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MRCP > Neurology > Flashcards

Neurology Flashcards

1
Q

Ataxia telangiectasia (inheritance)

Inheritance pattern

A

Autosomal recessive

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2
Q

Friedrich’s ataxia (inheritance)

A

Autosomal recessive

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3
Q

Lateral medullary syndrome

A

Wallenberg’s syndrome
Occlusion of posterior inferior cerebellar artery (PICA)
-> ataxia, nystagmus, ipsilateral Horner’s/pain and temp sensation loss, contralateral limb sensory loss

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4
Q

Right pupil larger than left, no reaction to light directly or consensually
Reduced/absent deep tendon reflexes

A

Adie’s pupil

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5
Q

Afferent pupillary defect

Findings

A

Due to impaired ipsilateral optic nerve function
Brief paradoxical pupillary dilatation on swinging light test

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6
Q

Bilaterally small pupils
Accommodate but do not react to light

A

Argyll Robertson pupils

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7
Q

Ptosis
Ipsilateral small pupil

Syndrome?

A

Horner’s syndrome

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8
Q

Ipsilateral ptosis
Pupil enlargement

A

Third nerve palsy

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9
Q

Miller Fisher Syndrome

Features
Antibodies

A

Variant GBS
Triad: ataxia, external ophthalmoplegia, areflexia

GQ1B antibodies

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10
Q

Gerstmann’s syndrome
Dominant parietal lobe infarct

Features

A

Finger agnosia
Acalculia
Agraphia
Left-right limb disorientation

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11
Q

Contralateral hemiparesis and sensory loss; worse in lower limbs

vessel?

A

Anterior cerebral artery

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12
Q

Contralateral hemiparesis; upper limbs affected more than lower
Contralateral homonymous hemianopia
Aphasia

A

Middle cerebral artery

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13
Q

Contralateral homonymous hemianopia with macular sparing

vessel?

A

Posterior cerebral artery

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14
Q

Weber’s syndrome (branches of posterior cerebral artery that supply midbrain)

Signs

A

Ipsilateral CN III palsy
Contralateral weakness of upper and lower extremity

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15
Q

Lateral pontine syndrome (anterior inferior cerebellar artery)

A

Ipsilateral: facial paralysis and deafness
Contralateral: limb/torso pain and temperature loss
Ataxia, nystagmus

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16
Q

Retinal/ophthalmic artery

Presentation

A

Amaurosis fugax

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17
Q

Mild-mod learning disability
Narrow face, large ears, flexible fingers, large testicles

Condition?
Gene
Inheritance

A

Fragile X syndrome
FMR-1 gene
X linked dominant

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18
Q

Torticollis muscle

A

Ipsilateral sternocleidomastoid

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19
Q

Fixed gaze palsy

A

Eyes look towards the lesion e.g. fixed gaze lesion to the right = right sided lesion

20
Q

Multi-system atrophy

A

Parkinsonism
Autonomic disturbance: erectile dysfunction, postural hypotension, atonic bladder
Cerebellar signs (ataxic gait)

21
Q

Progressive supranuclear palsy

A

Vertical gaze
Postural instability
Parkinsonism
Cognitive impairment within months

22
Q

Dementia with Lewy bodies

A

Visual hallucinations

23
Q

Normal pressure hydrocephalus

A

Dementia + urinary incontinence

24
Q

Subacute combined degeneration of the spinal cord (Vitamin B12 and E deficiency)

A

Affects posterior columns

  • Ipsilateral UMN weakness (spastic paresis)
  • Ipsilateral loss of proprioception and vibration
    Ataxic gait
25
Q

Syringomelia features

A

LMN signs and spinothalamic loss (pinprick and pain sensation)

26
Q

Neurocutaneous disorders
Retinal hamartomas
Epilepsy
Developmental problems
Ash leaf spots
Shagreen patches
Subungal fibromata

Condition?

A

Tuberous sclerosis

27
Q

Cafe au lait spots
Axillary/groin freckles
Neurocutaneous disorders
Iris hamartomas
NF2: bilateral acoustic neuromas and other CNS tumours

A

Neurofibromastosis 1 and 2

28
Q

Pituitary apoplexy

A

Bleeding into/impaired blood supply of pituitary
Sudden onset headache and non-functioning pituitary

29
Q

Bilateral spastic paresis and loss of temp/temp sensation

A

anterior spinal artery occlusion

30
Q

Sensory loss of postero-lateral aspect of leg and lateral aspect of foot, weakness in plantar flexion of foot, reduced ankle reflex, positive sciatic nerve stretch test

A

S1

31
Q

Ramsay Hunt treatment

A

oral aciclovir and prednisolone

32
Q

CT head: hypodense (dark), crescentic collection around the convexity of the brain

diagnosis?

A

chronic subdural haematoma

33
Q

Restless legs treatment

A

Dopamine agonist - Pramipexole, ropinirole

34
Q

Cerebellar ataxia and telangiectasia, onset is in childhood
Immunodeficiency

A

Ataxic telangiectasia

35
Q

Infantile-onset spinocerebellar ataxia

A

Friedreich’s ataxia

36
Q

Causes of facial palsy

A
  • Bells palsy
  • Ramsay-Hunt syndrome
  • acoustic neuroma
  • parotid cancer
  • HIV
  • multiple sclerosis
  • diabetes mellitus
37
Q

Distal muscle wasting and weakness

A

Charcot-Marie Tooth

38
Q

Bilateral spastic paresis and loss of pain/temperature sensation

occlusion where

A

Anterior spinal artery occlusion

Dorsal columns no affected as these are posterior

39
Q

Lambert Eaton syndrome

Which channels affected

A

Voltage gated calcium channels

40
Q

Myasthenia Gravis

Channels affected

A

Nicotinic acetylcholine receptors

41
Q

Treatment of myasthenic crisis

A

IV immunoglobulins OR
plasma exchange

42
Q

Third nerve palsy and headache

Important to exclude…

A

Posterior communicating artery aneurysm

43
Q

Treatment of SAH

A

Calcium channel blocker (Nimodipine) -> prevents vasospasm

44
Q

Measure of disability or dependence in activities of daily living in stroke patients

A

Barthel index

45
Q

involuntary, sudden, jerking movements which occur contralateral to the side of the lesion

A

Hemiballism

MRCP (19 decks)

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