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Year 3 Medicine > Amir Sam: Neurology > Flashcards

Amir Sam: Neurology Flashcards

1
Q

Causes of collapse (groups)

A
  1. Low glucose (hypoglycaemia)
  2. Heart:
    - Vasovagal
    - Arrythmia
    - Outflow obstruction
    - Postural hypotension
  3. CNS: seizure
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2
Q

Cardiac causes of collapse

A

Vasovagal
Arryhtmia (fast/slow)
Outflow obstruction (left: aortic stenosis; right: PE)
Postural hypotension

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3
Q

59 yr old man
Long-standing HTN
Exertional chest pain
Normal ECG

What is the most likely diagnosis?

A. Coronary artery stenosis
B. Musculoskeletal
C. Pericarditis
D. Relapsing polychondritis
E. Vasculitis
A

A. Coronary artery stenosis

HTN
Exertional chest pain
Normal ECG

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4
Q

Crease on ear lobe

A

Frank’s sign: diagonal crease along the tragus

Thought to be associated with coronary artery disease

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5
Q

Neurology problem: Anatomy

A 
Brain
Spinal cord
Nerve roots
Peripheral nerve(s)
Neuromuscular junction
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6
Q

Neurological problem: Pathology

A 
VIITT
Vascular
Infection
Inflammation/Autoimmune
Toxic/Metabolic
Tumours/Malignancy

Hereditary/congenital
Degenerative

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7
Q

Neurology problem: Where? Anatomy

A 
(level of the lesion/problem)
Brain
Spinal cord
Nerve roots
Peripheral nerve(s)
Neuromuscular junction
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8
Q

Neurological problem: What? Pathology

A

VIITT
Vascular (bleed/infarction)
Infection (meningitis/ encephalitis/ abscess)
Inflammation/Autoimmune (demyelination central: MS, peripheral: Guillain Barre. Also vasculitides (CTDS: SLE)
Toxic/Metabolic (DM, B12 deficiency)
Tumours/Malignancy (tumour directly causing symptoms or paraneoplastic manifestation- Pancoast’s)

Hereditary/congenital
Degenerative

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9
Q

Signs of UMN lesion

A

Tone: increased (spasticity)
Power: decreased
Reflexes: increased (upgoing plantars)

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10
Q

Signs of LMN lesion

A

Tone: reduced (flaccid)
Power: reduced
Reflexes: reduced

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11
Q

Cerebellar symtpoms

A

DANISH
Dysdiadokineses/Dysmetria (past pointing)
Ataxia (coordiantion/balance)
Nystagmus
Intention tremor (finger-nose test)
Slurred speech/ scanning (staccato speech)
Hypereflexia/hypotonia

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12
Q

Causes of cerebellar disease:

A

PASTRIES

Do a CT scan

Posterior fossa tumour
Alcohol
Stroke
Trauma
Rare
Inherited (Friedrich's ataxia)
Epilepsy drugs (carbamazepine, phenytoin)
Sclerosis (MS)

OR
Vascular (bleed/clot- Stroke)
Infection (varicella (chicken pox), toxoplasmosis)
Inflammation (demyelination- MS)
Malignancy/Tumour (primary (posterior fossa tumour) or metastasis)
Metabolic/Toxic (B12 deficiency, Alcohol)

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13
Q

Spastic paraparesis
Increased tone in legs, but weakness
Peripheral neuropathy

A

Subacute combined degeneration

Vitamin B12 deficiency (but can also present in other ways)

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14
Q

Hemisensory loss

A

Cerebral cortex (contralateral)

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15
Q

Sensory loss below a level (eg- umbilicus)- eg- with pin prick test

A

Spinal cord

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16
Q

Sensory loss in a dermatome(s)

A

Nerve roots (eg- radiculopathy)

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17
Q

Sensory loss in a specific area

A

Mononeuropathy

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18
Q

Glove and stocking distribution of sensory loss

A

Polyneuropathy (diabetic peripheral neuropathy)

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19
Q

Glove and stocking distribution of sensory loss

A

Polyneuropathy (diabetic peripheral neuropathy)

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20
Q

Reduced pin prick sensation in there left arm and left leg

A

Right cerebral cortex

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21
Q

Glove and stocking distribution of sensory loss. Causes:

A

Polyneuropathy:
The most common is diabetes

Infection: HIV
Inflammation: chronic inflammatory demyelinating polyneuropathy (CIDP)
Malignancy: Paraneoplastic; Paraproteinaemia
Metabolic: Diabetes, Alcohol, B12 deficiency

