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Take chocolate with you in the exam: eat 1 bar of chocolate after 1 hour of the exam
(Total of 6 bars in the 2 papers ☺ , I did so).
Diagnosis:
HS encephalitis may have normal CT, but MRI will show the charcterisitc temporal lobe
affection EXAM2014
9. CSF analysis:
glucose CSF/serum > 0.6. بروتين عالي حاجة بسيطة، عالي حاجة بسيطةpressure :فيروس
كله قليلglucose CSF/serum < 0.4 ،( بروتين قليلeg; Cryptococcus neofromans) فطر
inside the
bone
itself
calcified
الزقة في mening-
العضمة لكنها مش
طالعة منه
11. CT shows Falx cerebri calcification:
12.
13. Elderly and falls cay result in SDH, symptoms may be present subacutely.
14. It is quite unusual for systemic lymphoma to metastasise to the brain.
15.
Cereberllar Metastasis:
Scenario:
16.
Chronic subdural haemorrhage (hematoma):
Old Lady, AF, multiple skin bruises.
CT scan image shows a lesion within the right
parietal area and midline shift.
17. Primary CNS lymphoma present with seizures and focal signs, but the lesions are often
confined to the corpus callosum.
18. Paraplegia:
→ UMNL in LL >>>>Spastic paraplegia.
→ LMNL in LL >>>>> Flaccid paraplegia.
Intention (= Kinetic) tremors = Cerebellar tremors (occurs @ the end of purposeful movements.)
Rest tremors = Parkinsonian/ Essential tremors (Both treated with drugs that ↑ dopamine).
19.
Romberg test is a test of the body's sense of positioning (proprioception), which requires
healthy functioning of the posterior columns of the spinal cord.
The Romberg test is used to investigate the cause of loss of motor coordination (ataxia).
→ +ve Romberg test suggests that the ataxia is sensory in nature, that is, depending on loss
of proprioception.
→ If a patient is ataxic and Romberg's test is not positive, it suggests that ataxia is
cerebellar in nature >>> & then you should do cerebellar localization test.
20. Criteria for CT brain within the one hour of RTA include:
It affects approximately 85% of patients with a lesion above C6 (quadriplegic patients) and may be
triggered by cystitis, retention of urine, blocked catheter or constipation.
↑sympathetic activity →VC →HTN →stimulation of the carotid and aortic baroreceptors→↑vagal
tone → bradycardia.
22. cortical blindness = X in occipital lobe→ partial or complete loss of vision ± visual
hallucination(يخبط في الحاجةthey have visual anosognosia =)عنده مشكلة في النظر وهو مصر إنه زي الفل
23. Juvenile myoclonic epilepsy:
The commonest of the idiopathic generalised epilepsies.
• Absences شرود/ذهول
• Myoclonic jerks and
• Tonic-clonic seizures which tend to occur within an hour of waking.
Lifelong drug treatment is usually necessary to avoid relapses in patients who achieve
seizure-free status on medication. وليس لمدة سنتين فقط
24. Excessive exposure to the anaesthetic agent nitrous oxide (NO) → sensory neuropathy and
associated myelopathy (leg weakness, increased reflexes and plantar signs) زي مثال لو طبيب
.أسنان
NO→ inhibits vitamin-B -dependent enzyme methionine synthase, which converts
homocysteine to methionine, but not the vitamin-B -dependent conversion of methylmalonyl
coenzyme A to succinyl coenzyme A → homocysteine is raised, but that of methylmalonyl
coenzyme A is not.
neuro signs of Vit.B12 ↓ بيدي صورة شبه الـ
25. Headache when standing, that improves with lying flat ? Spontaneous intracranial
hypotension “Hypoooooooooooooooo”.
26. Botulism is caused by a toxin produced by the anaerobic bacterium Clostridium botulinum,
which blocks the release of acetylcholine from the motor nerve terminal.
➢ Early symptoms are blurred vision, dysphagia and dysarthria.
