Neuro Flashcards
(185 cards)
1
Q
Commonest psych manifestation of Parkinson’s?
A
Depression (40%)
2
Q
Thrombolysis w. alteplase for acute stroke criteria
A
Onset of symptoms <4.5 hours prior AND
Haemorrhage excluded by CT/MRI
3
Q
Absolute CIs to thrombolysis? (x11)
A
Prior stroke/TBI in last 3 months Previous IC haemorrhage Suspected SAH Lumbar puncture 7 days prior GI haemorrhage in 3 weeks prior Active bleeding Oesophageal varices Intracranial neoplasm Seizure during stroke Cardiac embolus Pregnancy Hypertension >200/120
4
Q
Indications for mechanical thrombectomy in stroke?
A
<6 hours after symptom onset AND proximal anterior/posterior circulation stroke confirmed by CTA/MRI
OR
6-24 hours after symptoms if confirmed proximal Ant/Post occlusion confirmed by imaging AND potential to salvage brain tissue (dwMRI)
NB- Perform with IV alteplase if <4.5hours from symptoms
5
Q
Acute ischaemic stroke secondary prevention drug regimen?
A
Aspirin + clopidogrel + statin (if cholesterol >3.5)
6
Q
Neuroleptic Malignant Syndrome Fx -and in who?
A
Tachycardia
Convulsions/Rigidity
Sweating
Seen in pts on antipsychotics recently started/dose change
7
Q
NEMS Rx
A
Stop antipsychotic
IV fluids (prevent AKI)
Consider Daltreone (reduces muscular contractions)
Consider bromocriptine
8
Q
NEMS blood findings
A
Raised CK
Raised WCC
Hyperkalaemia
Hypocalcaemia
9
Q
Valproate side effects (10)
A
P450 inhibition Nausea Teratogenicity Alopecia Weight gain Hyponatraemia Encaphalopathy Ataxia Hepatotoxicity Thrombocytopaenia
10
Q
Vestibular schwannoma Fx
A
CN 8 - Tinnitus, vertigo, unilateral sensorineural HL
CN 7 - Facial palsy
CN 5 - Absent corneal reflex
11
Q
Vestibular schwannoma Ix + Rx
A
MRI of CPA
Urgent ENT referral for surg/radiotherapy
12
Q
GCS Motor points
A
6 -obeys commands 5 - Localises to pain 4 - Withdraws from pain 3 - Decorticate posture 2 - Extending to pain 1 - No movement
13
Q
GCS Eye points
A
4 - Spontaneous
3 - To speech
2 - To pain
1 - None
14
Q
GCS Verbal points
A
5 - Oriented 4 - Confused 3 - Words 2 - Sounds 1 - None
15
Q
Type of antiemetic for chemotherapy related nausea?
A
5HT-3 inhibitors e.g. ondansetron, given with a steroid
16
Q
Uhthoff’s phenomenon?
A
The worsening of MS symptoms linked to heat exposure -bath, sweating, exercise etc.
17
Q
Acute MS Rx + desired effect?
A
IV/PO methylpred for <5 days. Speeds recovery from flare up but does not affect scale of recovery.
18
Q
Role of Beta interferons in MS Rx
A
Long term medication; Reduces flare ups by up to 30%.
19
Q
Baseline Ix in MS and why?
A
MRI with contrast - as contrast allows fulfilment of dissemination in time criterion.
20
Q
What are Dawson fingers?
A
Peri-corpus callosum lesions seen on T2 MR imaging in MS
21
Q
Fx and two types of MSA?
A
Parkinsonism
Autonomic instability
Cerebellar signs
MSA-C is mostly cerebellar
MSA-P is mostly Parkinsonisn
22
Q
Bedside test for CSF in rhino/otorrhoea?
A
Glucose (+ vs mucous)
23
Q
Gold standard test fo CSF?
A
Beta-2-transferrin
24
Q
Under what circumstances should a GP prescribe buccal midazolam as well as refer to epilepsy clinic after a first seizure?
A
- Neurological deficit
- Structural abnormality
- Abnormal EEG
- Patient considers risk of recurrence to be unacceptably high
25
Headache red flags? (13)
```
Unexplained vomiting
Headaches worse with fever
Headache triggered by cough/postural change
Immunocompromise
Hx of malignancy with brain mets
Thunderclap headache
New onset neurodeficit
New onset cognitive dysfunction
Change in personality
Impaired consciousness
TBI in <3 months
Fx of GCA or narrow angle glaucoma
```
26
Idiopathic intracranial hypertension Fx and risk factors?
