Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MedEd > Acute Neuro > Flashcards

Acute Neuro Flashcards

1
Q

Stroke and TIA definition?

A

Sudden onset focal neruological deficit of presumed vascular origin lasting >24 hours

TIA is same but <24hrs

Stroke 3rd leading cause of death. World is 2nd after IHD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Cause of ischaemic stroke?

A

Atehrsoclerosis and thrombosis

Embolism (AF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pathologies that lead to intracerebral hemorrhage?

A

HTN, Charcot-bouchard microaneurysm rupture, amyloid angiopathy, AV malformation
trauma, tumour, vasculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Score for stroke in AF patients?

A

CHA2DS2VASc

CHF, HTN, AGE >75, DM, Stroke/tia/TE, Vascular disease, Age > 65, Sex Female

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Score for bleeding if anticoagulated?

A

HAS-BLED
HTN, Abnormal renal or liver function (1 each), stroke, bleeding, labile INRS, elderly >65, drugs or alcohol (1 each)

> 2 Chad for anticoag unless Has >3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Stroke/TIA RFS?

A

HTN, DM, obesity, old age, hypercholesterolaemia, smoking, AF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Presentation of Stroke?

A 
Sudden onset,
Weakness/numbness face,arm, leg
Vision change
Dizziness, loss of coordination/balance
Speech problems
Sepcific to brain AREA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

ACA stroke presentation?

A

Contralateral hemiparesis
Lower>upper
behavioural changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

MCA stroke?

A 
Contralater hemiparesis Upperface/limb>lower
Contralateral hemisensory loss
apraxia
Aphasia
Quadrantopias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

PCA stroke?

A

Homonymous contralateral hemianopia

Visual agnosia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Posterior circulation stroke?

A

Brainstem stroke = decreased consciousness and CN pathology

Cerebellar = DANSISH
Dysdiadochokinesia
Ataxia
Nystagmus
Intention tremor
Slurred speech
Hypotonia/heel-shin test

Cerebellar is ipsilateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Features of lacunar infarcts?

A

Affecting internal capsule = pure motor deficit
Pontine = dizziness/vertigo/bilateral affects
Thalamus = cosnciousness
Basal ganglia = dyskinesias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Features of intracerebral haemorrhage?

A

headache and menigism
Focal neurological signs N+V
Signs of ICP
Seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Oxford stroke classification?

A

TACS = All3 of motor/sensory deficit, homonymous hemianopia, higher cortical dysfunction

PACS = 2 of above

POCS = isolated homonymous hemianopia, bainstem signs, cerebrellar ataxia

LACS = pure motor, pure sensory, senosrimotor deficits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Ix for strokes/TIAs?

A

Urgent non contrast CT head 1st

Bloods, ecg, vitals and maintain BP, hydration, sats and temp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Mx for hyperacute stroke?

A

<4.5 hours = IV alteplase

>4.5 hours of thrombolysis contraindicated = aspirin 300mg oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is further stroke management?

A

Swallowing assessment, VTE prophylaxis, GCS monitoring, early mobilisation adn rehab, MDT approach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Other IX for stroke?

A

CTA, MRI/MRA, carotid doppler

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is secondary prevention for stroke?

A

AF = warfarin prophylaxis

Non AF = continue aspiring for 2 weeks then lifelong clopidogrel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

management of haemorrhagic stroke?

A

ICU/stroke unit for monitoring and support

Surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Complication of stroke?

A

Aspiration pneumonia, cerebral oedema (ICP), immobility, depression, dvt, seizures, death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Complication of TIA?

A 
Stroke = ABCD2
Age 
BP
Clinical presentation
Duration
DM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Causes of non-syncopal collapse?

A

Epileptic seizures, non-epileptic sezures and others e.g. hypoglycaemia, alcohol and drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Features of reflex syncope?

A

Vasovagal: young, with precipitating factor, sweating, pale, quick recovery. May have brief clonic jerking of limbs

