Neurology Flashcards by Miranda King

Horizontal Nystagmus
- When appears?
- Area of cortex affected

On horizontal gaze
Medial longitudinal fasciculus - integration of CN III and CN VI

How well did you know this?

Not at all

Perfectly

Internuclear Ophthalmoplegia =
Associated with

= affected eye shows impairment of adduction.
When an attempt is made to gaze contralaterally (relative to the affected eye), the affected eye adducts minimally, if at all
Can abduct, will have nystagmus
Assoc: MS

How well did you know this?

Not at all

Perfectly

Asymmetrical Muscular Dystrophy

= fascioscapulohumeral MD

How well did you know this?

Not at all

Perfectly

Indication for Carotid Endartectomy

Stenosis of >70%-99%

How well did you know this?

Not at all

Perfectly

Descending paralysis
Ataxia
Ophthalmoplegia
Post Infection

= MF variant of GBS
Different to ascending paralysis usually seen

How well did you know this?

Not at all

Perfectly

Thrombolysis Window in Acute Stroke

4.5 hours

How well did you know this?

Not at all

Perfectly

Thrombectomy Window in Acute Stroke

6 hours

How well did you know this?

Not at all

Perfectly

CNIII nerve palsy
- Painful
- Not painful

Painful = posterior communicating artery aneurysm
Not painful = oculomotor nucleus

How well did you know this?

Not at all

Perfectly

Diagnosis of Multiple Sclerosis

MRI FLAIR

How well did you know this?

Not at all

Perfectly

Why can switching to carbamazepine cause a return of seizures?

= autoinduction
Carbamazepine induces its own metabolism, this decreases the half life
= reduction in carbamazepine levels after several weeks of treatment
> seizures
- Need to increase carbamazepine every 2 weeks to keep levels high

How well did you know this?

Not at all

Perfectly

Asymptomatic rash
Skin folds, male
Pink or brown well defined patches with scaling

Erythasma
= superficial skin infection caused by corynebacterium

How well did you know this?

Not at all

Perfectly

First line - myoclonic seizures, male

Sodium valproate

How well did you know this?

Not at all

Perfectly

Treatment of IIH

Acetazolamide

How well did you know this?

Not at all

Perfectly

Life prolonging treatment in MND

NIV - better than riluzole

How well did you know this?

Not at all

Perfectly

Where in the hypothalamus control satiety?

Ventromedial area
Because not even a MEDIUM meal will do

How well did you know this?

Not at all

Perfectly

Area responsible for chorea

Caudate nucleus

How well did you know this?

Not at all

Perfectly

Genetic mutation in CADASIL

NOTCH3

How well did you know this?

Not at all

Perfectly

Antibiotics MOST associated with myaesthenic crisis

Gentamicin (aminoglycosides)

How well did you know this?

Not at all

Perfectly

What is apomorphine?

Dopamine agonist
Used in Parkinson’s disease

How well did you know this?

Not at all

Perfectly

Bone conduction > air conduction

Conductive hearing loss
Weber’s lateralises to that side (sound travels from forehead through bone)

How well did you know this?

Not at all

Perfectly

What is tabes dorsalis?
How can it present?

= complication of neurosyphilis
Neuropathic pain, cerebellar signs, urge incontinence

How well did you know this?

Not at all

Perfectly

NF2
- key presentation
- genetic abnormality

= bilateral acoustic neuromas
Chromosome 22

How well did you know this?

Not at all

Perfectly

DAT scan =

SPECT scan

Management of spasticity in MS

Baclofen
Gabapentin - both first line

Management of TIA acronym

HALTSS HTN Antiplatelet/anticoagulation Lipid therapy Tobacco Sugar - diabetes Surgery

Painful Horner's Syndrome - why?

Carotid dissection until proven otherwise = sympathetic overlie carotid, lost in dissection = Horner's syndrome

Assessment of function in stroke scoring system

Modified Rankin

Mechanism of action of alteplase

Tissue plasminogen activator

Cortical haemorrhage cause Lobar haemorrhage cause

Cortical = HTN most likely Lobar = AVM, amyloid, tumour

Side effects of phenytoin (3)

Gum hyperplasia Hirsutism Megaloblastic anaemia

Features of MSA (3)

Symmetrical distribution Progresses quickly Responds poorly to levodopa

Features of Corticobasal degeneration (5)

Apraxia Aphasia Cognitive impairment Alien Hand syndrome Symmetrical distribution

Mechanism of levodopa

Precursor to dopamine - metabolised to give dopamine

Ophthalmoplegia - differentiation

= involvement of the pupil Medical causes e.g. diabetes, vascular don't usually involve the pupil

Internuclear Ophthalmoplegia - definition - causes (3)

= nystagmus and failure of adduction Indicates lesion in the medial fasciculus longitudinus e.g. MS, stroke, malignancy

Management of optic neuritis

IV methylprednisolone

Assessment of MS CSF findings

McDonald's criteria Oligoclonal bands in CSF

Miller-Fisher - association - presentation

Association = GQ1b ganglioside Ophthalmoplegia including peripheral neuropathy

CSF findings in GBS (2)

Elevated CSF protein Normal CSF cell count

Two types of autoimmune encephalitis

NMDA encephalitis CASPR2 encephalitis

Association with NMDA encephalitis

NMDA receptor antibodies - ovarian teratoma

Association with CASPR encephalitis

Sleep disorder

Causes of mixed LMN/UMN presentation (5)

MND Syringomyelia Cervical Spondylopathy Tabes Dorsalis Freiderich's Ataxia

Gene associated with Charcot Marie Tooth

PMP22 gene

MRI finding in sporadic CJD

Cortical ribboning

Neurocysticerosis investigation finding =

= multiple calcifications Poorly heated pork

Avoid doing in acute stroke

Correcting hypertension - allows the use of collateral blood vessels to supply the brain

CN III palsy - what to consider?

Pupil - if fixed need urgent neuroimaging ?carotid artery aneurysm

Where is responsible for hemiballismus?

Subthalamic nucleus

Amyloid is associated with...

Autonomic neuropathy

When can you rule out SAH?

If CTH within 6 hours of onset of headache can confidently rule out

Signs in CSF in MS (2)

IgG intrathecal synthesis Oligoclonal bands

Side effects of topiramate (2)

Weight loss Renal stones

Management of Tourette's Syndrome

Risperidone

Mechanism of Ropinirole

Dopamine receptor agonist

Brachial neuritis =

= neuralgic amyotrophy