Blurred vision/papilloedema
Headache
Sixth nerve palsy
Risk factors include being female, obese, pregnant and certain medications (steroids, OCP)
27
IIH Rx
```
Weight loss
Diuretics
Topiramate
Repeat LPs
Optic nerve sheath decompression and fenestration
```
28
Charcot Marie Tooth/Hereditary Sensorimotor Neuropathy Type 1
Inheritance and features?
Features begin in puberty
| Distal muscle wasting, pes cavus, clawed toes, foot drop, myopathy
29
Early features of retinitis pigmentosa?
Sensation of 'tunnel vision'
30
Ankle, Knee, Biceps and Tricpes reflex nerve roots?
S1-2
L3-4
C5-6
C7-8 (in that order)
31
Where would the lesion be found for each of the following types of dysphasia?
Wernicke's
Conductive
Brocca's
Wernicke's (receptive) - Superior temporal gyrus
Conductive - Arcuate something
Brocca's (expressive) - Inferior frontal gyrus
32
Features of a common peroneal nerve lesion?
```
Foot drop/ankle dorsiflexion weakness
Eversion weakness
Extensor hallucis longus weakness
Anterior muscle wasting
Numbness on lateral aspect of lower leg and dorsum of foot
```
33
What is the role of Riluzole in motor neuron disease?
Prevents stimulation of glutamate receptors predominantly in ALS, and has been shown to prolong life by about 3 months.
34
Time window for thrombectomy in acute ischaemic stroke?
6 hours - (thrombolysis <4.5 hours)
35
What is the role of the facial nerve?
Ears: Stapedius msucle controls hearing
Eyes: Lacrimation (and salivation)
Taste: Anterior 2/3 of tongue
Muscles of facial expression
36
Hyperacusis follows which CN palsy, and what is the mechanism?
Facial nerve palsy causes stapedius paralysis
37
Commonest + other neruological sequelae following meningitis?
Commonest is sensorineural hearing loss
| Others include epilepsy, abscess formation, paralysis, hydrocephalus
38
Rx guidelines for medical management of neuropathic pain
1st: Amytriptilline, Gabapentin, Duloxetine, Pregabalin
2nd: Tramadol
Topical capsaicin may be useful
39
Features of a temporal lobe seizure?
H - Hallucinations (any modality)
E - Epigastric rising
A - Automatisms (lip smacking)
D - Deja vu, Post ictal Dysphasia
40
Phenytoin side effects?
Acute: Dizziness, diplopia, nystagmus, ataxia, seizures, confusion.
Insidious: Gingival hyperplasia, hirsutism, drowsiness, megaloblastic anaemia, peripheral neuropathy
Idiosyncratic: Fevers, rash, Dupuytren's contracture, iatrogenic lupus, hepatitis
Teratogenic: Cleft palate and CHD
41
What is Todd's paresis?
Post-ictal weakness after a focal seizure
42
Degenerative cervical myelopathy: Fx, Ix, Rx?
Fx: Extremity parasthesia, neck/arm pain, clumsiness
Ix: MRI
Rx: Urgent surgical decompression
43
Where is the lesion in internuclear opthalmoplegia, and what does it cause clinically?
Medial longitudinal fasciculus - Causes contralateral coarse nystagmus on abduction failed adduction on ipsilateral side
44
EEG findings of an absence seizure?
Bilateral 3Hz spike and wave pattern
45
What is mononeuritis multiplex, and how is it different from polyneuropathy?
Non-contiguous, asymmetrical/sequential loss of sensory and motor function. This is different to polyneuropathy in that it is asymmetrical.
46
Causes of a third nerve palsy?
```
Diabetes
Vasculitis (e.g.Sarcoid)
Central venous thrombosis
Raised ICP
MS
```
47
Describe the ataxic gait
Wide based gait with impaired heel-to-toe gait
48
Difference between total and partial anterior circulation infarcts?
TACI has 3/3 whereas PACI has 2/3 of:
1. Hemiparesis/hemisensory loss
2. Homonymous hemianopia
3. Higher cognitive dysfunction (e.g. dysphasia)
49
Features of Lateral Medullary Syndrome?
Ipsilateral: Dysphagia, Ataxia, Nystagmus, Facial numbness, Horner's,
Contralateral: Hemisensory limb loss
50
Does Charcot Marie Tooth affect motor, sensory or both?
Both
51
Confirmed TIA management?