Carotid sinus hypersensitivity: tight collar and head turning

Situational syncope = micturation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Features of cardiac sncopes?
Arrhythmias: chesrt pain, palpitations, seconds and rapid spontaneous attack Stokes-adams attach = pallor, seconds, facial flush Outlet obstruction e.g. HOCM or AS Massive PE
26
Orthostatic causes of syncope?
Collapse on standing up from stress, lack of sleep, dehydration, drugs e.g. antihypertensives, ANS instability and baroreceptor dysfunction
27
Cerebrovascular causes of syncope?
Vertebrobasilar insuffiiency, subclavian steal and aortic dissection
28
Features of epileptic seizures?
Aura or no warning, <3 mins, tongue biting, twitching, incontinence, slow recovery and confusion
29
Feature of non-epileptic seizure?
Background Hx of depression
30
Definition of epilepsy?
A recurrent tendency to have unprovoked seizures. Seizure = an abnormal paroxysmal discharge of cerebral neurons
31
Aetiology of epilepsy?
Primary epileptic syndrome = idiopathic and seizures unprovoked Secondary seizures = tumours, infection, inflammation and trauma
32
Triggers for epilepsy?
Anything that alters cerebral excitability e.g. lack of sleep, flickering lights, alcohol and stress There may be no trigegr
33
Describe an aura?
Strainge feeling in gut, deja vu, strange smells and flashing lights, tingling, stiffness and twitching
34
Features post-seizure?
Slow recovery, post-ictal headache, confusion and myalgia Todds paresis is syndrome with wakness of paralysis of area of focal onset for seizure
35
What are the generalised epileptic seizure types?
Tonic clonic (LOC -> limbs stiffen = tonic and limb jerking = clonic) myoclnic (repetitive myoclonic jerks and common in puberty) clonic, tonic, atonic (loss of muscle tone and in children Absence seizures ( brief episodes with behaviorudal arrest 5-10 sec but maintained posture and in chldren
36
WHat are the epileptic focal seizures?
Focal impaired awareness seizure, focal aware seizures and focal seizures with secondary generalisation
37
Features of frontal lobe epilepsy?
Motor symptoms Jacksonian march : muscular spasm spreads from distal part of limb to wider body area Todds paresis Involuntary actions
38
Temporal lobe epilepsy features?
Aura Automatisms (playing with fingers, lip smacking) Hallucinations
39
Features of parietal lobe epilepsy?
Sensory disturbances e.g. pain, tingling, numbness
40
Features of occipital lobe epilepsy?
Visual phenomena e.g. spots, lines and flashes
41
Ix for epilepsy?
Need 2 or more unprovoked seizures >24 hours apart EEG Bloods (hypo, FBC, Electrolyte, serum prolactin elevated post seiuzure) CT/MRI (structural lesions)
42
Mx for seizures?
Generalised : 1) Sodium valproate 2) carbamazepine Focal: 1) Carbamazepine 2) Lamotrigine Others = phenytoin, levetiracetam, cobazam Pregnancy = avoid valproate and use lamotrigine
43
SEs of seizure management?
Psychiatric (depression) Weight gain ``` Carbamezepine = neutropaenia and osteoporosis Lamotrigine = TENS/Steven-johnsons ```
44
AED MOA?
Benzos via enhanced GABA inhibition Levitarecem b reduced glutamate excitation (pre) Lamotrigine, phenyotin and CBZ via block action potential deplaisation
45
What is status epilepticus and triggers?
Seizure lasting >5mins and repeated seixures without recovery or consciousness regain Trigger: non adherence to meds, alcohol abuse and OD & toxicivity
46
Mx for status epilepticus?
``` ABC Airway, IV access and monitoring -> IV lorazepam (repeat after 10mins) -> IV phenytoin -> ICU ```
47
Complications of epilepsy?
Sudden death in epilepsy Behavioural problems Fractures Complications from drugs
48
What is GUillain-Barre syndrome?
Acute autoimmune demyelination polyneuropathy affecting the PNS AI attacks the myelin in peripheral nerves. Mechanism is molecular mimicry
49
Presentation of GBS?
URTi, gastroenteritis (Campylobacter, CMV, HIV) - > 2-3 wees = peripheral neuropathy with acute progression, ascending aprasthesia and pain, symetrical limb weakness - > can progress to affect resp muscles = resp paralysis Other RFs = cancer (lymphoma and immunisation)
50
What signs are in GBS?
Hypotonia, flaccid paralysis, altered sensation and numbness, weakness, fasciculations
51
What is Miller-FIscher syndrome?
Triad of opthalmoplegia, areflexia and ataxia but NO muscle weakness
52
Ix for GBS?
Nerve conduction studies can be confirmatory (decreased velocity) CSF = albuminocytological dissociation with increased protein and nirmal glucose and cell count Spirometry Bloods = anti-ganglioside Abs n Miller-fisher variant and 25% GBS
53
What is hydrocephalus?
Excessive accumulation of CSF in the ventricular system in the brain Bimodal distribution
54
Types of hydrocephalus?
Non-communication/obstructive = stenosis of cerbral aqueduct, lesions in 3rd/4th ventricle, psoterior fossa lesions compressing 4th ventricle Communication hydrocephalus = decreased absoprton and increased production of CSF = tumours, meningitis (TB), normal pressure hydrocephalus )idiopathic ventricular enlargement with out elevated CSF pressure) hydrocephalus ex vacuo = ventricular expansion secondary to brain atrophy e.g. alzheimers
55
Presentation of hydrocephalus?
Acute = features of ICP e.g. n+V, headache, pappilloedema Gradual = cognitive impairement, unsteady gait, double vision, CN palsies NPH = 1) cognitive impairement, gait apraxia, hyperreflexia (wet, wacky, wobbly) Kids = sunset eyes and large head
56
hydrocephalus Ix?
1st = CT/MRI head CSF = ventricular drain may show infection LP is contraindicated in hih ICP
57
Causes of cord compression?
``` Trauma = young Chronic = old e.g. tumours, osteoporosis, corticosteroids, intervertebral disease e.g. disc herniation ```
58
Cord compression symptoms?
Depends on the level Motor = limb weakness, UMN symptoms below level of the lesion and LMN at level of lesion Sensry = loss below a specific level and back pain Autonomic = constipation, urinary retention, erectile dysfunction
59
Ix for cord compression?
Radiology with MRI definitive Bloods = FBC, U&Es, caclcium and immunoglobulins for MM Urine for bence jones for MM
60
What is cauda equine syndrome and causes?
Lumbosacral nerve roots that from the cauda equine in the spinal canal become compressed Commonly by disc compression and stenosis of the spinal canal
61
Presentatio of cauda equina syndrome?
LMN symptoms, perianal anaesthesis, bladde retention and leg weakness
62
What is radiculopathy and example?
Range of symptoms from compression of nerve at or near root where it exits the spinal cord E.g. sciatica = lumbosacral and pain and tingling radiating from the lower back to ipsilateral leg. Weakening in calf msucles
63
Causes of radiculopathy?
Degenerative disc disease, osteoarthritis, tumours, infection e.g. spondylithesis
64
Presentation and IX for radiculopathy?
``` Motor = LN symptoms from nerve Sensory = dermatomal with pain and numbness ``` CT/MRI for herniation Laegues sign for Sciatic
65
What is a dissociative seizure?
Cam resemble epileptic seizure but have NO biological correlate Prlonged duration Hx of abuse, psychological or emotional precipitant Mx involves psychotherapy

MedEd (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions