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MRCP Part 2 > Neurology > Flashcards

Neurology Flashcards

(53 cards)

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1
Q

Treatment for migraine prevention

A

Topiramate

Propanolol

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2
Q

Acute management of cluster headaches

A

Oxygen

SC triptan

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3
Q

Prophylaxis of cluster headaches

A

Verapami

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4
Q

What drugs cause peripheral neuropathy?

A 
Amiodarone 
Isoniazid 
Vincristine 
Nitrofurantoin 
Metronidazole
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5
Q

Features of multi system atrophy

A 
Parkinsonism 
Autonomic disturbance 
Erectile dysfunction 
Postural hypotension 
Atonic bladder 
Cerebellar signs
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6
Q

What is friedreichs ataxia?

A

Autosomal recessive condition that develops around age 10 - 15.

  • Gait ataxia and kyphoscolliosis
  • Absent ankle jerks
  • Cerebellar ataxia
  • Optic atrophy
  • Spinocerebellar tract degeneration
  • HOCM
  • Diabetes
  • High arched palate
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7
Q

Most common cause of death in friedreichs ataxia

A

HOCM

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8
Q

Subacute combined degeneration of the spinal cord.

A
  1. Bilateral spastic paresis
  2. Bilateral loss of prorioception and vibration
  3. Bilateral limb ataxia
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9
Q

Treatment of primary open angle gluacoma

A
  1. Prostoglandin analogue eye drop

2. Beta blocker, carbonic anhydrase inhibitor

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10
Q

Subthalamic nucleua of the basal ganglia

A

Hemibalism

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11
Q

Striatum (caudate nucleaus) of the basal ganglia

A

Huntingtons corea

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12
Q

What is von hippel lindau syndrome?

A 
Autosomal dominant condition predisposing to neoplasia.
- Cerebella haemangiomas 
Retinal haemangiomas 
Renal cysts 
Phaeochromocytoma 
Extra renal cysts 
Endolymphatic sac tumours 
Clear cell renal cell carcinoma
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13
Q

Best form on imaging for a TIA

A

MRI (with diffusion weighted imaging)

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14
Q

Treatment for glioblastoma multiforme?

A

Chemoradiotherapy with temozolamide (they have a synergistic effect on killing tumour cells.

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15
Q

Antibodies in myaesthenia gravis

A

Antibodies to acetylcholine receptors

ANti muscle specific tyrosine kinase antibodies

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16
Q

Treatment for myasthenia gravis

A

Pyridostigmine
Immunosupression may be needed in addition (initially prednisolone then azathioprine, cyclosporin or mycophenolate)
Thymectomy

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17
Q

Treatment of trigeminal neuralgia

A

Carbamazapeine

Microvascular secompression

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18
Q

Treatment of guillain barre

A

IV IG or Plasma exchange

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19
Q

Drugs that can exacerbate myaesthenia gravis

A 
Penicillamine 
Quinidine 
Procanamide 
Beta blocker
Lithium 
Ohenytoin 
Gentamicin, maclorlide, quinolones, tetracyclines
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20
Q

Symptoms of sporadic CJD

A

rapidly progressive dementia
Depression, apathy, euphoria, anxiety and emotional lability
Myoclonus, ataxia, nystagmus and hyperreflexia

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21
Q

MRI findings in CJD

A

Hypertintense signals in the basal ganglia and thalamus

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22
Q

Treatment for tics?

Study These Flashcards
A

Clonidine

Atypical antipsychotics

23
Q

Features of myotonic dystrophy

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A
  • features occur at age 20 - 30.
  • Myotonia (tonic spasm of muscle)
  • Mental impairment
  • Diabetes
  • Testicular atrophy
  • Cardiac involvment (heart block, cardiomyopathy)
    Dysphagia
24
Q

