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Year 6 Written > Neuro > Flashcards

Neuro Flashcards

1
Q

What is cataplexy?

A

Loss of skeletal muscle tone with strong (usually +ve) emotion

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2
Q

Features of de Quervain tendinopathy

A
  • Radial side wrist pain
  • Finkelstein test: pain worse by ulnar deviation of wrist when thumb against palm
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3
Q

Cord compression features

A
  • Short onset
  • Back pain at lumbar region
  • New onset leg weakness and urinary retention
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4
Q

Cord compression Ix

A

MR Imaging of spine

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5
Q

Extradural haemorrhage affected vessel

A

Middle meningeal artery

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6
Q

Migraine prophylaxis

A

Propranolol

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7
Q

What are the 2 sensory pathways and the 1 motor pathway? (+ where do they decussate)

A

Sensory
1. Dorsal column: fine touch, proprioception & vibration
decussates at medulla
2. Spinothalamic: (anterior - pressure, crude touch) + (lateral - pain, temp)
Decussates at level of entry

Motor
1. Corticospinal: voluntary movement
Decussates at medulla

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8
Q

Mx for encephalopathy

A

Rifaximin or lactulose
( to regulate BO)

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9
Q

What is Brown Sequard syndrome and what pattern of neuro issues does it present with?

A

Injury to one side of the spinal cord. Syx present at and below the level of injury.
- Ipsilateral loss movement and fine touch/proprioception
- Contralateral loss of pain and temp sensation

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10
Q

Myoclonus seizure

A

Sudden involuntary contraction >= 1 group muscles

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11
Q

Multiple sclerosis flare Mx

A

Methylprednisolone

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12
Q

Features of MCA stroke

A
  • Weakness arms>legs
  • Aphasia
  • Homonymous hemianopia
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13
Q

Lumbar spinal stenosis and features

A

Narrowing of area of spine that contains the nerves or spinal cord
- Intermittent weakness and numbness both legs
- May be better at rest - neurogenic claudication

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14
Q

Intrinsic handle muscle wasting - site of lesion?

A

T1 nerve root

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15
Q

Cord compression mx

A

Dexamethasone -> external beam radiotherapy

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16
Q

Most likely anatomical site of origin for impaired awareness seizures

A

Temporal lobe

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17
Q

Foot drop affected nerve

A

Common peroneal

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18
Q

Cerebellar stroke features

A

Triad of

  • Headache
  • N/V
  • Ataxia (profound imbalance)
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19
Q

Glasgow coma scale

A

Eyes
1 No response
2 To pain
3 To speech
4 Spontaneously

Voice
1 No response
2 Noises
3 Inappropriate words
4 Confused
5 Oriented TPP

Motor
1 No response
2 Abnormal extension
3 Abnormal flexion
4 Withdrawal from pain
5 Move to localised pain
6 Obey commands

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20
Q

Which part of the brains are there changes in Alzheimer’s?

