liehthem’s disease is a due to a deficiency in? (2)

A

B12 or copper

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6
Q

Two types of cavernous sinus thrombosis

A

Septic and aseptic

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7
Q

Posterior column involves fibres for?

A

Vibration, light touch and proprioception sensation

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8
Q

Lateral column involves fibres for?

A

Motor

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9
Q

Anterior column involves fibres for?

A

Pain and temperature sensation

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10
Q

Paraperesis

A

Bilateral UMN signs in the legs

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11
Q

How does a brown sequared lesion present? (unilateral lesion of the whole spinal cord)

A

Ipsilateral UMN signs in the leg
Ipsilateral loss of joint position and vibration
contralateral loss of pain and temp

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12
Q

5 causes of spinal cord compression

A 
Trauma 
Degenerative disease 
Tumours 
Infective lesions 
Epidural haemorrhage
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13
Q

LMN signs (5)

A 
Weakness 
Atrophy
Fasiculations 
Reduced / normal tendon reflexes 
Plantar response not present
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14
Q

Common type of anterior horn disease

A

Motor neurone disease

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15
Q

Polyneuropathy common causes (2)

A

Diabetes

B12 deficiency

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16
Q

Pyramidal weakness means there is….

A

Loss of power in the extensors of the UL and in the flexors of the LL

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17
Q

Where is proximal weakness common (2)

A

Myopathy and myasthenia gravis

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18
Q

Lesion above the pyramidal track, the weakness is …

A

on the contralateral side

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19
Q

Lesion below the pyramidal track, the weakness is…

A

Ipsilateral side

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20
Q

Clinical features of an UMN lesion (6)

A 
Spastic tone 
Pyramidal pattern of weakness 
Absence of muscle wasting 
Absence of fasiculations 
Brisk tendon reflexes 
Extensor plantar response
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21
Q

Classification of tremors (3)

A

Resting / Posture / Kinetic (intension / terminal)

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22
Q

Causes of a physiological tremor (4)

A

Anxiety
Metabolic problem (low glucose)
Alcohol withdrawal
Drugs - Beta agonist

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23
Q

What may diminish physiological tremors?

A

beta blockers

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24
Q

Characteristics of an essential tremor?