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22
Q

Glove and stocking distribution of sensory loss. Causes:

A

Polyneuropathy:
The most common is diabetes

Infection: HIV
Inflammation: chronic inflammatory polyneuropathy disorder (CIPD)
Malignancy: Paraneoplastic; Paraproteinaemia
Metabolic: Diabetes, Alcohol, B12 deficiency

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23
Q

Wasted, shortened lower limb
Reduced T,R,P unilaterally
Scars on leg
Sensation normal

A

Polio myelitis (favourite for OSCE)

Pure motor neuropathy (LMN- reduced TRP)
Wasted shortened limb (chronic)
Normal sensation
Lots of scars- corrective surgery as person grows

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24
Q

Toxic/metabolic causes of peripheral neuopathy:

A 
Drugs: (amiodarone; psychotoxic drugs- phenytoin)
Alcohol (high MCV, high GGT)
B12 deficiency (high MCV)
Diabetes: (HbA1C)
Hypothyroidism
Uraemia (high urea/creatinine)

Amyloidosis (chronic infection/inflammation or Myeloma)

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25
Q

Toxic/metabolic causes of peripheral neuopathy:

A 
Drugs: (amiodarone; psychotoxic drugs- phenytoin)
Alcohol (high MCV, high GGT)
B12 deficiency (high MCV)
Diabetes: (HbA1C)
Hypothyroidism
Uraemia (high urea/creatinine)

Amyloidosis (chronic infection/inflammation or Myeloma)

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26
Q

Toxic/metabolic causes of peripheral neuopathy:

A 
Drugs: (amiodarone; psychotoxic drugs- phenytoin)
Alcohol (high MCV, high GGT)
B12 deficiency (high MCV)
Diabetes: (HbA1C)
Hypothyroidism
Uraemia (high urea/creatinine)

Amyloidosis (chronic infection/inflammation or Myeloma)

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27
Q 
55 year old man
Numbness and tingling in hands and feet
PMH: T1DM
On basal/bolus insulin
HbA1C: 50mmol/L
B12: 500pg/ml (200-900)
eGFR: 90

Reduced sensation to PP (glove and stocking distribution)

  1. Codeine
  2. Duloxetine
  3. Hydroxocobalamin
  4. Paracetemol
  5. Pregabalin
A
  1. Duloxetine (first linbe- NICE)
    (also used for premature ejaculation)

Codeine/Paracetemol won’t work
Hydroxocobalamin- used in B12 deficiency

Pregabalin- used but not first line (considered if duloxetine is not effective)

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28
Q 
55 year old man
Numbness and tingling in hands and feet
PMH: T1DM
On basal/bolus insulin
HbA1C: 50mmol/L
B12: 500pg/ml (200-900)
eGFR: 90

Reduced sensation to PP (glove and stocking distribution)

  1. Codeine
  2. Duloxetine
  3. Hydroxocobalamin
  4. Paracetemol
  5. Pregabalin
A
  1. Duloxetine (first linbe- NICE)
    (also used for premature ejaculation)

Codeine/Paracetemol won’t work
Hydroxocobalamin- used in B12 deficiency

Pregabalin- used but not first line (considered if duloxetine is not effective)

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29
Q 
55 year old man
Numbness and tingling in hands and feet
PMH: T1DM
On basal/bolus insulin
HbA1C: 50mmol/L
B12: 500pg/ml (200-900)
eGFR: 90

Reduced sensation to PP (glove and stocking distribution)

A

Diabetic peripheral neuropathy

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30
Q

Toxic/metabolic causes of peripheral neuopathy:

A 
Drugs: (amiodarone; psychotoxic drugs- phenytoin)
Alcohol (high MCV, high GGT)
B12 deficiency (high MCV, anaemia)
Diabetes: (HbA1C)
Hypothyroidism (TFTs)
Uraemia (high urea/creatinine)

Amyloidosis (chronic infection/inflammation or Myeloma)

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31
Q 
55 year old man
Numbness and tingling in hands and feet
PMH: T1DM
On basal/bolus insulin
HbA1C: 50mmol/L
B12: 500pg/ml (200-900)
eGFR: 90

Reduced sensation to PP (glove and stocking distribution)

A

Diabetic peripheral neuropathy

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32
Q 
55 year old man
Numbness and tingling in hands and feet
PMH: T1DM
On basal/bolus insulin
HbA1C: 50mmol/L
B12: 500pg/ml (200-900)
eGFR: 90

