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4th Year > Neuro > Flashcards

Neuro Flashcards

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1
Q

Name the ascending spinal tracts?

What’s their overall function?

A 
DCML
Spinothalamic (anterior and lateral)
Spinocerebellar (ant and post)
Spino-olivary
Cuneocerebellar (only higher up)
Rostral spinocerebellar (only higher up)

SENSORY

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2
Q

Name the descending spinal tracts?

What’s their overall function?

A 
Corticospinal (anterior and lateral)
Reticulospinal 
Rubrospinal
Tectospinal 
Vestibulospinal

MOTOR

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3
Q

Function of lateral STT?

A

Pain & temp

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4
Q

Function of anterior STT?

A

Crude touch pressure

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5
Q

Function of DCML ?

A

Fine touch, vibration & proprioception

Fasiculus cuneatus = upper limb (above T6)
Fasciculus gracilis = Lower limb (below T6)

IPSILATERAL - crosses at medulla

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6
Q

Function of spin-cerebellar and spine-olivary tracts

A

Unconscios proprioception - lower limbs

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7
Q

Is STT ipsilateral or contralateral?

A

Contralateral - fibres cross at vertebral level

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8
Q

Name the pyramidal tracts?
What are their function?
Are they ipsilateral or contralateral?

A

Anterior and lateral CST

Voluntary movement
Anterior = ipsilateral - fibres do not cross until the level they innervate
Lateral = contralateral - Desiccateed e.g instruction from right side of brain travels on left side of spinal cord

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9
Q

Function of rubrospinal tract?

A

Fine motor control

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10
Q

Function of medial and lateral reticulospinal tracts?

A 
Medial = Contraction and increased tone
Lateral = Inhibits contraction & decreases tone
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11
Q

Cerebellar signs?

A

DANISH

Disdiadochkinesis/dismetria (past pointing)
Ataxia 
Nystagmus 
Intention tremor
Speech - slurerred, inappropriate, slow
Hypotonia
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12
Q

Side effects of Na Valproate?

A

TERATOGENIC
liver damage
hair loss
tremor

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13
Q

1st line treatment of focal seizures?

Side effects?

A

Carbamazepine

Agranulocytosis
Aplastic anaemia
Induces the P450 system so there are many drug interactions

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14
Q

Side effects of phenytoin?

A 
Folate and vitamin D deficiency
Megaloblastic anaemia (folate deficiency)
Osteomalacia (vitamin D deficiency)
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15
Q

Important potential side effect of lamotrigine?

A

Steven Johnson syndrome

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16
Q

Definition of status epilepticus

A

Seizure duration >5 mins
OR
>3 seizures in an hour

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17
Q

Management of status epilepticus

A

ABCDE

  • give O2
  • Get IV access - give IV lorazepam 4mg and repeat after 10 mins if seizure ongoing
  • IV phenobarbital or phenytoin if seizures continue

Buccal midazolam or rectal diazepam may also be used

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18
Q

When must you inform the DVLA that you have seizures?

A

Immediately after 1st seizure - stop driving

can recommence after 6 months if no further seizures

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19
Q

When are you at most risk of seizing after moderate - heavy alcohol consumption?

A

6-48 hours after stopping drinking

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20
Q

What’s a good website for patients or parents of patients with epilepsy?

A

epilepsy.org.uk

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21
Q

When might you be able to stop taking your epilepsy medications?

A

Seizure free for 2 years

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22
Q

What investigations may you perform for epilepsy?

A 
MUST DO AN ECG
Neurological examination 
EEG
MRI - look for any causes
FBC, U&E, LFTs - assess general health
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23
Q

Dose of folic acid for pregnancy in women with epilepsy?

A

5000 micrograms vs 400 in normal population

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24
Q

anti-epileptics safe in pregnancy?

