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MRCP Part 1 > Neurology > Flashcards

Neurology Flashcards

(108 cards)

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1
Q

Which HLA is associated with MG ?

A

HLADR2 and HLADR3

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2
Q

Which Type of Voltage Gated Pre-synaptic calcium channels are affected in LEMS ?

A

P/Q Calcium Channels

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3
Q
A

When Dyskinesia from Levodopa –> add COMT

Reduce Levadopa/ add Amantadine / duodopa –> Treat Dyskinesia

‘end-of-dose fluctuations’  –> Adjunct with MOAI

Anti-Muscarinic ( procyclidine, benztropine, trihexyphenidyl (benzhexol) —> Treat Drug induced PD vs Idiopathic PD

Add Apomorphine –> when ‘OFF’ effects precipitate

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4
Q

What is the side effect of Natalizumab in Multiple Sclerosis ?

A

JC Virus reactivation causing Progressive Multifocal Leukoencephalopathy

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5
Q

Wernicke’s vs Broca’s

A

Wernicke (Brodmann area 22 at Superior Temporal Gyrus) = Word Salad
Random Words
Comprehension IMPAIRED
Inferior division of L MCA

Broca’s (Brodmann Area 44 and 45) at Inferior Frontal Gyrus
Stutters and Word Finding Difficulty
Comprehension is PRESERVED
Superior Division of L MCA

Conductive Aphasia (Arcuate Fasciculus)
Fluent Speech but cant REPEAT

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6
Q

Third Nerve Palsy

A

Down and Out
Dilated
Ptosis
Painful and Dilated in Surgical

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7
Q

Causes of Facial Nerve Palsy

A

Upper Motor Neuron
Stroke

Lower motor neuron

1) Bell’s palsy
2) Ramsay-Hunt syndrome (due to herpes zoster)
3) Acoustic neuroma
4) Parotid Tumors
5) HIV
multiple sclerosis* (may be also UMN)
6) DM

B/L Facial Nerve Palsy

1) Sarcoidosis
2) GBS
3) Lyme disease
4) Bilateral acoustic neuromas (NF2)

as Bell’s palsy is relatively common it accounts for up to 25% of cases of bilateral palsy, but this represents only 1% of total Bell’s palsy cases

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8
Q

Path of Cranial Nerve 7

A
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9
Q

Transient Global Amnesia Treatment ?

A

Sudden Anterograde Amnesia –> Reassure as self limiting

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10
Q

False Localizing Lesion of CN6 seen when ?

A

Raised ICP and presents as B/L CN6 Palsy

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11
Q

Tuberous Sclerosis

1) Inheritance , Which Genes and Chromosomes and Proteins affected

2) Tumors where ?

3) Presentation

3) Treatment

A

Autosomal Dominant with Variable Expressivity and Incomplete Penetrance

TSC 1 - Chromosome 9 - Hamartin

TSC 2 - Chromosome 16 - Tuberin - Co-exists with PCKD as PKD 1 gene on Chromosome 16

2) Hamartia
Hamartoma
Giant Cell Astrocytoma’s
Retinal Nodular Hartoma’s - White Patches on Retina (Phakoma)
Adenoma Sebaceum (angiofibromas) - Butterfly distribution
Rhabdomyosarcoma

Angiomyolipoma of Kidney
Subungual Fibroma
Shagreen Patches and Ashleaf Spots

LAM in Lungs (Lymphangioleiomyomatosis)

3) Infantile Spasms - Vigabatrin and ACTH

Intellectual Disability
Astrocytoma - Evorilomus
Angiomyolipoma

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12
Q

Neurofibromatosis Type 1 and Type 2 Facts

1) Inheritance
2) Protein
3) Presentations

A

1) Autosomal Dominant

2) NF1 coding for Neurofibromin in Chromosome 17

NF2 coding for Merlin in Chromosome 22

3)