➢ Pupillary responses to light are impaired, tendon reflexes ↓ and typically there is
progressive symmetrical limb weakness.
➢ Most patients have evidence of autonomic dysfunction (such as dry mouth,
constipation or urinary retention). The edrophonium test is falsely positive in about
one-third of cases and does not distinguish botulism from other causes of
neuromuscular blockade.
27. Chemosis= conjunctival injection.
28. Orbital apex syndrome (involvement of cranial nerves II, III, IV and V1) = superior orbital
fissure syndrome (III, IV, V1,VI) +loss of vision (II=optic neuropathy). EXAM 2003
29. Temporal lobe epilepsy: ascending epigastric aura, olfactory and gustatory تذوق
hallucinations, ictal fear, oroalimentary automatisms (lip smacking, chewing and swallowing)
and limb automatism (fiddling, picking, tapping) The commonest cause of temporal lobe
epilepsy is hippocampal sclerosis. MRI brain is diagnostic. Surgical treatment has a
complete success rate up to 70% of cases.
30. Listeria meningitis should always be considered in ppl with low immunity (elderly,
diabetics, alcoholics and on immunosuppressive treatment). Brainstem involvement is
common.In CSF ↑WBCs, Protein, ↓Glucose.
31. Jerking of the limbs may occur with cardiac syncope, due to cerebral hypoperfusion.
32. The term ‘lacune’ refers to a small deep infarct resulting from occlusion of a penetrating
branch. Common lacunar strokes include a pure motor hemiparesis, pure hemisensory loss,
ataxic hemiparesis and dysarthria clumsy-hand syndrome.
33. Mononeuritis multiplex: painful, asymmetrical, asynchronous sensory and motor
peripheral neuropathy involving isolated damage to at least 2 separate nerve area. As the
condition worsens, it becomes less multifocal and more symmetrical. Causes are; vasculitis
(CSS)Wagners/PAN, DM, sarcoidosis, paraneoplastic syndrome ,amyloidosis. Nerve biopsy
→ confirm the diagnosis. TTT : prednisolone and cyclophosphamide.
34. Damage to the:
➢ caudate nucleus →chorea
➢ red nucleus → tremor
➢ dentate nucleus →ataxia
➢ hippocampus →memory impairment.
➢ Substantia nigra → Parkinsonism.
➢ Subthalamic nucleus of basal ganglia → Hemiballismus. TTT : tetrabenazin
➢ Medial thalamus & Mamillary bodies of hypothalamus → wernick’s , korsakoff’s
➢ Amygdala →Kluver-Bucy $.
35. Inclusion body myositis (IBM)
• Commonest cause of inflammatory myopathy in patients over 50 years of age.
• Presents with slowly progressive weakness and wasting of the finger flexors and
quadriceps.
• The slow, relentless قاسي/ متصلبprogression of muscle weakness in IBM →walking
difficulty, frequent falls and eventual need for mobility aids.
• Dysphagia is a common manifestation of the disease.
Investigations:
➢ CK is either normal or up to fivefold the upper range of normal.
➢ EMG : inflammatory myopathic changes: ↑ insertional and spontaneous activity
+ ↓ amplitude, polyphasic units with short duration.
36. Serum and CSF may contain anti-Purkinje-cell antibodies in paraneoplastic cerebellar $.
37. Lewy body disease is sensitive to neuroleptics. TTT: rivastigmine. Q
45. Polymyalgia rheumatica → stiffness (not weakness),↑ ESR , Normal CK , muscle biopsy.
46. Eaton-Lambert$ may cause autonomic dysfunction,& the ptn may come with impotence.
47. Thenar wasting (LOAF)
➢ Lateral two lumbricals.
➢ Opponens pollicis.
➢ Abductor pollicis brevis.
➢ Flexor pollicis brevis.