Reduced sensation to PP (glove and stocking distribution)

A

Diabetic peripheral neuropathy

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33
Q

Non metabolic causes of peripheral neuropathy:

A

Infection: HIV

Inflammation/Autoimmune: vasculitis, CTD (SLE), inflammatory demyelinating neuropathy (GBS acute, CIDP)

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34
Q

Non metabolic causes of peripheral neuropathy:

A

Infection: HIV

Inflammation/Autoimmune: vasculitis, CTD (SLE), inflammatory demyelinating neuropathy (GBS acute, CIDP)

Tumour/malignancy: paraneoplastic, paraproteinaemia

Hereditary: hereditary sensory, motor neuropathy (eg- if have pers cavus- arch in foot- so peripheral neuropathy has been there a long time)

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35
Q

Non metabolic causes of peripheral neuropathy:

A

Infection: HIV

Inflammation/Autoimmune: vasculitis, CTD (SLE), inflammatory demyelinating neuropathy (GBS acute, CIDP)

Tumour/malignancy: paraneoplastic, paraproteinaemia

Hereditary: hereditary sensory, motor neuropathy (eg- if have pers cavus- arch in foot- so peripheral neuropathy has been there a long time)

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36
Q 
34 year old man
Weakness in legs
Blurred vision
Legs: T: Increased; P: decreased; R: brisk, decreased pin prick sensation
Fundoscopy: shows blurred optic disc
Most likely causes of blurred vision?
A. Amaurosis fugax
B. Anterior uveitis
C. Papillodoema
D. Pailiitis
E. Vitreous haemorrhage
A

Weakness in both legs, increased tone- spastic paraparesis (not LMN)

There is a level of sensory loss (legs)

Lesion is in the spinal cord- inflammation in CNS so MS

D. Pappilitis- inflammation at the head of the optic nerve

DDx of blurred optic disc is papilloedema or papillitis

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37
Q

Blurred optic disk of fundoscopy:

A
  1. Papilloedema
  2. Papillitis

Both may have blurred vision (more likely in papillitis) and optic disc won’t be clear. However- papillitis will have pain when moving the eye (inflammation)

38
Q 
34 year old man
Weakness in legs
Blurred vision
Legs: T: Increased; P: decreased; R: brisk, decreased pin prick sensation
Fundoscopy: shows blurred optic disc
Most likely causes of blurred vision?
A. Amaurosis fugax
B. Anterior uveitis
C. Papillodoema
D. Pailiitis
E. Vitreous haemorrhage
A

Weakness in both legs, increased tone- spastic paraparesis (not LMN)

There is a level of sensory loss (legs)

Lesion is in the spinal cord- inflammation in CNS so MS

D. Pappilitis- inflammation at the head of the optic nerve

DDx of blurred optic disc is papilloedema or papillitis

39
Q

Blurred optic disk of fundoscopy:

A
  1. Papilloedema
  2. Papillitis

Both may have blurred vision (more likely in papillitis) and optic disc won’t be clear. However- papillitis will have pain when moving the eye (inflammation)

40
Q 
34 year old man
Weakness in legs
Blurred vision
Legs: T: Increased; P: decreased; R: brisk, decreased pin prick sensation
Fundoscopy: shows blurred optic disc
A

Multiple sclerosis

In CNS (spastic pareisis)
In spinal cord (sensory loss in both legs- a level- otherwise would be one side and in arm as well).

Blurred vision

Therefore inflammation in spinal cord and in optic nerve: 2 lesions separated in space/time- MS

41
Q

Blurred optic disc margins (fundoscopy)
Blurred vision
Pain on eye movement

Where and what?

A 
Optic nerve
Optic neuritis (papillitis)

Inflammation of optic nerve (eg- in MS)

42
Q

Blurred optic disc margins (fundoscopy)
Blurred vision
Pain on eye movement

Where and what?

