Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

revision > neuro > Flashcards

neuro Flashcards

1
Q

which parkinsons medication is most likely to cause inhibition disorders?

A

ropinirole (dopamine receptor agonist)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the features of bells palsy?

A

acute unilateral idiopathic facial nerve paralysis
- lmn palsy - forehead affected (umn spares forehead)
- post-auricular pain, altered taste, dry eyes, hyperacusis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the management of bells palsy?

A

oral pred
artificial tears, eye taping
?refer to ent, ?plastics if no paralysis improvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is degenerative cervical myelopathy?

A

disc degen, ligament hypertrophy, cord signal change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the features of DCM?

A

neck pain, loss of motor function in upper limb, loss of sensory function, loss of autonomic fn (urinary or faecal incontinence and/or impotence)
hoffman’s sign - flick hand - +ve = fingers twitch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

secondary prevention in TIA?

A

clopidogrel 75mg daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

management TIA?

A

300mg aspirin acutely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

which cranial nerves are affected in vestibular schwannomas? (acoustic neuroma)

A

cn V, VII and VIII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how does drug induced parkinsonism present?

A

bilateral sx
remain at presenting level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how does idiopathic parkinsons present?

A

difficulty with fine movts
inc tone
resting tremor
often asymmetrical sx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

if a patient presents to primary care with seizue episodes, what is the management?

A

refer to neuro - antiepileptics must be started by specialists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what type of visual field defects do parietal lesions cause?

A

contralateral inferior quadranopia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what type of visual field defects do temporal lobe lesions cause?

A

contralateral superior quadranopia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what type of visual field defect would a patient with sx of diabetes insipidus have?

A

craniopharyngioma - lower bitemporal hemianopia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how do you differentiate a focal impaired awareness seizure from an absence seizure?

A

FIA - ?longer, motor phenomena, automatisms, aura
absence - often child, up to 30s, recollection of event, no automatisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the sx of acoustic neuroma?

A

vertigo, unilateral sensorineural hearing loss and tinnitus cnviii
absent corneal reflex cnv
facial palsy cnvii

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

mgt ischaemic stroke for first 14 days?

A

300mg aspirin OD
after 14d - clopidogrel 75mg long term + statin if cholesterol over 3.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the mgt for myoclonic seizures?

A

m - sodium valproate
f - levetiracetam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the mgt for absence seizures?

A

ethosuximide
2L m- valproate, f- lamotrigine or levetiracetam
(carbamazepine may exacerbate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the mgt for tonic/atonic seizures?

A

m - sodium valproate
f - lamotrigine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the mgt for focal seizures?

A

focaL - Lamotrigine/Levetiracetam
1L - lamotrigine or levetiracetam
2L - carbamazepine, oxcarbazepine, zonisamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is the mgt for generalized tonic-clonic seizures?

A

m - SV
f - lamotrigine or levetiracetam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is the management for peritumoural vasogenic oedema?

A

IV dexamethasone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how does a lacunar stroke present?

A

pure motor hemiparesis
pure sensory stroke
sensorimotor stroke
ataxic hemiparesis
dysarthria/clumsy hand syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

how does a TACS present?

A

3Hs
Hemiplegia/sensory loss
Homonymous hemianopia
Higher dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what type of diet is most likely to be effective in reducing seizure frequency in epilepsy?

A

ketogenic diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

how do focal aware seizures present?

A

sudden but short-lived change in senses (which may be taste, smell, tactile, or visual) during which the patient remains fully conscious
typically remain conscious, accompanied with sweating, twitching or gaze deviation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

how does myasthenia gravis present?

A

muscle fatigability
- extraocular muscle weakness - diplopia
- proximal muscle weakness
- ptosis
- dysphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is MG associated with?

A
  • thymomas
  • autoimmune disorders
  • thymic hyperplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is the investigation of choice for MG?

A

antibody screen - pts have abs against acetylcholine receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

how does trigeminal neuralgia present?

A

unilateral brief electric shock-like pains, abrupt in onset and termination, limited to one or more divisions of the trigeminal nerve
pain evoked by light touch, including washing, shaving, smoking, talking, and brushing the teeth, and frequently occurs spontaneously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is the management for trigeminal neuralgia?

