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Nick's MD2 > Neuro > Flashcards

Neuro Flashcards

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1
Q

What are 2 signs and 2 symptoms of optic neuritis?

A

Pain on moving eye,
Loss of central vision,
Relative afferent pupillary defect
Papilloedema

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2
Q

What pattern of weakness is expected in the upper limb with an UMN lesion?

A

Extensors weaker in the upper limb

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3
Q

What pattern of weakness is expected in the lower limb with an UMN lesion?

A

Flexors weaker in the lower limb

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4
Q

How do you calculate risk of stroke in AF?

A 
CHADSVASC
CCF
HTN (140/90 or on treatment)
Age 75 or older (1 point)
DM
Stroke or TIA (2 points)
Vascular disease
Age 65-74 (1 point)
Sex category (f=1)
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5
Q

What is the immediate management plan for meningitis?

A 
1 blood cultures
2 dexamethasone
3 ceftriaxone + benzylpenicillin
4 (?CTB if needed)
5 LP
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6
Q

What is the drug treatment of choice for generalised epilepsy?

A

Sodium valproate

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7
Q

What is the drug treatment of choice for focal epilepsy?

A

Carbemazepine

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8
Q

What is the most common type of brain tumour?

A

Astrocytoma

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9
Q

What are 3 characteristic features from headache due to raised ICP?

A

Worse in the morning
Worse with coughing
Better after vomiting

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10
Q

What is a surgical third nerve palsy?

A

Compression - parasymapthetic fibres more affected - dilated pupil (EOM intact)
Often due to PCom aneurysm

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11
Q

What is a medical third nerve palsy?

A

Often due to diabetes - somatic motor fibres more affected - ophthalmoplegia (but pupillary reflex intact)

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12
Q

Principles of treatment for an astrocytoma

A
  • dexamethasone
  • resection of as much of the tumour as safely possibly
  • adjuvant CTx and RTx therapy
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13
Q

What is the typical pattern for a low grade glioma on T1 weighted MRI with contrast?

A

non enhancing mass with minimal mass effect

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14
Q

Most common symptom of low grade glioma?

A

Seizures

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15
Q

Principles of treatment of a low grade glioma

A
  • removal of as much as the tumour as safely possible

- defer RTx and CTx until tumour progression

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16
Q

What are the 4 signs of Gerstmann syndrome?

A

dysgraphia/agraphia
dyscalculia/acalculia
finger agnosia
left-right disorientation

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17
Q

which primary tumours commonly metastasise to the brain?

A

lung, breast, melanoma, kidney, GI

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18
Q

principles of treatment of brain metastases

A
  • dexamethasone
  • If 1 met: surgery
  • for 1-3 mets: stereotactic radiotherapy
  • for multiple mets: whole brain RTx
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19
Q

The level of sensory deficit tells you what about the level of injury?

A

the lowest possible level of injury (could be anywhere higher than this)

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20
Q

most common cause of nerve root injury?

A

herniated intervertebral disk

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21
Q

Claw hand implies a lesion of which nerve?

A

Ulnar

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22
Q

Wrist drop implies a lesion of which nerve?

A

Radial

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23
Q

Define oscillopsia

A

sensation that the visual world is moving

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24
Q

What is the difference in presentation between peripheral and central nystagmus?

A

Peripheral - may not be seen unless you remove the fixation of the eye
Central - will see it all the time

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25
What does a positive head impulse test imply?
Vestibular involvement (not central)
26
how do you diagnose myasthenia gravis?
- tensilon test with short acting ACh antagonist (edrophonium) - blood test for autoantibodies -ACh R, MuSK - CT chest (for thymoma) - EMG studies
27
treatment of myasthenia gravis
ACh antagonists plasma exchange IV immunoglobulin immunosuppression - steroids, azathioprine thymectomy
28
major diagnostic finding to diagnose myopathy
CK >1000
29
treatment for encephalitis
Acyclovir
30
safest seizure medication in pregnanct
Tegretol (carbamazepine)
31
when is the greatest risk of rebleed of a subarachnoid haemorrhage?
First 24-48 hours
32
What is a normal ICP?
10-15mmHg
33
When grading power, what does 5 indicate?
5 normal power
34
When grading power, what does 4 indicate?
4* active movement against gravity and resistance
35
When grading power, what does 3 indicate?
3 active movement against gravity
36
When grading power, what does 2 indicate?
2 active movement with gravity eliminated
37
When grading power, what does 1 indicate?
1 flicker or trace of contraction
38
When grading power, what does 0 indicate?
0 no contraction
39
what is dysmetria?
overshooting (in finger-nose test)
40
the head impulse test can help you differentiate between which two diagnoses
vestibular neuritis - head impulse test positive posterior fossa stroke - head impulse test normal (when you have acute onset severe gait ataxia, nausea, vomiting, continuous)
41
When grading reflexes, what does 0 indicate?
0 absent
42
When grading reflexes, what does 1 indicate?
1+ hypoactive
43
When grading reflexes, what does 2 indicate?
2+ normal
44
When grading reflexes, what does 3 indicate?
3+ hyperactive without clonus
45
When grading reflexes, what does 4 indicate?
4+ hyperactive with clonus
46
Cerebral infarction typically shows which type of necrosis?
Licquefactive
47
At what vertebral level does the spinal cord stop?
L1/2
48
Erector spinae muscles: How would you identify them by palpation? What movements do they support?
Between spinous process and ribs | Extension/flexion of the back
49
What is endangered with a fracture of the medial epicondyle of the elbow?
Ulnar nerve
50
Hypometric saccades... where is the pathology?
Cerebellum
51
GCS motor scale
``` 6 Obeys commands 5 Localises to pain 4 Withdraws to pain 3 Abnormal flexion to pain 2 Abnormal extension to pain 1 No response ```
52
GCS verbal scale
``` 5 Oriented 4 Confused 3 Inappropriate words 2 Incomprehensible 1 No response ```
53
GCS eye opening scale
4 Spontaneous 3 To voice 2 To pain 1 None
54
Which action reliably tests the function of the ulnar nerve in the hand?
Finger abduction
55
What is the sensory deficit with a lesion of the ulnar nerve at the wrist?
Palmar surface of the medial 1.5 fingers and palm | Dorsal 1.5 fingers are supplied by the posterior cutaneous branch that arises in the forearm
56
Why is benzylpenicillin given in empirical treatment of meningitis?
To cover Listeria monocytogenes
57
Acute management of ischaemic stroke
Alteplase (tPA) within 4.5 hours of onset | If >4.5 hours or tPA contraindicated, aspirin 150-300mg
58
After how much time will blood appear isodense to brain on CT?
2 weeks
59
What is the triad of Menierre's disease?
1) Tinnitus 2) Vertigo 3) Hearinig loss
60
What does the superior branch of the occulomotor nerve supply?
Superior rectus and levator palpebrae
61
What does chadsvasc measure?
Risk of stroke from AF
62
How do you differentiate vasogenic oedema from cytotoxic oedema on MRI?
Vasogenic oedema doesn't cross border from grey matter to white matter

Nick's MD2 (21 decks)

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