NF1

Cafe - Au - Lait Spots
Cutaneous Neurofibromas
Pigmented Iris Hartomas (Lisch Nodules)
Phaeochromocytoma

NF2 (2 Ears , 2 Eyes and 2 parts of Brain)

Bilateral Acoustic Neuroma
Juvenile Cataracts
Mengiomas and Ependymoma

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13
Q

Von Hipple Lindau Syndrome

A

MRCP

M: Mutation in VLH suppressor gene on chromosome 3

R: Retinal haemangiomata presenting as vitreous hemangioma, Renal cyst, Clear Renal cell carcinoma

C: CNS haemangioblastoma

P: Pheochromocytoma, Pancreatic cyst

Endolymphatic Sac Tumors

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14
Q

Causes of Chorea

HITING ME

Hemochromatosis and Rheumatic Heart Disease DONT cause Chorea

A

Hereditary -
1. Wilsons
2. Huntingtons
3. Neuroacanthocytosis

Infection -
1. Streptococcus Pyogenes - Sydenham Chorea
2. SLE & APLS

Toxins
1. LDOPA
2. Neuroleptics (Dopamine Agonists)
3. CO poisoning

Ischemia

Neoplasia

Gynecological - Pregnancy, Chorea Gravidum

Myeloproliferative - Polycythemia Rubra Vera

Endocrine - Thyrotoxicosis

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15
Q

Causes of Action / Postural Tremor

BEATINGS

A

Benign Essential Tremor
Hypoglycemia
Hyperthyroidism
Alcohol Withdrawal
Infection - Syphilis

Toxins - Lithium, SV, Salbutamol, TCA, Hatter’s Shakes (Lead Mercury Arsenic)

Enhanced Physiological Tremor

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16
Q

What is Autoinduction ?

A

Drug induces the enzymes that break it down

CARBAMEZAPINE

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17
Q

Side Effects of Carbamazepine

A

-SJS
-Diplopia
- Cytochrome 450 INDUCER
-Agranulocytosis/leucopenia
-SIADH and Hyponatremia

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18
Q

Neuropathic Pain Control in Diabetics ?

A

Duloxetine

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18
Q

Neuropathic Pain

A

Change drug
DONT ADD

Amitriptyline Duloxetine
Gabapentin Pregabalin

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19
Q

MOA of Pregabalin / GABApentin

A

Gabapentin and Pregabalin bind to alpha2Gamma subunit of Voltage Gated Calcium Channels at Presynaptic Neurons

Inhibiting depolarization and release of Neurotransmitters like Glutamate or Substance P

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20
Q

Thrmobolysis and Thrombectomy Guidance ______________

A
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21
Q

Benign Intracranial Hypertension

A

Obese Young Women

Drugs -
COCP
Steroids
Tetracyclines
Tetinoids (Isotretinoin, tretinoin) / vitamin A
lithium

Carbonic Anhydrase Inhibitors like Acetazolamide
Add on Topiramate

Optic nerve sheath decompression
VP Shunt

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22
Q

Guidance
CMTD Freidriehs

A
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23
Q

Migraine Treatment

A

Acute -
Triptan + NSAID OR Triptan + PCM

If not working then
Non Oral Metoclopramide or Prochlorperazine

Consider adding Non Oral Triptan or Nsaid

Prophylactic -

Topiramate
Propranolol
Amitriptyline
Riboflavin 400mg/day
If Predictable Menstrual Migraine - Frovatriptan or Zolmitriptan

