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YEAR 4 > Neurology > Flashcards

Neurology Flashcards

1
Q

Thunderclap headache

A

subarachnoid haemorrhage

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2
Q

Risk factors for berry aneuryms?

A 
Smoking
Hypertension
Aduld PKCD
Marfans
Ehlers danlos
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3
Q

What is xanthochromic CSF?

A

yellow coloured metabolised and broken down RBCs that forms several hours after a bleed

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4
Q

Why is fresh blood on LP not always indicative of SAH?

A

it can be blood from inserting the needle (traumatic tap)

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5
Q

Lucid period after head trauma followed by sudden collapse or deterioration?

A

extradural haemorrhage (between skull and dura mater)

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6
Q

lentiform appearance

A

extradural haemorrhage

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7
Q

Cogwheel rigidity

A

Parkinsons Disease

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8
Q

Woody texture muscle swelling with raised CK

A

duchenne or becker MD

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9
Q

Toe walker or positive gowers sign

A

MD

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10
Q

Mask-like expression

A

PD

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11
Q

Fluctuating cognitive defecit

A

LB dementia or delirium

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12
Q

REM distrubance

A

LB dementia or PD

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13
Q

Vivid visual hallucination normally of children and non-threatening

A

LB dementia

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14
Q

Acute onset cognitive disturbance that fluctuates

A

delirium

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15
Q

Personality/behaviour changes then dementia

A

frontotemporal dementia (picks disease)

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16
Q

memory and personality problems in someone with a history of CVD

A

vascular dementia

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17
Q

Stepwise deterioration

A

vascular dementia (small strokes affecting some functions and not others)

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18
Q

Pain on loud noise

A

facial nerve palsy

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19
Q

Painful third nerve palsy (reduced eye movements, pupil dilation)

A

posterior communicating artery aneurysm

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20
Q

myalgia, myositis and myoglobinaemia/uria

A

rhabdomyolysis

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21
Q

Complications of rhabdomyolysis?

A

DIC

acute renal failure

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22
Q

Inflammatory myopathy with poor response to steroids

A

inclusion body myositis

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23
Q

What is inclusion body myositis?

A

disease of muscle cells characterised by abnormal protein inclusions (misfolded proteins that aggregate and accumulate)

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24
Q

Symptoms of inclusion body myositis?

