Neurology 🦻🏻

Question 1

Question 2

Brown sequard usually from what trauma type

Answer 2

Penetratiing

Question 3

Explain neurogenic shock

Answer 3

Traumatic spinal cord injury. Means the SNS cannot access it’s route! But vagus can as it doesn’t go via SC. So we have unopposed PNS, causing low BP and bradycardia. We may see high BP and HR at first, due to trauma causing huge NE and E release form adrenal medulla

Question 4

Krhabbe disease symptoms

Answer 4

Deafness, blindness, seizure, peripheral neuropathy, intellectual disability

Question 5

Cutaneous findings with spinal dysrphrism

Answer 5

Hair tuft, lipoma, masses, hemangioma, dimple

Question 6

What is tethered syndrome and what are the symptoms

Answer 6

Tethered cord syndrome is a neurological disorder caused by an abnormal stretching and tethering of the spinal cord within the spinal column. Its seen with spinal dysphrasism. This condition typically occurs when tissue attachments limit the normal movement of the spinal cord within the spinal canal, leading to various neurological and musculoskeletal symptoms. Common symptoms of tethered cord syndrome may include back pain, LMN leg weakness, numbness or tingling in the legs, foot deformities, and changes in bowel or bladder function

Question 7

Why is genetic testing for apo e4 CId for routine evaluation of suspected dementia

Answer 7

False positives and negatives can cause major distress

Question 8

MMSE and MCA cutoffs

Answer 8

Less than 24 and 26 resp

Question 9

Radiculopathy…. Usual cause if acute, and usual cause if chronic

Answer 9

Acute is herniated disc. Chronic is spondylosis /osteophytes

Question 10

Usual radiculopathy invx?

Answer 10

Usually a clinical Dx…. Don’t need mri or X-ray

Question 11

Dx stroke: vertigo/nystagmus (vestibular nucleus), loss of pain/temperature sensation on the ipsilateral face (trigeminal nucleus) and contralateral body (spinothalamic tract), bulbar weakness (lower cranial nerves), and ipsilateral Horner syndrome (descending sympathetic).

Answer 11

A lateral medullary infarct (Wallenberg syndrome)

Question 12

Polymyositis and statin myopathy…. Affect bulbar or ocular?

Answer 12

No

Question 13

Usually what is the first derma manifestion of NF1

Answer 13

Cafe au lait

Question 14

If stroke patient not editable for tPA or thrombectomy… what’s the mx

Answer 14

AntiPLT (not anti coag due to risk of hemorrhagic conversion), permissive HTN (<220/120), find cause

Question 15

Permissive HTN if have or don’t have thrombolysis

Answer 15

Prior to tPA 185/110, after tPA 180/105

No tPA 220/120

Question 16

Answer 16

Appreciate the odd nomenclature of cervicle stuff

Question 17

Can we do nerve conduction studies for radiculopathy

Answer 17

No

Question 18

Radiculopathy vs brachial plexus Injury symptoms

Answer 18

Similar symptoms in theory. Radiculopathy is more dermatomal and myotomal. Brachial plexus injury causes more pain with arm movement, whereas radic more with neck movement. The cause of injury for plexus injury is usually trauma

Question 19

Three causes of asterixis

Answer 19

Liver, uraemia, CO2 retention

Question 20

Chronic kernicterus symptoms .

Answer 20

Dev delay, upward gaze palsy, choreathetoid movement, sensorineural hearing loss.

Question 21

Acute kernicterus symptoms

Answer 21

Lethargy, hypotonia then hypertonic, apnoea, feeding issues, high pitched inconsolable cry (icteral cry)

Question 22

Anti PLT therapy CI for how long after tPA or thrombectomy procedure

Answer 22

24 hr, due to risk of hemaorhagic conversion

Question 23

Does vestibular schwannoma usually cause vertigo

Answer 23

No

Question 24

Chronic movements can be seen in both singer P and seizure. Contrast the timing of the movements in relation to the loss of consciousness

Answer 24

In seizure the myoclonic movement as seen before or during the loss of consciousness. Myoclonic movement a scene usually after the loss of consciousness in syncope (is due to hypoperfusion)