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24
DMD vs Beckers vs Myotonic vs FSH Dystonia
DMD (X linked Recessive) Proximal Muscles Gowers Maneuver Waddling Gait Dilated CDM Weak Reflexes Becker's Muscular Dystrophy
25
Myotonic Dystrophy Inheritance , Features and Associations
Myotonic Dystrophy (Autosomal Dominant - CTG Trinucleotide Repeat) DM1 - CTG Trinucleotide Repeat at end of DMPK gene on Chromosome 19 (Distal First) DM2 - Repeat Expansion of ZNF9 gene on Chromosome 3 (Proximal First) LMN Distal Muscle Weakness Loss of Ankle Reflex Face Bilateral Ptosis Mastication Weakness Frontotemporal Balding Myotonia Slow Release Hand Shake Percussion Myotonia Slow to Open eyes after Shutting tight Christmas Tree Cataracts Hypertrophic Cardiomyopathy & HB Dysphagia Testicular Atrophy 3T 3D - 3T: Toupee (balding), ticker (cardiomyopathy), testicles (atrophy) - 3D: diabetes, dysarthria, learning disability
26
Internuclear Ophthalmoplegia explain pathophysiology and how to differentiate from a Oculomotor Palsy ?
Demyelination of MLF Located in Paramedian area of Midbrain and Pons Features 1. Unable to ADDUCT of the eye on the same side as the lesion 2. Horizontal nystagmus of the ABDUCT TING eye on the contralateral side Test of Convergence to help INO>Oculomotor Nuclear Palsy
27
Drugs causing Peripheral Neuropathy
I AM Very Peripherally Numb Isoniazid Amiodarone Metronidazole Vincristine Phenytoin Nitrofurantoin
28
Ataxia Telangiectasia 1) Inheritance 2) Features
Autosomal Recessive ATM Gene 1-5 y/o VS FA Spider Nevi IgA Deficiency - Recurrent Chest Infection Cerebellar Ataxia Risk of Leukemia or Lymphoma (NH)
29
Friedrichs Ataxia
Trinucleotide Repeat (GAA) Chromosome 9 10-15y/o vs AT Ataxia + DANISH Loss of Reflexes Optic Atrophy Kyphoscoliosis HOCM / T1DM
30
What is the MOST COMMON INHERITED Peripheral Neuropathy ? What do you see on biopsy of neurons in this disease ?
Charcot Marie Tooth Disease Autosomal Dominant PMP22 gene T1 - Demyelination T2 - Axonal Intrinsic Feet Muscles (Frequent Ankle Sprains) Sensory Loss High Arch Feet Champagne Inverted Feet Loss of Reflexes Onion Skin Peel Appearance on Neuronal Biopsy Decreased Velocity on EMG
31
Anti Hu Anti Ri Anti GAD Anti Yo
Anti Hu - Painful Peripheral Neuropathy Cerebellar Neuroblastoma SCLC and Encephalomyelitis Anti Ri - Ocular opsoclonus-myoclonus Anti GAD - Breast , Colorectal and SCLC Stiff Person Syndrome Anti Yo - Cerebellar Ovarian Breast Purkinje Fibers Peripheral Neuropathy in Breast Cancer
32
Syringomyelia Presentation ?
Cape Like 1) Loss of Pain and Temperature 2) Hypersensitive to Vibration and Touch 3) Upgoing Plantar 4) Spastic (Immobile) 5) Sometimes , Rarely , Bladder and Bowel Involvement
33
Klumke's vs Erbs Palsy
Klumpke's Palsy (CLAW HAND) C8-T1 Erbs (WAITERS TIP) C5-C6
34
Restless Leg Syndrome Treatment ?
Massage Treat Iron Deficiency Dopamine Agonist - Ropinirole, Pramipexole Benzodiazepine Gabapentin
35
Nucleotide Repeats
GAA - Friedreich Ataxia CTG - Myotonic Dystrophy CAG - Huntington's CGG - Fragile X Syndrome
36
Huntington's Disease Ix and Tx
Ix - MRI - increase in size of Frontal Horn of Lateral Ventricles Gordon Reflex Phenomenon NO CURE BUT for CHOREA Tetrabenazine Reversible inhibitor of VMAT 2 Impaired packaging of Monoamines into vesicles (esp Dopamine) Reduced Release