A

carbamazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

how does an AICA stroke present?

A

sudden onset vertigo and vomiting
ipsilAterAl fAciAl pArAlysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

how does a PICA present?

A

sudden onset vertigo and vomiting
dysphagia
ipsilateral facial pain and temp loss
contralateral LIMB pain and temp loss
ataxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what is broca’s aphasia?

A

brocas - broken - word flow broken (expressive)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what is wernicke’s aphasia?

A

wernicke’s - what? - doesn’t understand a command (receptive)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

how do you manage a patient with a suspected TIA if they are on warfarin/DOAC/have a bleeding disorder?

A

admit and arrange CT head to rule out haemorrhage before giving aspirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

how does normal pressure hydrocephalus present?

A

triad
1. urinary incontinence
2. gait disturbance
3. dementia
(magnetic gait specific finding NPH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what is seen on imaging in NPH?

A

ventriculomegaly without sulcal enlargement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

how is status epilepticus managed?

A

ABC - airway adjunct, oxygen, check blood glucose
1L IV benzos - prehospital PR diazepam or buccal midazolam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

upper vs lower bitemporal hemianopia pathology?

A

Upper - pitUitary lesion
lOwer - craniOpharyngiOma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what dose of rectal diazepam do you give in status?

A

10mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what is the most common neurological consequence of meningitis?

A

sensorineural hearing loss
(then seizures, focal neuro deficits, sepsis, abscess, brain herniation, hydrocephalus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what are the features of neuroleptic malignant syndrome?

A

FEVER
Fever
Encephalopathy
Vitals dysregulation - in HR + RR
Enzyme - CK increase
Rigidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what are the mechanisms of action of the 3 main antiemetics?

A

1, 2, 3
1. cyclizine h1 receptor
2. metaclopramide d2 receptor
3. ondansetron 5ht3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

how does a pca stroke present?

A

contralateral homonymous hemianopia with macular sparing
visual agnosia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what syndrome is caused by a posterior inferior cerebellar artery infarct (PICA)?

A

lateral medullary syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

how to remember tibial vs peroneal nerve lesion presentation

A

TIPPED
Tibial nerve - Inversion - Plantarflexion
Peroneal nerve - Eversion - Dorsiflexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

how does spontaneous intracranial hypOtension present?

A

worse when upright
low csf - usually from a leak, associated with marfan’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what needs to be considered when starting a phenytoin infusion?

A

cardiac monitoring - pro-arrhythmogenic effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

what is the treatment pathway for neuropathic pain?

A

1L: amitriptyline, duloxetine, gabapentin, or pregabalin
2L: tramadol as ‘rescue therapy’ for exacerbations
topical capsaicin for localised neuropathic pain

52
Q

what drug is used for long term prophylaxis of cluster headaches?

A

verapamil

53
Q

which blood vessels are affected in subdural haemorrhage?

A

bridging veins between cortex and venous sinuses

54
Q

which blood vessels are affected in subarachnoid haemorrhages?

A

vessels of circle of willis, eg basilar and anterior circulating arteries

55
Q

what is the mechanism of action of pyridostigmine?

A

long acting acetylcholinesterase inhibitor
used in MG

56
Q

how to remember status mgt?

A

oh my lord phone the anaesthetist
O - O2
M - buccal midazolam or rectal diazepam
L - IV lorazepam
P - IV phenytoin
A - rapid induction of anaesthesia

57
Q

what eye defect is most commonly associated with raised ICP?

A

3rd nerve palsy due to herniation (down and out, ptosis, sometimes pupil dilation)

58
Q

where would the lesion be if there was a left homonymous hemianopia?

A

right optic tract (not nerve) - R optic radiation or occipital cortex

59
Q

what condition is chiari malformations associated with?

A

syringomyelia - dilatation of csf space within spinal cord - loss of pain sensation, temp and non-discriminative touch. cape like distribution

60
Q

how does an mca stroke present?

A

contralateral hemiparesis
sensory loss
upper extremity affected more
contralateral homonymous hemianopia
aphasia

61
Q

which antiemetic causes extrapyramidal side effects?