A

slowly progressive muscle weakness and wasting in distal and proximal muscles

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25
Weakness, frontal balding, cataracts, ptosis
myotonic dystrophy (onset 30s, +ve FH)
26
What are nerve cell bodies called?
PNS: ganglion CNS: nucleus
27
What are bundles of axons called?
PNS: nerve CNS: tract
28
Where is level of T4?
male nipple
29
Where is level of T10?
umbilicus
30
Cervical plexus
C1 - C4
31
Brachial plexus
C5 - T1
32
Lumbar plexus
L1 - L4
33
Sacral plexus
L5 - S4
34
Sympathetic outflow (thoracolumbar)
T1 - L2 (extra lateral horn in grey mater of spinal cord) | travels to sympathetic chains and then passes into all spinal nerve anterior and posterior rami
35
Parasympathetic outflow (craniosacral)
CN 3, 7, 9, 10 | pelvic splanchic nerve S2-4
36
How do APs relay sensory information?
Duration of firing of APs is duration of stimulus Frequency of AP firing is proportional to the amplitude of stimulus release of neurotransmitter is proportional to frequency of APs
37
afferent meaning
conducting inwards
38
Spinal damage to dorsal column?
ipsilateral loss of fine touch and vibration below the level (e.g. left side damage to dorsal column causes left sided symptoms as the fibres haven't crossed yet)
39
Spinal damage to spinothalamic tract?
contralateral loss of crude touch, pressure, pain and temperature (e.g. left side damage to spinothalamic tract causes right sided symptoms right sided symptoms because fibres have crossed)
40
sensory cortex damage?
contralateral loss of fine touch, vibration, crude touch, pain and temperature (both tracts have crossed)
41
When does a resting tremor occur?
when the muscle is relaxed
42
When does an action tremor occur and give some examples
``` occurs with muscle contraction postural (maintaining a position against gravity) intention (purposeful movement towards a target) task specific (when performing certain tasks, writing, speaking) ```
43
action tremor that gradually worsens, FH, no associated disease, improved with alcohol
essential tremor
44
Lesion of optic nerve
ipsilateral monocular visual loss
45
Lesion of optic chiasm
bitemporal haemianopia
46
Lesion at optic tract
contralateral homonymous hemianopia
47
Lesion at parietal upper optic radiation
contralateral homonymous inferior quadrantanopia
48
Lesion at temporal lower optic radiation
contralateral homonymous superior quadrantanopia
49
lesion at occipital visual cortex
contralateral homonymous hemianopia with central sparing
50
Ankle jerk
S1
51
Knee jerk
L4
52
Biceps
C5
53
Brachradialis
C5
54
Triceps
C7
55
Babinski positive
toe extension (indicates UMN lesion)
56
What causes myasthenia gravis?
autoimmune ABs to nicotinic Ach receptors at neuromuscular junction (prevents Ach from LMN from binding to receptors on muscle cells)
57
Treatment of essential tremor?
propanolol | primidone
58
Parkinsons tremor
resting tremor (pill rolling)
59
Cerebeller tremor
slow easily visible tremor of extremities, intention tremor, past pointing
60
What is myasthenia gravis associated with?
hyperplasia of thymus or thymoma
61
Treatment of myasthenia gravis?
pyridostigmine (anticholinesterase inhibitor) steroids thymectomy
62
What happens in myasthenia gravis?
inflammation and destruction of muscle cells | skeletal muscle weakness (extraocular muscles commonly affected first)
63
What separates the hemispheres of the brain?
medial longitudinal fissure
64
Where are the primary sensory and primary motor cortex located?
primary motor: precentral gyrus | primary sensory: postcentral gyrus
65
Function of the frontal lobe?
movement, personality, executive functions (making decisions)
66
Function of temporal lobe?
primary auditory cortex, smell, memory, facial recognition, language
67
Function of parietal lobe?
processes sensory information (regarding the body in 3D space, interpreting visual information, processing language and maths
68
Function of occipital lobe?
primary visual cortex
69
Where are broca and wernickes areas and function of each?
Broca's area: anterior, production of speech | Wernike's area: posterior, understanding speech
70
Function of the cerebellum
coordinates skeletal muscle contraction, balance and fine motor control
71
Function of brainstem?
essential functions of life (HR, BP, breathing, GI function, consciousness) receives info from thalamus
72
What is the corpus collosum?
thick band of nerve fibres, communication between hemispheres
73
Leg symptoms + midline shift
Falcine herniation (brain herniation due to high ICP)
74
Back pain worse on coughing?
slipped disc
75
Headache worse on coughing?
lesion in posterior fossa
76
Bilateral sciatica, male sexual dysfunction, bowel and bladder symptoms?
cauda equina
77
Pleocytosis
increased WBC's in CSF
78
Migraine prophylaxis
propanolol, topiramate or amitryptaline | valproate, pisotifen, gabapentin, pregabalin (if one doesn't work by 4months, try another)
79
Injury to upper brachial plexus
(C5 - C6) erbs palsy (waiters tip, paralysis of the arm)
80
When does erbs palsy commonly occur?
shoulder dystocia (should fails to deliver after fetal head)
81
Injury to lower brachial plexus?
(C8 - T1) Klumpke's palsy (claw hand)
82
Simmond's test positive
(no planter flexion when squeezing calf) | achilles tendon rupture
83
Anti acetylcholine receptor antibody?
myasthenia gravis
84
purely motor symptoms with ocular sparing
motor neuron disease
85
Where do signals come from that make up the extrapyramidal system?
cerebellum | basal ganglia
86
Where do signals come from that make up pyramidal system?
motor cortex (cerebrum)
87
What causes internuclear ophthalmoplagia?
damage to medial longitudinal fasiculus (in brainstem)
88
What happens in internuclear ophthalmoplagia?
affected eye cant adduct and other eye will nystagmus on abduction
89
What is MS?
demyelinating disorder of CNS | T4HS causing inflammation and damage to oligodendrocytes
90
What is the common trio in MS?
Nystagmus Dysarthria intention tremor
91
What the immunomodulators used in MS?
IFN beta copaxone tecfidera
92
How are acute exacerbations of MS treated?
symptomatically | with oral or IV steroids
93
Drugs used in MS for urinary symptoms?
oxybutynin (anti-cholinergic) desmopressin (synthetic ADH) catheter
94
Cerebeller lesion symptoms?
Ataxia (affected balance, coordination (gait wobbily, wide based) and speech/dysarthria) intention tremor, past pointing Dysdiadochokinesia (impaired ability to perform fast movements) pendular reflex
95
Drugs used in MS for spasticity?
baclofen tizanidine botox
96
Drugs used in MS for sensory pain?
gabapentin, amitriptyline

YEAR 4 (27 decks)

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