37
Huntington Disease Gene and Inheritance
HTT gene Chromosome 4 Autosomal Dominant
38
Huntington Disease pathophysiology
Cholinergic and GABAergic neurons in the striatum of the basal ganglia Low ACh Low GABA but HIGH Dopamine
40
Multiple Sclerosis DMARD Criteria
1. Relapsing and Remitting + 2 relapses in 2 years + able to walk 100m UNAIDED 2. Secondary Relapsing + 2 relapses in 2 years + able to walk 10m (AIDED or UNAIDED) DMARD's Natalizumab (Antibodies against alpha-4 beta-1-integrin) - JC Virus reactivation B interferon (reduce relapse NOT progression) Fingolimod (Sphingosine-1-phosphate receptor modulator ) Daclizumab  (Antibody against CD25 part of the IL12R  ) Alemtuzumab (Antibodies against Alpha 4 integrin) Fatigue - r/o obvious causes - Trial Amantadine Spasticity - Gabapentin / Baclofen Bladder Dysfunction - Get USS first Significant Residual Volume --> ISC If not --> Antimuscarinic Oscillopsia - Gabapentin
41
Miller Fisher vs GBS Presentation Antibodies
Anti GM1 in GBS Anti GQ1b in MFS
42
Ondansetron MOA
5HT3 antagonist Depress Vomit Centre in Medulla Oblangata
43
Sodium Valproate Side Effects
Teratogenic INHIBITOR OF P450 Alopecia Weight Gain Hepatotoxic Tremor Thrombocytopenia Hyponatremia Hyperammonemic Encephalopathy - L Carnitine as treatment
44
When is Vitamin B12 Levels Falsely Normal ?
When you inhale Nitric Oxide
45
Phenytoin Side Effects
Acutely Nystagmus, Slurred Speech Diplopia Ataxia Chronically Gingival Hyperplasia Coarsening of Facial Features Megaloblastic Anaemia (Folate NOT Vit B12) Peripheral neuropathy Osteomalacia (increased Vit D metabolism) Idiosyncratic Fever TEN Hepatitis Dupuytren's contracture* Aplastic anaemia Drug Induced Lupus
46
Phenytoin when to check levels ?
Usually no need to But Trough Levels immediately before dose if 1. Toxicity 2. Dose adjustment 3. Non adherence
47
Phenytoin MOA ?
Binds to Na channels increasing refractory period
48
Benign Idiopathic Hypertension Treatment ?
Carbonic Anhydrase Inhibitor
49
How to treat Medication Overuse Headaches?
Opoids- Withdraw gradually Triptans and Simple Analgesia - Abruptly
49
Subarachnoid Hemorrhage Investigation
Do CT Head within 6 hours and if NAD --> Alternative Dx If CT Head > 6 hours and if NAD --> LP done after 12 hours of symptom onset (Xanthochromia) Once SAH confirmed CT Angiogram --> if CI then MRA or Digital Subtraction Angiogram Repeat CT if worsening Neurology
50
Complications of SAH
1. Rebleed 2. Hydrocephalus (external ventricular drain) 3. Vasospasm (7-14 days post) - ensure euvolemia 4. SIADH
51
Side effect of Ondansetron ?
Constipation
52
Homonymous quadrantanopia's
Superior: lesion of the inferior optic radiations in the temporal lobe (Meyer's loop) Inferior: lesion of the superior optic radiations in the parietal lobe (Barums Loop) Mnemonic = PITS (Parietal-Inferior, Temporal-Superior) Knights Templars !!!!!
53
Bitemporal Hemianopia
Optic Chiasm upper quadrant defect > lower quadrant defect = inferior chiasmal compression, commonly a pituitary tumour lower quadrant defect > upper quadrant defect = superior chiasmal compression, commonly a craniopharyngioma
54
CJD Features VCJD mnemonic
V-vertical upgaze palsy C-clonus....myoclonus, cerebellar signs (ataxia, nystagmus) J- Just rigidity D- Dementia SIGN= hockey stick sign on MRI
