Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Helena's finals > neurology 2 > Flashcards

neurology 2 Flashcards

1
Q

work up post stroke

A 
long term ECG + 24 hour tape - AF
HTN
lipids
HbA1c
carotid dopplers 
cardiac echo for thrombus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

most common cause of peripheral neuropathy

A

diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

peripheral neuropathy causes

A 
Alcohol
B12/folate
CKD
Diabetes
Everything else eg. drugs (chemo, isoniazid)
syphillis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

down and out eye

A

3rd nerve (oculomotor) palsy

pupil dilated (parasympathetic fibres) - surgical cause eg. tumours, aneurysms

pupil not dilated - medical cause eg. diabetes, vascular disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

6th nerve palsy cause

A

raised ICP - 6th nerve has longest intracranial path (false localising sign)

Multiple sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

forhead sparing 7th nerve palsy

A

stroke, multiple sclerosis ie. upper motor neurone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

NOT forhead sparing 7th nerve palsy

A 
bell's palsy
ramsy hunt
Guillain barre syndrome
Lyme disease
local malignancy eg. parotid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

shen do you start parkinsons treatment

A

when symptoms are affecting quality of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

acute multiple sclerosis first line

A

methylprednisolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Cerebellum signs

A 
Dysdiadokinesia
Ataxia (broad based)
Nystagmus 
Intention tremor
Slurred speech 
Hypotonia

Dysarthia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Causes of cerebellar syndrome

A 
MS
Stroke
Tumour 
Drugs (phenytoin)
Alcohol
Paraneoplastic syndrome — treat underlying cancer
Hypothyroidism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Causes of motor neurone disease

A

Sporadic disease of anterior horn cells of the motor pathway

Genetic forms - SOD1 mutation (A Dom)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Mx MOtor neurone disease

A

Riluzole - increases life expectancy for 3 years

Supportive MDT 
- SALT
Communication aids 
Dietician - gastrostomy due to loss of swallowing 
Psychology

Ventilation —- life threatening resp failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Proximal myopathy
Causes
Signs

A

shoulder girdle/ hip and thigh muscle weakness

Causes
Inherited:
- duchennes, beckers (pseudo calf hypertrophy)
- muscular dystrophy type 1&2

Acquired:
Infection - hiv, influenza
Inflammation - RA, dermato/polymositis, sarcoidosis
Endocrine - addisons, Cushing Diseas
Autoimmune - thyroid disease, SLE
Drugs - alcohol, steroids

Signs
- walking aids
- muscle mass is normal, symmetrical proximal muscle wasting is late sign
- underlying cause
- muscle tenderness!!!!!! – disorder of blood vessels
- difficult standing without arms
Normal sensation, reflexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q 
dermato vs poymysositis
definition
causes
investigations
treatment
A

inflammatory myositis - dermatomyositis involves the skin

polymyositis is a diagnosis of exclusion of other causes of inherited and acquired myopathies

causes of polymyositis: autoimmune, connective, drugs (statins), infections (HIV), idiopathic
causes of dermatomyositis: cancer (ovary, GI, breast)

signs
inspection: normal/ symmetrical proximal muscle wasting, skin (heliotrope rash, gottren’s papules)
palpation: muscle tenderness
facial weakness +/- dysphagia
power: proximal muscle weakness (unable to stand from a squatting position, difficulty lifting things, difficulty walking up stairs
normal reflexes or reduced if severe muscle atrophy
normal sensation

Ix. Drug history, elevated CK, EMG , muscle biopsy is diagnostic

Mx. steroids, steroid sparing agents (azathioprine, methotrexate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

causes of drug induced parkinsonism

A

dopamine antagonists such as antixpsychotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

essential/dystonic tremor vs parkinsons tremor

A

essential tremor:

  • improves with alcohol
  • symmetrical tremor

parkinsons tremor

  • asymmetrical
  • pill rolling
  • worse at rest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what sleep issue may preceed parkinsons disease

A

rapid eye movement sleep disorder: poor sleep, acting out dreams

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what roportion of patients with parkinsons disease have depression

A

one third

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

examination findings for parkinsons

A

inspection:

