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5th year > Neuro > Flashcards

Neuro Flashcards

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1
Q

What nerve lesion causes ‘claw hand’ deformity?

A

Ulnar nerve

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2
Q

What nerve lesion do you get ‘ape hand’?

A

Median nerve (wrist or higher)

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3
Q

What lesion causes hand of ‘benediction’ - unable to make a fist?

A

Median nerve lesion HIGH up lesion

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4
Q

What nerve lesion causes Saturday night palsy?

A

Radial nerve

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5
Q

What nerve lesion would causes pain and numbness in the lateral aspect of thigh? On palpation of the hip pain is worse?

A

Meralgia parasthetica - compression of the lateral femoral cutaneous nerve

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6
Q

What fracture is most likelly to lead to foot drop?

A

Head of the fibula - common peroneal nerve

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7
Q

What are the 3 types of peripheral neuropathies (catergories)?

A

Acute symmetrical peripheral neuropathy

Chronic symmetrical peipheral neuropathy

Multiple mononeuropathy

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8
Q

What is the most common cause of chronic symmetrical peripheral neuropathy?

A

Diabetic neuropathy

Then Nutrutional B12, B1 deficiencies

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9
Q

What is the definition of multiple mononeuropathy?

A

malfunction of 2 or more nerves in separate areas of the body

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10
Q

What is the most common cause of multiple mononeuropathy ?

A

Vasculitis

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11
Q

What condition?
Muscle weakness in your legs that travels to your upper body and gets worse over time.
difficulty walking steadily

A

Guillian Barre Syndrome

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12
Q

What is the pathophysiology of Guillian Barre?

A

Infection, produce antibody, that antibody attacks nerves.

Acute symmetrical peripheral neuropathy - predominantly motor

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13
Q

What condition?

20 yo distal muscle wasting and sensory loss with proximal progression. Mum had it.

A

Charcot Marie Tooth

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14
Q

What condition?
Onset before 20, progressive ataxia
Decreased propioception/vibration/muscle weakness
Cardiomyopathy

A

Freidreich’s Ataxia

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15
Q

What is multiple sclerosis?

A

Chronic demyelination of neurons in brain or spinal cord

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16
Q

Is MS more common in males or females?

A

Females 2.5x

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17
Q

What are the 4 types/progression patterns of MS?

A
  1. Relapsing and remitting (most common)
  2. Secondary progressive (follows 1)
  3. Primary progressive
  4. Progressive relapsing
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18
Q

What ist he criteria to diagnose MS called?

A

Macdonalds criteria

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19
Q

What is MCdonalds criteria?

A

At least 2 or more neurological lesions/attacks in different places at different places

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20
Q

What would you see on MRI of 95% of MS patients?

A

Periventricular lesions

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21
Q

What may you see on CSF analysis of MS?

A

Raised protein
Oligoclonal bands
Raised IG

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22
Q

What is the treatment or relapses for MS?

A

IV methylprednisolone

Muscle Spasms - baclofen
Bladder - ANticholinergics

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23
Q

What are the two most common types of moror neurone disease?

A

Amyotrophic lateral sclerosis (80%)

Progressive bulbar palsy (20%)

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24
Q

What part of the body is most commonly affected FIRST in ALS?