55
Peadiatric Epilepsy Syndromes Facts
Infantile Spasm (West Syndrome) Months of life Salaam Attack Intellectual disability Vigabatrin and Steroids EEG - Hypsarrhythmia Lennox Gastaut Syndrome 1-5 years Atypical absences, falls, jerks Intellectual disability EEG: slow spike Ketogenic Diet Juvenile myoclonic epilepsy (Janz syndrome) - Dropping Breakfast 1) Teenage Girls 2) Generalized Seizures in Morning or after sleep deprivation 3) Myoclonic Jerks before 4) Daytime Absences EEG - Generalised spike and wave or polyspike and slow-wave discharges Sodium Valproate Benign Rolandic epilepsy Paraesthesia on Unilateral face on waking up
56
Homonymous Hemianopia Lesions Optic Tract or Optic Radiation ALWAYS CONTRALATERAL !!!
C(ongruous) = Radiation lesion. I(ncongruous) = Tract lesion.
57
DVLA guidance for Seizure, Syncope and TIA
First unprovoked Seizure - 6 months (all tests NAD) Known Epileptic or Multiple Provoked - 12 months (if EEG abnormal or brain imaging) No driving whilst Anti-Epileptic Meds being withdrawn and for 6 months last dose TIA - 1 month - (No DVLA) Multiple TIA - 3 months (DVLA) Syncope simple faint: no restriction single episode, explained and treated: 4 weeks off single episode, unexplained: 6 months off two or more episodes: 12 months off Craniotomy for Meningioma - 1 year Narcolepsy/cataplexy: cease driving on diagnosis, can restart once 'satisfactory control of symptoms'
58
Cluster Headache
Acutely - O2 AND Subcutaneous Sumatriptan Prophylaxis - Verapamil MRI with Gadolium - Investigation of Choice Triggered by Alcohol
59
Treatment of MG ?
60
Baclofen MOA
GABA Agonist
61
Vigabatrin Side Effect
GABA Transaminase inhibitor ---> Increasing GABA levels Visual Field Defects 6 monthly checks
62
Migraines Treatment 1) When Pregnant ? 2) Can given when on HRT ? 3) When Menstruation ?
1) PCM 1st Line NSAID's 2nd line in 1st & 2nd Trimester cuz in 3rd Trimester (Closure of PDA) 2) Yes but make it worse 3) Mefenamic Acid OR combination of aspirin, paracetamol and caffeine
63
MFS Plantar Up or Down going ?
Down going Up is abnormal
64
Cholesteatoma pathognomic
Foul Smelling Discharge
65
Cyproheptadine vs Datrolene MOA
Datrolene - Ryanodine receptor binder and reduce calcium release from SR Cyproheptadine - 5HT2A receptor antagonist and also H1 blocker
66
NMS features Serotonin Syndrome distinguishing features
Fever Autonomic Dysfunction Rigidity Mental State Mydriasis Diahorrea Hyperreflexia (vs decreased reflexes in NMS)
67
Gold Standard for Intracranial Venous Thrombosis
MRI Venogram
68
Phenytoin what to give in the last trimester of Pregnancy ?
Vitamin K to prevent Hemorrhagic Disease of Newborn
69
When to give Folate 5 mg ?
If BMI≥30 Diabetes  Coeliac disease  Anti epileptic medication  Neural tube defect in either partners  Thalassemia Pre-conception till 12th week of Pregnancy
70
Polyneuropathies Which Ones are Predominantly Motor vs Sensory
PREDOMINANTLY MOTOR: CLD Has Poor proGnosis. C- CIDP L- lead poisoning D- DIPHTHERIA H- HSMN (CMTD) P- PORPHYRIA G- GBS PREDOMINANTLY SENSORY: VALUED: V- Vitamin B12 deficiency A- Amyloidosis L- Leprosy U- Ureamia E- Ethanol D- Diabetes
71
Parts of the Hypothalamus and their functions