A 
Optic nerve
Optic neuritis (papillitis)

Inflammation of optic nerve (eg- in MS)

43
Q

Weak legs
Upgoing planatars, hypereflexia
Fevers, night sweats

A

Pott’s Disease: TB of the spine- abscess compressing spinal cord

MRI: diagnosis
Neurosurgeons and and TB treatment

44
Q

Causes of spastic paraparesis:

weak legs, hypertonia, upgoing plantars

A

Vascular: infarction in anterior spinal artery

Infection: Abscess (Pott’s disease TB)

Inflammation: MS, transverse myelitis (associated with Mycoplasma pneumoniae)

Toxic/metabolic: B12 deficiency

Tumour/Malignancy: Tumour of spinal cord

45
Q

Multiple Sclerosis:

A

Two lesions

Separated in time/space

46
Q

Multiple Sclerosis:

A

Two lesions

Separated in time/space

47
Q 
60 year old
pain and paraesthesia in right anterolateral thigh
PMH: T2 diabetes
Metformin
HbA1C: 60 mmo

BMI: 30
Reduced pin prick sensation in anteriolateral thigh

Next step?
A.Lose weight
B. Insulin
C.Statin
D.Aspirin
E.MRI brain
A

A. Lose weight

Where? What?
Anterolateral thigh, pain and paraesthesia (prickling)- one area- so mononeuropathy

He has meralgia parasthetica: compression of the lateral femoral cutaneous nerve (as it passes inguinal ligament)

Reassure, avoid tight garments, LOSE WEIGHT

If persistent: carbamazepine, gabapentin

48
Q

Sensory innervation of hand: lateral 3 1/2 digits (index and middle finger)

A

Median nerve

49
Q

Sensory innervation of the hand: Medial 1 1/2 digits (little finger)

A

Ulnar nerve

50
Q

Sensory innervation of the hand: Medial 1 1/2 digits (little finger)

A

Ulnar nerve

51
Q

Sensory innervation of the hand: base of thumb (dorsal)

A

Radial nerve

52
Q

Sensory innervation of the hand: base of thumb (dorsal)

A

Radial nerve

check to see if sensation at base of the thumb- anatomical snuffbox

53
Q

Radial nerve palsy:

A

wrist drop, sensation lost at base of hand and back and proximal of first 3 fingers

54
Q

Pain in buttock, radiating down the leg below the knee

A

Sciatica- compression of lumbosacral nerve roots (radiculopathy)
Compression by disc herniation, spinal canal setnosis

Radiculopathy (disease of nerve roots)

55
Q

wrist drop, loss of sensation at base of thumb

A

Radial nerve palsy

56
Q

wrist drop, loss of sensation at base of thumb

A

Radial nerve palsy

57
Q 
60 year old man
Recurrent falls
Tremor at rest
Rigidity
More forgetful
Dysphagia
Microphagia (small handwriting)
Limited upgaze

Most likely diagnosis?

A. Progressive supranuclear palsy
B. Lewy body dementia
C. Stroke
D. Epilepsy
E. Alzheimer's disease
A

Parkinsonian features

PLUS limited upgaze

A. Progressive supranuclear palsy

Parkinson’s (tremor, rigidity, bradykinesia)

PSP (Steele-Richardson syndrome): parkisnonian features, upgaze abnormality

58
Q

Triad of tremor, rigidity, bradykinesia

A

Parkinson’s disease

59
Q

Alzheimer’s and Parkinsonian features

PLUS hallucinations

A

Lewy Body dementia

60
Q 
55 yr-old man
confusion and chest pain
no headache or neck stiffness
recently moved to new house
Temp: 37
PR: 100, BP: 120/60
Normal CVS/Resp/GI/Neuro exam
ECG: sinus tachycardia, widespread ST depression
Blood glucos: 7 mmol/L
WCC/CRP normal
CT head normal
A

New house: CO poisoning

Rule out other things (normal)

61
Q 
55 yr-old man
confusion and chest pain
no headache or neck stiffness
recently moved to new house
Temp: 37
PR: 100, BP: 120/60
Normal CVS/Resp/GI/Neuro exam
ECG: sinus tachycardia, widespread ST depression
Blood glucos: 7 mmol/L
WCC/CRP normal
CT head normal
A

New house: CO poisoning

Rule out other things (normal)

62
Q

Causes of confusion (reduced AMTS):

A

VIITT/VIMM and others

Hypoglycaemia!!!

Vascular: bleed
Infection: meningitis, encephalitis
Inflammation: cerebral vasculitis
Metabolic/Toxic: CO poisoning
Malignancy/Tumour

Other causes:
post-ictal (history of seizure)
Dysphagia (receptive/expressive)- not confused but can’t communicate- stroke/TIA
Dementia: Alzheimer’s, Vacular (multi-infarct- history of IHD/PVD), alcoholic (signs of excess alcohol), Inherited eg- Huntington’s (other features- chorea)
Depressive pseudodementia (depression): elderly, withdrawn, poor eye contact. Often a precipitating factor

63
Q

Causes of confusion (reduced AMTS)

A

VIITT/VIMM and others

Hypoglycaemia!!!