Aspiring 300mg
52
What percentage of patients with meningitis do not exhibit neck stiffness?
30%
53
What type of headache is polymyalgia rheumatica associated with?
Temporal arteritis
54
Seconadary stroke prevention in those who do not tolerate clopi?
Aspirin + dipyridamole lifelong
55
Cranial nerve responsible for direct response to light?
Optic nerve
56
What would cause bitermporal hemianopia with upper versus lower quadrant defect?
Upper quadrant = inferior chaism = pituitary tumour.
| Lower quadrant = upper chaism = craniopharyngioma
57
Which antiepileptic is most associated with weight gain?
Sodium Valproate
58
Presentation of syringomyelia?
Cape like anaesthesia distribution
| Impaired temperature and pain sensation but fine touch, vibration and proprioception are in tact.
59
Causes of syringomyelia?
Chiari malformation
| Others: Tumours, trauma, infection
60
What is autonomic dysreflexia?
Occurs with spinal cord injury at T6 or above.
| Characterised by hypertension, sweating, flushing but with no appropriate increase in heart rate
61
Migraine acute and prophylactic management?
Acute: Triptan + NSAID/paracetamol
Prophylaxis: Topiramate or propranolol
62
TIA definition?
By tissue not time now - requires a normal MRI
63
Which is more severe, Duchenne's or Becker's?
Duchenne's, Becker's often only presents after age of 10
64
What is Hoffman's sign and what does it indicate?
This is seen in patients with degenerative cervical myelopathy, and describes the phenomenon where flicking of one finger stimulates twitching in other fingers of the same hand.
65
Technical name for frozen shoulder? Which movement is often most affected and what is the most suitable management option?
Adhesive capsulitis, where external rotation is often worst affected. Early physiotherapy is advised.
66
What are the features of tuberous sclerosis?
Neuro: Learning delay, seizures
Cutaneous: Shagreen patches (lumps over cervical spine), ash leaf spots (hypopigmented leaf lesions), adenoma sebaceum (angiofibromas in butterfly distribution over nose), subungual fibromata
Other: Retinal hamartomas (dense white areas on retina), cardiac rhabdomyomata, PKD
67
What is a Jacksonian march seizure
A focal aware seizure which starts by affecting a peripheral body part before quickly marching over the respective foot, hand or face
68
Neuroleptic Malignant Syndrome tetrad?
Hyperthermia
Rigidity
Autonomic instability
Altered mental status
69
What are the characteristic features of Guillain Barre syndrome?
Characteristically, progressive, ascending weakness of all four limbs. Sensory symptoms tend to be mild.
Other Fx may include Hx gasroenteritis, hyporeflexia, CN involvement
70
What is secondary generalisation with respect to Jacksonian march seizures
When the electrical disorder spreads over larger brain areas, developing into a grand mal seizure
71
What investigations would you do to diagnose GB syndrome?
LP - Raised protein with normal WCC
| Nerve conduction studies
72
What are the features of Charcot Marie Tooth disease?
```
Heredity
Hx of ankle dislocations
Distal muscle atrophy
High foot arch (pes cavus)
Foot drop
Hammer toes
Hypo reflexia
```
73
What are the features of an essential tremor?
Postural tremor worse if arms outstretched
| Improved by alcohol and rest
74
Management for essential tremor?
Propranolol 1st line
| Primidone sometimes used
75
What brain region is affected in Wernicke's aphasia?
Left superior temporal gyrus
76
What brain region is affected in Broca's aphasia?
Left inferior frontal gyrus
77
Signs of lateral medullary syndrome?
```
Ipsilateral ataxia
Nystagmus
Dysphagia
Facial numbness
Cranial nerve palsy with contralateral hemisensory loss
```
78
What are the signs of a lacunar infarct?
Presents with one of the following:
1. Unilateral weakness/sensory deficit of face, arm and or leg
2. Pure sensory stroke
3. Ataxic hemiparesis
79
What would be the MRI findings in a pt with DCM?
Disc generation and ligament hypertrophy with accompany spinal cord signal change
80
What is the management of tremor in drug induced Parkinsonism?
Procyclidine
81
What are some side effects of levodopa?
Dyskinesia, on-off effect, dry mouth, anorexia, palps, postural hypotension, psychosis, drowsiness
82
Why should levodopa not be acutely stopped?
May cause acute dystonia
83
Dopamine receptor agonists may cause what condition which should be monitored for?
Pulmonary and cardiac fibrosis
84
Which nerve supplies the interossei muscles?
