3A neuro

Question 1

stroke

Answer 1

Acute cerebrovascular event lasting for more than 24 hours or causing death

Question 2

TIA

Answer 2

same as a stroke but lasting less than 24 hours
no CNS death

Question 3

2 types of stroke

Answer 3

Ischaemia or infarction of the brain tissue secondary to a disrupted blood supply
Intracranial haemorrhage, with bleeding in or around the brain

Question 4

risk score for stroke following TIA

Answer 4

ABCD^2

Question 5

causes for ischemia or infarction to brain

Answer 5

A thrombus or embolus (AF, Valve disorder/replacement, inf endocarditis)
Atherosclerosis
vasculitis

Question 6

Atheroma formation

Question 7

TIA Mx

Answer 7

Aspirin 300mg daily (started immediately)
Referral for specialist assessment within 24 hours
MRI scan

Question 8

Stroke presentation

Answer 8

often Asymmetrical
Sudden onset
Limb weakness
Facial weakness
Dysphasia

Question 9

Mx Stroke

Answer 9

exclude hypoglycaemia
CT to rule out haemorrhage
300Mg aspirin for 2 weeks

Thrombolysis with Alteplase or thrombectomy

Question 10

Assessments for underlying causes

Answer 10

Carotid imaging for carotid artery stenosis
ECG for AF

Question 11

anterior blood supply of brain

Answer 11

middle cerebral <-Internal carotids

Question 12

posterior blood supply of brain

Answer 12

Basilar <- vertebral <- subclavian

Question 13

upper motor neurone

Answer 13

motor cortex
medulla / spinal cord

Question 14

lower motor neurone

Answer 14

anterior horn cell
spinal nerve root
motor neurone

Question 15

Anterior horn pathology

Answer 15

motor neurone disease

Question 16

neuromuscular junction pathology

Answer 16

myasthenia gravis

Question 17

onset instant for muscle weakness

Answer 17

vascular
traumatic

Question 18

onset hours or days for muscle weakness

Answer 18

inflammatory
infective

Question 21

spinal cord lesions (myelopathy) examples

Answer 21

trauma, compression, MS, spinal stroke

Question 22

Motor neurone disease

Answer 22

anterior horn pathology
mixed UMN and LMN signs
progressive painless paralysis

Question 23

UMN signs

Answer 23

tone
reflexes
plantar
ALL INCREASE

Question 24

LMN signs

Answer 24

tones
reflexes
plantar
muscle mass
ALL DECREASE

Question 25

peripheral neuropathy

Answer 25

months or years
chronic slow progressive
starts in legs and longer nerves is symmetrical
Sensory loss

POOR DIABETIC control