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P2a - Neuro > mock questions > Flashcards

mock questions Flashcards

1
Q

what is the most common cause of meningitis in children under 8?

A

strep pneumonia

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2
Q

are fasiculations UMN or LMN?

A

LMN

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3
Q

what would not being able to distiguish between shades of red indicate?

A

MS

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4
Q

what would the prescence of a face droop in a stroke indicate?

A

middle cerebral artery - even if the legs are affected more than the arms

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5
Q

what is a prognostically beneficial drug for MND?

A

riluzole

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6
Q

what is the gene affected in huntingtons?

A

on chromosome 4, CAG trinucleotide repeat

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7
Q

what is pain and temperature transported in?

A

lateral spinothalamic tract

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8
Q

what is pain and crude touch transported in?

A

anterior spinothalamic tract

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9
Q

what receptors are in the sympathetic nervous system?

A

nicotinic and adrenergic

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10
Q

what is the first line treatments for migraines?

A

triptans, ibuprofen, paracetamol

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11
Q

what is the prophylaxis treatments for migraines?

A

1st line acute - triptans

1st line chronic - Propranolol, Topiramate or Amitriptyline

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12
Q

what is the scoring system for weather someone will have a stroke after a TIA?

A

ABCD2 score

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13
Q

what is the ABCD2 score?

A

A: Age > 60 years = 1 point

  • B: BP >140/90 at initial evaluation = 1 point
  • C: Clinical features
  • Speech disturbance without weakness = 1 point
  • OR unilateral weakness = 2 points
  • D: Duration
  • Symptoms 10-59 minutes = 1 point
  • Symptoms >60 minutes = 2 points
  • D: Diabetes mellitus in patient history = 1 point
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14
Q

how long after the start of symptoms can thrombolysis with alteplase be used in a stroke patient with a rules out haemorrhage ?

A

within 4.5 hours

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15
Q

Trevor returns to A+E after having a similar episode with more significant and
longer lasting symptoms. His symptoms were: hemiparesis with sensory deficit in his chin
and arm, homonymous hemianopia, and dysphasia. Trevor was brought in within 3 hours of
onset of symptoms and haemorrhage was ruled out.
what treatment would be used?

A

thrombolysis with alteplase within 1.5 hours

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16
Q

what is the first line prophylaxis treatment for migranes?

A

triptans - sumatriptan / almotriptan

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17
Q

what is the most common causative pathogen for kids with meningitis?

A

strep pneumoniae

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18
Q

what is the treatment for raynaud’s?

A

nifedipine

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19
Q

who would you expect to have meningitis caused by listeria monocytogenes?

A

pregnant women

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20
Q

which causative agent has the worst prognosis for meningitis?

A

neisseria meningitis

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21
Q

which causative agent is most likely to cause meningitis in neonates?

A

strep agalactiae

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22
Q

what are the signs of MS?

A 
D - diploplia
E - eye movements
M - motor weakness and spasticity
Y - nYstagmus 
E - elevated temperature
L - lhermitte's pnenomenon (electric shock?)
N- neuropathic pain
A - ataxia
T - talking slurred
I - impotence
O - overactive bladder
N - numbness
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23
Q

what does risperidone do?

A

used to reduce jerky movement, mange aggression and chorea.

given in huntingtons

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24
Q

what is the most common cause of meningitis?

A

strep pneumonia

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25
Q

what is the difference between a common peroneal nerve palsy and L5 radiculopathy?

A

both present with foot drop and weakness of the toe extenders
in CPNP - ankle eversion is affected
L5 - weeknes in ankle inversion

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26
Q

what would suggest ulnar nerve damage?

A

claw hand and pain in elbow

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27
Q

what is the first line treatment for trigeminal neuralgia?

A

carbamazepine

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28
Q

what investigations would be carried out when diagnosing dementia?

A

MMSE, MRI, CSF analysis, confusion screen to rule out reversible causes

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29
Q

what type of dementia has step wise progression?

A

vascular

30
Q

which nerve opens the fist?

A

radial

31
Q

what are risk factors for alzheimer’s?

A

down’s syndrome, reduced physical or congenitive activity, depression, loneliness

32
Q

what would been seen on the MRI scan of someone with alzheimer’s?

A

Extracellular deposition of beta amyloid plaques Tau neurofibrillary tangles Damaged synapses Cortical atrophy (hippocampus)

33
Q

what treatment can be given for alzheimer’s?

A

Acetylcholinesterase e.g., donepezil, galantine, rivastigmine, memantine

34
Q

what causes guilliene barre syndrome?

A

recent campylobacter infection, CMV, EBV, mycoplasma infection

35
Q

what are the signs of guillene barre syndrome?

A

motor weakness starting distally, Paraesthesia Respiratory involvement Autonomic involvement – HR changes, BP changes, urinary control symptoms

36
Q

how is GB syndrome diagnosed?

A

Lumbar puncture with raised CSF proteins

37
Q

how is GB syndrome treated?

A

IV immunoglobulins plasma exchange, supportive care in HDU/ITU

38
Q

what is it called when sensation is lost in the genitals?

