Y4 Neurology Rvc Finals

Front 1

What are the THREE criteria that indicate start of treatment for epilepsy?

Back 1

Status epilepticus
2 or more seizures within 6 weeks
3 or more seizures within 6 months

Front 2

What FOUR drugs facilitate bladder emptying?
How do they work?

Back 2

Prazosin - blocks alpha-stimulation to relax external urethral sphincter
Bethanecol - blocks beta-stimulation to contract detrusor
Diazepam - blocks striated urethral muscle
Dantrolene - blocks striated urethral muscle

Front 3

Whhen is chemical stimulation of bladder emptying required?

Back 3

UMN disease

Front 4

How can intrinsic and extrinsic spinal cord lesions be differentiated?

Back 4

Intrinsic lesions are non-painful, extrinsic lesions are painful

Front 5

What FOUR drugs restore urinary continence?

Back 5

Phenylpropanolamine - alpha agonist - increase internal sphincter tone
Propantheline - anticholinergic - decrease detrusor tone
Oestrogen - improve external sphincter tone
Testosterone - improve external sphincter tone

Front 6

What is the function of cranial nerve I?

Back 6

CN I - olfactory. Transmits smell

Front 7

What is cranial nerve II?

Back 7

CN II - optic nerve. Transmits vision

Front 8

What 3 nerves are involved in the control of eye movement?

Back 8

CN III - oculomotor
CN IV - trochlear
CN VI - abducent

Front 9

What does cranial nerve V do?

Back 9

CN V - trigeminal. Controls muscles of mastication and facial sensation

Front 10

What are the 2 functions of cranial nerve VII?

Back 10

- Controls muscles of facial expression
- Tear production

Front 11

What nerve is responsible for hearing?

Back 11

CN VIII - vestibulocochlear

Front 12

How do you test cranial nerve IX?

Back 12

CN IX - glossopharyngeal

Gag reflex

Front 13

What does cranial nerve X supply?

Back 13

CN X - vagus. Larynx and viscera (parasympathetic)

Front 14

What is cranial nerve XI? What does it innervate?

Back 14

CN XI - accessory. Supplies the trapezius muscle

Front 15

What is the function of cranial nerve XII?

Back 15

CN XII - hypoglossal. Supplies the tongue

Front 16

In the spinal cord, are proprioceptive pathways ipsilateral, bilateral or contralateral?

Back 16

Ipsilateral

Front 17

In the spinal cord, are pain pathways ipsilateral, bilateral or contralateral?

Back 17

Bilateral

Front 18

What is the neurology 5-finger rule?

Back 18

- Onset
- Clinical course (i.e. progression)
- Pain
- Lateralisation
- Neurolocaliation
(Of Course People Love Nandos / Old Codgers Park Like Numpties)

Front 19

Are tendon reflexes monosynaptic or polysynaptic?

Back 19

Monosynaptic

Front 20

Are withdrawal reflexes monosynaptic or polysynaptic?

Back 20

Polysynaptic

Front 21

What do you assess in the neurological examination, and in what order?

Back 21

Mentation
Posture
Gait
Postural reactions (proprioception)
Spinal reflexes
Cranial nerves
Palpation
Nociception

(Matthew Pead's Guinea Pigs Can't Sing Paulo Nutini)

Front 22

How can ataxia and lameness be differentiated in horses?

Back 22

Lameness causes regular irregularities, ataxia causes irregular irregularities

Front 23

What is a seizure?

Back 23

A seizure is a transient and involuntary change in behaviour or neurological status due to hypersynchronous firing of CNS neurons

Front 24

What is the prodrome?

Back 24

The period days to hours before a seizure

Front 25

What 3 broad categories may the causes of seizures be classified as?

Back 25

Symptomatic (related to a structural brain lesion), reactive (due to a toxic or metabolic cause) or idiopathic (suspected genetic component)

Front 26

What signs are associated with sensory ataxia?

Back 26

Arched back, wide stance, abnormal postural reactions and limb paresis. Signs are subtle

Front 27

What are the 3 types of vestibular ataxia?

Back 27

- central (lesion in vestibular nuclei)
- peripheral (lesion in vestibular organ or CN VIII)
- paradoxical (lesion in cerebellum)

Front 28

What causes a head tilt and conscious proprioceptive deficits on opposite sides?

Back 28

Paradoxical vestibular ataxia (lesion in cerebellum)

Front 29

What causes a hypermetric gait, broad-based stance, intention tremor, and delayed but exaggerated postural reactions?

Back 29

Cerebellar ataxia.

There may also be opisthotonus (increased neck extensor tone)

Front 30

What 2 ocular signs can be used to locate a cerebellar lesion?

Back 30

Vision is normal but there may be anisocoria (pupil dilation) on the opposite side to the lesion and a menace deficit on the same side as the lesion.

Front 31

What is cauda equina?
What THREE nerves and SEVEN spinal cord segments does it affect?

Back 31

Cauda equina (lumbosacral syndrome) causes LMN signs in the tail, hindlimbs and anus.
Affects femoral (L4-L5), sciatic (L6-L7) and pudendal (S1-S3) nerves

Front 32

Give FIVE possible causes of lumbosacral disease.
What is the prognosis?

Back 32

Disc degeneration
Articular facet subluxation
Interacute ligament thickening/folding
Epidural fibrosis
Spondylosis of articular facets
Prognosis depends on clinical signs: good if only lameness is observed, poorer with LMN signs or incontinence

Front 33

Name FIVE add-on drugs for management of canine epilepsy

Back 33

Gabapentin
Pregablin
Levetiracetem
Zonisamide
Felbamate

Front 34

Where do spinal nerves exit the vertebral canal?

