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#passmed 2023 > Neuro > Flashcards

Neuro Flashcards

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1
Q

What is an example of Parkinsons Plus disorder?

A

Progressive supranuclear palsy

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2
Q

What are the CF of Progressive supranuclear palsy that make it different to normal Parkinsons? (2 things)

A
  1. Dysarthria
  2. Reduced vertical eye movements
    (but has normal TRAP Parkinsons CF as well)
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3
Q

What are the CF of a cluster headache? (4 things)

A
  1. Episodic + intense
  2. Unilateral eye pain (stabbing)
  3. Lacrimation
  4. Restless
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4
Q

What complication can Parkinsons lead to due to Autonomic failure over time?

A

Postural hypotension

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5
Q

What are the CF of Encephalitis? (5 things)

A
  1. Seizures
  2. Fever
  3. Headache
  4. Vomiting
  5. Swelling + Increased brain signal @ MRI
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6
Q

What are 95% of Encephalitis caused by?

A

HSV

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7
Q

What is the immediate Tx for Encephalitis?

A

Aciclovir

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8
Q

What will the CSF show in Lumbar puncture of Encephalitis? (2 things)

A
  1. Raised lymphocytes
  2. Raised protein
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9
Q

What is the classical triad of Normal Pressure Hydrocephalus? (3 things)

A
  1. Dementia
  2. Gait abnormality
  3. Urinary incontinence
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10
Q

Normal Pressure Hyrocephalus is a ____ cause of dementia?

A

Reversible

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11
Q

What is the Mx for Normal Pressure Hyrocephalus?

A

Ventriculoperitoneal shunting

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12
Q

What is the key CF of Myasthenia gravis?

A

Weakness that worsens throughout the day

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13
Q

What is an Eye symptom of Myasthenia gravis?

A

Blurred vision that worsens throughout the day

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14
Q

What autoantibodies do Myasthenia gravis pt have?

A

Acetylcholine receptor autoantibodies

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15
Q

What cancer is Myasthenia gravis linked to?

A

Thymoma

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16
Q

What other conditions if Myasthenia gravis linked to?

A

AI conditions like SLE

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17
Q

What investigations should you do for Myasthenia gravis? (3 things)

A
  1. Single fibre electromyography (myo like mya)
  2. Acetylcholine receptor autoantibodies
  3. CK normal
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18
Q

What is the FIRST line Mx for Myasthenia gravis?

A

Pyridostigmine (acetylcholinesterase inhibitor)

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19
Q

What is the Mx of ischaemic stroke with no signs of haemorrhage on CT?

A

Within 4.5 hours of presenting = Thrombolysis + Thrombectomy

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20
Q

What can you develop after a Lumbar puncture?

A

Iatrogenic headache

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21
Q

What is another name for Simple Partial seizure? Why is that name better?

A

Focal aware seizure
Tells you if pt is aware or not (aka LOC or not)

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22
Q

What is another name for Complex Partial seizure? Why is that name better?

A

Focal impaired awareness seizure
Tells you if pt is aware or not (aka LOC or not)

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23
Q

What is the Afferent and Efferent Nerve in the Corneal Reflex?

A
  • Afferent = V1 (ophthalmic)
  • Efferent: 7 (facial)
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24
Q

What is the Afferent and Efferent Nerve in the Jaw Jerk Reflex?