.والمريض يخبط في الجدران ومع ذلك يقولك انا كويس وشايف كل حاجة حلو
Foville's $ → ipsilateral Horizontal gaze (6) and facial weakness + contralateral hemiplegia
So, in CT:
Dilatation of both lateral and 3rd ventricles →The Sylvian aqueduct(= cerebral
aqueduct)obstruction
Dilatation of all the ventricles.→ normal pressure hydrocephalus (gait ataxia, mental dysfunction
and urinary incontinence)
56. The ultimate decision to consent a dead relative to organ “harvest” following the brain-stem
death of a patient, rests with the family.
57. Dermatomes of face:
63. Meniere's disease →recurrent attacks of severe vertigo, vomiting, tinnitus and hearing loss.
64. Cerebellar pontine angle tumour →ipsilateral cerebellar dysfunction & Cr n.5,6,7,8 palsy.
65. TTT of MS:
The most common form of myelopathy is cervical spondylotic myelopathy (=cervical myopathy), is
caused by arthritic changes (spondylosis) (specially in RA.) of the cervical spine → narrowing of the
spinal canal (spinal stenosis) ultimately causing compression of the spinal cord.
73. Circumflex (=Axillary nerve) neuropathy : → weakness and fasciculations of the deltoid.
74. Inclusion body myositis, an inflammatory myopathy, would present with bilateral often
asymmetrical weakness, which has a tendency to affect distal musculature. The tendon
reflexes would be normal and the creatine kinase would be normal or mildly elevated.
75. Huntington's chorea is a neurodegenerative disorder →incoordination and cognitive
impairment.
76. Mercury poisoning →PN, muscle weakness, problems with coordination and speech.
77. Lead poisoning →insomnia, cognitive impairment, delirium, tremor, hallucinations and
convulsions.
78. Wilson's disease→ extrapyramidal features (tremor, parkinsonism, dystonia), dysarthria,
psychiatric features, liver cirrhosis and Kayser-Fleischer ring.
79. Hereditary spastic paraparesis usually begins with in the lower limbs.
80. periventricular white matter lesions:
Causes are:
Normal senescent (=aging) changes. علشان كدا لو جابهالك في سؤال والمريض كان سنه كبير بيبقى غالبا عايز
يوقعك بها
Small strokes.
MS (patchy, periventricular). PML (extensive): hemiplegia+gait X+dysartheria + cognetiveX,
definitive diagnosis is? Brain biopsy to see asymmetric foci of demyelination &intranuclear
inclusions containing the JC virus
Vitamin B6 (pyridoxine) deficiency.
81. Cerebellopontine angle tumor: (e.g. acoustic neuroma) →
• GCS < 6.
• the haematoma is very large and death is expected
• a structural cause for the haematoma is identified
• Immediate surgery to evacuate the haematoma is planned.
ischemic stroke You should lower BP only if SBP >220 or DBP >120. لكن األمر مختلف في الـ
In Hgic stroke , when to refer for hematoma evacuation? Low GCS or cerebellar Hge. otherwise
observe. Give measures that↓ ICP(mannitol, sedation, assisted hyperventilation)only if there is brain
edema (i.e Hge per se is not an indication for these measures)
MRI: multiple hyperintense lesions affecting paraventricular deep white matter within both cerebral
hemispheres. All Lesions enhance with gadolinium contrast (but in MS , some lesions only
enhances).
Anterior circulation arises from the ICA and supplies the front of the brain.
Posterior circulation arises from the vertebral arteries (branch from subclavian), and
supplies the back of the brain and brainstem. The circulation from the front and the
back join together (anastomise) at the Circle of Willis.
Vertebral artery supply posterior part of brain +brain stem+upper spinal cord.
85. Head and neck pain in a patient with stroke suggests dissection.
86. Carotid artery:
External: supplies the neck, face and skull.
Internal: >>> Amurosis fugax
87. Symptoms of posterior circulation ischemia (cerebellar, brainstem signs) =vertebral artery
affection.