Back 34

Cranial to the correspondingly numbered vertebral body in the cervical spine but caudal to the correspondingly numbered vertebral body in the thoracic and lumbar spine.

Front 35

What is polyneuritis equi?

Back 35

Immune-mediated damage to femoral, sciatic and pudendal nerves following adenovirus infection.

Prognosis is good for life but poor for return to function

Front 36

Describe the Schiff-Sherrington phenomenon

Back 36

Border cells in the canine thoracolumbar spine provide ascending inhibition to thoracic limb muscle tone

Front 37

What nervous signs in cats may be associated with hypervitaminosis A?

Back 37

C1-C5 or C6-T2 myelopathy

Front 38

What signs are associated with botulism?

Back 38

Tongue flaccidity and generalised paresis in horses with history of access to hay or silage.

Prognosis poor

Front 39

How is Myasthenia gravis diagnosed?

Back 39

Tensilon test: ability to perform repetitive muscular movements improves with IV edrophonium chloride (acetylcholinesterase) administration

Front 40

What drug is used to treat Myasthenia gravis?

Back 40

Pyridostigmine: cholinesterase inhibitor.

Immunomodulatory drugs may also be used to control acquired M. gravis

Front 41

What is the first line of epilepsy treatment?

Back 41

Phenobarbital

Front 42

What epilepsy drug should not be used in cats?

Back 42

Potassium bromide (causes feline asthma)

Front 43

What NINE side effects are associated with phenobarbital?
How should treatment be monitored?

Back 43

Sedation, polydipsia, polyphagia, neutropenia, thrombocytopaenia, anaemia, T4 reduction, hepatotoxicity, seizures if suddenly withdrawn

Monitor with biochemistry and bile acid stimulation tests until stable, then every 6 months

Front 44

What TWO risks are associated with use of potassium bromide in medical management of canine epilepsy?

Back 44

Renal disease: causes ataxia, sedation and skin reactions
High dietary chloride lower serum concentration (bacon/sea swimming)

Front 45

What is the principle of treatment of epilepsy?

Back 45

Increases the epileptic threshold - animals may still seizure!

Seizures are reduced to 50% of their former frequency in 2/3 of dogs

Front 46

What 4 phases are involved in the emergency treatment of status epilepticus?

Back 46

- Phase I: stabilise patient - diazepam (beware delayed CV crash)
- Phase II: maintenance therapy - phenobarbital or KBr
- Phase III: add another antiepileptic drug - diazepam, ketamine, propofol
- Phase IV: prolonged anaesthesia

Front 47

What cranial nerves contribute to taste sensation?

Back 47

I, V, VII, IX and X

Front 48

A dog has conscious proprioceptive deficits on the right and altered mentation. Where is the lesion?

Back 48

Cerebrum, on the left

Front 49

A dog has an altered level of consciousness, non-specific pain and thermoregulatory disturbance. Where is the lesion?

Back 49

Thalamus

Front 50

A dog presents with an altered level of consciousness and deficiency in movement of the right eye. Where is the lesion?

Back 50

Medulla, on the right

Front 51

A dog presents with an altered level of consciousness, abnormal respiratory pattern and difficulty eating. Where is the lesion?

Back 51

Pons

Front 52

A dog presents with intention tremor, hypermetria, and propioceptive deficits on the right. Where is the lesion?

Back 52

Cerebellum, on the left

Front 53

Name FOUR ways of testing spinal reflexes in a dog?
How would you test them in a horse?

Back 53

Tendon reflex
Withdrawal reflex
Crossed extensor reflex
Cutaneous trunci
Assume all are intact in a horse if its standing

Front 54

How is spinal neurological disease graded?

Back 54

0 (normal) to 5 (recumbent)

Front 55

What is status epilepticus?
When does brain damage occur?

Back 55

Continuous seizure activity lasting over five minutes
Brain damage occurs if it persists for longer than 30 minutes

Front 56

What are cluster seizures?

Back 56

Two or more seizures within 24h

Front 57

What are the TWO types of focal seizure?

Back 57

Simple (no loss of consciousness) or complex (loss of consciousness)

Front 58

Give SEVEN metabolic causes of seizures

Back 58

Hypernatraemia
Hyponatraemia
Hypocalcaemia
Thiamine deficiency
Hypoglycaemia
Uraemia
Hepatic encephalopathy

Front 59

What is aura?

Back 59

Perceived smell or feeling of deja-vu immediately before a seizure

Front 60

What is ictus?

Back 60

The event of a seizure itself

Front 61

What term is used to describe the altered neurological status hours or days after a seizure?

Back 61

Post-ictus

Front 62

Give FOUR add-on drugs for management of epilepsy in cats

Back 62

Diazepam
Zonisamide
Levetiracetam
Gabapentin

Front 63

How long should behaviour modification therapy be used for?

Back 63

Expect to treat for around 6-8 months before resolution of clinical signs; once this is achieved continue threapy for a further 8 weeks then withdraw in 25% increments over a furhter 8 weeks

Front 64

Give FOUR types of behaviour-modifying drugs in use

Back 64

Serotonin re-uptake inhibitors (amitriptyline, clopramine)
Benzodiazepines
Acepromazine
Selegiline

Front 65

Give FOUR ways peripheral and central vestibular disease can be differentiated

Back 65

Central: abnormal postural reactions
Abnormal occulovestibular reflex Nystagmus
Positional strabismus develops when neck is extended

Front 66

What is paradoxical vestibular disease?

Back 66

Clinical signs are on the opposite side to the lesion; lesion is the caudal cerebellar peduncle or para-flocconodular lobe of the cerebellum