Ulnar nerve
85
What is the management of trigeminal neuralgia?
Carbamazepine 100mg BD
86
Secondary prevention following TIA or stroke?
Clopidogrel
87
What should all patients with GCS below 8 be considered for?
Anaesthetic review and intubation/ventilation
88
Give four causes of postural hypotension with compensatory tachycardia
Deconditioning
Dysfunctional heart (AS)
Dehydration (disease, drugs, dialysis)
Drugs (GTN, Parkinson's, antidepressants)
89
What are the driving laws if a patient has a first unprovoked seizure?
Inform DVLA and can only reapply for license after 6 months of being seizure free
90
Visual field defect caused by pituitary adenoma?
Bilateral superior quadrantopia
91
Visual field defect caused by craniopharyngioma
Bilateral inferior quadrantopia
92
What type of migraine treatment (prophylactic or treatment) are triptans, and when precisely should it be taken?
Treatment - should be taken after onset of headache, NOT after onset of aura
93
What are some contraindications to triptan use?
PMH ischaemic heart disease or cerebrovascular disease
94
Fx of ACA stroke?
Contralateral hemiparesis and sensory loss with lower limbs affected more than upper limbs
95
Fx of MCA stroke?
Contralateral hemiparesis and sensory loss with upper limbs affected more than lower limbs.
Contralateral homonymous hemianopia
Aphasia
96
Fx of PCA stroke?
Contralateral homonymous hemianopia with macular sparing
| Visual agnosia
97
Why is there macular sparing in PCA strokes?
The macula receives dual blood supply from the MCA and PCA
98
What are some risk factors for MS?
Smoking, previous EBV infection, genetics (HLADRB1*15), vitamin D deficiency
99
What are some other features of Bell's palsy?
Post auricular pain, altered taste, dry eyes, hyperacusis
100
Why do Bell's patients present with hyperacusis
Paralysis of the stapedius muscle so unable to regulate volume effectively
101
What is the acute management of stroke?
Control glucose, hydration, sats and temperature
Aspirin 300mg as soon as haemorrhage has been excluded
Commence statin if cholesterol is over 3.5
Regarding AF, do not start anticoagulation until 14 days after the incident - due to risk of haemorrhagic transformation
102
Brown Sequard syndrome results in what neurological pattern due to damage of which tracts?
1. Ipsilateral spastic paresis (lateral corticospinal tract)
2. Contralateral loss of pain and temperature sensation (Spinothalamic tract)
3. Ipsilateral loss of proprioception and vibration (dorsal columns)
103
What is the rule regarding first TIA and driving/DVLA?
Can start driving if symptoms free for 1 month, no need to inform DVLA
104
What are some factors indicating pseudoseizure may be more likely than seizure
Gradual onset and resolution
Ability to control the location of symptoms
Psychiatric link
105
What are the features of NPH?
'Wet, wobbly, wacky'
| Urinary incontinence, gait ataxia, dementia
106
What is seen on neuroimaging of NPH, and how is it managed?
Hydrocephalus with enlarged 4th ventricle
| Management is by ventriculoperitoneal shunting
107
What is an automatism, and what seizure type might they be seen in?
A repetitive, automatic behaviour - e.g. lip smacking. They are commonly seen in focal seizures with impaired awareness
108
What are the first and second line medications for secondary stroke prevention?
1. Clopidogrel
| 2. DAPT
109
Third nerve vs. fourth nerve palsy?
Down and out vs. up and out
110
What are some red flag symptoms of trigeminal neuralgia warranting urgent referral?
```
Sensory changes (SN deafness is common)
Hx of skin or oral lesions which may spread perineurally
Pain only in V1 of CN5, or bilaterally
FHx MS
Age less than 40
```
111
WHich infection is most strongly associated with GB syndrome?
Campylobacter jejuni
112
Which drugs are known to precipitate myaesthenic crises?
```
Beta blockers
Penicillamine
Quinidine
Lithium
Phenytoin
Abx
```
113
Gait ataxia is caused by lesisons where in the cerebellum?
Vermis
114
What is the management for Bell's palsy?
1mg/kg pred for 10 days with lubricating eye drops
115
What are the signs of a pontine haemorrhage?
Reduced GCS
Quadriplegia
Reactive miosis
Absent horizontal eye movements
116
Which antiemetic is most likely to precipitate extrapyramidal side effects?
Metoclopramide
117
What may be used for rescue therapy in the case of exacerbations of neuropathic pain?