88. The recurrent episodes of vomiting and vertigo in a man with DM and a previous MI
represent posterior territory TIAs (=vertebral a.) until proven otherwise. EXAM2012
BPPV فالناس افتكرت انهاclinic وحصلت لما حرك راسه في الـvomiting , vertigo جاب المريض عنده
89. sentinel bleed headache is felt posteriorly
90. Meniere’s and acoustic neuroma are associated with tinnitus. BPPV : no tinnitus.
91. Meniere’s = recurrent tinnitus and hearing loss, which occurs in episodes +sense of pressure
inside ear. EXAM 2012
92. Tizanidine = α-2 agonist (centrally acting muscle relaxant), used in TTT of muscle spasm
in MS patients who did not respond well to Baclofen. EXAM 2012 سؤال مكرر
93. Tetrabenazine , used in symptomatic treatment of hyperkinetic movement disorders
اضطرابات فرط الحركة, such as: Huntington's chorea , Hemiballismus,Tourette syndrome
,Tardive dyskinesia,.
94. Young lady, doing Scuba diving , started to complain of migraine attacks . despite
following the decompression tables , think about ASD → paradoxical nitrogen emboli , do
ECHO. EXAM 2012
95. Neurons:
Sensory (ascending).
Motor (descending): the cell body is in any place in CNS (motor area /brainstem
/spinal cord), axon may be in spinal cord or even outside it to muscles, glands,…
➢ UMN.
➢ LMN
96. MND =progressive neurodegenerative disease involving the corticospinal =pyramidal /
corticobulbar= extra pyramidal tracts / AHCs.=death of the nerve that controls voluntary
muscles:
MND = PLAB:
EMG/NCS →generalised fasciculations in clinically normal and abnormal muscles with preserved
motor conduction and sensory studies.
→ Heart block.قلب
➢ C5 and C6 roots → Erb's palsy, usually the result of traumatic avulsion (commonly
occurring during delivery at birth) → loss of shoulder abduction and elbow flexion with loss
of biceps and brachioradialis reflexes.
➢ C7,8 → absent triceps reflex.
➢ C8 and T1→ Klumpke's palsy, often the result of a fall that has been stopped by grasping a
fixed object with one hand→weakness of small muscles of the hand and of the long finger
flexors and extensors, and a sensory disturbance affecting the medial half of the ring finger
and little finger.
➢ C8 and T1 also→ medial cord lesion.
hyporeflexia. Then respiratory difficulty , limb weakness after that. مريض واقع في كله
111. Pseudo seizures =non-epileptic attack:
Commonly misdiagnosed as true seizures and treated inappropriately with anti-epileptic drugs.
Violent shaking, resistance to passive eye opening and normal vital signs are useful indicators of
pseudoseizures.
Urinary incontinence can also occur in pseudoseizures but tongue biting is rare.
→ Autonomic X.
Infarctions in a non-arterial distribution in the white matter often associated with Hge, should suggest the
possible diagnosis of venous thrombosis.
On contrast-enhanced CT scan, the reverse delta sign (that is, empty triangle sign) can be observed in the
superior sagittal sinus from enhancement of the dural leaves surrounding the comparatively less dense
thrombosed sinus. Look @ item 62
119. Migraine with aura can cause stroke but commonly with posterior circulation S/S.
120. Vertebral artery dissection → head(sever pain behind 1 eye+ brainstem signs+ Horner) &
neck pain + posterior circulation S/S.
121. SAH classically presents with a thunderclap headache and neck stiffness. صداع رهييب
122. Internuclear ophthalmoplegia (INO)
يعني ما بين حاجتينInter كلمة.. internuclear يعني ايه
The tract in-between the 2 nuclei are called medial longitudinal fasciculus (MLF).
