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Flashcards in Passmedicine Deck (48):
1

What is Weber's syndrome?

Ipsilateral third nerve palsy with contralateral hemiplegia -caused by midbrain strokes

2

Brocas area

Involved in producing coherent speech

3

Wernickes area

Involved in speech processing and understanding language

4

Driving rules if you are withdrawing from epilepsy medication?

Cannot drive till 6 months after last dose (ie stop meds and wait six months)

5

Driving and fainting

No restriction

6

Driving and syncope? (explained and non-explained)

Explained - 4 weeks off
Non-explained - 6 months off
Two or more episodes - 12 months off

7

Stroke/TIA and driving?

1 month off driving, may not need to inform DVLA if no neurological deficit
Multiple TIAs - 3 months off driving and inform DVLA

8

Gold standard marker for CSF?

Beta-2 transferrin
If not, then just check for glucose :)

9

How does phenytoin work?

Binds to sodium channels and increases the refractory period

10

What do you need to be careful of when starting a phenytoin infusion?

Need to monitor heart because it is unpredictable and can cause arrhythmias

11

Which muscles are likely to waste in motor neurone disease?

Small hand muscles
Tibialis anterior

12

When might the symptoms of carpal tunnel syndrome be worse?

At night e.g. "might wake patient during the night"

13

Which hand muscles are supplied by the median nerve?

LOAF muscles

14

Someone has a painful third nerve palsy, what should you be worried about?

Posterior communicating artery aneurysm

(pupil dilated)

15

What is Weber's syndrome? Which part of the brain does it occur in?

Caused by midbrain stroke
Ipsilateral third nerve palsy with contralateral hemiplegia

16

Treatment for cluster headache? and prophylaxis?

100% oxygen and triptan
Prophylaxis: verapamil

17

Which nerve wraps around the humerus and may be damaged in shoulder dislocation?

The axillary nerve

18

Which level is affected in Klumpkes palsy, and which other syndrome might occur?

Klumpke's palsy is C8-T1
Involvement of T1 may also cause Horner's syndrome

In Klumpke's paralysis, there is typically weakness of the hand intrinsic muscles

19

Which level is affected in Erb's palsy?

C5 and C6
(brachial trunks)

20

Obese young females with headaches/blurred vision, what should you think

Idiopathic intracranial hypertension

21

Which nerve palsy might be present in idiopathic intracranial hypertension?

Sixth nerve palsy

22

Which medications can increase risk of idiopathic intracranial hypertension?

Tetracyclines
Isotretinoin
Contraceptive pill
Steroids
Levothyroxine
Lithium

23

Management of idiopathic intracranial hypertension?

Weight loss
Repeated lumbar puncture
Acetazolomide


(might need to do optic nerve sheath decompression and fenestration to prevent damage to the optic nerve)
-remember idiopathic intracranial hypertension can cause blindness if not treated promptly

24

Which nerve supplies the extensors of the arm/hand

The radial nerve

25

Which muscle supplies the interosseous muscles of the hand?

The ulnar nerve

26

Which rami make up the brachial plexus?

C5 - T1

27

Real Teenagers Drink Cold Beer

Roots
Trunks
Divisions
Cords
Branches

28

Normal pressure hydrocephalus triad

Incontinence
Dementia
Gait

29

Why do you have to be careful when combining sodium valproate and lamotrigine?

Combining sodium valproate and lamotrigine can cause serious skin rashes, such as Steven-Johnson's syndrome

30

Which test should you perform if you suspect degenerative cervical myelopathy?

You should perform Hoffman's test (flick the patients middle finger, and you are looking for abnormal flexion in the thumb)

A positive Hoffman's sign is a sign of motor neurone dysfunction and points to a disease of the CNS

31

When should you give someone migraine prophylaxis?

When someone is experiencing more than 2 migraines per month

32

Migraine prophylaxis for pregnant women?

Give them propanolol
(acute treatment - paracetamol)

33

Why should you avoid using topiramate as migraine prophylaxis in pregnant women?

Associated with cleft lip and palate if used in the first trimester of pregnancy

(although used in migraine prophylaxis, topiramate is an anticonvulsant)

Not much evidence about triptans in pregnancy so usually avoided

34

Medication particularly useful for prophylaxis of menstrual migraines?

Triptans

35

What is CADASIL syndrome?

Cerebral autosomal dominant ateriopathy with subcortical infarcts

(type of genetic condition where you get strokes)

36

Someone develops a foot drop, which nerve might be involved?

Common peroneal

37

Someone develops a foot drop and then a wrist drop, which condition should you consider?

Mononeuritis multiplex

38

What arteries are involved in a posterior circulation infarct?

The vertebrobasilar arteries

39

When is essential tremor more noticeable?

When arms are stretched out

40

What makes essential tremor better?

Propanol and alcohol

(i guess remember the "ol's")

41

A 69 year old woman presents with a 3 week history of headache, which is worse on the right side. She is generally unwell and feels "weak", noting particular difficulty in getting up from a chiar

Temporal arteritis

42

What type of seizure is Carbamazepine of no use in?

Absence seizure

43

Most common presenting feature of MS

Optic neuritis

44

A 32 year-old female presents with a 3 day history of altered sensation on her left foot and right forearm. On examination she has clonus in both legs and has hyperreflexia in all limbs.

Multiple sclerosis

45

What type of seizure is Carbamazepine of no use in?

Absence seizure

46

First line treatment for trigeminal neuralgia

Carbamazepine

47

Migraines and hormone replacement therapy?

Safe to prescribe hormone replacement therapy however might make migraines worse

48

Which nerve is associated with a wrist drop

Radial nerve