A

metaclopramide

62
Q

how does guillain barre present?

A
  • progressive, symmetrical weakness of all limbs
  • classically ascending
  • hypOreflexia
  • maybe mild sensory sx or none
  • often hx of gastroenteritis
63
Q

how is GBS investigated?

A

LP - raised protein, normal WCC
nerve conduction studies - dec motor nerve conduction velocity

64
Q

what is brown sequard syndrome?

A

lateral hemisection of the spinal cord

65
Q

how does brown sequard syndrome present?

A

ipsilateral weakness and proprioception/vibration loss
contralateral pain/temp loss

66
Q

what is the management for acute stroke within 4.5h?

A

thrombolysis and thrombectomy

67
Q

where is broca’s area?

A

inferior frontal gyrus (frontal lobe)

68
Q

where is wernicke’s area?

A

superior temporal gyrus (temporal lobe)

69
Q

what are the symptoms of normal pressure hydrocephalus?

A

wet - incontinence
wacky - dementia
wobbly - gait apraxia

70
Q

which drugs can exacerbate myasthenia gravis?

A

penicillamine
quinidine, procainamide
beta blockers
lithium
phenytoin
abx: gentamicin, macrolides, quinolones, tetracyclines

71
Q

what does a cnvi palsy present with?

A

contralateral defective eye abduction and horizontal diplopia

72
Q

rhyme to remember nerve roots and their actions?

A

s1/2 button my shoe
l3/4 kick the door
c5/6 pick up sticks
c7/8 close the gate

73
Q

what medications are used for spasticity in MS?

A

baclofen and gabapentin

74
Q

what is the treatment for a focal seizure in a man?

A

lamotrigine or levetiracetam

75
Q

in a patient with leg weakness and no arm weakness or aphasia, which vessel is likely to be affected?

A

ACA

76
Q

what imaging is used for MS?

A

MRI brain and spine with contrast - shows demyelinating lesions

77
Q

what sign is seen on MR venography in sagittal sinus thrombosis?

A

empty delta sign

78
Q

how does sagittal sinus thrombosis present?

A

headache
diplopia
bilateral papilloedema

79
Q

what is first line for post herpetic neuralgia?

A

don’t - duloxetine
get - gabapentin
pain - pregabalin
again - amitriptyline

80
Q

how does trochlear nerve palsy present?

A

defective downward gaze, vertical diplopia

81
Q

how does subacute combined degeneration of the cord present?

A

dorsal columns and lat corticospinal tracts
loss of proprioception and vibration sense
spasticity and brisk knee reflexes
babinski positive

82
Q

first line tx for parkinsons disease?

A

levodopa - if motor sx affecting QoL
if not, dopamine agonist, levodopa, mao-B inhibitor

83
Q

what are the side effects of phenytoin?

A

P - p450 interactions
H - hirsutism
E - enlarged gums
N - nystagmus
Y - yellow skin
T - teratogen
O - osteomalacia
I - interaction with B12 metabolism
N - neuropathies

84
Q

what are the features of a low pressure headache?

A

post lumbar puncture
young women with low BMI
within 24-48h after LP
worse upright
improves in recumbent position

85
Q

how are anti-epileptic drugs stopped?

A

can be considered if seizure free for over 2 years, stop AEDs over 2-3months

86
Q

what medication is used for cluster headache prophylaxis?

A

verapamil

87
Q

how does pontine haemorrhage present?

A

reduced GCS, paralysis and bilateral pin point pupils

88
Q

what is cushings triad (raised ICP)?

A

widening pulse pressure
bradycardia
irregular breathing

89
Q

which medications are associated with idiopathic intracranial hypertension?

A
  • tetracycline abx (like doxycycline)
  • isotretinoin
  • contraceptives
  • steroids
  • levothyroxine
  • lithium
  • cimetidine
90
Q

how does CJD present?

A

rapid onset dementia and myoclonus

91
Q

what is lhermitte’s sign?