  • walking aids
  • mask like face
  • stooped posture
  • shuffling gait, small steps, loss of arm swing on one side, difficulty turning, unsteadiness, difficulty initiating gait

tone - assymmetrical cogwheeling, tremor, rigidity

power function - repetitive hand movements like walking the thumb along the fingers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

subacute combined degeneration of the cord

examination findings

A

UMN (myelopathy) + distal LMNs (length dependent neuropathy)

inspection

  • walking aids
  • normal/ proximal muscle mass wasting
  • anaemia

tone normal

power normal

reflexes: brisk, extensor plantar responses
sensation: vibration and proprioception loss, paraesthesia, loss of sensation disttally
coordination: limb incoordination
gait: ataxic, romberg’s sign positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

special test in subacute combined degeneration of the spinal cord

A

romberg test - cant stay balanced with eyes closed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Lhermitte’s phenomenon

A

intrinsic lesion of cervical cord

passive flexion of the neck gives electric shock sensation down the back

multiple sclerosis and subacute combined degenereation of the spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

signs of B12 deficiency

A 
megaloblastic anaemia
neuropathy
myelopathy
optic atrophy
pyschiatric/ cognitive impairment 
glossitis
autonomic neuropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Charcot marie tooth disease - cause - diagnostic investigations - features of disease
autosomal dominant chr 17 - sensorimotor neuropathies patients present before age 20 - progressive peripheral nerves DESTRUCTION Ix. genetic desting classic type 1A disease - distal > upper limb muscle wasting - inverted champagne bottle appearance -- preserves thigh muscles - foot deformities: toe clawing, hammer toes, charcot joints, pes cavus (high arch) - wasting of small muscles in hand -- ulnar nerve damage - tremor - scoliosis tone normal/ reduced distal weakness absent reflexes sensation lost distally in all modalities high stepping gait due to bilateral foot drop (popliteal nerve)
26
Carotid endartectomh
75% stenosis symptomatic
27
Heels and toes walking | Which nerves regions
Heels L4/5 | Toes S1/2
28
Triceps reflex root
C7/8
29
Biceps reflex root
C5/6
30
Brachioradialis root
C6
31
Knee reflex root
L3/4
32
Ankle reflex root
S1/2
33
Tuning fork nerves
128Hz
34
causes of small pupil
miosis anisocoria (different sizes) - degree of anisocoria is worse in the dark - physiological: no more than 1mm difference in diameter between the eyes and equal in light - pilocarpine (pharmacological) - Horners (ptosis, miosis, anhidrosis) - Argyll Robertson pupil - tertiary syphilis, sudden constriction on accomdation, both pupils miosis but to different degress. do not react to light - opiate use (bilateral) - multiple sclerosis topical cocaine solution - if equal dilation = physiological - if anisocoria = horner's
35
horner's where is the lesion
hydroxy amphetamine 1% solution pupils dilate equally = central lesion anisocoria remains = post ganglionic lesion
36
mx syphilis
penicilin G IV --> IM for a total of 3 weeks | HIV serology
37
congenital syphilis
Hutchinson triad 1. interstitial keratitis - inflammation of the cornea 2. hutchinson's incisors - widly spaced teeth 3. Cranial 8 deafness
38
internuclear opthalmoplegia findings
cause: interruption of the medial longitudinal fasciculus that connects the nuclei of cranial nerves 3 and 6 to coordinate them unilateral - ipislateral failure to adduct on contralateral gaze + nystagmus in other eye * horizontal diplopia bilateral - exotropic eyes (eyes look out away from nose), vertical nystagmus -- Multiple sclerosis
39
bulbar palsy - definition - where is the lesion - causes - signs
lower motor neuron syndrome involving the lower cranial nerves 11, 12 lesions can be anywhere from the nuclei in the medulla to the lower motor neuron causes: stroke (nerve bodies in the brainstem), motor neurone disease, medullary infarction, brainstem tumours, guillain barre, lyme disease, congenital signs: - NG tube for feeding - saliva at side of mouth - tongue fascivulations (but can move rapidly from side to side) - say ahhh (failure of soft palate to elevate) - dysphagia - lip, tongue, palatal weakness - note and quality of speech -- nasal - absent gag reflex/ jaw jerk
