Neurology e lecture

Question 1

Dorsal column vs spinothalamic pathway

Answer 1

Question 2

4 categories of causes of coma

Answer 2

1. metabolic
2. diffuse intracranial (injury to the brain itself)
3. space occupying lesions
4. brainstem injury

Question 3

Metabolic causes of coma

Answer 3

• hypoglycaemia
• hypercalcaemia
• diabetes mellitus
• drug overdose
• “the failures”

Question 4

Diffuse intracranial causes of coma

Answer 4

• meningitis
• encephalitis
• SAH
• trauma
• epilepsy

Question 5

Examples of hemispheric lesions causing coma

Answer 5

• cerebral infarct
• cerebral haemorrghage
• subdural hematoma
• extradural hematoma
• abscess
• tumour

Question 6

Brainstem causes of coma

Answer 6

• brainstem infarct
• tumour
• abscess
• cerebellar haemorrghage
• cerebellar infarct

Question 7

Concepts of consicousness

Answer 7

Vegetative state: brainstem is intact but there’s vast damage to the rest of the cortex.

Locked in syndrome: brainstem is largely intact. Patient can’t MOVE.

Question 8

Definition of seizure

Answer 8

Paradoxical discharge of cerebral neurones which is apparent to an external observer (eg generalised seziure) or as an abnormal perceptual experience by the subject

i.e. it’s the physical manifestation of sudden changes in electrical activity in the brain

Symptoms:

• abnormal perceptual exprience by subject
• paradoxical cerebral discharge
• body stiffening
• TACHYCARDIA
• breathing may be absent in a tonic-clonic seizure

Question 9

Definition of epilepsy

Answer 9

A RECURRING tendency to have seizures

(diff from a seizure- seizure is a one off event whereas epilepsy is recurrent seizures)

Question 10

Two broad categories of seizures in epilepsy

Answer 10

1. generalised- affects diff parts of the brain
2. partial- affects a localised area of the brain

Question 11

Types of generalised seizures in epilepsy

Answer 11

(All of these are generalised seizures, affecting different parts of the brain simultaneously. Tonic-clonic is the most common type)

Question 12

Types of partial seizures in epilepsy

Answer 12

Question 13

Status epilepticus

Answer 13

Question 14

How do patients with LIS communicate?

Answer 14

Vertical eye movements and blinking

Question 15

Coma vs vegetative state vs LIS vs minimally conscious state

Answer 15

Coma: patients may have reflexes and postural movements

Vegetative state: may be purposeful movement and withdrawal from noxious stimuli

MCS: may reach for objects and localise noxious stimuli

LIS: quadriplegia

Question 16

Broadly what is the mechanism for headaches?

Answer 16

The brain doesn’t have pain receptors but the meninges and blood vessels do.

Pains are referred back into trigeminal nerves and C2 root (occipital nerve)

Question 17

Causes of acute single headaches

Answer 17

Question 18

Causes of recurrent headaches

Answer 18

Question 19

Causes of a triggered headache

Answer 19

Question 20

Causes of dull headache with increasing severity

Answer 20

Question 21

Causes of dull headache, unchanegd over time

Answer 21

Question 22

Broad mechanisms of syncope

Answer 22

Anything that reduces perfusion of the brain.

1. Things affecting HR
2. Things affecting stroke volume: acute and chronic
3. Other

Question 23

Causes of syncope: things affecting Heart rate

Answer 23

• bradycardia
• complete heart block
• tachycardia
• ventriuclar tachycardia

Question 24

Causes of syncope: things that affect stroke volume

Answer 24

Acute vs chronic

Question 25

Causes of syncope: things affecting peripheral resistance

Answer 25

Question 26

Definitino of stroke

Answer 26

Rapidly developing clinical signs of focal (or global) disturbance of cerebral function, with symptoms lasting 24 hours or more, with no apparent cause other than that of vascular origin.

Question 27

Symptoms of stroke in anterior circulation of the brian

Answer 27

- contralateral hemiparesis - aphasia - apraxia - visual neglect

Question 28

Symptoms of stroke in posterior circulation of the brain

Answer 28

4Ds + Ataxia Dysphagia Diplopia Dysarthria (slurred speech) Dizziness (vertigo) Ataxia

Question 29

Define TIA

Answer 29

Acute episodes of focal disturbance of cerebral or visual function, lasting less than 24h, due to inadequate blood supply

Question 30

Symptoms of PICA

Answer 30

Ipsilateral cerebellar ataxia

Question 31

Symptoms of posterior cerebral artery stroke

Answer 31

Question 32

Symptoms of middle cerebral artery stroke

Answer 32

Question 33

Which artery is affected in LIS?

Answer 33

Basilar artery

Question 34

Important brain infections

Answer 34

- meningitis- affects the meninges - encephalitis- within the substance of the brian (often affects temporal lobe)

Question 35

Organisms that can cause meningitis

Answer 35

Question 36

Definition of PD

Answer 36

Question 37

Symptoms of PD on the face

Answer 37

Question 38

Symptoms of PD: gait

Answer 38

Question 39

Tremor in PD

Answer 39

Question 40

Rigidity in PD

Answer 40

Question 41

Main drug for PD

Answer 41

L-DOPA Precursor of dopamine, able to cross the BBB unlike dopamine. eg Sinamet, Madopar

Question 42

L-Dopa side-effects

Answer 42

Question 43

What happens in MS?

Answer 43

Question 44

Which areas are commonly affected by MS?

Answer 44

Question 45

Examples of sensory and motor neuropathies

Answer 45

Question 46

Classification of polyneuropathies

Answer 46

Question 47

What causes radial nerve palsy?

Answer 47

AKA saturday night palsy. Caused byd raping the arm over back of chair for hours

Question 48

Type of neuropathy in renal disease

Answer 48

Progressive sensorimotor neuropathy

Question 49

Type of neuropathy in connective tissue disease

Answer 49

Mononeuritis multiplex

Question 50

Type of neuropathy in Alcoholic neuropathy

Answer 50

Progressing numbness, burning pains, distal muscle weakness

Question 51

Type of neuropathy in AIP

Answer 51

Motor neuropathy and abdominal pain