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Passmed 3rd year > Neuo Passmed > Flashcards

Neuo Passmed Flashcards

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1
Q

Contralateral hemiparesis + sensory loss, lower extremity >upper

A

Anterior cerebral artery

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2
Q

Contralateral hemiparesis + sensory loss, upper extremity > lower.
Contralateral homonymous hemianopia
Aphasia

A

Middle cerebral artery

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3
Q

Contralateral homonymous hemianopia with macular sparing

Visual agnosia

A

Posterior cerebral artery

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4
Q

Ipsilateral CN III palsy

Contralateral weakness of upper and lower extremity

A

Weber’s syndrome:

Branches of posterior cerebral artery that supply the midbrain.

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5
Q

Ipsilateral: facial pain/numbness + temperature loss
Contralateral: limb/torso pain and temperature loss
Ataxia, nystagmus

A

Posterior inferior cerebellar artery (lateral medullary syndrome, Wallenberg syndrome)

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6
Q

Symptoms are similar to Wallenberg’s (see above), but:

Ipsilateral: facial paralysis and deafness

A

Anterior inferior cerebellar artery (lateral pontine syndrome)

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7
Q

Locked-in syndrome

A

Basilar Artery

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8
Q

Either isolated hemiparesis, hemisensory loss

Strong assoc. w/ hypertension

A

lacunar stroke

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9
Q

What increases the risk of intracerebral haemorrhage after treatment for stroke?

A

Aspirin, Clopidogrel + IV Alteplase all increase the risk of further bleeding and clinical deterioration.

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10
Q

What is cushing’s triad?

A

Hypertension, Bradycardia, Tachypnoeic

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11
Q

Total Anterior Circulation

A
  1. unilateral hemiparesis and/or hemisensory loss of the
    face, arm & leg
  2. homonymous hemianopia
  3. higher cognitive dysfunction e.g. dysphasia
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12
Q

Partial Anterior Circulation infarct

A

involves smaller arteries of anterior circulation e.g. upper or lower division of middle cerebral artery
2 of the above criteria are present

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13
Q

Lacunar Infarct

A

involves perforating arteries around the internal capsule, thalamus and basal ganglia presents with 1 of the following:
1. unilateral weakness (and/or sensory deficit) of face and
arm, arm and leg or all three.
2. pure sensory stroke.
3. ataxic hemiparesis

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14
Q

Posterior Circulation

A

Involves vertebrobasilar arteries

  1. cerebellar or brainstem syndromes
  2. loss of consciousness
  3. isolated homonymous hemianopia
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15
Q

Vitamin B12 Deficiency?

A

subacute combined degeneration of spinal cord.

Dorsal column affected first.

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16
Q

Rapid correction of hyponatremia can cause what?

A

Osmotic demyelination syndrome

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17
Q

Osmotic demyelination syndrome presents with…

A

Speech disturbances, swallowing dysfunction, limb paralysis, movement disorders, and behavioural and psychiatric disturbances

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18
Q

When will thrombectomy be suitable between 6 - 24hrs?

A

If there is the potential to salvage brain tissue shown via CT perfusion / diffused-weighted MRI

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19
Q

Is Migraine contraindicated COCP?

A

If patient have migraine w/ aura then the COCP is absolutely contraindicated due an INCREASED risk of stroke

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20
Q

Parkinson’s + dementia + visual hallucinations, think?

A

Lewy body Dementia

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21
Q

Chronic Lithium use?

A

Fine tremor in chronic treatment, coarse tremor in acute toxicity

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21
Q

Focal seizure on the Temporal lobe (HEAD)

A

Hallucinations (auditory/gustatory/olfactory), Epigastric rising / Emotional, Automatisms (lip smacking/grabbing/plucking), Deja vu/Dysphasia post-ictal)

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22
Q

Focal Seizure on the Frontal Lobe

A

Head/leg movements, posturing, post-ictal weakness, Jacksonian march

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23
Q

Focal seizure on the parietal Lobe

A

Paraesthesia (Sensory affected)