A
  • Afferent = V3 (mandibular)
  • Efferent: V3 (mandibular)
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25
What is the Afferent and Efferent Nerve in the Gag Reflex?
* Afferent = 9 (9lossopharyn9eal) * Efferent: 10 (vagal nerve) (same as Carotid sinus reflex)
26
What is the Afferent and Efferent Nerve in the Carotid sinus Reflex?
* Afferent = 9 (9lossopharyn9eal) * Efferent: 10 (vagal nerve) (same as Gag reflex)
27
What is the Afferent and Efferent Nerve in the Pupillary light Reflex?
* Afferent = 2 (optic nerve) * Efferent: 3 (oculomotor)
28
What is the Afferent and Efferent Nerve in the Lacrimation Reflex?
* Afferent = V1 (ophthalmic) * Efferent: 7 (facial)
29
What should you start pt on once ischaemic stroke confirmed? (3 things)
1. 300mg daily (2 weeks) 2. 75mg Clopidogrel (forever) 3. Offer statin if not already on one
30
What is used for the long term prophylaxis of Cluster headaches?
Verapamil
31
What age does MND usually present at?
After 40
32
What are the CF of MND? (7 things)
1. Asymmetrical limb weakness 2. Mix of UM + LM signs 3. Small hand muscles wasting 4. Tibialis anterior wasting 5. Fasciculations 6. NO sensory sings 7. SPARING of ocular muscles (eye)
33
How do you diagnose MND?
Clinical
34
How do you feed ppl with MND?
PEG (percutaneous gastrostomy tube)
35
Which nerve palsy gives you Down n Out appearance of eye?
3
36
What is the best management for Idiopathic intracranial HTN with no visual changes?
WL
37
What is the best management for Idiopathic intracranial HTN WITH visual changes?
WL + Acetazolamide
38
What does ANTERIOR Cerebral artery stroke cause? (2 things)
1. Leg weakness (contralat) 2. Leg sensory loss (contralat) 3. NO face weakness 4. NO speech impairment
39
What does MIDDLE Cerebral artery stroke cause? (4 things)
1. Aphasia (can’t talk) (so you say MMMM) 2. Homonymous hemianopia (contralat) 3. Arm weakness (contralat) 4. Arm Sensory loss (contralat)
40
What does POSTERIOR Cerebral artery stroke cause? (2 things)
1. Homonymous hemianopia w MACULAR sparing (contralat) 2. Visual agnosia (can’t recognise things)
41
What does ANTERIOR INFERIOR Cerebellar artery stroke cause? (2 things)
1. Facial paralysis (ipsilateral) 2. Deafness (ipsilateral)
42
What does POSTERIOR INFERIOR Cerebellar artery stroke cause? (4 things)
1. Facial pain + Temperature loss (ipsilateral) 2. Nystagmus 3. Limb / torso pain Temperature loss (contralat) 4. Ataxia (can’t control body movements)
43
What does Retinal / ophthalmic artery stroke cause? (4 things)
Amaurosis fugax (aka temporary loss of vision in one / both eyes)
44
In strokes how many arteries can be clarted? Wdym?
Several, so you can get mix of ant + middle cerebral clartation CF
45
What arteries are clarted in TACI (Total Anterior Circulation Infarct)?
Anterior + Middle Cerebral arteries
46
What Triad of CF is seen in TACI (Total Anterior Circulation Infarct)? (3 things)
1. Unilateral weakness / sensory loss (face + arm + leg) 2. Homonymous hemianopia 3. Higher cogn dysf (dysphasia)
47
What arteries are clarted in Partial Anterior Circulation Infarct (PACI)?
Smaller arteries in anterior circulation (upper / lower division of middle cerebral artery)
48
What is seen in Partial Anterior Circulation Infarct (PACI)?
2/3 of Triad of TACI: 1. Unilateral weakness / sensory loss (face + arm + leg) 2. Homonymous hemianopia 3. Higher cogn dysf (dysphasia)
49
When is Carotid endarterectomy indicated in TIA pt?
Carotid artery stenosis 70+ %
50
What is the rule when Neuropathic meds are not working?
Switch meds, don’t add (aka if amitriptyline not working, switch to pregabalin)
51
How do you remember motor innervation of hand?
Rock, Paper, Scissors = Median, Radial, Ulnar (in alphabetical order) * Rock = clench fist like rock = Median nerve * Paper = stretch hand = Radial nerve is finger extension * Scissors = imagine scissors made from ring + index finger = Ulnar is finger abd + add
52
What are the CF of Focal seizure (originating in temporal lobe)? (3 things)
1. Change in taste / smell 2. Lip smacking 3. Repetitive finger movements
53
What did we say is unique about Focal seizure Mx?
Only one with FIRST line lamotrigine, all others is Sodium valproate
54
What scan is FIRST line for strokes?
CT head WITHOUT contrast
55
What meds are FIRST line for spasticity in MS? (2 things)
1. Baclofen 2. Gabapentin
56
What will you see in CSF of MS pt?
Oligoclonal bands
57
How do you remember lesions causing Homonymous Quadrantopias (aka quarter of vision in eye gone)
PITS * Parietal = Inferior * Temporal = Superior (and obv will be contralat)
58
When can you stop Anti-epileptics and how should you stop them?
* If seizure free for 2 years * Stop over 2-3 months
59
What is the Acute Tx for Migraine? (3 things)
Triptan + NSAID / Paracetamol
60
What is used for PROPHYLAXIS of Migraines?
Topiramate / Propranolol
61
How do you remember what the Spinothalamic tract does
SPinoThalamiC 1. Simple touch 1. Pain 2. Temperature 3. Crude touch
62
What do you get in Syringomyelia?
Spinothalamic clartation (so the 4 things we mentioned clarted)
63
What type of Dementia does MND increase risk of?
Frontotemporal dementia
64
What is the most common complication of Meningitis?
SN HL
65
What is a side fx of Phenytoin?
Peripheral neuropathy (feet n hand numbness) (P for P)
66
If you have Down n Out eye (aka 3rd CN palsy) but its painful, whats the Dx?
Posterior communicating artery aneurysm (PCA)
67
Whats important to proect in Bells palsy pt?
Eyes = give them night time drops n lubricants
68
What is a side fx of Triptans?
Throat / chest Tightness (TTT)
69
What should you give pt with raised ICP bc traumatic injury while they wait for CSF drainage surgery?
IV mannitol (diuretic so reduces pressure)
70
What is the CSF drainage surgery done for raised ICP bc traumatic injury?
External ventricular drain
71
What is Webers Syndrome? (2 things)
Midbrain stroke with: 1. CN 3 palsy (down n out, dilated pupil) (ipsilat) 2. Weakness (contralat)
72
What roots is the Ankle reflex?
S1 – S2 button my shoe
73
What roots is the Knee reflex?
L3 – L4 kick the door
74
What roots is the Biceps reflex?
C5 – C6 pick up sticks
75
What roots is the Triceps reflex?
C7 – C8 open the gate
76
What is FIRST line meds for Trigeminal Neuralgia?
Carbamazepine
77
How do you differentiate Acute vs Chronic bleeding in CT head?
Acute = bright (hyperdense) Chronic = dark (hypodense) AB CD
78
What is the new FIRST line med ofr Absence seizures?
Ethosuximide

#passmed 2023 (39 decks)

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