clinical 2 Flashcards
what is chorea
involuntary, rapid, jerky movements
what causes chorea
damage to basal ganglia, especially caudate nucleus
what 4 features are associated with motor neurone disease
- fasciculation
- absence of sensory signs/symptoms
- lower motor neuron signs in arms and upper motor neuron signs in legs
- wasting of the small hand muscles/tibialis anterior is common
what will electromyography show in someone with motor neurone disease
a reduced number of action potentials with an increased amplitude
what will nerve conduction studies in motor neurone disease show?
will be normal - but can rule out neuropathy
raised intracranial pressure of uncertain cause is called
Idiopathic intracranial hypertension
Idiopathic intracranial hypertension can lead to what if untreated
papilloedema leading to blindness
who gets Idiopathic intracranial hypertension
overweight woman and on certain medications
what medications are associated with Idiopathic intracranial hypertension
tetracycline antibiotics isotretinoin contraceptives steroids levothyroxine lithium cimetidine
how do you treat idiopathic intracranial hypertension
repeated therapeutic lumbar punctures, where the pressure is lowered by draining off CSF until symptoms settle and with acetazolamide (diuretic)
ABCD2, A is
age >= 60 yrs (1 point)
ABCD2, B is
Blood pressure >= 140/90 mmHg (1 point)
ABCD2, C is
Clinical features:
- Unilateral weakness (2 points)
- Speech disturbance, no weakness (1 point)
ABCD2, D is
Duration of symptoms
- > 60 minutes (2 points)
- 10-59 minutes (1 point)
- diabetes (1 point)
ABCD2 score does what
asses risk of stroke in days following TIA
max possible ABCD2 score
7
for ABCD2, what score means you’re at risk
4+
if someone scores 4+ on ABCD2 what is treatment
- aspirin (300 mg daily) started immediately
- specialist assessment and investigation within 24 hours of onset of symptoms
- measures for secondary prevention introduced as soon as the diagnosis is confirmed
what is phonophobia
hypersensitivity to sound
in what condition is phonophobia very common
migrane
initial symptoms for lewy body dementia apposed to pakinsons
lewy body = dementia symptoms first, along with hallucinations
parkinsons = movement problems first
characteristic histological feature of lewy body dementia
alpha-synuclein cytoplasmic inclusions (Lewy bodies) in the substantia nigra, paralimbic and neocortical areas
what drugs should be avoided in those with lewy body dementia and why
Neuroleptics - they develop irreversible parkinsonism
how do you diagnose lewy body dementia
single-photon emission computed tomography (SPECT)
tricep reflex is what nerve and what root
radial nerve C7
what must epileptic woman take if trying to conceive/pregnant while on sodium valproate
5mg folic acid daily
why do epileptic woman take folic acid during pregnancy if on sodium valproate
to avoid neural tube defects
phenytoin (anti epileptic): associated with what in babies?
cleft palate
what do you give pregnant woman who are on phenytol in last month and why
B12 to prevent clotting disorders in baby
what anti epileptic should child baring age woman NOT take
sodium valproate
parkinsons drug strongly associated with pulmonary fibrosis is
cabergoline
parkinsons is firstly treated with which group of drugs
dopamine receptor agonist
examples of dopamine receptor agonists (4)
Bromocriptine, ropinirole, cabergoline, apomorphine
what type of injury usually causes extradural haematoma
- acceleration to deceleration trauma
- blow to side of head
what is risk factors for subdural haematoma
old age, alcoholism and anticoagulation
what head injury do you get ‘lucid interval’
extradural haematoma
most common location of epidural haematoma and why
temporal region where skull fractures cause a rupture of the middle meningeal artery
extradural haematoma located where
between dura mater and skull
which haematoma has half moon appearance
extradural
partial horners syndrome associated with which type of headache
cluster
type of headache associated with family history
cluster
main autonomic symptoms associated with cluster headache
rhinorrhoea, nasal congestion and lacrimation
treatment of acute cluster headache
100% oxygen, subcutaneous or a nasal triptan
prophylaxis of cluster headaches
verapamil, prednisolone
impingement of nerve root C7 will cause numbness where
middle finger and palm
landmark for C5/C6
thumb and index finger
** Make a 6 with your left hand by touching the tip of the thumb & index finger together - C6 **
landmark for T4
nipples - T4 for the teat pour
landmark for T10
umbilicus - BellybuT-TEN
landmark for L1
inguinal ligament - L for ligament, 1 for 1nguinal
landmark for L4
knee caps - Down on aLL fours - L4
landmark for L5
L5 = Largest of the 5 toes
landmark for S1
Lateral foot, small toe
S1 = the smallest one