All the nuclei of the hypothalamus along with their functions: Suprachiasmatic - Circadian rhythm Anterior - Cooling Posterior - Heating Ventrolateral - Secretes orexin => wakefulness and feeding Medial - Satiety Arcuate - Satiety Paraventricular - Oxytocin Supraoptic - ADH Preoptic - VL => Sleep; VM => GnRH Mamillary - Memory Dorsomedial - Behavior
72
Topiramate MOA
1) blocks voltage-gated Na+ channels 2) increases GABA action 3) carbonic anhydrase inhibition - Decrease Urinary citrate excretion Formation of alkaline urine that favours the creation of calcium phosphate stone INDUCER Causes Acute Close Angle Glaucoma
73
AICA vs PICA Presentation
Facial PAIN in PICA (Lateral Medullary or Wallenburg) For Wallenburg = Ipsilateral: facial pain and temperature loss Contralateral: limb/torso pain and temperature loss Ataxia, Nystagmus AS ABOVE + Ipsilateral Facial PARALYSIS and Deafness in AICA (Lateral Pontine) Wallenburg 1. Ipsilateral facial loss of pain and temperature (CN V spinal nucleus)   2. Contralateral loss of pain and temperature  3. Ipsilateral CN 9-12 palsies (dysphagia, hoarseness, hiccups)  4. Ipsilateral cerebellar signs (ataxia, nystagmus, vertigo)  5. Ipsilateral Horner’s syndrome  6. No UMN weakness 
74
Webers Syndrome
Ipsilateral CN III palsy Contralateral weakness of upper and lower extremity Paramedian Branches of PCA
75
Subacute Degeneration of Spinal Cord
Absent Ankle Reflex Brisk Knee Reflex Positive Rhomberg Lateral CST and Dorsal and Spinocerebellar
76
Which Antiepileptic given IV causes Hypotension ?
Phenytoin
77
Proximal MCA infarct = large vessel occlusion = thrombectomy
78
Rinnes and Webers interpretation
If Conductive Hearing Loss on Rinnes then Webers Lateralizes to AFFECTED Ear If Sensineural Hearing Loss on Rinne then Weber Lateralizes to UNAFFECTED ear
79
What is associated with BIH ?
Cranial Nerve 3 due to Uncal Herniation via the Tentorium
80
Causes of Parkinsomism
Parkinson's disease drug-induced e.g. antipsychotics, metoclopramide* progressive supranuclear palsy multiple system atrophy Wilson's disease post-encephalitis dementia pugilistica (secondary to chronic head trauma e.g. boxing) toxins: carbon monoxide, MPTP
81
Causes of Spastic Paraparesis
Spastic paraparesis mnemonic: COMPACTS HD * Cord compression (trauma, tumor) * Osteoarthritis of the cervical spine * Multiple sclerosis (demyelination) * Parasagittal meningioma * AIDS (HIV causing transverse myelitis) * Cervical osteoarthritis * Tropical spastic paraparesis * Syringomyelia * Hereditary spastic paraplegia * Disc compression (alternative term for cord compression)
82
Wernicke's Encephalopathy Triad
Ataxia (Broad Based Stomping) Encephalopathy Oculomotor Dysfunction 1. Lateral Rectus Palsy 2. Sluggish Pupils 3. Anisocoria 4. NYSTAGMUS (Most Common) 5. Conjugate Gaze Palsy
83
What feature suggests more of an idiopathic Parkinson's
Asymmetrical Tremor
84
Pheochromocytoma associated with which conditions
Phaeochromocytoma is associated with 1,2,3 NF-1, MEN 2(a,b), VHL (chromosome 3)
85
Focal Seizures Antiepileptic Drugs 1st and 2nd Line
First Line - Lamotrigine or levetiracetam Second Line = carbamazepine, oxcarbazepine or zonisamide
86
ALS Genetic Mutation ?
90% Sporadic 10% Familial C9orf72 SOD1 - More Important
87
Treatment for ALS
