20 cards Flashcards
Management of parkinson disease
Levodopa plus dopamine agonists (benserazide, carbidopa)
Adverse effects of dopamine agonists
Pathological shopping, eating, hoarding, gambling, sexual preoccupation, medication abuse, puncding
CI to dopamine agonists
Impulse control disorders
List of Parkinson plus syndromes
Dementia with lewy bodies
Multiple system atrophy
Progressive supranuclear palsy
Corticobasal degeneration
Progressive supranuclear palsy clinical features
Early onset falls, visual disturbances, dysphagia, difficulty with eye movements
Axial rigidity, postural instability, cognitive changes
Clin F of Parkinson disease
Bradykinesia, rigidity, resting tremor
Clin F of multiple system atrophy
Parkinsonism and early autonomic dysfunction (postural hypotension, arrhythmias, GI upset, incontinence)
+/- cerebellar features: nystagmus, incoordination, slurred speech
Clin F of corticobasal degeneration
Parkinsonism
Akinetic rigidity in unilateral limb
Apraxia
Alien limb phenonmenon
Features of 3rd nerve palsy
Down and out, ptosis, pupil may be dilated
Key diagnostic test in suspected guillian barre syndrome
LP- increased protein (usually seen 1-2 weeks) , normal WCC
Definition of TIA
Now tissue based not time based
Transient episode of neurological dysfunction caused by focal brain, SC or retinal ischemia without acute infarction
How does extradural hemorrhage appear on imaging
Biconvex
What to give for nausea in Parkinson’s disease
Domperidone - do not cross BBB, no EPS
SFX of phenytoin
PHENYTOIN
P450 induction
Hirtuism
Enlarged gums
Nystagmus
Yellow/ brown skin tinge
Teratogenicity
Osteopenia
Inhibition of folate absorption
Neuropathy
Circle of Willis
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Clin F of MCA occlusion
Contralateral motor and sensory deficits - face, arm, sometimes leg. May be homonymous hemianopia, conjugate eye deviation towards side of lesion
If occlusion of dominant hemisphere - global aphasia
If occlusion in non dominant - contralateral hemispatial neglect
Clin F of vestibular neuritis
Sudden onset of sever vertigo associated with loss of balance without hearing loss or tinnitus
Reccent URTI
Balance disturbacen
Catch up saccade on rapid movement to affected side
Clin F of acute labrynthitis
Viral inf and hearing loss
Clin F of meniers
Vertigo > 20 min
Tinnitus, sensorineural hearing loss, aural fullness
Clin F of anterior spinal artery occlusion
Sudden onset of back pain, motor weakness, superficial sensory deficitis below the level of the spinal cord with preservation of deep sensation
