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OSCE Pharmacology > Neurology > Flashcards

Flashcards in Neurology Deck (37)
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1

What kind of aura would you expect for epilepsy?

Dizziness
Deja vu/Jamais vu
Unusual smell/taste/vision

2

Which cranial nerves may be affected by a cavernous sinus thrombosis?

3, 4, 5, 6

5 is particularly associated with pain and loss of corneal reflex

3

Give 5 causes of any cranial nerve palsy.

Diabetes
Stroke
MS
Tumour
Vasculitis

4

Give 3 causes of a unilateral Ptosis. Will they be partial or complete?

Horner's - partial
CN 3 palsy - complete
Congenital

5

Give 3 causes of a bilateral Ptosis.

Myaesthenia gravis
Myotonic dystrophy
Congenital

6

What are the features of a cranial nerve 3 palsy?

Eye down and out
Complete Ptosis
Dilated pupil

7

What are the signs of Horner's syndrome?

Unilateral:

Partial Ptosis
Miosis (constricted pupil)
Anhydrosis

8

How would you differentiate between Bell's palsy and a umn facial nerve palsy?

If frontalis is spared then it is umn stroke.
Due to bilateral innervation of this muscle.

9

What are the bulbar signs? What are they indicative of?

Slurred speech, dysphagia, absent gag reflex.

LMN damage to CN9-12 in medulla
Polio
MND
Myaesthenia gravis

10

What is your differential for a CN1 problem?

Trauma
Viral infection
Meningitis

11

What is your differential for monocular blindness?

Retinal detachment
Ophthalmic artery thrombus
Giant cell arteritis

12

What is your differential for bitemporal hemianopia?

Pituitary adenoma
Aneurysm in the circle of Willis

13

What is your differential for a homonymous hemianopia?

Anything behind the chiasm:

Stroke
Tumour
Abcess

14

What is your differential for a CN5 problem?

Trigeminal neuralgia
Herpes zoster

15

What is your differential for a CN8 problem?

Furosemide
Gentamicin
Age

16

What kind of aura would you expect for a simple vasovagal faint?

Nausea
Sweating
Dizziness

17

What are the myotomal roots of the reflexes?

Ankle - S1/2
Knee - L3/4
Biceps and brachioradialis - C5/6
Tricep - C7/8

18

What are the cardinal signs of Parkinson's?

Bradykinesia
Rigidity (cog wheel)
Resting tremor (pill rolling)

May also have masked fascies and slurred speech.

19

What are the signs of a cerebellar lesion?

DANISH

Disdiadokinesis
Ataxia
Nystagmus
Intention tremor
Speech - slurred
Hypotonia

20

What are the signs of an ulnar nerve lesion?

LMN signs in fourth and fifth fingers

21

What are the signs of a median nerve lesion?

LMN signs in the thenar muscles and palmar surface

22

What are the signs of a radial nerve lesion?

Wrist drop and weakness of extension of the elbow

23

What are the signs of an upper motor neuron lesion?

Hypertonia
Hyperreflexia
Spastic muscle weakness
Babinski's
Clonus

24

What are the signs of a lower motor neuron lesion?

Hypotonia
Hyporeflexia
Flaccid weakness
Muscle wasting
Fasciculations

25

How would you grade muscle weakness?

0 - no movement
1 - flicker
2 - unable to move against gravity
3 - unable to move against resistance
4 - reduced power, able to move against resistance
5 - normal

26

What birth injury causes damage to the upper brachial plexus? How does it present?

Erbs = waiters tip

Shoulder adducted
Arm internally rotated
Forearm pronated

27

What birth injury causes damage to the lower brachial plexus? How does it present?

Klumpke's

Wasting of small muscles in hand - claw
Flexion of the elbow and wrist
Horner's may accompany

28

Give 5 causes of peripheral neuropathy?

Diabetes
Uraemia (kidney failure)
Vasculitis
Anaemia
Alcohol

29

Give 4 causes of foot drop.

Common peroneal nerve palsy
Stroke
L4/5 lesion
Motor neurone disease

30

What is syringomyelia? How does it present?

Blockage of CSF in spinal canal - syrinx
Affects spinothalamic tracts as they cross

Loss of pain and temperature on both sides in a cape like pattern.