A 
Bilateral 
Progressive 
Worse on concentration 
Usually terminal 
Improves with alcohol
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25
Oral anti cholinesterase used in MG
pyridostigmine
26
Guillain-Barre syndrome usually follows what type of infections?
Resp / GI (diarrhoea)
27
What is GB syndrome?
Post infective inflammatory demyelinating neuropathy
28
What is shown on LP in GB syndrome?
Cytoalbuminologic dissociation Normal cell count Elevated protein
29
What is a bells palsy?
Acute LMN facial palsy
30
What is ramsay hunt syndrome?
Herpes zoster responsible for a bells palsy
31
Usual recovery time for bells palsy
80% within 2-8 weeks
32
Treatment for bells palsy
high dose steroids within the 1st week | eye care
33
Treatment for acute migraine
Triptan NSAIDS Metoclopromide (antiemetic)
34
Prophylactic treatment for migraine
Propanolol / topiramate
35
Treatment for acute cluster headache
O2 support | Sublingual / nasal triptan
36
Contraindications for triptans (2)
History of IHD/ TIA
37
Antibiotic given in suspected bacterial meningitis
Cefotaxime
38
When is an LP contraindicated in suspected B.meningitis (4)
Signs of raised ICP Sepsis Trauma Major coagulopathy
39
Normal range of csf pressure on LP
7-18CM
40
extradural haematoma is a ...... type of bleed.
arterial
41
presentation of an extradural haematoma on a scan
midline shift ventricular swelling blood on the scan soft tissues swelling outside the skill
42
Who are at risk of a subdural haematoma?
elderly / alcoholics (can occur even after a trivial injury)
43
Charcot-Marie tooth disease is?
Hereditary demyelinating neuropathy
44
Motor characteristics of CMT
Distal wasting of LL (eventually spread to UL) | Reduced reflexes
45
Sensation characteristics of CMT
Glove and stocking sensation loss
46
Foot deformities in CMT (2)
Pes cavus and toe clawing
47
Extra tests in those having strokes <55 y/o
'Young' stroke blood tests include thrombophilia and autoimmune screening - performed in those under 55 with no obvious cause of a stroke
48
Most common brain tumour
Glioma
49
where do secondary brain tumours often metastasie from
lung breast kidney malignant melanoma
50
3 ways brain tumour may present
Epileptic fit Symptoms of raised ICP Neurological deficit
51
Fredreich's ataxia genetics
autosomal recessive
52
onset of Fredreich's ataxia (age)
<20
53
Clinical features of fredreichs ataxia
``` Ataxia Sensory +/- cerebellar Foot deformities Weakness Distal wasting Loss of LL tendon reflexes Gradual sensory loss Nystagmus ```
54
Testing in Fredreich's ataxia
MR Genetics
55
Drugs commonly causing parkinsonism
neuroleptics
56
Suspect what in pt who is <40y/o with Parkinsonism
Wilsons disease
57
Blood test in muscular dystrophy
Creatinine kinase
58
What organ needs monitoring in muscular dystrophy?
cardiac
59
prognosis of those with muscular dystrophy
20 years
60
Vertigo
illusion of rotatory movement
61
vetigo usually due to pathology of?
inner ear or 8th CN
62
Causes of dizziness
``` Anaemis Hypo Anxiety Hypoventilation Postural hypotension Pyrexia ```
63
Disorders of the inner ear causing vertigo
BPPB Menieres Otitis media Labyrinthitis
64
8th CN pathology causing vertigo
Acoustic neuroma Otoxic drugs HZV
65
Associated symptoms with dizziness
``` Nausea Vom Sweating Ear symptoms Neuro symptoms Aura - migraine ```
66
Caloric tests
Use cold water in the ear to cause nystagmus reflex lost with 8th CN pathology
67
Tests in dizziness
Lying and standing BP ECG Vital signs Hearing tests FBC ESR Brain scan
68
Signs of raised ICP
Worse in morning Vomiting Visual disturbance
69
Associated symptoms with headache
``` Vision Vomiting Neck stiffness Drowsiness Fever / rash ```
70
Important blood test in temporal arteritis
ESR
71
Treatment of SAH
Angiography then endovascular coiling or clipping
72
Primary headache
No underlying pathology
73
Secondary headache
Underlying pathology e.g. tumour / vasculitis
74
When does GB syndrome reach a peak
4 weeks
75
Pathogenesis of GB syndrome
acute inflammatory demyelination of peripheral nerves
76
AB to check for in GB syndrome
Antiganglioside antibodies
77
Special tests in GB syndrome
ECG EMG and nerve conduction studies LP for CSF analysis
78
Acute treatment of GB syndrome
``` Medical emergency ABCDE Admit ITU involvement early with resp support IV immunoglobulin ```
79
Medication for SAH
Nimodipine
80
Guillain-Barre syndrome presentation
Bilateral glove and stocking parathesia Distal symmetrical weakness CN dysfunction 2/3 autonomic dysfunction
81
symptoms assoc with migraine
nausea photophobia phonophobia
82
Common triggers for migraines
``` tiredness, stress alcohol combined oral contraceptive pill lack of food or dehydration cheese, chocolate, red wines, citrus fruits menstruation bright lights ```
83
when should triptans be taken for a migraine?
as soon after the start of the headache
84
SE of triptans
``` tingling heat tightness in throat and chest heaviness pressure ```
85
Contraindications for triptans
Hx of or risk of IHD or CV disease
86
Which gland is often abnormal in Myasthenia gravis?
thymus
87
myasthenia gravis pathophysiology
antibodies directed against acetylcholine receptors in the post synaptic muscle membrane
88
Treatment of myasthenia gravis
Medical - pyridostigmine, immunosuppressants Surgical - thymectomy
89
Treatment of a myasthenia gravis crisis
IV immunoglobulins
90
Causes of sensory neuropathies
Diabetes Alcohol B12 deficiency Chronic renal failure
91
Causes of motor neuopathies
GB syndrome | CMT
92
Important history points in peripheral neuropathy?
PMH - diabetes SH - hx of alcohol abuse SE - anaemia symptoms
93
CMT findings on neuro exam
``` Atrophy (peripherally) Hammer toe / high arch Weakness Hypo/areflexia Sensory loss in a glove and stocking distribution ```
94
Causes of facial nerve palsy
``` Idiopathic - Bells palsy Vascular - stroke Infective - Ramsey hunt syndrome (herpes zoster), Lyme disease Tumour - acoustic neuroma Sarcoidosis - parotid gland enlargement ```
95
Carpal Tunnel syndrome is associated with
RA Pregnancy HypotT Acromegaly
96
Management of CTS
Conservative - splinting Medical - steroid injections Surgical - Decompression by division of flexor retinaculum
97
Two systems involved in nystagmus
central posterior vestibular system
98
Transverse myelitis
Heterogeneous focal inflammatory disorder of the spinal cord characterised by acute or subacute development of motor weakness, sensory impairment, and autonomic dysfunction.
99
Investigations in transverse myelitis
LP MRI MRI of the spinal cord reveals a focal hyperintense lesion and cerebrospinal fluid usually shows pleocytosis.
100
Therapy in acute transverse myelitis
Corticosteroids Plasmapherisis (2nd line)
101
triad of normal pressure hydrocephalus
Ataxia, urinary incontinence and dementia
102
first line treatment in trigeminal neuralgia
Trigeminal neuralgia - carbamazepine is first-line

Neuro - C.U (4 decks)

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