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Passmed 3rd year > Neuo Passmed > Flashcards

Neuo Passmed Flashcards

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
Q

Focal Seizure on the occipital Lobe

A

Floaters / Flashes (Visual affected)

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25
Q

Amyotrophic lateral sclerosis (50% of patients)

A

LMN signs in legs and UMN signs in arms

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26
Q

Primary lateral sclerosis

A

UMN only

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27
Q

Progressive muscular atrophy

A

LMN signs only
affects distal muscles before proximal
carries best prognosis

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28
Q

Progressive bulbar palsy

A

palsy of the tongue, muscles of chewing/swallowing and facial muscles due to loss of function of brainstem motor nuclei
carries worst prognosis

29
Q

Management of acute migraine?

A

Triptan + NSAID or triptan + paracetamol

30
Q

Prophylaxis for migraine?

A

Topiramate or propranolol if experiencing 2 or more attacks per month

31
Q

Brown-squared syndrome?

A

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
Q

Which bacteria are most likely to cause GBS?

A

Campylobacter Jejuni

33
Q

Typical symptoms of Guillain-Barre syndrome

A

progressive, symmetrical weakness of the limbs, often in an ascending fashion

34
Q

Foramen ovale contents

A 
Otic ganglion
V3 (Mandibular nerve:3rd branch of
trigeminal)
Accessory meningeal artery
Lesser petrosal nerve
Emissary veins
35
Q

Foramen Spinosum

A

Middle meningeal artery

Meningeal branch of the Mandibular nerve

36
Q

Foramen rotundum

A

Maxillary nerve

37
Q

Jugular Foramen

A

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
Q

Stylomastoid foramen

A

Stylomastoid artery

Facial Nerve

39
Q

Superior Orbital Fissure

A 
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
Q

Subacute Combined Degeneration of the spinal cord

A

Posterior section of the spinal cord

  1. Bilateral spastic paresis
  2. Bilateral loss of proprioception and vibration sensation
  3. Bilateral limb ataxia
41
Q

Friedrich’s ataxia

A

Same as subacute combined degeneration of the spinal cord

In addition to cerebellar ataxia → other features e.g. intention tremor

42
Q

Anterior spinal Artery occlusion

A
  1. Bilateral spastic paresis

2. Bilateral loss of pain and temperature sensation

43
Q

What is paroxysmal hemicrania?

A

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
Q

What is Internucluar ophthalmoplegia?

A

Occurs due to a lesion of the Medial Longitudinal Fasciculus (MLF), a tract that allows conjugate eye movement
Contralateral eye abducts w/ nystagmus.

45
Q

What is the 1st line for spasticity in multiple sclerosis?

A

Baclofen and gabapentin

46
Q

What is Thoracic Outlet Syndrome?

A

Disorder involving compression of brachial plexus, subclavian artery or vein at the site of the thoracic outlet.

47
Q

Lesion in the Amygdala may cause?

A

Docility, dietary changes and hyperphagia, hyperorality, hypersexuality and visual agnosia.

48
Q

Features of Glioblastoma Multiforme?

A

Most common primary tumour in adults –> poor prognosis.
Solid tumours with central necrosis.
Treatment surgical +/- chemo or radiotherapy. Steroids used to treat oedema.

49
Q

Features of Meningioma’s?

A

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
Q

Features of Pilocytic astrocytoma’s?

A

Most common primary brain tumour in children.

Histology: Rosenthal fibres (corkscrew eosinophilic bundle).

51
Q

Features of Medulloblastoma?

A

Aggressive paediatric brain tumour that arises within the infratentorial compartment.
Histology: Rosette pattern of cells with many mitotic figures.

52
Q

Mechanism of Action of Baclofen?

A

GABA receptor agonists that acts in the CNS.

53
Q

What are oligodendrocytes?

A

responsible for myelin production in the CNS.

54
Q

What are Schwann cells?

A

responsible for myelin production in the PNS

55
Q

RAPD pathway of mechanism?

A

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
Q

Broca’s area

A

Non-fluent of speech and grammar is impaired, but comprehension is intact.

57
Q

Wernicke’s aphasia

A

Difficulty understanding language and speech which lacks meaning (neologisms) Comprehension is impaired

58
Q

Conduction aphasia

A

Speech is fluent but repetition is poor. Aware of the errors they are making. Comprehension is intact.

59
Q

What is syringomyelia?

A

A fluid filled cyst forms in spinal cord and expands over time.
Causes slowly progressive neurological symptoms.

60
Q

Is NF1/2 related to bilateral vestibular schwannoma?

A

NF2 is related to vestibular schwannomas.

61
Q

What is the most common complication following meningitis?

A 
Sensorineural hearing loss (most common)
Seizures, focal neurological deficit
Infective = sepsis
Intracerebral abscess
Pressure
Brain herniation
Hydrocephalus
62
Q

What does a Positive Hoffmans Sign mean?

A

sign of upper motor neuron dysfunction and points to a disease of the central nervous system.

63
Q

Acoustic neuroma is best visualised?

A

MRI of cerebellopontine angle

64
Q

How would a pt with Uncal herniation present?

A

Raised ICP can cause a 3rd nerve pals.
May loss consciousness
Diplopia

65
Q

Acute treatment for cluster headache?

A

Subcutaneous sumatriptan and 100% oxygen.

66
Q

What is Multiple System Atrophy?

A

Postural hypotension, autonomic disturbance may be seen in Parkinson’s disease the ataxic gait point towards a diagnosis of multiple system atrophy.

67
Q

Urinary incontinence + Gait Abnormality + Dementia

A

Normal Pressure Hydrocephalus

68
Q

What mimics TIA ?

A

Hypoglycaemia = can lead to focal neurological symptoms.

69
Q

Management for bells palsy?

A

Oral prednisolone within 72 hrs and give eye lubricants.

Passmed 3rd year (7 decks)

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