Riluzole (Glutamate Antagonist) Edaravone (Decrease Physical Deterioration) Baclofen , Clonazepam, Tizanidine (Spasticity) Antidepressants (Pseudobulbar Effect) NIV - Better for Survival - When FVC < 80% PEG feeding recommended
88
MOA for Baclofen Clonazepam Tizanidine
Baclofen - GABA B Agonist in the spinal cord Clonzepam - GABA A Agonist Tizanidine - agonism at central α2 receptors
89
Chronic Subdural Hemorrhage on CT Acute Subdural Hemorrhage on CT
HYPODENSE (dark) compared to the substance of the brain. HYPERDENSE
90
Conditions with elevated protein in CSF ?
Guillain-Barre syndrome TB and Fungal Meningitis Froin's syndrome* Viral Encephalitis
91
Whats Froin Syndrome
Increase in CSF protein below a certain blockage Tumour , Prolapse etc ....
92
MRI Sequences
MRI FLAIR - MS MRI STIR - Thyroid Eye Disease MRI Susceptibility Weighted - Microhemorrhages and Iron Deposits
93
TIA Treatment guidelines
Aspirin 300mg STAT Aspirin + Clopidogrel for 21 days OR Aspirin + Ticagrelor for 30 days Then Monotherapy !!!! Statins 80mg to reduce non HDL by 40% Carotid Endarterectomy only if >50%
94
Brain Abscess Treatment
IV Ceftriaxone + Metronidazole
95
Causes of Autonomic Neuropathy
DM GBS MSA aka Shy-Drager syndrome PD Infections: HIV, Chagas' disease, neurosyphilis drugs: antihypertensives, tricyclics craniopharyngioma
96
Treatment for Bells
Give Oral Pred in 72 hours Eye protection from keratopathy
97
Degenerative Cervical Myelopathy Treatment
MRI ALWAYS Spinal and Neurosurgical Referral Ideally within 6 months Post Op Recurrence Refer to Spinal and Neurosurgery (Not Analgesia)
98
LEMS vs MG
Hyporeflexia Autonomic Dysfunction Present vs MG
99
Drug for Restless Leg Syndrome
Ropinirole
100
Anti NMDA receptor encephalitis features
Associated with Ovarian Teratomas AfroCarribean Psychiatric Disturbance MRI Normal but FLAIR shows abnormalities Anti GM1 (AIDP of GBS) and Anti MUSK
102
What's the treatment for Post Lumbar Puncture Headache
Blood Patch
103
Complex Regional Pain Syndrome Diagnostic Criteria is called ?
BUDAPEST Diagnostic Criteria
104
Common Peroneal Nerve Innervation and Damage Presentation ?
weakness of foot dorsiflexion weakness of foot eversion weakness of extensor hallucis longus sensory loss over the dorsum of the foot and the lower lateral part of the leg wasting of the anterior tibial and peroneal muscles
105
HSV Encephalitis Features on CT
Low Density at Medial Temporal and Inferior Frontal Lobes EEG pattern: lateralised periodic discharges at 2 Hz
106
CADASIL Full Form Inheritance Chromosomal and Genetic Mutation ?
Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy AD Chromosome 19 NOTCH3 Patients often present with Migraine with MRI showing Multiple Hyperintense White Matter Lesions
107
Up and Down Beat Nystagmus in Cerebellum Where ?
Vermis- top of cerebellum- upbeat nystagmus Arnold-Chiari- cerebellar tonsils are low- Downbeat nystagmus
108
Parkinson Plus Syndromes Features
PSP: vertical gaze + Falls + Axial Rigidity > Limb Rigidity , Frontal Lobe Involved and Bulbar Features Present Distinguishing feature from Parkinson: tremor is rare, mild, irregular, not in rest but when hands are in use    NPH: dementia + urinary incontinence MSA: cerebellar + autonomic (Orthostatic Hypotension, Incontinence) Hot Cross Bun Sign Lewy body: visual hallucinations

MRCP Part 1 (18 decks)

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