Vascular: bleed: headaches, collapse.
Subdural haematoma (fall, fluctuating conciousness)

Infection: meningitis, encephalitis (?temp, ?intracranial (meningitis/enceph), ?extra-cranial (chest/UTI in elderly)

Inflammation: cerebral vasculitis, autoimmune encephalitis

Metabolic/Toxic: CO poisoning, drugs, U&Es, LFTs, Vit deficiency, Endocrinopathies

Malignancy/Tumour

Other causes:
post-ictal (history of seizure)
Dysphagia (receptive/expressive)- not confused but can’t communicate- stroke/TIA
Dementia: Alzheimer’s, Vacular (multi-infarct- history of IHD/PVD), alcoholic (signs of excess alcohol), Inherited eg- Huntington’s (other features- chorea)
Depressive pseudodementia (depression): elderly, withdrawn, poor eye contact. Often a precipitating factor

64
Q

Causes of confusion (reduced AMTS)

A

VIITT/VIMM and others

Hypoglycaemia!!!

Vascular: bleed: headaches, collapse.
Subdural haematoma (fall, fluctuating conciousness)

Infection: meningitis, encephalitis (?temp, ?intracranial (meningitis/enceph), ?extra-cranial (chest/UTI in elderly)

Inflammation: cerebral vasculitis, autoimmune encephalitis

Metabolic/Toxic: CO poisoning, drugs, U&Es, LFTs, Vit deficiency, Endocrinopathies

Malignancy/Tumour

Other causes:
post-ictal (history of seizure)
Dysphagia (receptive/expressive)- not confused but can’t communicate- stroke/TIA
Dementia: Alzheimer’s, Vacular (multi-infarct- history of IHD/PVD), alcoholic (signs of excess alcohol), Inherited eg- Huntington’s (other features- chorea)
Depressive pseudodementia (depression): elderly, withdrawn, poor eye contact. Often a precipitating factor

65
Q

GCS:

A 
Eyes (4)
Verbal response (5)
Motor response (6)
66
Q

GCS Eyes:

A

1: no response
2: open to pain
3: open to speech
4: spontaneous opening

67
Q

GCS Motor:

A

Motor (6)

1: no response to pain
4: withdraws to pain
5: localising response to pain
6: obeying commands

68
Q

GCS Verbal:

A

Verbal (5)

1: none
2: sounds
3: words
4: confused conversation
5: orientated

69
Q

GCS Verbal:

A

Verbal (5)

1: none
2: sounds
3: words
4: confused conversation
5: orientated

70
Q

Abbreviated Mental Test:

A 
DOB
Age
Time
Year
Place
Recall (3 words)
Recognise doctor/nurse
Prime minister
Second WW
Count backwards from 20
71
Q

Abbreviated Mental Test:

A 
DOB
Age
Time
Year
Place
Recall (3 words)
Recognise doctor/nurse
Prime minister
WWII
Count backwards from 20
72
Q

Abbreviated Mental Test:

A 
DOB
Age
Time
Year
Place
Recall (3 words)
Recognise doctor/nurse
Prime minister
WWII
Count backwards from 20
73
Q

Abbreviated Mental Test:

A 
DOB
Age
Time
Year
Place
Recall (3 words)
Recognise doctor/nurse
Prime minister
WWII
Count backwards from 20
74
Q

Headache in the Emergency Department (serious causes):

A

Meningitis (fever, neck stiffness, meningism, Kernig’s sign)- treat with ceftriaxone

Subarachnoid haemorrhage: (sudden onset, thunderclap. CT, LP (xanthochromia- yellow CSF- breakdown products of RBCs))

Giant cell arteritis: polymyalgia rheumatic, (shoulder girdle pain, stiffness, jaw claudication, malaise, fever).
>50years. Give high dose steroids

Also:
Migraine: throbbing, vomiting, photo/phonophobia, FHx, Aura

75
Q

Headache in the Emergency Department (serious causes):

A

Meningitis (fever, neck stiffness, meningism, Kernig’s sign)- treat with ceftriaxone

Subarachnoid haemorrhage: (sudden onset, thunderclap. CT, LP (xanthochromia- yellow CSF- breakdown products of RBCs))

Giant cell arteritis: polymyalgia rheumatica(shoulder girdle pain, stiffness malaise, fever) or alone.
>50years. Give high dose steroids

