Flashcards in Misc Neuro/Mental Deck (63):
What law suggests that memories are lost from most recent to furthest back in dementia?
What is astereognosis?
Inability to recognise familiar objects by touch alone
What is tactile agnosia?
Not able to identify stuff drawn on hand
3 areas of frontal lobe function?
Prefrontal area - personality, judgment, abstract thought
What is frontal lobe syndrome?
Disinhibition, facetious humour, apathy, distractibility, perseveration, urinary incontinence
2 temporal lobe functions?
Speech (Wernickes) - deficit in which results in fluent aphasia
3 parietal lobe things?
Visual and auditory sensation
Integration, planning and sequencing
What will a non-dominant parietal lobe lesion yield?
Sided neglect of dominant side (usually L)
Problems with visuospatial awareness
What does a dominant parietal lobe lesion yield?
Can't tell L from R
Literacy and numeracy trouble
What is anasagnosia?
Failure to recognise ones own disability, typical of parietal lobe lesions
What is autotopagnosia?
Misidentification of ones own body parts
Non-epileptic tendencies of TLE?
Rf for schizophrenia
What is Pick's disease?
A cause of Frontotemporal dementia syndrome characterised by early personality and behaviour change with language difficulty (finding words) and late memory change
What histological findings characterise Picks disease?
Tau inclusion bodies conforming to silver stain aggregations
3 defining characteristics of a learning disability?
Intellectual deficit (IQ 70 or less)
Social or adaptive dysfunction
Onset in developmental period (thus excluding dementia, head injury)
IQ definitions of varying learning disability severity?
Mild = 50-70
Moderate = 35-50
Severe = 20-35
Profound = less than 20
What is fragile X syndrome?
Inherited (X linked) disorder causing learning difficulties, behavioural and concentration problems, hyperactivity and avoidance of eye contact
Physical features of fragile X?
Large head with long prominent ears
Lax joints, mitral valve prolapse, scoliosis, flat feet
What blood parameter doesn't need to be checked for lithium therapy?
4 types of EPSEs?
Acute dystonic reaction
Triad of normal pressure hydrocephalus?
Gait disturbance (due to affect on sacral nerves) +/- pyramidal signs
Urinary +/- bowel incontinence for same reason
Slowly progressive, reversible dementia
3 common causes of communicating hydrocephalus?
Infarct of arachnoid granulations
Signs of hydrocephalus in kids?
Acute signs of raised ICP
Chronic FTT, developmental delay
Dilated scalp veins and tense fontanelles
'Setting sun' sign on eyes
Chronic signs of adulthood hydrocephalus?
Increasing head size
Gait spasticity and unsteadiness
Impaired upward gaze (neck pain)
6th nerve palsy
What is pharmacokinetics?
What the body does to the drug - absorption, distribution, metabolism, excretion
What is pharmacodynamics?
What the drug does to the body
What term refers to what the body does to the drug?
What term refers to the effect a drug has on the body?
3 factors affecting depression diagnosis in other cultures?
Stigma and reluctance to seek help
Alternate, particularly somatic presentations
What is affective blunting?
The objective loss of emotional reactivity
What is loss of affect?
Subjective feeling of ability to 'feel'
What is catalepsy?
Like waxy flexibility but no resistance (cross between waxy flexibility and cataplexy)
What is cataplexy?
Sudden loss of muscle tone leading to collapse, often alongside narcolepsy but otherwise due to excessive emotional response
What is logoclonia?
Like perseveration - repeating last syllable of word over and over
What is palilalia?
Repetition of word over and over with increasing frequency
Outcomes of schizophrenia in terms of percentages?
50% chronic fluctuant
15% have continuous Sx
10% have severe incapacity
What is a section 37?
Person convicted of imprisonable offence detained in hospital for Rx and released when 'well'
What is a section 41?
Like a section 37 but for 'dangerous' patients who can't be released after Rx without the confirmation of the Home Secretary
Section used to detain imprisoned patients in hospital for treatment and subsequent release?
Section retained for dangerous patients treated under section 37 who can't be released after?
Patients under which sections can't be treated without informed consent?
72 hour ones - 4, 5(2), 135 and 136
What procedures require full informed consent for patients under section 2, 3, 37 or CTO?
Medication over 3 months
Who can apply for sections?
Doctors and nurses for 5
5 principles of the mental capacity act?
Support people in making their own decisions
Accept that people may make eccentric or unwise decisions
If capacity lacking, make decisions in best interest of patient
If capacity lacking, make least restrictive decisions
2 step functional testing of capacity?
1) does person have an impairment in functioning of mind or brain?
2) if so does it impair their ability to have capacity to make this decision?
4 questions to ask yourself when assessing capacity?
Can they take in and understand information
Can they retain information long enough to make decision
Can they weigh up and use the information to make a decision
Can they communicate the decision
2 types of LPA?
Property and affairs LPA
Personal welfare LPA incl medical and social
Mild moderate severe breakdown of depressive episode in terms of number of Sx?
Mild = 2+2
Moderate = 2+3 or 4
Severe = 3+4 or psychotic, marked biological Sx etc.
All for at least 2 weeks, or less for severe
What defines chronic depression?
Sx last over 2 years
Management strategies for OCD?
+/- help from lithium, SSRIs, TCAs
3 theories behind development of dissocial PD?
What personality disorder often shows significant EEG changes?
Dissocial personality disorder
5 areas of cognition?
Attention and concentration
Intellect and intelligence
Higher executive function
What is neurofibromatosis type 1?
Autosomal dominant condition whereby peripheral nerves grow neurofibromas (skin/subcut tissue)
Skin features of neurofibromatosis type 1?
2 or more neurofibromas (well defined erythematous nodules varying in size and shape)
Cafe au lait spots (6 or more) flat patches
Non-skin manifestations of neurofibromatosis type 1?
Dorsal root spinal cord tumours
Optic nerve gliomas
Lisch nodules (iris hamartomas)
Invasive plexiform neuromas causing bony erosion
What characterises neurofibromatosis type 2?
Central schwannomas - main presenting feature is bilateral acoustic neuromas in 20s causing SN hearing loss
Other facial and cranial signs
Max eye score for GCS?
Max motor score for GCS?
Max verbal score for GCS?
Motor scoring for GCS from 6 to 1?
Withdraws from pain (normal flexion)
Abnormal flexion (decorticate)
Verbal scores for GCS from 5 to 1?
Confused or disoriented