: فلما تيجي تبص يمين هيحصل اآلتي3rd&6th وظيفتها انها بتنسق الحركة مابين الـMLF الـ
left 3rd cr وفي نفس الوقت الـ، ) فيشد العين اليمين لبرا (يعني الى الجهة اليمنىright lateral rectus ms هيشغل الـright 6th cr n. الـ
. فيحرك العين الشمال إلى الجهة اليمنىleft medial rectus muscle هيشغل الـn
:يحصل حاجتين
abducing eye والعين السليمة دي اسمها. في العين السليمة ألنها اتلخبطت من اللي حصلNystagmus-1
Gaze palsy:
Vertical: (due to X in midbrain) = 3rd Cr.N
impairment of convergence & diplopia happens هيحصل فيه3rd cr. N إذا لو اضرب الـ
126. Lower brachial plexus lesion typically will involve muscles supplied by T1, present with ill-
defined pain in the axilla and the sensory disturbance will involve the inner aspect of the
forearm. There may also be diminished brachial and radial pulses.
127. Scenario:
Old Patient with chronic bronchitis suffers few seconds of severe headache , followed by
syncope for seconds. What is this?
Mostly he is having chiari malformation , when he coughs → Sudden pressure headache
→Transient obstructive hydrocephalus → LOC
128. Ulnar neuropathy is a common complication with ill patients in hospital.
129. Mollaret’s meningitis: Rare condition.
Recurrent meningitis.
It is a benign condition, caused by HSV, EBV. EXAM2013
CBC: Atypical monocytosis.
134. Addition of clopidogrel to aspirin in stroke patients is of no benefit and increases GIT side
effects.
ومحتاجAF يعني لو مريض عندهwarfarin فيما يخص الـischemic stroke ال يعامل مثل الـTIA الـ.135
ASA 300 mg وتكمل علىWarfarin هتوقف الstroke إنما لو هو... TIA هتكمل عليه عادي لو هوwarfarin
for 2 weeks.
136. MG (ocular, bulbar and limb weakness) may be:
Sero +ve = +ve Anti-acetylcholine receptor antibodies
Sero –ve : -ve Anti-acetylcholine receptor antibodies. 40% of sero –ve MG have +ve
Anti-muscle specific tyrosine kinase (MuSK) antibodies
TTT in MG:
1- No respiratory involvement:
(10-20 mg) can be cautiously added. High dose prednisolone can lead to
paradoxical worsening of myasthenia gravis.
→ IV Ig or plasmaphoresis.
139. Anti-parkinsonians:
→ Off time : refers to periods of the day when the medication is not working well, causing
→ Dopamine agonists:
Ergot derivatives: Cabergoline (prescribed only in patients who have developed dyskinesia
or motor fluctuations despite optimal levodopa therapy / or/ those not adequately controlled
with a non-ergot-derivatives).
Non ergot derivatives: Bromocriptine, Apomorphine
140. Bitemporal hemianopia is due to ???? compression on optic chiasm.
141. Ocular apraxia and optic ataxia are both features of larger bilateral parietal lobe lesions.
This is known as "Balint's syndrome".
142. Contralateral neglect is a feature of damage to the right parietal lobe.
143. Occlusion of basilar artery, posterior cerebral artery and vertebral arteries produces signs
and symptoms of posterior and brainstem circulation syndromes.
144. URTI→ followed by affection of upper brachial plexus (C5-6).
Fortnight = 2 W
TTT: conservative
145. CJD:
NvCJD →young age, psychiatric, sensory disturbances.MRI:changes in post. thalamus
Sporadic CJD →Memory problems, Myoclonus, cerebellar dysfunction.MRI: changes
in caudate & Putamen
146. Epley and Semont are used in TTT of BPPV.
147. Throat infection → abnormal movements of limbs (think about Sydenham’s chorea).
Speech is affected in 20%. Those who have had several attacks in childhood may develop
chorea in adulthood when exposed to drugs as OCP, phenytoin or digoxin, or pregnancy.
TTT: for chorea with tetrabenazine or sulpiride and for acute infection: course of penicillin for.
→ P communicating A aneurysm.
→ Pitutry adenoma.
→ Cavernous s. thrombosis.
→ Ophthalmoplegic migraine (episodic third nerve palsy and headache)
→ Monoueuritis.