Also:
Migraine: throbbing, vomiting, photo/phonophobia, FHx, Aura

76
Q

Headache in the Emergency Department (serious causes):

A

Meningitis (fever, neck stiffness, meningism, Kernig’s sign)- treat with ceftriaxone

Subarachnoid haemorrhage: (sudden onset, thunderclap. CT, LP (xanthochromia- yellow CSF- breakdown products of RBCs))

Giant cell arteritis: polymyalgia rheumatica(shoulder girdle pain, stiffness malaise, fever) or alone.
>50years. Give high dose steroids

Also:
Migraine: throbbing, vomiting, photo/phonophobia, FHx, Aura

77
Q

Throbbing headache, vomiting, photo/phonophobia, FHx, Aura

A

Migraine

High dose aspirin (900mg)/ naproxen (NSAIDs)

78
Q

Determining what management of stroke:

A

Time of onset

4.5 hours

79
Q

Management of stroke

A
80
Q

Management of stroke >4.5 hours

A

> 4.5 hours

  • CT head (exclude haemorrhage)
  • Aspirin (300mg), assess swallow
  • Maintain hydration, oxygenations, monitor blood glucose

(Don’t treat BP acutely unless >220/120- dangerous to bring it down to quickly)

81
Q

TIA

A
  • Aspirin
  • Don’t treat BP actuely (unless >220/120 or other indication)
  • ECG, Echocardiogram
  • Carotid Doppler
  • Risk factor modification
82
Q

Management of stroke

A
83
Q

Management of stroke >4.5 hours

A

> 4.5 hours

  • CT head (exclude haemorrhage)
  • Aspirin (300mg), assess swallow
  • Maintain hydration, oxygenations, monitor blood glucose

(Don’t treat BP acutely unless >220/120- dangerous to bring it down to quickly)

84
Q

TIA

A
  • Aspirin
  • Don’t treat BP actuely (unless >220/120 or other indication)
    Find underlying cause- to see if the patient is a candidate for carotid end arterectomy:
  • ECG, Carotid Doppler, Echocardiography (thrombus in the heart causing emboli)
  • Risk factor modification (stop smoking, DM, HTN)
85
Q

TIA

A
  • Aspirin
  • Don’t treat BP actuely (unless >220/120 or other indication)
    Find underlying cause- to see if the patient is a candidate for carotid end arterectomy:
  • ECG, Carotid Doppler, Echocardiography (thrombus in the heart causing emboli)
  • Risk factor modification (stop smoking, DM, HTN)
86
Q

40 year old
Back ache
LMN weakness (weak legs and depressed reflexes)

Admitted to HDU
Regular FVC
Cardiac monitor
IVIG

Most likely diagnosis?

A. Guillain-Barre
B. Stroke
C. Cord compression
D. Cauda equina syndrome
E. Myaesthenia Gravis
A

A. Guillain-Barre

LMN, young person
Back ache- radiculopathy (nerve roots)

Stroke and Cord compression would cause UMN signs (brisk reflexes)

Cauda equina- LMN legs, but saddle (perianal) anaesthesia, problems with bowel (is still a DDx- MRI to see any compression)

87
Q

Management of Guillain-Barre

A
  • Admit to HDU
  • Regular FVC (forced vital capacity- respiratory depression)
  • Cardiac monitor (autoimmune disturbances)
  • IVIG (IV immunoglobulins treatment)

If FVC drops below 20ml/kg- send to ITU- intubation

88
Q

Management of Guillain-Barre

A
  • Admit to HDU
  • Regular FVC (forced vital capacity- respiratory depression)
  • Cardiac monitor (autoimmune disturbances)
  • IVIG (IV immunoglobulins treatment)

If FVC drops below 20ml/kg- send to ITU- intubation

89
Q

Management of Guillain-Barre

A
  • Admit to HDU
  • Regular FVC (forced vital capacity- respiratory depression)
  • Cardiac monitor (autoimmune disturbances)
  • IVIG (IV immunoglobulins treatment)

If FVC drops below 20ml/kg- send to ITU- intubation

90
Q

Management of Giant Cell Arteritis:

A

Giant cell arteritis/Temporal arteritis:

If suspected: Start on high dose prednisolone 60mg/d immediately to prevent visual loss
Blood: ESR (will be increased) and so will CRP
Get a temporal artery biopsy within 7 days of starting treatment (10% will be negative as skip lesions occur)

Year 3 Medicine (17 decks)

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