Neuro Short Flashcards
(75 cards)
1
Q
Causes of sensory predominant neuropathy?
A
B12 Diabetes EtOH Myeloma Paraneoplastic
2
Q
Signs of severity in parkinson’s disease?
A
motor fluctuations dyskinesia psychosis dementia sleep disturbance orthostatic hypotension
3
Q
Causes of motor predominant neuropathy?
A
AIDP CIDP charcot marie tooth MND MMN
4
Q
Causes of unilateral pes cavus?
A
burns
compartment syndrome
polio
spinal trauma
5
Q
Causes of bilateral pes cavus?
A
freidrich's ataxia muscular dystrophy SMA cerebral palsy hereditary spastic paraparesis
6
Q
What nerves supply biceps reflex?
A
C5-6
7
Q
What nerves supply brachioradialis reflex?
A
C5-6
8
Q
What nerves supply triceps reflex?
A
C6-7
9
Q
What nerves supply knee jerk reflex?
A
L3-4
10
Q
What nerves supply ankle jerk reflex?
A
S1-2
11
Q
What nerves supply plantar reflex?
A
L5-S1
12
Q
Causes of unilateral cerebellar disease?
A
mass ischaemia paraneoplastic MS trauma
13
Q
Cause of bilateral cerebellar disease?
A
anti epileptic drugs friedreich's hypothyroidism paraneoplastic MS trauma EtOH
14
Q
Signs of Freidrich’s ataxia?
A
cerebellar signs posterior column loss in the limbs upper motor neuron signs in the limbs peripheral neuropathy optic atrophy pes cavus cardiomyopathy diabetes mellitus
15
Q
Causes of chorea?
A
wilsons
drugs
sydenhams (rheumatic fever)
huntingtons
16
Q
Differential diagnosis for MS?
A
paraneoplastic syndrome vitamin B12 deficiency CNS vasculitis SLE sarcoidosis HIV syphilis migraine somatoform disorders
17
Q
Causes of Horner’s syndrome?
A
lung apex carcinoma thyroid malignancy carotid artery aneurysm brain stem lesion retro orbital lesions syringomyelia
18
Q
Causes of pupil constriction?
A
horner’s syndrome
argyll robertson pupil
pontine lesion
narcotics
19
Q
Causes of pupil dilatation?
A
third nerve lesion adie's pupil iritis post trauma cerebral death congenital
20
Q
Causes of papilloedema?
A
space occupying lesion hydrocephalus IIH hypertension central retinal vein thrombosis cerebral venous sinus thrombosis
21
Q
Causes of ptosis with normal pupils?
A
myotonic dystrophy
facioscapulohumeral dystrophy
thyrotoxic myopathy
myasthenia gravis
22
Q
Causes of ptosis with constricted pupils?
A
horner’s syndrome
23
Q
Causes of ptosis with dilated pupils?
A
third nerve lesion
24
Q
Clinical features of third nerve palsy?
A
ptosis
down and out eye
unreactive dilated pupil
25
Causes of third nerve palsy?
```
tumour
demyelination
trauma
brain stem infarction
diabetes
aneurysm
```
26
Causes of unilateral lower motor neuron seventh nerve palsy?
```
tumour
MS
acoustic neuroma
meningioma
bell's palsy
ramsay hunt
otitis media
fracture of temporal bone
parotid tumour/sarcoid
```
27
Causes of bilateral lower motor neurone facial weakness?
GBS
sarcoidosis of parotid
mononeuritis multiplex
28
Causes of sensorineural deafness?
```
degenerative
high noise exposure
congenital rubella
congenital syphilis
acoustic neuroma
vascular disease of internal auditory artery
brain stem lesion
```
29
Causes of multiple cranial nerve palsies?
nasopharyngeal carcinoma
chronic meningitis
GBS
vascular brain stem lesions
30
Site of lesion in Wernicke's aphasia?
posterior part of first temporal gyrus in dominant lobe
31
Site of lesion in Broca's aphasia?
posterior part of third frontal gyrus
32
Signs of a lower motor neurone lesion?
weakness
wasting
decreased/absent reflexes
fasciculation
33
Signs of an upper motor neurone lesion?
weakness
spasticity
clonus
hyperreflexia
34
Causes of painful peripheral neuropathy?
```
diabetes mellitus
alcohol
vitamin B12/B1 deficiency
carcinoma
porphyria
```
35
What are the nerve conduction study findings in a demyelinating peripheral neuropathy?
slowed conduction velocity
| delayed or absent F waves
36
What are the nerve conduction study findings in an axonal peripheral neuropathy?
reduced amplitude
| relative normal conduction velocity
37
Causes of mononeuritis multiplex?
```
diabetes
polyarteritis nodosa
SLE
RA
sarcoid
acromegaly
```
38
Causes of thickened nerves?
hereditary motor and sensory neuropathy
acromegaly
CIDP
amyloidosis
39
Causes of fasciculation?
```
benign idiopathic fasciculation
motor neuron disease
motor root compression
malignant neuropathy
spinal muscular atrophy
```
40
What are the clinical features of Charcot-Marie-Tooth?
pes cavus (high arch of foot)/clawing of the toes
distal muscle atrophy
symmetrical distal weakness
absent reflexes
thickened nerves
high stepping gait/foot drop
reduced sensation (motor symptoms usually predominant over sensory symptoms)
41
What are the clinical features of C5/C6 upper trunk brachial plexus lesion?
hand in waiter's tip position
| sensory loss over lateral aspect of arm/forearm and thumb
42
What are the clinical features of a radial nerve lesion?
wrist and finger drop
| sensory loss over anatomical snuffbox
43
What are the clinical features of a median nerve lesion?
inability to flex index finger
inability to abduct thumb
sensory loss over thumb, index, middle and half of ring finger on palmar aspect
44
Causes of carpal tunnel syndrome?