A

Lamotrigine and levetiracetam

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25
Long term use of anti-epileptics increase the risk of...
Osteoporosis
26
What contraceptives should be avoided in enzyme inducing anti-epileptics such as carbamazepine and phenytoin?
COCP and POP - reduced effectiveness
27
Emergency contraceptive in epilepsy?
Copper IUD
28
Contraceptive advise when taking lamotrigine?
Non enzyme inducing but oestrogen can reduce the effectiveness of lamotrigine -- Progesterone only contraceptive
29
Myelin cells in CNS?
Oligodendrocytes
30
Which type of hypersensitivity is MS?
Type IV (cell mediated)
31
Electrical shock sensation on flexion of neck?
Lermits sign | - problem in sensory pathway of cervical spinal cord - DCML
32
how long do symptoms have to be progressing for to be diagnosed as primary progressive MS?
1 year
33
Features of optic neuritis?
Central scotoma RAPD Painful eye movements Impaired colour vision
34
What will an LP show in MS?
Oligoclonal bands
35
Treatment of acute relapse of MS
Methylprednisolone 500mg daily for 5 days | or 1g IV if severe/oral doesn't work
36
Which spinal tract is most affected by syringomyelia?
STT - arises from centre of cord so affects fibres when they deccusate - cape like numbness
37
Trigeminal autonomic cephalgia management acute vs prophylaxis?
``` Acute = oxygen therapy Prophylaxis = verapamil ```
38
forehead affected =
LMN
39
plucking at clothes/smacking lips suggests what kind of seizure?
Focal , affecting temporal lobe
40
Management of paroxysmal hemicranial?
absolute response to indomethacin
41
spasticity in MS?
Baclofen & gabapentin
42
Functions of the frontal lobe?
Voluntary movement Expressive language higher functioning
43
Occipital lobe function?
Vision & memory
44
Temporal lobe function?
understanding and processing language
45
Parietal lobe function?
Sensory perception - taste, smell, hearing, sight cognition writing speech
46
Swollen neurons/Picks bodies?
Frontotemporal dementia
47
CSF shows raised tau but normal amyloid?
Frontotemporal
48
Intracellular fibrillary tangles
Alzheimers
49
What must you include when stating that someone has agoraphobia?
Whether it is with or without panic disorder
50
What are the core symptoms of depression? (3)
Low mood Anhedonia Fatigue
51
Name the atypical antipsychotics
``` Olanzapine Clozapine Quetiapine Risperidone Aripiprazole ```
51
Name the atypical antipsychotics
``` Olanzapine Clozapine Quetiapine Risperidone Aripiprazole ```
52
Name the typical antipsychotics
High potency - Haloperidol - Prochlorperazine Low potency - Chlorpromazine
53
IQ < ? is a learning disability?
<70 | Average = 100
54
Mild Moderate Severe Profound LD ranges
mild = 50-69 moderate = 35-49 severe = 20 - 34 profound <20
55
Indications for ECT?
Severe resistant depression Intractable (prolonged) mania 4th line in resistant schizophrenia Catatonia
56
Absolute contraindications to ECT
MI <3 months Recent CVA Intracranial mass Pheochromocytoma
57
Section 47 form
Lack of capacity in x for x duration
58
What is section 136
Someone found in a public place who appears to have a mental disorder can be taken by the police to a Place of Safety. Can only be used for up to 24 hours, whilst a Mental Health Act assessment is arranged
59
What is section 17a
Supervised Community Treatment (Community Treatment Order) - can be used to recall a patient to hospital for treatment if they do not comply with conditions of the order in the community, such as complying with medication
60
symptoms of neuroleptic malignant syndrome
Fever rigidity autonomic dysfunction
61
Treatment of acute dystonia?
Procyclidine
62
Management of MS flare?
Mild - symptomatic therapy Moderate - methyl prednisolone 500mg for 5 days Severe - admit for IV steroids
63
Which antiemetics need to be avoided in Parkinson's?
Metoclopramide and prochlorperazine Low dose domperidone may be used instead
64
Antidepressants in parkinson's?
SSRI are effective but can worsen motor and REM sleep disorders TCAs can also be used but beware cognitive impairment & risk of falls
65
Symmetrical pill rolling tremor?
Drug induced Parkinsonism
66
What is split hand syndrome associated with?
Amyotrophic lateral sclerosis (AML)
67
Most common and 2nd most common MND?
``` 1 = Amyotrophic lateral sclerosis 2 = Progressive bulbar palsy ```
68
Treatment for muscle cramps?
Baclofen | Quinine
69
Treatment of muscle spasms?
Baclofen | Tizanidine/dantrolene
70
is emotional lability an UMN or LMN sign?
UMN
71
Which dementia is common in MND?
Frontotemporal
72
Differentials of UMN problem?
Spastic CP Acquired brain injury Tumour
73
Imaging in demyelination?
MRI contrast
74
Post exposure prophylaxis for meningitis?
One dose of ciprofloxacin
75
Seizure where clonic movements move proximally
Frontal lobe
76
Na Valproate is associated with weight gain. | True or false?
True
77
visual defect with craniopharyngioma?
inferior quadrantanopia

4th Year (15 decks)

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