Treatment for paroxysmal hemicrania

25
Treatment for neuroleptic malignant syndrome
IV fluids Dantrolene Bromocriptine
26
What is facioscapulohumeral muscular dystrophy?
Autosomal dominant muscular dystrophy that affects the face, scapula and upper arms first (symptoms tend to present by age 20)
27
How do you test for friedrichs ataxia?
Serum genetic testing of the GAA trinucleotide repeat
28
What is neuromyelitis optics (devics disease)
``` Demyelinating CNS disorder. - Bilateral optic neuritis - Myelitis - Spinal cord lesion invloving 3 or more spinal levels - Normal M~RI brain Aquaporin 4 positive serum antibody ```
29
Treatment of neuromyelitis optica
Immunosupressants (eg rituximab)
30
Which type of lunch cancer is associate with sensory neuropathy?
Small cell lung cancer (Anti Hu antibodies) Also causes cerebellar synndrome and enchephalomyelitis
31
What is the treatment of valproate induced hyperammonaemic encephalopathy
L Carnitine
32
What do you see in the CSF of patients with guillan barre syndrome
High protein
33
What medications increase the risk of idiopathic intracranial hypertension?
``` COCP Steroids Tetracyclines Vitamin A Lithium ```
34
Medications used in idiopathic intracranial hypertension
Acetazolamide | Topiramte
35
Treatment ladder in parkinsons disease
1. Levodopa (if symptoms impact on quality of life) 2. Dopamine agonist of MAOB inhibitors if symptoms not impacting on quality of life 2. MAO B inhibitor on COMT inhibiitors as an adjunct to people on levodopa who are having fluctiatioms despite optimal therapy
36
What does entacapone do?
COMT inhibitor that reduced the breakdown on L dopa (can be used as ad adjunt to levo dopa if ongoing motor symptoms)
37
What medication can be used to help daytime sleepiness in parkinsons disease?
Modafinil
38
What medication can be used to help REM sleep behaviour disorder in parkinsons?
Clonazepam or melatonin
39
What medication can be used for postural hypotension in parkinsons disease?
Midodrine
40
What medicatin can be used to help with drooling in people with parkinsons disease>
Glycopyrronium bromide
41
Investigations in myaesthenia gravis?
Single fibre electromyography CT Thorax (to exclude thymoma) CK (normal) Autoantibodies- Acetylcholine receptor, anti muscle specific tyrosine kinase antibodies) Tensilon test (edrophonium reduced muscle weakness temporarily
42
Management of myasthenic crisis?
Plasmapheresis | IVIG
43
Nerve conduction tests - normal velocity but reduced amplitude
``` Axonal pathology - Diabetes - B12 - Paraneoplastic HIV ```
44
Nerve conduction tests - reduced velocity and normal amplitude
Demyelination - MS - Guillan barre CIDP
45
What do glioblastoma look like on imaging?
Solid tumours with central necrosis and a rim that enhances with contrast.. Also associated with vasogenic oedema.
46
What do meningioma look like on imaging?
Contrast enhancing lesion
47
Total anterior circulation infarcts
All of... 1. Unilateral hemiparesis/hemisensory loss of the face arm and leg 2. Homonymous hemianopia 3. Higher cognitive dysfunction eg dysphasia Middle and anterior cerebral arteries
48
Partial anterior circulation infarcts
2 of 1. Unilateral hemiparesis/hemisensory loss of the face arm and leg 2. Homonymous hemianopia 3. Higher cognitive dysfunction eg dysphasia Involves the smaller arteries of the anterior circulation.
49
Lacunar infarcts
``` 1 of the following 1. Unilateral weakness 2. Pure sensory stroke 3. Ataxis hemiparesis Involves perforating arteries of the unternal capsule, thalamus and basal ganglia ```
50
Posterior circulation infarcts
1 of the following 1. Cerebellar or brainstem syndrome 2. Loss of consciousness 3. Isolated homonymous hemianopia
51
What is the criteria for needing ventilatory support in guillan barre syndrome?
FVC of less than 15 - 20.
52
What is miller fisher syndrome?
Variant of guillan barre syndrome associated with opthlmoplegia, areflexia an ataxia. The eye muscles are affected first and it usually presents with a descendng paralysis rather than ascending. Anti GQ1b antibodies are present in 90% of cases.
53
Drug used after levodopa for tremor predmiant parksinons disease?
Anticholinergics such as procyclidine

MRCP Part 2 (11 decks)

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