```
idiopathic
RA
hypothyroidism
acromegaly
pregnancy
trauma/overuse
```
45
What are the clinical features of an ulnar nerve lesion?
weak finger abduction and adduction
claw hand
sensory loss over the little finger and medial half of the ring finger
46
What are the clinical features of a femoral nerve lesion?
weakness of knee extension
loss of knee jerk
sensory loss of inner aspect of thigh
47
What are the clinical features of a sciatic nerve lesion?
weakness of knee flexion
foot drop
loss of ankle jerk
sensory loss on posterior thigh and total loss below the knee
48
What are the clinical features of a common peroneal nerve lesion?
foot drop
| loss of foot eversion
49
What are the causes of foot drop?
```
common peroneal nerve palsy
sciatic nerve palsy
lumbosacral plexus lesion
L4/5 root lesion
peripheal motor neuropathy
distal myopathy
motor neurone disease
precentral gyrus lesion
```
50
What causes spinothalamic (pain and temperature) loss only?
syringomyelia
brown-sequard syndrome (contralateral leg)
anterior spinal artery thrombosis
lateral medullary syndrome (contralateral to other signs)
51
What causes dorsal column (vibration and proprioception) loss only?
```
subacute combined degeneration
brown-sequard syndrome (ipsilateral leg)
spinocerebellar degeneration
multiple sclerosis
tabes dorsalis (syphillis)
```
52
What are the clinical features of syringomyelia?
loss of pain and temperature in cape distribution
weakness, atrophy and areflexia of arms
upper motor neurone signs in lower limbs
53
Signs of lateral medullary syndrome?
```
ipsilateral signs:
- horner's syndrome
- nystagmus
- facial sensory impairment
- ataxia
- diplopia
contralateral signs
- pain and temperature loss in body
```
54
Signs of myotonic dystrophy?
```
bilateral ptosis
wasting of facial muscles
frontal baldness
cataracts
grip myotonia (slow release of grip)
percussion myotonia - tap thenar eminence - will display a muscle twitch then slow relaxation
```
55
Complications of myotonic dystrophy?
```
dilated cardiomyopathy
cardiac arrhythmias
aspiration
dysphagia
diabetes
thyroid dysfunction
infertility
cataracts
```
56
Causes of parkinsonism?
```
parkinson's disease
drugs
parkinson's plus syndrome
stroke in basal ganglia
postencephalitis
wilson's disease
```
57
What is the pathology underlying parkinson's disease?
degeneration of the substantia nigra neurons in the basal ganglia
58
Investigations for peripheral neuropathy?
```
FBE
UEC
LFTs
folate
B12
HbA1c
TFT
HIV
myeloma screen
CSF analysis
nerve conduction studies
```
59
Signs of parkinson's?
```
mask like facies
hypophonia
pill rolling tremor
cogwheel rigidity
bradykinesia
freezing
stooped posture
shuffling gait
reduced arm swing
```
60
How would you differentiate a tremor in parkinsons to an essential tremor?
essential tremor usually symmetrical and worse with movement
61
What are the cerebellar signs?
```
dysdiadochokinesis
dysmetria
impaired heel shin test
nystagmus
ataxia
broad based gait
staccato speech
```
62
In which cause of foot drop is inversion preserved?
common peroneal nerve palsy
63
In which causes of foot drop is the ankle jerk preserved?
common peroneal nerve palsy, L4/5 root lesion
64
What does pyramidal weakness look like in the lower limbs?
weakness of hip flexion, knee flexion and dorsiflexion
65
What does a cranial nerve VI palsy cause?
isolated abduction defecit
66
Differential diagnosis for ophthalmoplegia that doesn't fit with a specific CN palsy?
graves ophthalmopathy
| myasthenia gravis
67
Where is the lesion for a superior quandrantonopia?
temporal lobe
68
Where is the lesion for an inferior quandrantonopia?
parietal lobe
69
What is the differential diagnosis for a bitemporal hemianopia?
```
pituitary tumour
craniopharyngioma
suprasellar meningioma
glioma
metastasis
```
70
What are the findings of an ulnar nerve palsy?
wasting of the small muscles of the hand sparing the thenar eminence
weakness of finger abduction/adduction
weakness of the flexion of 4th and 5th fingers
reduced sensation over 5th and half of 4th fingers
71
What are the causes of an ulnar nerve palsy?
lesions at elbow/wrist - fracture, compression
| mononeuritis multiplex
72
What are the findings of a radial nerve palsy?
wrist extension weakness
finger extension weakness
forearm supination weakness
sensory loss over anatomical snuffbox
73
What are the findings of a median nerve palsy?
wasting of the thenar eminence
weakness of thumb abduction, flexion and opposition
sensory loss over palmar aspect of first 3 and a half digits
74
Differential diagnosis for hemiparesis?
```
stroke
tumour
demyelination
abscess
post ictal
```
75
Where is the stroke if predominantly leg weakness is involved?
anterior cerebral artery
