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MRCP2 > Neurology > Flashcards

Neurology Flashcards

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1
Q

GBS:

A

Sensory loss (–)
Ankle reflex (–)
ANS involvement (+)
Joint position/vibration (reduce)
NCS - abnormal by day 10

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2
Q

Wilson Dz

A

Neuro Signs
(behaviour change, parkinson, tremor, ataxia, dystonia)
Family Hx Liver Dz(+)
Most accurate Test: 24 hr urine Cu++
Most rapid Dx sign: KF ring

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3
Q

Idiopathic intracranial HTN
Dx ?
Rx ?
other features ?

A

LP (Dx + Rx)
sudden onset headache (worse in morning/increase with cough)
Rx: Weight loss, BP 140 labetalol
Rule out cerebral venous sinus thrombosis
6th CN palsy: False localizing sign

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4
Q

Myotonic dystrophy Type1

A

Myotonia (problem opening eyes)
difficult to release hand grip quickly
Distal limb involvement
mild intelectual impairment
DMPK gene defect
worse in cold
B/L cataract
B/L ptosis
cardiomyopathy, conduction defects

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5
Q

Myasthenia Gravis

A

cold improves NMJ transmission (ice-pack test)

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6
Q

MG vs LEMS ?

A

ANS dysfunction (–) in MG
ANS dysfunction (+) in LEMS
(ANS = dry mouth/erectile dysfunction)

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7
Q

B12 deficiency
Dx features ?

A

SCD
Demyelination of
1) Spinocerebellar
2) Corticospinal
3) Dorsal column
……………………………
Features:
Ataxia,
paresthesia,
impaired joint position/vibration.

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8
Q

MND
Most imp feature ?

A

Sensory Loss (Negative)

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9
Q

Temporal lobe epilepsy
features ?

A

Deja Vu
epigastric sensation -
loss of consciousness
Oral automatism (lip smacking)

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10
Q

CJD
features ?

A

Progressive mental decline (100%)
Myoclonus/movement disorder (100%)
cerebellar signs (70%)
pyramidal (60%)
extra-pyramidal signs
behaviour problem (55%)
visual changes
……………..
Dx - MRI late stage = cerebral atrophy,
CSF = increase protein, increase IgG

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11
Q

skull injury
Rx ?

A

staph
flucloxacillin + Genta
(linezolid - variable effects)

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12
Q

Nocturnal seizures
Features ?
Dx ?

A

stupor
incontinence
post-event drowsiness
headache
muscle pain
+/- severe learning disability
lack of sleep/TV - trigger attack
………………………
Dx - EEG

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13
Q

Paragangionoma
Features ?

A

pulsatile tinnitus (conductive hearing loss)
CN 10, 11, 12 palsy

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14
Q

Hypoglossal tumor
Features ?

A

CN 12 palsy

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15
Q

Acoustic neuroma
Features ?

A

CN 5 to 8 palsy

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16
Q

Mitochondrial disorder
features ?

A

ataxia
deafness
epilepsy
Eye movement problem
DM

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17
Q

holmes-adie pupil
Features ?

A

large, irregular, sluggish reactive pupil
DTR (-)
Accomodation (N), visual acquity (N)

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18
Q

Tertiary syphilis
features ?

A

memory impairment
gait ataxia

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19
Q

Brown sequard syn:
Features ?

A

Ipsilateral
*vibration/propioception
*hypertonia/hyperreflexia
*weakness
extensor plantor
……………
contralateral
pain/temperature
……………………
segmental anesthesia
*at level of lesion

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20
Q

stroke prevention
medications ?

A

clopidogrel
atorvastation
perindopril (BP Mx)

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21
Q

carotid endarctectomy
absolute c/i ?

A

asymptomatic complete carotid occlusion

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22
Q

Post-TIA/Stroke
Rx ?

A

dual anti-PLT 3weeks
long term clopidogrel

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23
Q

early parkinson feature ?

A

REM Sleep behavior disorder

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24
Q

Lewy body dementia
Rx ?