40
pseudobulbar palsy
BILATERAL UPPER motor neurone syndrome involving 11, 12 lesions from the cortex to the nuclei in the medulla causes: motor neuron disease, bilateral hemispheric infarction, high brainstem tumour, multiple sclerosis, trauma signs: - signs: - NG tube for feeding - saliva at side of mouth - spastic tongues (do not fasciculate) + slow/spastic when moved from side to side - say ahhh (failure of soft palate to elevate) - dysphagia - lip, tongue, palatal weakness - note and quality of speech -- high pitched, dysarthria - absent gag reflex - brisk jaw jerkjaw jerk
41
MND and bulbar palsy
typicall mixed bulbar/pseudobulbar palsy | - fasciculating tongue with brisk jaw jerk
42
where does the spinal cord end
L1/2 at the conus
43
cauda equina syndrome symptoms
pain in lower back variable paralysis/ sensory disturbance of lower limbs saddle anaesthesia bladder/bowel/sexual disturbance LMN signs
44
cauess of cauda equina syndrome
***lumbar disc prolapse traumatic ``` infective abscess ankylosing spondylitis vascular (epidural haematoma) neoplastic iatrogenic (spinal anesthesia) ```
45
mx cauda equina
urgent decompression by neuro surgeons
46
pilocarpine uses
reduce pressure inside the eye and treat dry mouth angle closure glaucoma until surgery can be performed, ocular hypertension, primary open angle glaucoma, and to bring about constriction of the pupil following its dilation.
47
signs and symptoms of myasthenia gravis
bilateral ptosis diplopia at extremes of gaze fatiguable ptosis (ask patient to look up) facial weakness dysphagia painless fatiguable muscle weakness - check power, raise arms up and down then re-check power normal reflexes, sensation
48
tenilon test
myasthenia gravis | IV edrophonium temporarily improves weakness but not done in elderly due to cardiac side effects
49
cervical myelopathy
progressive compression of the spinal cord at the cervical lesion - denegerative, neoplastic, infective, trauma LMN at the level of the lesion UMN signs below ``` walking aid increased tone, clonus pyramidal weakness brisk reflexes loss of sensation (vibration, proprioception) ``` spastic stiff legs and foot drop
50
hoffman sign
finger flick the middle nail index finger and thumb flex in response multiple sclerosis, cervical myopathy
51
pyramidal weakness
UMN weakness upper limb flexors stronger than extensors lower limb extensors stronger than flexors
52
foot drop nerve involved
peroneal nerve injury
53
spinal cord stroke
rare usually anterior spinal arteries --> loss of pain and temperature, preservation of proprioception and vibration (dorsal medial lemniscus supplied by posterior spinal arteries)
54
transverse myelitis
inflammation of the spinal cord can be isolated or occur with MS can occur following bacterial/ viral infections (especially where there is a rash) ascending weakness, sensory disturbances are common
55
carotid stenosis
>70% stenosis of at least one carotid endartectomy -- mx. endartectomy or stenting >50% surgical if symptomatic <70% stenosis - antiplatelets, statins, lifestyle changes
56
optic neuritis
pain in one eye on movement blurred vision worsened with heat - hot shower/ exercise *Urthoff's sign) pale optic disc
57
Multiple sclerosis vs Guilain barre as CSF analysis
MS -- oligoclonal bands only in the CSF (not in serum) GBS -- systemic so the oligoclonal bands are in the CSF & serum think where does the inflammation start
58
Sub arachnoid haemorrhage imaging
CT scan -- may not show anything initially, takes 6hrs | CSF --- xanthochromia 4-12 hours after
59
normal CSF opening pressure
10-18 cm H20
60
what does blood, oedema and ischaemia look like on CT
blood = white oedema (ischaemia/infarct) = grey normally infarcts dont show anthing on CT
61
work up for first seizure in adult life
space-ocupying lesions - malignancy, neurocysticercosis cerebral bleeds metabolic disturbancs immunocompromised (HIV): cryptococcus neoformns, TB, toxoplasmosis

Helena's finals (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions