Neurology Flashcards
Where do the majority of intracerebral haemorrhages occur?
Basal ganglia
Which nerve roots are being tested by the cremasteric reflex?
L1-2
Which nerve roots are being tested by the epigastric reflex?
T7-9
Which nerve roots are being tested by brachioradialis reflex?
C5-6
Which nerve roots are being tested by the ankle jerk?
S1-3
Which nerve roots are being tested by the anal reflex?
S4-5
What is the normal pH of CSF?
7.31
Describe the electrolyte levels in CSF compared to plasma
CSF: lower K, Ca and protein
Higher Na, Cl, bicarbonate and magnesium
What is a normal white cell value in CSF?
Less than 4/ml
What is a normal opening pressure of CSF?
Less than 20cm of water
What is a normal glucose concentration in the CSF?
Approximately 2/3 of plasma
3.3-4 mmol/L
What is mononeuritis multiplex?
Neuropathy where individual nerves are affected, especially linked with CNIII and VI
What is the diagnostic criteria for delirium?
Disturbance of consciousness: reduced clarity of awareness of environment, reduced ability to focus, sustain or shift attention
Change in cognition: memory deficit, disorientation, language disturbance, perceptual disturbance
Disturbance develops over a short period: hours or days
Fluctuation over the course of the day
What is the diagnostic criteria for delirium?
Disturbance of consciousness: reduced clarity of awareness of environment, reduced ability to focus, sustain or shift attention
Change in cognition: memory deficit, disorientation, language disturbance, perceptual disturbance
Disturbance develops over a short period: hours or days
Fluctuation over the course of the day
In which patient group should bupropion be used with caution as a smoking cessation aid?
History of epilepsy or other seizure disorders such as excessive alcohol consumption
In which patient group should varenicline be used with caution as a smoking cessation aid?
Psychiatric conditions with suicidal ideation or attempts
The foot processes of which cell type support the blood brain barrier?
Astrocytes
Wrap around every capillary in the brain, important for movement of water and glucose between circulation and brain
Which are the cells of the choroid plexus which produce CSF?
Ependymal cells
What neuropathies can be associated with B12 deficiency?
Glove and stocking anaesthesia Optic atrophy Psychosis Sensory ataxia Spastic paraparesis
What signs would you expect in a patient with Parkinson’s disease?
Bradykinesia: slow festinant gait with difficulty changing direction or arm swinging
Rigidity: stiff, lead pipe rigidity during elbow flexion, cog wheel rigidity at the wrist with superimposition of tremor
Tremor: pill rolling tremor of fingers
What symptoms might you get with cervical spondylosis?
Tingling, numbness, weakness and wasting in upper limbs
How is neurofibromatosis inherited?
Autosomal dominant
What is the NIH consensus criteria for diagnosis of neurofibromatosis?
2 or more of the following:
Six or more cafe au lait spots over 5mm diameter in pre pubertal individual
Two or more plexiform neurofibromas
Freckling in the axillary or inguinal regions
Optic glioma
Two or more lisch nodules (iris hamartomas)
Distinctive osseous lesion such as sphenoid dysplasia
First degree relative with NF1
A 70 year old man complains of a 6 month headache, visual disturbances and weight loss. On examination he is sensitive on palpation of the scalp which is tender, what is the likely diagnosis?
Giant cell arteritis