Tramadol
118
What are some features suggestive of MND?
```
Fasciculations
Absence of sensory involvement
Mixture of upper and lower motor signs
Small hand and tibialis anterior muscle wasting is common
Doesnt affect external ocular muscles
No cerebellar signs
```
119
Which nerve is most commonly damaged in Colle's fracture? What is its motor and sensory innervation?
Median nerve
Motor: LOAF - Lateral 2 lumbricals, opponens pollicis, abductor pollicis, flexor pollicis
Sensory: Lateral 3.5 fingers
120
What are first line investigations for patients with suspected vestibular schwannoma?
Audiography
| Gad enhanced MRI
121
What is a Chiari 1 malformation and what is it associated with?
Herniation of the cerebellar tonsils through the foramen magnum. This disrupts CSF flow, predisposing to hydrocephalus and syringomyelia.
122
What haematological abnormality may be caused by phenytoin?
Megaloblastic anaemia
123
What are some features of a vasovagal episode?
```
Associated with short post ictal period
External stress (may be psychological)
May be associated with mild-moderate limb twitching/jerking
```
124
Which drugs most commonly cause Stevens Johnson syndrome
```
Allopurinol
Lamotrigine
Carbamazepine
Phenytoin
Phenobarbital
Sertraline
Sulfasalazine
Anti virals/biotics/fungals
```
125
What is the management for Stevens Johnson syndrome?
Stop the causative agent
Admit to ICU
Obtain IV and NG access
126
Name one trigger for cluster headaches
Alcohol
127
What is the first line management for idiopathic intracranial hypertension, and how does it work?
Acetazolamide is a carbonic anhydrase inhibitor which reduces CSF production, normalisng ICP
128
What non-pharmacological option is best for IIH
Weight loss
129
Jacksonian march seizures are a feature of what type of epilepsy?
Frontal lobe epilepsy
130
Third nerve palsies occur in the context of which type of herniation within the brain?
Transtentorial/uncal
131
Which patient population has three times higher rates of Bell's palsy than the general population?
Pregnant women
132
What would cause the following picture?
Weakened dorsiflexion, inversion and eversion of the ankle with normal plantar flexion, as well as reduced sensation in the first web space between big and second toe
L5 lesion
133
Which nerves are frequently injured during axillary dissection causing sensory loss over the axilla?
Intercostobrachial
134
Which nerve is responsible for pronation of the forearm?
Median
135
What is the management of an acute myaesthenic crisis?
Plasmapheresis and IVIG
136
What is the management of NEMS?
Dantrolene and Lorazepam
137
What is the management for a thyroid storm crisis?
IV hydrocortisone, propranolol, fluids
138
What type of dementia is MND associated with?
Frontotemporal
139
```
Which of the following is not a use of carbamazepine?
Trigeminal neuralgia
Absence seizures
Bipolar disorder
Temporal lobe epilepsy
Focal impaired awareness seizures
```
Absence seizures
140
Which medications are associated with IIH?
```
Tetracycline antibiotics
Isotretinoin
Contraceptives
Steroids
Levothyroxine
Lithium
```
141
What is the management plan for IIH?
```
Weight loss
Diuretics e.g. Acetazolamide
Topiramate
Repeated therapeutic LPs
Optic nerve sheath decompression and fenestration or Ventriculoperitoneal shunting
```
142
What medication is used for long term prophylaxis of cluster headaches, and what is used for acute management?
Prophylaxis: Verapamil
Acutely: Sumatriptan + O2
143
Which two drugs are first line in spasticity in MS patients?
Baclofen, gabapentin
144
What is the management and prognosis for absence seizures (petit mal)?
Ethosuximide and valproate are first line
| 90-95% are seizure free by adolescence
145
What are some features of cavernous sinus syndrome?
Painn, opthalmoplegia, proptosis, trigeminal nerve lesion, Horner's syndrome
146
What is Lhermitte's sign, and when is it seen?
Parasthesia of the hands on neck flexion. Seen in MS and indicatyes disease near the dorsal column nuclei of the cervical cord.
147
What is Ramsay Hunt syndrome?
Herpes zoster infection of the facial nerve causing drooping and hearing loss
148
What diet is an extablished treatment for children with treatment resistant epilepsy?
Ketogenic diet
149
What might cause a headache which is worse on standing than it is on lying, in an otherwise well patient?
Spontaneous intracranial hypotension
150
What is the commonest neurological manifestation of sarcoidosis?
