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Y6 Passmed > Neuro > Flashcards

Neuro Flashcards

1
Q

What is Hoovers sign used for

A

to differentiate between organic and non organic LL weaknes

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2
Q

how do you test Hoovers sign

A

ask pt to raise weak leg

if organic: examiner will feel contralateral healthy leg push down against their hand (synergistic contraction)

if functional: contralateral healthy leg will not push down

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3
Q

what is Hoffman sign

A

UMN sign (also in cervical myelopathy)
flick pts middle finger at DIP
POSITIVE if thumb and index finger move closer together

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4
Q

what causes degenerative cervical myelopathy

A

cervical spondilitis

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5
Q

sx of degenerative cervical myelopathy

A

pain in neck and limbs
loss of autonomic dunction
loss of motor function (loss of digital dexterity)
loss of sensory function (numbness

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6
Q

how do you ix degenerative cervical myelopathy

A

cervical MRI urgent

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7
Q

what causes syringomyelia

A

development of fluid filled cyst in SC

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8
Q

sx syringomyeliA

A

cape like (neck, shoulders, arms) loss of sensation to pain and temperature

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9
Q

whatt is mode of inheritance of tuberous sclerosis

A

AD

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10
Q

fts tuberous sclerosis

A

Cutaneous features
depigmented ‘ash-leaf’ spots which fluoresce under UV light
roughened patches of skin over lumbar spine (Shagreen patches)
adenoma sebaceum (angiofibromas): butterfly distribution over nose
fibromata beneath nails (subungual fibromata)
café-au-lait spots* may be seen

Neurological features
developmental delay
epilepsy (infantile spasms or partial)
intellectual impairment

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11
Q

how can you remember multiple systems atrophy

A

Me in church when i fainted

  • autonomic dysfunction (postural hypotension)
  • ataxia (woozy))
  • rigidity, tremor
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12
Q

Brown Sequard syndrome

A

ipsilateral weakness below lesion
ipsilateral loss of proprioception and vibration

contralateral loss of pain and temperature

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13
Q

what causes brown sequard syndrome

A

lateral hemisection of the spinal cord

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14
Q

describe the tremor in parkinsons

A

Resting
Pill rolling (4-6Hx)
asymmetrical / unilatera
improves with voluntary movement

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15
Q

what can you give in Idiopathic Intracranial HTN

A

Acetazolamide - carbonic anhydrase inhibitor used in IIH to reduce CSF production to reduce intracranial pressure

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16
Q

what can withholding levodopa precipitate?

A

neuroleptic malignant syndrome

Levodopa is a CRITICAL DRUG in PD - do not forget!!

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17
Q

which drugs precipitate MG attack

A

Abel Loves PS Beer

Antibiotics (gentamicin, macrolide, quinolone, tetracycline)
Lithium
Penicillamine, Phenytoin
Beta blocker

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18
Q

when can you withdraw antiepileptics

A

when patient has been seizure free for 2 years

stop antiepileptics over 2-3 months

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19
Q

which type of brain haemorrage is the slowest developing, and when does it present’?

A

SUBDURAL haematoma

because there is slow blleding of the bridging veins > develops over 4-7 weeks > pt presents with confusion

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20
Q

explain Wernicke’s aphasia

A

Wernicke’s = receptive

speech is fluent
COMPREHENSION IMPAIRED
REPETITION IMPAIRED

Lesions here mean that sentences make no sense, they use wordd substitution and neologisms but speech remains fluent aka wor salad

21
Q

What is the function of Brocas area

A

speech production - making it fluent

22
Q

Explain Bbbrocas aphaia

A

Compreehenssion IS normal

speech is NON FLUENT, LABOURED, SLOW
Repetition is impaired

23
Q

what is conducton aphasia

A

speech is fluent
comprehenssion is sintact
REPETITION IS POOR

24
Q

what is global aphasia

A

very bad - all three domainss

can’t comprehend, speech not fluent, repetition iss poor

25
Q

how do pts with global aphasia communicate

A

via gesturess

26
Q

on what side do brainstem injures present

A

IPSILATERAL face signs

CONTRALATERAL body signs

27
Q

what type of CT must you get in suspected stroke

A

non contrast CT

28
Q

side effects of chronic phenytoin use

A

gum hypertrophy
megaloblastic anaemia
peripheral neuropathy

29
Q

easy way to detect LEMS from MG

A

LEMS improves with exercise!!!

it also has autonomic sx (dry mouth, impotence, difficulty micturating)

30
Q

what scale monitors functional ssatus in patients with sstroke?

A

Barthel index

moniitors functional status and improvement post stroke
describes 10 tasks > scored by the amount of time and assistance required for each task

31
Q

which seizure type is carbamazepine ineffective in

A

ABSENCE and MYOCLONIC

32
Q

how do third nerve palsies caused by microvascular infarction (poorly controlled diabetes, hypertension, and atherosclerosis) present

A

Ptosis

PUPIL IS SPARED

33
Q

How do third nerve palsies caused by intracranial lesions present?

A

ptosis, mydriasis, and the characteristic ‘down and out’ pupil that is not responsive to light.

34
Q

what score system can you use to DETECT stroke in ED

A

ROSIER

detects acute stroke (compared to stroke mimics)

35
Q

What is the functon of the NIHSSS

A

Quantifies severity of stroke and predics outcome

36
Q

how does Progressive Bulbar Palsy present

A

BULBAR PALSY > so it affects CN 9-12

  • dysarthria
  • dysphagia
  • tongue wasting
  • fasciculations
37
Q

how long does an AV fistula take to be ready for use?

A

6-8 week s

38
Q

where are AV fistulas commonly found

A

brachiocephalic or radiocephalic

this is why you need to feel the arms in ABDO EXAM

39
Q

complications of AV fisstula

A 
infection 
stenosis 
thrombosis 
bleeding 
steal syndrome
40
Q

what blood test identifies true CNS seizures

A

PROLACTIN (raised 10-20 mins post ictal)

41
Q

how long must you not drive for following a TIA / Stroke?

A

1 month

42
Q

how does an essential tremor present

A

POSTURAL (worse on arms outstretched, with sustained muscle tone)

involves hands / fingers and vocal cordas

43
Q

how do you manage an essential tremor

A

propanolol

44
Q

what nerves are affected in vestibular schwannoma

A

V, VII and VIII

V = absent corneal reflex 
VII = facial numbness
XIII= vertigo and unilateral hearing loss
45
Q

what is the difference between a medical and surgical 3rd nerve palsy

A 
Medical = pupil sparing 
Surgical = pupil involvement (pupil BLOWN)
46
Q

what is the most common cause of a PAINFUL 3rd nerve palsy

A

posterior communicating artery aaneurysm

47
Q

what URGENT investigation should all TIA pts have

A

an urgent CAROTID DOPPLER (unless not a candidate for carotid endocardectomy)

48
Q

What does the independent result of high PROTEIN on CSF indicate

A

GBS

Y6 Passmed (8 decks)

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