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Medicine > Basic Neurology > Flashcards

Basic Neurology Flashcards

0
Q

Meningitis

A 
Photophobia
Fever
Neck stiffness
Headache
Rash (bacterial) 
Treatment in hospital ceftriaxone
CT head then do lumbar puncture
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1
Q

Migraine

A 
Aura, sense of déjà vu
Headache one side of the head
Photophobia, noise sensitivity
Zig-zagging lines in front of eyes
Nausea
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2
Q

Stroke

A 
One sided arm and leg weakness
Slurred speech
Problems with swallow
One sided facial weakness 
Increased reflexes and tone on one side
Lose vision on side of weakness
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3
Q

Raised intracranial pressure

A

Worse on coughing/bending over/lying down/in the morning
Nausea vomiting
Headache
Possible Papillodeoma - swollen optic discs
Causes: tumour, infection, inflammation

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4
Q

Hepatic encephalopathy

A

Build up of ammonia in the liver
Causes confusion
Give lactulose

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5
Q

Sub-arachnoid haemorrhage

A

Most severe thunderclap headache in occipital lobe peaks rapidly
CT head then CT angiogram
CSF: xanthochromia
Linked to polycystic kidneys
Treatment: CCB nimodipine reduce vasospasm then neurosurgery to relieve bleed
Main cause: aneurysm, eg. Berry aneurysm in Circle of Willis

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6
Q

Viral encephalitis

A

MRI of temporal lobes
Headache
Confusion
Treat with acyclovir

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7
Q

Bell’s palsy

A

Lower motor neurone
Droop on one side of face
Can be caused by viral
Treat with steroids

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8
Q

Cauda equina syndrome

A 
Neurological emergency
Commonest cause is central disc prolapse
Compression of central sacral or lumbar roots 
Sciatica 
Loss of bladder/bowel control/sexual dysfunction
Saddle sensory loss
Lower limb weakness
Can cause paralysis 
Urgent MRI and surgical referral
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9
Q

Guillain-Barre Syndome

A

Autoimmune disease that affects the myelin
60% have infection two weeks before
Ascending loss of limb function
Absence of reflexes
Test their vital capacity, monitor their peak flow

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10
Q

Motor neurone disease

A

Combination of upper motor neurone and lower motor neurone signs
Absence of sensory symptoms
Wasting/weakness of small muscles in hand
Fasiculations uppers limbs/shoulders
Leg weakness/brisk reflexes/extensor plantars

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12
Q

Multiple sclerosis

A

Affects young women
Different neurology separated in time and location in body
Inflammatory demyelinating CNS disorder
Relapsing/remitting, secondary progressive, primary progressive
Typical presentation:
Option neuritis - loss of colour vision
Transverse myelitis - altered sensation from umbilicus down
Investigation: brain MRI/LP oligoclonal banding
Treat with steroids: methyl prednisalone

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12
Q

Parkinson’s

A 
Cogwheel rigidity
Tremor - pill rolling worse at rest
Difficulty getting going - propel themselves forward 
Loss of facial expression (hypomimia) 
Bradykinesthia 
Prone to Lewy-Body dementia
Caused by dopamine deficiency 
Treat with l-dopa but can lead to dystonia
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13
Q

Myasthenia gravis

A

Autoimmune against acetylcholine receptors
Weakness progressive through the day
Small muscles affected most
Droopy eyes
Difficult to swallow
Serum AChR antibody test
Treat with neostigmine - antiacetylcholineesterase
Find out their peak flow as could get to the lungs

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14
Q

Epidural/extradural haemorrhage

A 
Damage to the middle meningeal artery 
Limited by the suture lines of the skull
Biconvex appearance on CT
Often a blow to the temporal region: petrion 
Lucid interval after injury
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15
Q

Subdural haemorrhage

A

May be acute or chronic signs may be delayed by up to 2 weeks
Common in alcoholics because of recurrent falls and cerebral atrophy
Is crescent shaped on imaging
Damage to veins that bridge the subdural space
Suspect it in those with evolving strokes and fluctuating levels of consciousness

16
Q

Subarachnoid haemorrhage

A

Between arachnoid mater and pia mater
Usually caused by ruptured cerebral aneurysm
Thunderclap severe headache
CT scan

17
Q

Diffuse axonal injury

A

Tearing of nerve fibres due to shearing force during injury

Shaken Baby Syndrome

19
Q

Basal skull fracture

A

CSF leakage

Accumulates and dribbles through ear, nasopharynx, nose, raccoon eyes, haemotympanum

20
Q

Duchenne’s Muscular Dystrophy

A

X-linked recessive
Affects mostly boys, present around age 4 with delayed motor milestones, waddling gait, proximal limb weakness, calf pseudohypertrophy and scoliosis
Gower’s sign positive - walk up legs to stand up
Investigation: raised creatinine kinase
Treat with steroids
Patients die 20-30 from respiratory problems

21
Q

Wernicke-Korsakoff Syndrome

A

Wernicke’s encephalopathy
Lack of vitamin B1 - thiamine
Often caused by alcohol dependency
Px: ataxic gait, opthalmaplegia, confusion with IV thymine
Otherwise leads to Korsakoff syndrome - irreversible, can’t make new memories, confabulation

22
Q

Headache Red Flags

A

Trauma, thunderclap, focal neurological deficit, vomiting, loss of consciousness/altered consciousness, papilloedema, headache waking up in the morning, jaw claudication, fever, neck stiffness

23
Q

Cluster headaches

A 
severe unilateral supraorbital +/- temporal pain with ipsilateral eye watering  
happen every other day up to 8xday
more common in men, smokers 
Treat with sumatriptan SC and oxygen 
Prophylaxis verapamil
24
Q

Temporal arteritis (giant cell arteritis)

A

Over 50, immune mediated vasculitis
Temporal headache, myalgia, malaise
possible visual disturbance, scalp tenderness, acute blindness, jaw claudication
Ix: raised ESR, temporal artery biopsy
Treat with corticosteroids eg prednisolone, low dose aspirin

25
Q

Trigeminal neuralgia

A

chronic debilitating condition sporadic and sudden ‘electric shocks’ in the trigeminal nerve distribution
can be triggered by light touch to face, eating, cold winds or vibrations
treat with carbamazepine

26
Q

Alzheimer’s

A

Progressive degeneration in cerebral cortex, affected neurons develop surrounding amyloid plaques, neurofibrillary triangles and produce less acetylcholine
Px memory lapses, difficulty finding words for things, inability to remember recent events
Ix MRI scans to exclude other cerebral pathology, special PET scan do differentiate from vascular dementia
Tx ACE inhibitors eg donezipil, second line NMDA antagonist eg me memantine

27
Q

Vascular dementia

A

Syndrome of cognitive impairment due to complications of cerebral vascular disease ie infarcts
RF: Hx of stroke, TIA, hypertension, diabetes, hyperlipidaemia, smoking, obesity etc
Px: dementia in step wise manner, Hx or MRI evidence of cerebrovascular disease
Tx: reduce RFs, no pharmacological interventions

Medicine (23 decks)

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