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Lottie's Question Books > Neuro > Flashcards

Neuro Flashcards

(76 cards)

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1
Q

What is the main risk factor of stroke?

A

HTN

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2
Q

List factors that convey a better prognosis for MS?

A

Under 25

Optic neuritis or sensory disturbance as primary complaint

Greater than 1 year between events

Few lesions on MRI

Female

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3
Q

What is amaurosis fugax?

A

Painless unilateral vision loss of short duration.

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4
Q

What causes amaurosis fugax?

A

Retain artery emboli due to AF

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5
Q

What is the immediate Tx of stroke? Why?

A

1st = nil by mouth –> prevent aspiration pneumoia

2nd = CT head –> can tell between ischaemic and haemorrhagic better

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6
Q

List complete contraindications to thrombolysis in stroke Tx

A

Onset more than 3hrs ago

Current seizure

BP > 180/110

Surgery less than 2 weeks ago

Bleeding

Previous intracranial bleed

LP less than 7 days ago

Stroke less than 3 months ago

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7
Q

Spine claudication, lumbar pain, sciatica on moving. Better when walking uphill vs down. Dx?

A

Spinal stenosis

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8
Q

Ascending polyneuropathy and associated motor loss. Dx?

A

GBS

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9
Q

What causes GBS?

A

Inflammation of peripheral nerves

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10
Q

List Sx of PD

A

TRAID = bradykinesia, tremor, rigidity

ALSO: narrow based gait, hypomimia, micrographia, kicking/yelling in sleep, autonomic dysfunction, postural instability

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11
Q

Pt fitting for 20 mins. Had 2 x rectal diazepam and still fitting. What is going on?

A

Status epilepticus

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12
Q

Woman w bad migraines taking co-codamol and ibuprofen. Headaches getting worse. Mx? Why?

A

Stop all Tx

Medication over use headache now

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13
Q

What is Tx for status epilepticus?

A

Phenytoin loading

Call ITU

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14
Q

What is the indication for requesting phenytoin levels?

A

Dose adjustment

Patient compliance

Toxicity - if Sx suggestive of this

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15
Q

Woman stares blankly for 1 minute then starts picking at clothes. Returns back to reality feeling tired. Dx?

A

Complex partial seizures

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16
Q

What feature differntiaties compelx and simple partial seixures?

A

Complex = dont remember event

SImple = retain conciousness, so remeber event

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17
Q

What feature is indicative of compelx partial seizures?

A

Pts carry out repetitive and purposeless motions such as chewing / lip smacking / picking at clothes

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18
Q

What feature is indicative of absence seizures?

A

In KIDS

Stare blankly for a few seconds

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19
Q

Traid of Wernicke’s ?

A
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20
Q

What is Korsakoff’s?

A

Anterograde amnesia (forget new information)

Post alcoholic

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21
Q

Signs of Wernicke/Korsakoff’s?

A

Broad gait but clumsy

Diplopia

Low MMSE - can’t register new info

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22
Q

Pt has 5/5 power upper limbs but 0/5 power lower limbs. Where is the lesion?

A

Spinal cord

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23
Q

What is the dermatomal level of the shoulders?

A

C4

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24
Q

What is the dermatomal level of the nipples?