151. Subarachnoid blood → (headache, nuchal rigidity and photophobia).
PCA/ ACAسواءا كان.. Subarachnoid space في الـartery أي نزف بقى من أي
152. decerebrate rigidity
https://www.patient.info/doctor/thrombolytic-treatment-of-acute-ischaemic-stroke
157. Patient with depression + Migraine came with hyperreflexia, HTN , Hyperpyrexia,
tachycardia , what had happened?
He was receiving Fluxetin (SSerotonin RI) is antidepressant →↑serotonin level+
Sumatriptan (For migraine): ↑ serotonin level → serotonin $ .TTT is? Cyproheptadine or
methesergide.
158. CIDP → Progressive affection of motor , sensory modalities in all 4 limbs+areflexia.
TTT: Steroids, plasmapheresis and IV Ig. Physiotherapy is effective adjunct.
159. Cervical spondylosis → UMNL + sensory level.
160. Patients with syncope can commonly have jerking of the limbs when they are unconscious
and this does not mean they have had a seizure.
161. Vasovagal syncope comes with warning symptoms e.g. feeling hot and blurring of vision.
Tilt table testing is useful to support the diagnosis of vasovagal syncope.
162. Brachial plexus
MURASL-M -مراسلM
After the fits, there is temporary paralysis for few hours (Todd’s paralysis).
ataxia. علشان بيكون معاها هي كمان أحياناcerebellar tremors فمتتخدعش وتفكر انها
It is resistant to TTT.
173. Multiple sclerosis is a CNS disorder (not peripheral) and therefore presents UMNL signs
such as brisk reflexes and not LMN signs.
174. Osteomyelitis of the spine → UMNL.
175. Myasthenia gravis does not cause reflex abnormalities (it is a neuromuscular junction
disorder).
176. The CT scan shows evidence of calcified phakomas
in the periventricular white matter.
DD of phakoma :
VHL $.
NF
Tuberous sclerosis (TS)
Sturge-Weber syndrome
TS.
Sturge-Weber $.ستيرج ويبر
Sturge-Weber $.
Port-wine affection in
هتالقيitis وبيكون معاهtemporal lobe اللي هو كمان بيجي في الـHS encephalitis لكن في الـ
179. Paraneoplastic neurological syndromes are uncommon but important because they
frequently present before the malignancy.
180. Judu ,Yoga → vertebral artery dissection.
181. What is the target of cerebral perfusion pressure in patients presented with intracerebral
bleed? Ans: 60-80 mmHg.
182. Permanent vegetative state = حالة غيبوبة دائمةirreversible damage to the cerebral
hemispheres but the brain stem remains intact EXAM2004
The patient breathes spontaneously without mechanical support.
HD stable and has cycles of eye closure and opening that resemble a normal sleeping pattern.
Patient is inattentive and unaware of his/her surroundings.
Patients may have spontaneous movements (moaning, grunting, teeth grinding, roving eye
movements) and may also smile, laugh and cry without any apparent reason.
There is eye movement; the eyes do not track a moving object. Patients may respond to painful
stimuli and may have myoclonus in response to startling stimuli.
Primitive reflexes may be present. Posture may become decorticate and plantar responses are
commonly extensor.
183. Diagnostically if dementia occurs within 12 months of the onset of parkinsonian features
the patient has Lewy body disease. ☺ cognitive ملوية, - و رؤية ملويةlewy = ملوية
184. Scenario:
Patient with SAH→ GCS 13/15→ after 2 days→ more ↓ of consciousness or new disability.
Why this happened?
Rebleeding? No.
Vasospasm? Yes.
This is a delayed cerebral ischemia (DCI) due to vasospasm. Typically, the development of
DCI starts on day 3 after the initial SAH and is maximal at days 5-14, resolving on day 21.
How to prevent this? CCBs, Nimodipine
185. Cerebral ischaemia from cerebral vasospasm is the most common cause of death and
disability following aneurysmal subarachnoid hemorrhage (SAH).
186. Hyperchloraemic metabolic acidosis is a documented complication of neobladder
formation.
