Neurology

Question 1

What is scotoma

Answer 1

Small patch of visual loss

Question 2

What causes monocular visual loss

Answer 2

Lesion at the optic nerve

Question 3

What causes bitemporal hemanopia

Answer 3

Lesion at optic chiasm

Question 4

What causes homonymous hemaninopia

Answer 4

Lesion at right optic tract

Question 5

What causes lower homonymous quadrantanopia

Answer 5

Lesion at left parietal radition

Question 6

What causes upper homonymous quadrantanopia

Answer 6

Lesion at left temporal

Question 7

What causes homonoymous hemianopia with central sparring

Answer 7

Lesion at right occipital pole

Question 8

What does compression of median nerve cause

Answer 8

Carpal tunnel (abductor pollicis brevis weakness)

Question 9

What does compression of the ulnar nerve cause

Answer 9

Abductor digiti minimi weakness

Question 10

What does compression of the radial nerve cause

Answer 10

Saturday night palsy

Question 11

What is ankle clonus

Answer 11

tested by rapidly flexing the foot into dorsiflexion, inducing a stretch to the gastrocnemius muscle. Subsequently beating of foot will result, but only a sustained clonus (5 beats or more) is considered abnormal.

Question 12

What is a LMN lesion

Answer 12

flaccid, hypotonic, hyporeflexic, denervation atrophy (atrophy occurs early on, and much quicker), -Babinski

Question 13

What is an UMN lesion

Answer 13

spastic (muscle is spasm), hypertonic, hyperreflexive, disuse atrophy (lack of use even though muscle is in spasm), Babinski. Everything above the anterior horn. Lose the ability to send a spinal pathway from the upper cortical centre down to the anterior horn. Muscle has unregulated innervation.

Question 14

Where does the spinal cord terminate

Answer 14

L1 vertebra - conus medullaris, everything below conus is LMN (cauda equine)

Question 15

What is the course of CN III, IV, V (I, II), VI

Answer 15

Cavernouse sinus

Question 16

What goes through the cerebellopontine angle

Answer 16

V, VII, VII

Question 17

What goes the the base of the skull (jugular/hypoglossal foramine)

Answer 17

IX, X, XI, XII

Question 18

What is the Edinger–Westphal nucleus

Answer 18

parasympathetic pre-ganglionic nucleus that innervates the iris sphincter muscle and the ciliary muscle

Question 19

What is Babinski’s sign

Answer 19

in normal adults, the plantar reflex causes a downward response of the hallux. An upward response of the hallux is a sign of upper motor neurone disease

Question 20

What does Freiderich’s ataxia affect

Answer 20

Lateral corticospinal, dorsal columns, spinocerebellar. Bilateral spastic paresis, bilateral loss of proprioception and vibration, bilateral limb ataxia + cerebellar taxia

Question 21

What does syringomyelia affect

Answer 21

Ventral horns, lateral spinothalamic tract. Flaccid paresis, loss of pain and temperature sensation

Question 22

What is Guillain Barre Syndrome

Answer 22

Immune reaction of demyelination of the peripheral nervous system - often caused by Campylobacter Jejunii (gram negative)
Cross reaction of antibodies in the gangliosides and the peripheral nervous system
Anti-GM1 antibodies in 25% of px

Question 23

What do parietal lobe lesions cause

Answer 23

Sensory inattention, apraxias, astereognosis, inferior homonymous quadrantopia

Question 24

What do occiptal lobe lesions cause

Answer 24

Homonoymous hemaniopia, cortical blindness, visual agnosia

Question 25

What do temporal lobe lesions cause

Answer 25

Wernicke's aphasia: area involved with word formation. Lesion results in word substitution Superior homonoymous quadrantopia Auditory agnosia Prosopagnosia

Question 26

What do frontal lobe lesions cause

Answer 26

``` Expressive (Broca's Aphasia): on posterior aspect of the frontal lobe. Speech is non-fluent laboured, and halting Disinhibition Preservation Anosmia Inability to generate a list ```

Question 27

What do cerebellum lesions cause

Answer 27

Midline: gait and trunctal ataxia Hemisphere: intention tremor, past pointing, nystagmus

Question 28

What is an extradermal ahematoma

Answer 28

Bleeding into the space between the dura mater and the skull. Trauma or blow to side of the head. Temporal region -> cause rupture of MCA Raised intracranial pressure

Question 29

What is a subdural haematoma

Answer 29

Bleeding into the outermost meningeal layer. Most common and frontal and parietal lobes.

Question 30

What is a subarachoid haemorrhage

Answer 30

Occurs spontaneously in the context of ruptured cerebral aneurysm.

Question 31

What is the minimal cerebral perfusion

Answer 31

70mmHg in adults | 40-70 mmHg in children

Question 32

What do C fibres transmit

Answer 32

Slow transmission of mechanothermal (unmyelianted)

Question 33

What do A gamma fibres transmit

Answer 33

High intensity mechanical stimuli

Question 34

What does the medullary resp centre do

Answer 34

: Inspiratory and expiratory neurones. Has ventral group which controls forced voluntary expiration and dorsal group controls inspiration

Question 35

What does the apneustic centre do

Answer 35

lower pons. Stimulates inspiration- activates and prolongs inhalation. Overridden by pneumotaxic centre to end inspiration.

Question 36

What does the pneumotaxic centre do

Answer 36

Upper pons. Inhibition of inspiration.

Question 37

What is the short synacthen test

Answer 37

Test for cortisol production