Neuro 2

Question 1

huntingtons chorea inheritance

Answer 1

autosomal dominant

there is genetic anticipation- trinucleotide repeats increase every generation meaning onset is quicker and severity higher

Question 2

what medication may be used in huntingtons for chorea symptoms

Answer 2

tetrabenzine

Question 3

what tumor is myasthenia gravis associated with

Answer 3

thymoma

Question 4

antibodies associated with myasthenia gravis

Answer 4

anti Ach receptor antibodies
MuSK antibodies
LRP4 antibodies

Question 5

what muscles are most affected in myasthenia gravis

Answer 5

proximal muscles of the limbs
small muscles of the head and neck

Question 6

mx of myasthenia gravis

Answer 6

pyridostigmine- cholinesterase inhibitor

immunosupression eg prenisolone or azothioprine

rituximab

Question 7

how is a myasthenic crisis managed

Answer 7

non invasive or mechanical ventilation
IV immunoglobulins or plasmapheresis

Question 8

lambert eaton myasthenic syndrome has autoantibodies against

Answer 8

voltage gated calcium channels on presynaptic membranes

Question 9

features of autonomic distrubance

Answer 9

dry mouth
impotence
blurred vision
dizziness
urinary retention
ileus
heart arrythmia

Question 10

how to differentiate myasthenia gravis from LEMs

Answer 10

LEMs muscle strength improves with use

myasthenia gravis muscle strength is worse with use

Question 11

LEMs is associated with

Answer 11

small cell lung cancer

Question 12

what is charcot marie tooth disease

Answer 12

an inhertied disorder causing peripheral neuropathy

Question 13

drugs causing peripheral neuropathy

Answer 13

isoniazid
amiodarone
leflunomide
cisplatin

Question 14

features of charcot marie tooth disease

Answer 14

peripheral neuropathy
high foot arches- pes cavus
distal muscle wasting
hyporeflexia
hypotonia

Question 15

infections associated with GBS

Answer 15

campylobacter jejuni
cytomegalovirus
EBV

Question 16

GBS pathophysiology

Answer 16

antibodies synthesised by B cells against the offending pathogen also fit antigens on the myelin sheath or nerve axons

Question 17

ix for GBS

Answer 17

nerve conduction studies
CSF analysis

Question 18

what does lumbar puncture show in GBS

Answer 18

raised protein with normal cell counts and glucose

Question 19

time frame of GBS

Answer 19

usually sx peak 2-4 weeks after initial infection

recovery can take months to years

Question 20

NF1 inheritance

Answer 20

autosomal dominant

Question 21

how many neurofibromas are considered significant

Answer 21

2

Question 22

sx NF1

Answer 22

neurofibromas
glioma of optic nerve
bony dysplasia- bowing
iris harmatomas
axillary freckling

Question 23

bilateral acoustic neuromas

Answer 23

NF2

Question 24

features of tuberous sclerosis

Answer 24

ash leaf spots
shagreen patch
angiofibromas (small pigmented papules across face and cheeks)
cafe au lait spots
isolated patch of white hair on head

neurological:
epilepsy
learning disability
brain tumors

Question 25

first line for chronic or frequent tension headaches

Answer 25

amitriptyline

Question 26

sinusitis mx over 10 days

Answer 26

steroid nasal spray abx- phenoxymethylpenicillin

Question 27

what is a silent migraine

Answer 27

aura but no headache

Question 28

when are triptans used in migraine mx

Answer 28

acutely

Question 29

triptan dosing for migraines

Answer 29

take one dose as soon as sx start if it doesnt work do not take another dose during the same attack

Question 30

triptan moa

Answer 30

5 HT receptor agonists (stimulate serotonin receptors)

Question 31

migraine prophylaxis meds

Answer 31

propanolol topiramate amitriptyline

Question 32

topiramate caution

Answer 32

very teratogenic- take effective contraception

Question 33

medical word for constricted pupil

Answer 33

miosis

Question 34

medial word for dilated pupil

Answer 34

mydriasis

Question 35

cluster headaches acute treatment

Answer 35

triptan high flow oxygen

Question 36

propylaxis for cluster headache

Answer 36

verapamil