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Internal medicine > Neuro > Flashcards

Neuro Flashcards

1
Q

Neurocutaneous syndromes

A

Neurofibromatosis
Sturge Weber
Tuberous sclerosis
Von Hippel Lindau
Ataxia telegiectasia

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2
Q

Operating and historical definition of status epilepticus

A

Operating: >5Mins
Hisorical: >30mins

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3
Q

Difference between medical and surgical third nerve palsies

A

Surgical CN3 palsy usually affects pupil(Causes mydriasis)
Medical CN3 palsy may spare the pupil

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4
Q

Causes of peripheral neuropathy

A

Diabetic neuropathy
Alcoholism
Syphilis
Charcot Marie tooth
Leprosy

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5
Q

Triad of Miller Fisher Syndrome

A

A subset of GBS

Ophthalmoplegia
Ataxia
Areflexia

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6
Q

Webers test

A

Localises towards side of conductive hearing loss

OR

Localises away from side of sensorineural hearing loss

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7
Q

Rinne test

A

Positive: AC>BC (Normal or sensorineural hearing loss)
Negative: BC>AC(conductive hearing loss)

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8
Q

CN and muscles involved in bulbar palsy(medulla oblongata lesion)

A

CN 9,10,11,12 LMN lesion

Palate and tongue muscles

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9
Q

1st rule of 4 of Brainstem

A

4 CN in brainstem and above
4 CN in pons
4 CN in medulla oblongata

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10
Q

2nd rule of 4 of brainstem

A

4 midline nuclei that can divide 12

CN 3,4,6,12

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11
Q

3rd rule of 4 of brainstem

A

4 midline structures

  1. Motor(corticospinal)
  2. Medial Lemniscus(DCML)
  3. MLF
  4. Motor nuclei of midline(3,4,6,12)
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12
Q

4th rule of 4 of brainstem

A

4 side structures

  1. Spinothalamic
  2. Spinocerebellar
  3. Sympathetic pathway
  4. Sensory nucleus of CN V
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13
Q

Dydx MG and LEMS

A

LEMS has reduced reflexes,MG does not

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14
Q

Chronic Mx of MG

A

AchE-inhibitor: Pyridostigmine
Immunosuppression: Corticosteroids or azathioprine

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15
Q

5 key signs in neuro exam

A

Wasting
Reflexes
Tone babinski

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16
Q

Non modifiable risk factors for stroke

A

Age
Gender
ethnicity

17
Q

Modifiable stroke risk factors

A

DM
HLD
HTN
Atrial fibrillation

Smoking
Atherosclerotic disease
Vasculitides
HIV
OCPs
Haem eg Thrombophilias

18
Q

Signs of POCS posterior occipital circulation stroke

A
  1. CN palsy with contralateral motor loss
  2. Bilateral motor sensory deficit
  3. Conjugate eye movement
  4. Cerebellar dysfunction
  5. Isolated homonymous hemianopia
19
Q

Features of TACS total anterior circulation stroke

A

ALL of the following
-loss of higher cortical dysfunction
-homonymous hemianopia
-motor/sensory stroke
-

20
Q

Features of partial anterior circulation stroke(PACS)

A

2 of the TACS criteria

OR

1) higher cortical dysfunction alone
2) Limited sensory motor deficit

21
Q

Features of Lacunae stroke(LACS)

A

Any of
1) Pure motor deficit
2) Pure Sensory deficit
3) Ataxic Hemiparesis
4) Sensorimotor
5) NO higher cortical function loss or posterior circulation issues

22
Q

Nerves that pass through the cavernous sinus

A

CN3, CN4, CNV1 CNV2 CN6

23
Q

Nerves that pass through the superior orbital fissure

A

CN2 CN3 CN4 CNV1 CN6

24
Q

Exclusion criteria for rTPA

A
  1. Age >80
  2. On anticoagulation regardless of INR
  3. NIHSS >25
  4. Hx of stroke/DM
25
Q
A
26
Q

6Ms of complex opthalmoplegia

A
  1. Myasthenia Gravis
  2. Myopathy of EOMs
  3. Miller Fisher Syndrome
  4. Mononeuritis multiplex
  5. Multiple Sclerosis
  6. Multiple CN pathology
27
Q

4 steps to multiple CN neuropathies

A
  1. Rules of 4
  2. Brainstem clubs
  3. Meninges/base of skull lesions
  4. Peripheral neuropathy
28
Q

Gold standard for SAH diagnosis

A

4 vessel cerebral angiogram
-2 ICA 2 vertebral artery

CT or digital subtraction

29
Q

Dx criteria of NF1

A

2/7 of

Cafe au lait spots or hyperpigmented nodules(6+ , >5mm for prepubertal, >15mm for postpubertal)
Neurofibromas
Crowe sign( Freckles on axillary/inguinal region)
Lisch nodules(2+)
Optic nerve Gliomas
Sphenoid dysplasia/ long bone abnormalities
First deg relative with NF1

30
Q

Gene affected by NF1

A

NF1 gene on chromosome 17

31
Q

Gene affected by NF2

A

NF2 gene on chromosome 22

32
Q
A
33
Q

Criteria for fitness to drive for an patients with epilepsy in Singapore

A

3 years seizure free and 1 year off anti epileptic drugs

Internal medicine (15 decks)

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