A

pyridostigmine (ACh inhibitor)

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25
drug worsening psychotic/behavior problem in parkinson ?
Ropinarole (D agonist)
26
inclusion-body myositis Features ?
progressive, painless, late-onset muscle weakness wasting of forearm flexor/quadriceps CK - High
27
solitary, 1 unprovoked seizure DVLA ?
6 months off driving
28
MELAS Features ?
DM Short stature proximal myopathy stroke-like event MRI - Multiple cortical lesion
29
CADASIL Features ?
Migraine with aura family Hx Migraine/early dementia stroke-like episode Typical MRI findings
30
Botulism features ?
*ophthalmoplegia (blurred vision) *descending paralysis (CN - Arm - leg) *severe cases - resp failure features < 48 hrs food poisoning
31
Tourette syn Rx ?
haloperidol (D2 receptor blocker)
32
miller-fischer syn Dx ? features ?
Anti-GQ1b ophthalmoplegia areflexia ataxia .................... *if cognitive impairment - Miller fischer is NOT dx
33
Lamber-Eaton Myasthenia Syn Rx ?
3,4 Diaminopyridine
34
Argyl-Robertson pupil Features ?
35
B/L occipital Cortical infarct
pt believes, he can see, but actually he can't
36
trigeminal neuralgia rule out ?
r/o structural lesion/MS causing demyelination as pt have decrease corneal reflex
37
Myotonic dystrophy features ?
myotonia (impaired relaxation of muscle after voluntary contraction) muscle atrophy (face, neck) frontal bald cataract heart abnormality hypogonadism
38
tardive dyskinesia features ?
chronic dopamine blocking agents leads to involuntary movement
39
acute dystonia
s/e of metoclopramide
40
sagital sinus thrombosis features ? risk factors ?
headache, increase ICP, venous infarction, seizures ............. risk factors - dehydrate/pregnancy
41
wernickie-enceph features ? risk groups ? complications ?
delirium ocular signs ataxia thiamine deficiency hypoTN/hypothermia ................. risk groups ? alcoholic malnourished (hyperemesis gravidarum) recent GI surgery .................. failure to treat - chronic cognitive impairment (korsakoff syn)
42
cluster headache Acute Rx ? Prevention ?
high flow O2/sumatriptan prevention - verapamil
43
Anterior spinal cord syn (supplies anterior 2/3 spinal cord) features ?
1)Corticospinal tract (motor paralysis) 2)Spinothalamic tract (loss of pain) *Vibration=preserved (Dorsal column)
44
NPH 3 features ?
ataxia cognitive impair urinary incontinence
45
Lewy body dementia features ? Rx ?
parkinson + hallucination on up-titration of dopamine medicine Rx - increase anti-parkinson medicine - s/e confusion/hallucination. Rx atypical anti-psychotic (risperidone)
46
Basilar A dissection features ?
SAH symptoms rare Dz
47
Progressive supra-nuclear pasly features ?
Early falls vertical gaze supra-nuclear palsy involuntary eye closure/twitching initially vague personality change (apprehension)
48
Multiple-system atrophy
ataxia orthostatic hypotension syncopal episodes urinary symptoms parkinson features - poor response to levodopa
49
ataxia telangiectasis features ?
childhood ataxia
50
friedrich ataxia features ?
teen-age progressive ataxia lower limb areflxia plater - extensor vibration/propioception - reduce cardiomyopathy (70%) DM, Deafness
51
Spinal muscular atrophy type3 Rx ?
Risdi plan (Dz modifying Rx)
52
Cerebellum tumor (hemangioblastoma) features ?
h/o minor symptoms (Headache, lethargy) - leads to sudden deterioration (ataxia, obstruction, hydrocephalus)
53
corpus callosum lesion ?
inability to read written words
54
Amygdala (limbic system) function ?
decision making emotional response memory
55
hippocampus (limbic system) function ?
saving memory 1 of 1st part affected by alzheimer's
56
TB meningitis
CSF protein - increase lymphocytes - increase glucose - decrease +/- obstructive hydrocephalus +/- CN palsy
57
cryptococcal meningitis
CSF protein - increase CSF pressure - increase h/o pnemonitis - weeks earlier HIV (+) Hydrocephalus
58
Coxsackie meningitis (aseptic)
entero-virus CSF protein - less elevated Glucose - Normal
59
CMV meningoencephalitis ?
CSF pressure - increase lymphocytes - increase protein - increase glucose - decrease MRI - ependymal enhancement
60
HSV encephalitis
drowsiness mood changes memory loss
61
mumpts meningoencephalitis
parotid swelling LN enlarged headache confusion Amylase - increase, epigastric pain CSF - monocytosis, increase protein, Glucose Normal
62
Ropinarole indications ?
D agonsit Rx Parkinson, restless leg syn decrease ON/OFF phenomenon (but no prognostic benefit)
63
restless leg syn
pramipexole > ropinarole
64
entecapone/selegiline
decrease motor fluctuations use alongwith levodopa
65
carbamazepine
Rx trigeminal neuralgia
66
apomorphine
s/c pump, use in late stage dz
67
amantadine
mild anti-parkinson effect
68
clozapine
pt with auditory hallucination/suicidal attempt

MRCP2 (22 decks)

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