A

Limbs - loss of function

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25
What is affected first in progressive bulbar palsy?
Speech | Chewing
26
What drug is disease modifying but only extends life 2-4m?
Riluzole
27
What is the main cause of death in MND?
Respiratory failure
28
What is the pathophysiology of Parkinson Disease?
Reduction in dopamine production in the substantia niagra (part of the basal ganglia involved in the control of movement including the initiation of movement)
29
Is PD more common in men or women?
Men
30
Using the Brain Bank Criteria you need BLANK and one of BLANK, BLANK or BLANK for a diagnosis of PD
BRADYKINESIA Resting Tremor Rigidity Postural instability
31
What is controversially thought to be a first sign of PD?
Anosmia
32
Whats the diagnosis? | Tremor worse on movement, better at rest, not made worse by concentration
Benign essential tremor
33
What is the treatment for a benign essential tremor?
Reassurance +/- Propanolol
34
What is the mutation responsible to Huntington disease?
CAG repeat on chromosome 4
35
What are some early symptoms of Huntington Disease?
o Personality change o Self nglect o Clumsiness o Fidgeting/grimacing
36
What are some of the late symptoms of Hungtington Disease?
o Chorea o Rigidity o Depression then dementia
37
Most common aura in migraines
Scintillating scotoma
38
Are migraines usually unilateral or bilateral?
Unilateral
39
What is status migrainosus?
Debilitating migraine lasting for longer than 72h
40
Why do you not want people taking analgesia for headache more than 15 days a month?
Medication overuse headaches
41
What is the first line treatment for acute migraine?
Simple analgesia
42
What is the second line treatment for acute migraine?
Triptan (sumitriptan) and simple analgesia
43
What medicaition can be used for prevention of migraine?
Propanolol, Topiromate, Amitryptiline | NOT Gabapentin
44
What medication can be given to prevent migraines in a 34 year old with hypertension and asthma?
Topiromate or Amitrpytiline | Propanolol - CI asthma
45
Is tension headache bilateral or unilateral?
Bilateral
46
How many headaches do you need in a month to get a diagnosis of tension type headache?
10
47
What is the treatment for a tension type headache?
Simple analgesia - try avoid taking too much Treat cause (depression/sleep/pain) Low dose amitryptiline can be used for prevention
48
Who does an SDH most commonly occur in? (2)
Elderly Alcoholics Because of cerebral atrophy
49
What vessels cause bleeding in SDH?
Bridging veins
50
What has happened if SDH in a young child?
Shaken baby syndrome
51
What is the triad for shaken baby?
SDH Retinal haemorrhages Encephalopathy
52
What does SDH look like on CT?
Crescent - crosses suture lines
53
What is management of SDH?
Refer to Neurosurgery (may require Burr holes) Treat raised ICP if occurs`
54
What is the main cause of EDH?
Trauma
55
IS EDH common in children?
No - squishy skulls
56
What does EDH look like on CT?
Lens shape - does not cross suture lines
57
What part of the skulls is particularly prone to trauma leading to EDH?
Pterion frontal, parietal, temporal, and sphenoid bones join together
58
What artery runs undeneath the pterion?
Middle meningeal
59
Classical presentation timeline for EDH?
Trauma --> Fine (lucid interval) --> rapid deterioration --> death (30%)
60
What is the most common cause of SAH?
Trauma
61
What is the most common cause of spontaneous SAH (atraumatic SAH)?
Berry anurysm
62
What are two genetic conditions that lead to increase risk SAH?
1. Ehlos Danlos (/Marfans) | 2. Autosomal dominant polycystic kidney disease
63
What two activities that the patient may have been doing at onset of headache increase likelihood of SAH?
Exercise and Sex
64
Why may somoene have headache and neck pain in the hours/days leading up to SAH?
Sentinel bleeds (warning bleeds)
65
What is the key investigation for SAH and what would you see?
CT head Starfish of death
66
In 7% of SAH CT heads are normal, what investigation do you do for these patients?
LP at 12 hours (would show xanthochromia)
67
Bamford classification of TACI?
3 of: 1. Unilateral weakness 2. Higher cognitive dysfunction 3. Homonymous heminopia
68
Bamford classification of PACI?
2 of: 1. Unilateral weakness 2. Higher cognitive dysfunction 3. Homonymous heminopia
69
Bamford classification of Lacunar stroke?
1 of: 1. Pure motor 2. Pure sensory 3. Ataxic hemiparesis
70
Bamford classification of posterior circulation stroke?
1 of: 1. Cerebellar syndrome 2. LOC 3. Isolated homonymosu heminopia
71
What is the DANISH acronym and what is it used for?
``` Cerebellar symptoms Dysdiodochokinesis Ataxic gait Nystagmus Intention tremor Slurred speech Hypotonia ```
72
What artery is most commonly occluded in stroke?
Middle cerebral artery
73
What artery if occluded results in locked in syndrome?
Basilar artery
74
How do you tell the difference in facial droop between bells palsy and stroke?
Stroke is upper motor neurons so spares UPPER part of face Can raise eyebrow
75
What are the reasons for CT head immediately in 1 hour in suspected stroke?
1. Indications for thrombolysis 2. Risk factors for haemorrhagic stroke a. anticoagulants b. known bleeding condition c. decreased GCS 3. Symptoms suggesting SAH a. unexplained progressive/fluctuating Sx b. meningism c. thunderclap headache
76
What is the time cut off for thromoblysis?
4.5 hours
77
What medications for secondary prevention of stroke?
Clopidogrel 75mg life Statin Consider anti hypertensives Consider anticoag if AF
78
In a CN5 lesion does the jaw point towards or away from lesion?
Towards
79
In a CN10 lesion does uvula point towards or away from lesion?
Away
80
In a CN12 lesion does the tongue point towards or away from lesion?
Towards
81
Describe a 3rd nerve palsy?
Down and out | Dilated pupil
82
What is the most common vision disturbance in CN4 palsy?
Vertical diplopia

5th year (4 decks)

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