A

Temporal

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21
Q

Myasthenia gravis pathophysiological process

A

Autoimmunity

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22
Q

Lower limb dermatomes

A
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23
Q

Upper limb dermatomes

A
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24
Q

Feature of hypoglossal nerve lesion

A

Tongue deviates towards side of lesion on protrusion

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25
Trigeminal neuralgia and features
Irritation of trigeminal nerve. - sudden and intense pain in the face, jaw, and cheek - Triggered when brushing teeth/cold wind touching face
26
Mx for neuropathic bladder due to MS
If post-void >100ml: intermittent self-catheterisation
27
Bell's palsy and features
- Facial N paralysis - Unilateral facial weakness - NOT forehead sparing
28
Bell's palsy mx
Prednisolone
29
Mx for parkinsonism syx(but not PD)
Procyclidine hydrochloride
30
Akathisia v dystona v tardive dyskinesia
Akathisia: feeling of restlessness Dystonia: abn muscle tone -> muscular spasm + abn positions Tardive dyskinesia: invol movement of face and jaw
31
Spinal cord compression features
- Back pain - Bilateral leg weakness +/- Recent fall
32
IN MS, which cells are affected?
Oligodendrocytes
33
Trigeminal neuralgia mx
Carbamazepine
34
GB features
Numbness + weakness + pain Start distally and spreads proximally Problems with balance and coord
35
Spatial neglect issues - where is lesion?
Parietal
36
Horner's and features
Damage to the sympathetic supply to the face 1. Ptosis (droopy upper eyelid) 2. Miosis (excessive constriction) 3. Anhidrosis
37
Dx of MS and best ix
clinical diagnosis by consultant neurologist, 2 lesions disseminated in time and space which may be clinical or MRI with evidence of demyelination. MRI
38
Ramsay Hunt and features
Herpes zoster virus affecting facial N 1. Painful rash/blisters in ear canal or on outside of ear 2. Weakness/paralysis of facial muscles on affected side 3. Loss of taste sensation front two-thirds of tongue 4. Tinnitus // hearing loss 5. Vertigo//dizziness
39
Cauda equina and features
medical emergency caused by compression or damage to the nerve roots that make up the cauda equina - perianal anesthesia - urinary/fecal incontinence - lower extremity weakness/ paralysis
40
Conus medullaris compression and features
occurs when there is pressure on the conus medullaris, the lower end of the spinal cord - back pain ++ - perianal anaesthesia - bladder/bowel dysfunction
41
Status epilepticus mx
Time 0min: IV lorazepam (0.1mg/kg) or buccal midazolam or PR diazepam Time 10 min: IV lorazepam (repeat) Time 15 min: IV phenytoin 20mg/kg or IV levetiracetam or IV sodium valproate Time 20-30min: Trial second agent from above or IV phenobarbital Time >30 min: rapid induction anaesthesia
42
Cluster headache mx acutely
Triptan ± short term O2 therapy
43
Cluster headache prophylaxis
verapamil (alt topiramate)
44
Migraine acute mx
paracetamol/ibuprofen + triptan ±anti-emetic drug, e.g., metoclopramide
45
MS spasticity syx mx
1Baclofen or gabapentin 2 Try other agent 3 combo OR dantrolene
46
Campylobacter, ascending polyneuropathy, anti GM1+ve
Guillan-barre syndrome
47
Optic n/spinal cord lesion, normal MRI + anti aquaporin 4+ve
neuromyelitis optica
48
What are the cerebellar signs?
Dysdiadodiskinesia Ataxia Nystagmus Intention tremor Slurred speech Hypotonia
49
Specific MS signs
- Uhthoff's phenomenon (visual syx worse with incr body temp) - Lhermitte's syndrome (paraesthesia in limbs when pt flexes neck)
50
what is disulfiram used for and what is its mechanism
Promotes alc abstinence inhibitor of acetaldehyde dehydrogenase
51
Wernicke's encephalopathy features
- nystagmus - ataxia - confusion
52
Wernicke's enceph mx
1. If hypo (<4mmol/L) - treat 2. 2 pairs IV pabrinex immediately after glucose 3. cont for 5 days, 2 pairs TDS 4. prophylactic thiamine indef
53
cape like distribution of pain/temp loss (shoulders + upper limbs)
Syringeomyelia
54
Sensory level L1-2 loss, upgoing plantars, absent knee reflexes (mixed UMN+LMN)
Conus medullaris lesion
55
VDRL +ve & loss vibr/proprioception
Tabes dorsalis (tertiary neurosyphillis)
56
Saddle anaesthesia + downgoing plantars
Cauda equine syndrome
57
Anterior spinal artery syndrome
Occlusion of ant spinal artery, which supplied anterior 2/3 of spinal cord
58
If high suspicion of SAH but normal CT
LP at 12hr for xanthochromia
58
HTN + brady + kussmaul breathing
Cushing's triad of raised ICP - impending herniation of brain
59
SAH CT findings
hyperdensity within cisterns/sulci
60
Extradural haemorrhage involved vessel
middle meningeal artery
61
Extradural haemorrhage CT
hyperdense biconvex (lemon)
62
Subdural haematoma involved vessel
bridging dural veins
63
Subdural haematoma CT
Cresenteric collection (banana)
64
SAH involved vessel
Ruptured cerebral aneurysm
65
focal weakness after seizures
Todd's paralysis
66
Diabetic painful neuropathy mx
Duloxetine
67
Progressive muscle weakness over days + other LMN signs (±younger pt) w/ preservation of sensation after diarrhoea
GBS
68
GBS mx
IV immunoglobulin
69
GBS LP finding
High protein + low cell count
70
SAH RF
excessive alcohol

Year 6 Written (26 decks)

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