A

Saddle anaesthesia

39
Q

how does prostate cancer lead to cauda equina?

A

Prostate cancer can metastasize to the spine via the venous blood flow in this area. Compression of the spinal cord by metastatic tumours (below L1 level, where the cauda equina begins)

40
Q

how is cauda equina treated?

A

Decompressive surgery of the spine e.g., lumbar laminectomy

41
Q

what does an ABCD2 score of over 6 mean?

A

calculates risk of stroke after TIA, score of 6 or more strongly predicts a stroke and should be referred to a specialist immediately

42
Q

what are the important differentials for epilepsy?

A

Syncope, non-ectopic seizure

43
Q

what does a CT scan look like of an extradural haemorrhage?

A

hyperdense mass that is biconvex shaped and adjacent to the skull

44
Q

how is high ICP treated?

A

IV mannitol - osmotic diuretic

45
Q

what are the tests that can be done for carpal tunnel syndrome?

A

Phalen’s test, Tinel’s test

46
Q

what nerve roots are affected in carpal tunnel syndrome?

A

C6, C&, C8, T1

47
Q

what is the treatment of viral meningtis?

A

give analgesic, antipyretic and hydration

48
Q

what is horner’s syndrome?

A

anhidrosis (reduced sweating), miosis (pupil constriction), ptosis (eyelid droop). Damage to the sympathetic nerves., can be caused by a pancoast tumour

49
Q

what would brown sequard syndrome cause?

A

proprioceptive, vibration and motor loss on the ipsilateral side and pain and temperature loss on the contralateral side 2 levels below the lesion.

50
Q

what is given in SAH?

A

nimodipine - CCB

51
Q

what is the 1st line acute treatment of migraines?

A

triptans (more effective than paracetamol and no risk of overdose)

52
Q

what would champagne bottle weakness suggest?

A

Charcot-marie tooth

53
Q

what would meningitis caused by a gram negative diplococci be suggestive of?

A

neisseria meningitidis

54
Q

what is the treatment for bacterial meningitis caused by NM?

A

Urgent antibiotics Cefotaxime IV Consider Amoxicillin if ptx. Immunocompromised / over 55

55
Q

what is the pathology of parkinsons?

A

Degeneration of dopaminergic neurons resulting in reduced dopaminergic output in the substantia nigra (in the basal ganglia) Normally dopamine stimulates movement from the basal ganglia since it inhibits the inhibitory pathway of the striatum therefore allowing movement. In Parkinson’s the amount of dopamine is reduced therefore there is less inhibition of the inhibitory pathway therefore less movement.

56
Q

what are the red flags of headaches?

A 
New Headache with Hx of Cancer
Cluster Headache 
Seizure 
Altered: consciousness / memory / confusion/ coordination 
Papilloedema
57
Q

what are the signs of LMN lesions?

A

Decreased tone/ flaccid
Decreased Reflexes,
Muscle wasting,
Fasciculations

58
Q

what are the signs of UMN leisons?

A

Increased tone/ Spasticity,
Brisk reflexes,
Minimal muscle atrophy- weakness,
Babinski’s sign

59
Q

which antiemetic is contraindicated in parkinson’s?

A

metoclopramide - D2 receptor antagonist. crosses the blood brain barrier, can cause extrapyramidal side effects and parkinsonism

60
Q

what are the driving rules for a TIA?

A

no need to inform DVLA, but don’t drive for 1 month

61
Q

what is the prophylaxis for cluster headaches?

A

verapamil

62
Q

where does the medulla develop from?

A

myelencephalon

63
Q

what are the prophylaxis medications for migranes?

A

propranolol, amitriptyline, acupuncture, topiramate

64
Q

what is the ABCD2 score?

A

1 point - Age>60, BP >140mmHg systolic or >90mmHg diastolic, speech disturbance without weakness, TIA duration 10-59 minutes, history of diabetes mellitus. 2 points - unilateral weakness and TIA duration 60 minutes

  • Score 6+ should be assessed immediately by a specialist
  • Score >4 should be assessed within 24 hours by a specialist
  • All patients with suspected TIA should be seen by a specialist within 7 days
65
Q

is the tremor in parkinsons symmetrical or asymmetrical?

A

asymmetrical, usually worse on one side

66
Q

what is brudzinski’s test?

A

Lying the patient supine and flexing their neck a positive test involves the patient involuntarily flexing their hip and knee - suggests meningitis

67
Q

what tract is damaged ipsilaterally to the lesion in brown sequard syndrome?

A

DCML pathway

68
Q

what can cause cauda equina?

A

tumours, spinal metastases, spiondylolisthesis, abscess, trauma, slipped disk

69
Q

how is cauda equina treated?

A

Immediate hospital admission (1), emergency MRI scan (1), lumbar decompression surgery

70
Q

when does the non blanching rash form in meningitis?

A

in meningitis septicaemia

71
Q

what is given when meningitis is suspected?

A

IM, benzylpenicillin

72
Q

what are the best antibiotics for treating meningitis?

A

Cefotaxime or ceftriaxone, 3rd generation Cephalosporin.

P2a - Neuro (40 decks)

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