Facial nerve palsy (bilateral)
151
What are the signs of a cholesteatoma?
Facial nerve weakness accompanied by a foul smelling ear discharge
152
What differences would be seen on CT between an acute or chronic haemorrhage
Acute is hyperdense, chronic are hypodense
153
Subdural haemorrhages result from bleeding of which vessels?
Bridging veins - which run between the cortex and venous sinuses?
154
What is the MOA of ondansetron, and what are two side effects?
Competitive 5HT-3 antagonist.
| Adverse effects include QT prolongation and constipation
155
Which neurofibromatosis is associated with bilateral hearing loss due to vestibular schwannomas?
Type 2
156
What might happen if you give folate ONLY to a patient deficient in B12?
Subacute combined degeneration of the cord
157
What is subacute combined degeneration of the cord?
Caused by B12 deficiency, it involves:
Damage to posterior columns (sensory ataxia with positive Romberg)
Damage to lateral columns (UMN signs)
Damage to peripheral nerves (LMN signs)
158
Acute withdrawal of levodopa may precipitate what?
NEMS
159
What is Weber's syndrome?
A midbrain stroke resulting in ipsilateral oculomotor paralysis and contralateral hemiparesis/plegia
160
What does DANISH stand for?
```
Dysdiadochinesia/Dysmetria
Ataxia
Nystagmus
Intention tremor
Slurred stacato speech
Hypotonia
```
161
What is cataplexy?
Sudden and transient loss of muscle tone caused by strong emotion (laughter/terror etc.)
162
What is the first line management option for myasthenia gravis and how does it work?
Pyridostigmine - a long acting anticholinesterase inhibitor
163
What are the features of a T1 lesion, and how is it commonly caused?
Weakness of finger aBduction and thumb aDduction
Loss of sensation over medial epicondyle
Commonly caused by a traction injury?
164
Aneurysm of which artery may cause a painful third nerve palsy?
Posterior communicating artery
165
List some causes of a athird nerve palsy
```
Diabetes mellitus
Vasculitides
Uncal herniation with raised ICP
Posterior communicating aneurysm
Weber's syndrome
Cavernous sinus thrombosis
```
166
Which Parkinsonian disorder might present with unilateral symptoms?
MSA
167
What are the features of Arnold-Chiari malformation?
Non communicating hydrocephalus
Headache
Syringomyelia
168
The tremor in idiopathic Parkinson's is usually symmetrical. True or false?
False - it is usually asymmetrical. Drug induced parkinsons may cause a bilateral tremor
169
3rd nerve palsy causes miosis (constricted) or mydriasis (dilated)?
mydriasis
170
Mid shaft humeral fractures are associated with injury of which nerve? How would you test for this nerve?
Radial nerve - test by extension at the wrist
171
True or false:
| A Parkinsonian tremor will improve with voluntary movements
True
172
Management (1st and second line) for generalised tonic clonic epilepsy?
1: Valproate
2: Lamotrigine or carbamazepine
173
What blood test might you do post ictally to differentiate true from pseudoseizures?
Prolactin (will be raised 10 minutes after an episode)
174
When is Phalen's test positive?
Carpal tunnel syndrome
175
What cutaneous feature are indicative of NF1?
Axillary freckles
176
Abnormal flexion vs extension, which give two GCS points, which gives 3?
Abnormal flexion gives 2 points
177
What is the management of restless leg syndrome?
```
Simple measures such as walking/stretching
Treat any iron deficiency
Dopamine agonists e.g. ropinirole
Benzos
Gabapentin
```
178
Which nerve is at risk of injury in a surgical neck of humerus fracture/
Axillary nerve?
179
Which nerve roots are affected in Klumpkes palsy, and what is a common complication of this?
C8-T1 are affected
| T1 involvement often also causes Horner's syndrome
180
Which nerve roots are injured in Erb's palsy?
C5-6
181
What monitoring must be commenced when starting a phenytoin infusion?
Cardiac monitoring due to pro-arrhythmogenic effects
182
What might cause pain and weakness bilaterally on walking which resolves on rest?
Lumbar canal stenosis or vascular claudication from PVD
183
Where do 5-HT3 antagonists work?
At the chemotherapy trigger zone at the medulla oblongata
184
What is Hoover's test used for?
To discriminate between organic and non-organic lower leg weakness. Normal leg should push down as the patient attempts to raise the affected leg.
185
Which antibodies are seen in Lambert Eaton syndrome?
VGCa channel antibodies