187. Wilson >> affects parenchymatous organs : Liver, brain , kidney. Gold standard is liver
biopsy , but take care, as those patients have liver affection>>↑ PT , PTT , so in such
condition , depend on Copper studies.
Fasciculations=LMNL ألنMND فكر فيUMN signs + fasciculations لما تالقي.188
189. When a patient asks many times What am I doing here?This is transient global amnesia.
Subclavian steal phenomenon. لما يعمل مجهود بايده يبقى دي غالباdrop attacks مريض بيجي له.190
191. D.D of autonomic neuropathy: (like postural hypotension)
PARD بارد
PCT.
AIDS /Amyloid
R.F
DM
192. TTT of essential tremors is? .بالترتيب
Propranolol , then ًأوال
Primidone.
Topiramate.
Clozapine in resistant cases.
193. Leptomeninges = arachnoid mater & the pia mater.
194. Common scenario: Sinusitis/mastoiditis/Otitis externa→ Skull base osteomyelitis→affect
nerves passing through Jugular foramen. This is a rare but potentially life threatening
condition affecting people with compromised immunity. Typically, Pseudomonas
aeruginosa is the causative pathogen.
195. Locked in $ =? X in basilar artery→ X Ventral pons EXAM2013
196. Thalamic lesions →contralateral loss of sensation, which can later progress to thalamic
pain syndrome.
197. In adults the presence of any amnesia for patients >65 years of age is an indication for CT
scanning. In adult patients of any age, >30 minutes of retrograde amnesia is an indication of
CT scan. also Fall >1 m or >5 stairs is an indication EXAM2013
198. Autonomic dysreflexia occurs in patients with spinal cord injury above the level of T6.
199. Diabetic amyotrophy starts Unilateral, then becomes Bilateral EXAM2014 Theme.
200. Parkinson patient we recently increased L-Dopa to him>>>started to have visual
hallucinations, how to reat? Clozapine/chlorpromazine? EXAM2017 سؤال مكرر
Ans: Clozapine. Chlorpromazine has a bad impact on movement. EXAM2014
EXAM2017 يبقى اختاره أفضل... في السؤالQuietapine ولو فيه
201. Antipsychotics هتقتل مريض الـALzehimer dementia.
202. ↑ ICP in pregnancy. Diamox is contraindicated. Steroids will aggravate it .TTT is LP.
203. Lewy body disease is sensitive to neuroleptics. يعني ايه؟
worsening of فحصل لهdopamine بدأوه على دوا بيزود الـParkinsonism or psychosis يعني مريض عنده
EXAM2014 Underlying Lewy body dementia. يبقى ده عنديParkinson disease
204. Normal pressure hydrocephalus→ dementia, urinary incontinence, gait X TRIAD
parkinson ال يوجد معهdementia هذا النوع من الـ..Parkinson gait وليسGait abnormality
205. Lewy body dementia =Dementia+Parkinson+Visual hallucinations+fluctuating cognitions
Normal فخليك عارف ان الـ.. علشان يلبخكurinary incontinence وتالقيه في السؤال يحط لك احيانا فيها
Triad عبارة عنpressure hydrocephalus
206. Restless leg $ TTT? Ropinirol /Pramipixole → Pregabalin EXAM2014 EXAM2018
Pixole أو اديه بوكسRopeاربط رجله بحبل
207. Essential tremors (affects both ULs) TTT: Propranolol/Primidone (Phenobar. analogue).
208. Chiari malformation types:
→ I: Herniation of cerebellar tonsils:
→ II: ------------- MO, 4th ventricle, cerebellum.( وهو دا النوع اللي اسمهArnold Chiari malfo)
→ III: ------------ Cerebellum. + there is spina bifida of cervical part of spinal cord
(syrnix)
209. Syringomyelia:
1st: affects spinothalamic tract.
Later: affects ipsilateral pyramidal tract →
LMNL, not UMNL, why? Because the
pyramidal tract decussated from before.
→ Medial trunk compression gives medial forearm pain and ulnar sensory disturbance (not
more lateral hand and no triceps weakness).