A

T4

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25
What is the dermatomal level of the umbillicus?
T10
26
What is the dermatomal level of pockets?
L1
27
What is the dermatomal level of the knee?
L3
28
Crossed signs (eg L arm but R face) indicate that the lesion is where?
Brainstem
29
R arms and legs affected but also L face. Where is the lesion?
Left brainstem - R motor tract but L cranial nervee
30
In the swinging torch test, which cranial nerve is efferent and which is afferent?
A = CN 2 E = CN 3
31
What is the name of a failed swinging torch test lesion?
Relative afferent pupillary defect
32
What feature distinguishes myopathy from MG?
Fatiguability
33
Why are MG muscles fatiguable?
Use up the ACh to exhaustion therefore fatigued
34
How does MG differ from Lambert-Easton syndrome?
LE = increased repeition leads to increased strength MG = increased repetion leads to decreased strength
35
What causes Lambert Easton?
Auto AB against VGCC
36
Which condition is Lambert Easton most associated with?
Small cell lung cancer
37
What conditions is MG associated with?
Thyrotoxocosis, haemolytic anaemia, pernicious anaemia, connective tissue disease
38
Is Bells palsy UMN or LMN?
LMN
39
What is Mx of Bells palsy?
Lubricating eye drops & taping eye shut at night Steroids and acyclovir if PC \<48hrs
40
What is the most common cause of UMN facial palsy?
Stroke
41
What causes intranuclear opthalmoplegia?
Problem with communication between CN VI of right eye and CN III of left eye - often a lesion in the medial longitudinal fasciculus
42
Name a common cause of opthalmoplegia
MS
43
Flick distal phalynx of middle finger and thumb will contract. What sign is this?
Hoffman's sign
44
What does Hoffamn's reflex indicate?
UMN lesion
45
What features are classic of Lewy-Body dementia?
extra-pyramidal (parkinsonian)
46
Pt has disinhibition and problems finding words. Dx?
Fronto-temporal dementia
47
Causes of absent ankle jerk with upgoing plantars?
Cord compression Cord degeneration MND Freidrich's ataxia
48
Is MS UMN, LMN or mixed?
UMN only - never has LMN signs
49
Unsteady gait, difficulty raising right leg which he swings round in an arc on walking. R arm and wrist are flexed. Dx?
Hemiplegic gait
50
Which conditions have a scissoring gait?
MS and cerebral palsy
51
Which condition has a high stepping gait?
Foot drop
52
Which condition has a stomping gait?
Diabetic neuropathy
53
R lower quadrantoptia. Where is the lesion?
L parietal lobe
54
R upper quadrantopia. Where is the lesion?
L temporal lobe
55
Dizziness on moving head. Dx?
BPPV
56
Dizziness, tinnitus, hearing loss and sensation of increased ear pressure. Dx?
Menieres
57
Where does Meneires affect?
Inner ear
58
How do you differentiate Menieres from vestibular neuronitis?
VN does not affect hearing but Menieres does
59
Cafe au lait spots, axillary freckling and neurofibromas. Dx?
Neurofibromatosis type 1
60
Bilateral acoustic neuromas leading to deafness. Less cutaneous manifestations. Dx?
Neurofibromatosis type 2
61
Telangectasia, epistaxis, vascualr disorders. Dx?
Hereditary haemorrhagic telangectasia
62
What is evident on CT of extradural haematoma?
Lenticular (convex) shaped haematomas
63
Who gets subdural haematomas?
Elderly and alcoholics
64
Thunderclap headache. What does CT head show?
Blood along sulci and fissures (SAH)
65
Stroke w visual problems, dizziness, nystagmus and dysdiadokinesis. Where is lesion?
Posterior circulation - occipital lobe
66
Aphasia, agnosia, agraphia. Where is the lesion?
Left parietal lobe
67
Memory probelms with upper quadrantopia. Dx?
BILATERAL temporal lobe lesions
68
Visual / sensory / motor neglect. Dx?
RIGHT parietal lobe
69
5 day Hx of numbness and tingling in hands and feet, getting worse and worse. Complete resolution after 1 weeks. Dx?
GBS
70
What is Kernig's sign?
Patients leg is held flexed at hip and knee and there is pain and resistance on susequent knee extension
71
Meningism with LP results of: normal glucose low protein high lymphocytes Dx?
Viral meningitis
72
Meningism with LP results of: low glucose normal/raised protein high neutrophils Dx?
Bacterial meningitis
73
Meningism with LP results of: low glucose high/normal protein high lymphocytes Dx?
TB/fungal meningitis
74
LP results of: high glucose very high protein high RBC Dx?
SAH
75
Patient stands with feet together and closes her eyes. Unable to keep still. What test is this?
Rombergs
76
What does positive Rombergs show?
Proprioceptive loss

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