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24
Focal Seizure on the occipital Lobe
Floaters / Flashes (Visual affected)
25
Amyotrophic lateral sclerosis (50% of patients)
LMN signs in legs and UMN signs in arms
26
Primary lateral sclerosis
UMN only
27
Progressive muscular atrophy
LMN signs only affects distal muscles before proximal carries best prognosis
28
Progressive bulbar palsy
palsy of the tongue, muscles of chewing/swallowing and facial muscles due to loss of function of brainstem motor nuclei carries worst prognosis
29
Management of acute migraine?
Triptan + NSAID or triptan + paracetamol
30
Prophylaxis for migraine?
Topiramate or propranolol if experiencing 2 or more attacks per month
31
Brown-squared syndrome?
Caused by lateral hemisection of the spinal cord. ipsilateral weakness below lesion ipsilateral loss of proprioception and vibration sensation contralateral loss of pain and temperature sensation
32
Which bacteria are most likely to cause GBS?
Campylobacter Jejuni
33
Typical symptoms of Guillain-Barre syndrome
progressive, symmetrical weakness of the limbs, often in an ascending fashion
34
Foramen ovale contents
``` Otic ganglion V3 (Mandibular nerve:3rd branch of trigeminal) Accessory meningeal artery Lesser petrosal nerve Emissary veins ```
35
Foramen Spinosum
Middle meningeal artery | Meningeal branch of the Mandibular nerve
36
Foramen rotundum
Maxillary nerve
37
Jugular Foramen
Anterior: inferior petrosal sinus Intermediate: glossopharyngeal, vagus, and accessory nerves. Posterior: sigmoid sinus (becoming the internal jugular vein) and some meningeal branches from the occipital and ascending pharyngeal arteries.
38
Stylomastoid foramen
Stylomastoid artery | Facial Nerve
39
Superior Orbital Fissure
``` Oculomotor nerve (III) Recurrent meningeal artery Trochlear nerve (IV) Lacrimal, frontal and nasociliary branches of ophthalmic nerve (V1) Abducent nerve (VI) Superior ophthalmic vein ```
40
Subacute Combined Degeneration of the spinal cord
Posterior section of the spinal cord 1. Bilateral spastic paresis 2. Bilateral loss of proprioception and vibration sensation 3. Bilateral limb ataxia
41
Friedrich's ataxia
Same as subacute combined degeneration of the spinal cord In addition to cerebellar ataxia → other features e.g. intention tremor
42
Anterior spinal Artery occlusion
1. Bilateral spastic paresis | 2. Bilateral loss of pain and temperature sensation
43
What is paroxysmal hemicrania?
Occurs in women + occurs multiple times a day. Involves attacks of severe, unilateral headache, usually in the orbital, supraorbital or temporal region. Associated with autonomic features,
44
What is Internucluar ophthalmoplegia?
Occurs due to a lesion of the Medial Longitudinal Fasciculus (MLF), a tract that allows conjugate eye movement Contralateral eye abducts w/ nystagmus.
45
What is the 1st line for spasticity in multiple sclerosis?
Baclofen and gabapentin
46
What is Thoracic Outlet Syndrome?
Disorder involving compression of brachial plexus, subclavian artery or vein at the site of the thoracic outlet.
47
Lesion in the Amygdala may cause?
Docility, dietary changes and hyperphagia, hyperorality, hypersexuality and visual agnosia.
48
Features of Glioblastoma Multiforme?
Most common primary tumour in adults --> poor prognosis. Solid tumours with central necrosis. Treatment surgical +/- chemo or radiotherapy. Steroids used to treat oedema.
49
Features of Meningioma's?
Second most common primary brain tumour. Benign and arise from the arachnoid cap cells of the meninges Located next to the dura + cause symptoms by compression rather than invasion.
50
Features of Pilocytic astrocytoma's?
Most common primary brain tumour in children. | Histology: Rosenthal fibres (corkscrew eosinophilic bundle).
51
Features of Medulloblastoma?
Aggressive paediatric brain tumour that arises within the infratentorial compartment. Histology: Rosette pattern of cells with many mitotic figures.
52
Mechanism of Action of Baclofen?
GABA receptor agonists that acts in the CNS.
53
What are oligodendrocytes?
responsible for myelin production in the CNS.
54
What are Schwann cells?
responsible for myelin production in the PNS
55
RAPD pathway of mechanism?
Occurs when there is a defect in the afferent pathway. Presents with absent constriction of both pupils when a light is shown in the affected eyes. e.g. RAPD in the left eye.
56
Broca's area
Non-fluent of speech and grammar is impaired, but comprehension is intact.
57
Wernicke's aphasia
Difficulty understanding language and speech which lacks meaning (neologisms) Comprehension is impaired
58
Conduction aphasia
Speech is fluent but repetition is poor. Aware of the errors they are making. Comprehension is intact.
59
What is syringomyelia?
A fluid filled cyst forms in spinal cord and expands over time. Causes slowly progressive neurological symptoms.
60
Is NF1/2 related to bilateral vestibular schwannoma?
NF2 is related to vestibular schwannomas.
61
What is the most common complication following meningitis?
``` Sensorineural hearing loss (most common) Seizures, focal neurological deficit Infective = sepsis Intracerebral abscess Pressure Brain herniation Hydrocephalus ```
62
What does a Positive Hoffmans Sign mean?
sign of upper motor neuron dysfunction and points to a disease of the central nervous system.
63
Acoustic neuroma is best visualised?
MRI of cerebellopontine angle
64
How would a pt with Uncal herniation present?
Raised ICP can cause a 3rd nerve pals. May loss consciousness Diplopia
65
Acute treatment for cluster headache?
Subcutaneous sumatriptan and 100% oxygen.
66
What is Multiple System Atrophy?
Postural hypotension, autonomic disturbance may be seen in Parkinson's disease the ataxic gait point towards a diagnosis of multiple system atrophy.
67
Urinary incontinence + Gait Abnormality + Dementia
Normal Pressure Hydrocephalus
68
What mimics TIA ?
Hypoglycaemia = can lead to focal neurological symptoms.
69
Management for bells palsy?
Oral prednisolone within 72 hrs and give eye lubricants.

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