A

tingling in hands when flexing neck/electric shock sensations down spine
indicates disease near dorsal column nuclei of cervical cord

92
Q

what type of stroke does contralateral homonymous hemianopia with macular sparing and visual agnosia indicate?

A

posterior cerebral

93
Q

which antiepileptic drug is most associated with wt gain?

A

sodium valproate

94
Q

what drugs increase the risk of IIH?

A

COMAAR
ciclosporin
oral contraceptives
mineralocorticoids
amiodarone
antibiotics (tetracyclines, sulphonamides)
retinoic acid

95
Q

which nerve is at risk in a fracture of the humeral shaft?

A

radial nerve

96
Q

what is weber’s syndrome?

A

midbrain stroke
characterised by ipsilateral CNIII palsy and contralateral hemiparesis

97
Q

what type of visual field defect does Primary open angle glaUcoma cause?

A

Unilateral Peripheral visual field loss

98
Q

what nerve does saturday night palsy affect?

A

radial nerve

99
Q

what is tuberous sclerosis?

A

AD condition
neurocutaneous features

100
Q

what are the features of tuberous sclerosis?

A

ash leaf spots
shagreen patches
adenoma sebaceum
fibromata beneath nails
cafe au lait (moreso neurofibromatosis)
devt delay
epilepsy
intellectual impairment

101
Q

what are the features of neurofibromatosis?

A

axillary/groin freckles
pheochromocytomas
NF2 - acoustic neuromas
iris hamartomas
ocular hamartomas
AD

102
Q

how does multi-system atrophy present?

A
  • parkinsonism
  • autonomic disturbance
    > erectile dysfunction
    > postural hypotension
    > atonic bladder
  • cerebellar signs
103
Q

how do jacksonian march seizures present?

A

clonic movt travelling proximally

104
Q

which lobe is associated with jacksonian march?

A

frontal lobe

105
Q

what are the most important initial investigations in status epilepticus?

A

ABDCE - hypoxia
BM - hypoglycaemia

106
Q

how does extradural haemorrhage appear on CT?

A

BICONVEX mass

107
Q

how does subdural haemorrhage appear on CT?

A

crescent

108
Q

how is acute relapse of MS managed?

A

methylprednisolone

109
Q

how does venous sinus thrombosis present?

A

headache
nausea and vomiting
reduced consciousness

110
Q

what is the effect of rocuronium in MG?

A

rocuronium rocks !
(hyperefficacious)

111
Q

what is the effect of suxaemethonium in MG?

A

Suxaemethonium sucks !!
hypoefficacious

112
Q

what is the effect of suxamethonium in MG?

A

Suxamethonium sucks !!
hypoefficacious

113
Q

what is found in CSF of pts with MS?

A

oligoclonal bands

114
Q

how does lambert-eaton syndrome present?

A
  • repeated muscle contractions lead to inc muscle strength
  • limb-girdle weakness
  • hyporeflexia
  • autonomic sx
115
Q

what drug is used in the management of IIH?

A

acetazolamide - carbonic anhydrase inhibitor

116
Q

what is the pattern of typical migraine aura?

A

spreading scintillating scotoma
(jagged crescent)

117
Q

what is the mechanism of action of memantine?

A

NMDA receptor agonist

118
Q

which tumours most commonly metastasise to the brain?

A
  • lung
  • breast
  • kidney
  • melanoma
  • colorectal
119
Q

how is acute myasthenic crisis managed?

A

plasmapheresis and ivig

120
Q

what is the preferred method of nutrition for patients with MND?

A

PEG tube

121
Q

what medications are used to treat neuroleptic malignant syndrome?

A

dantrolene in some cases
bromocriptine (dopamine agonist)

122
Q

above which level of spinal cord injury does autonomic dysreflexia occur?

A

above T6

123
Q

what is uhthoff’s phenomenon?

A

neurological sx exacerbated by increases in body temp
(associated with MS)

124
Q

what is uhthoff’s phenomenon?

A

neurological sx exacerbated by increases in body temp
(associated with MS)

125
Q

what medication is used for restless leg syndrome?

A

dopamine agonists - ropinirole

126
Q

what medication is used for restless leg syndrome?

A

dopamine agonists - ropinirole

revision (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions