clinical 5 Flashcards
The symptoms of Parkinson’s disease are characteristically asymmetrical or symmetrical
asymmetrical
when is parkinsons tremor most noticeable
at rest
Hz of essential tremor
6-8 Hz
first line treatment for essential tremor
propanolol
Urinary incontinence + gait abnormality + dementia =
normal pressure hydrocephalus
which neuropathies have sensory loss
- diabetes
- uraemia
- leprosy
- alcoholism
- vitamin B12 deficiency
which neuropathies have mostly motor loss
- Guillain-Barre syndrome
- porphyria
- lead poisoning
what is dysesthesia
abnormal sensation
dopamine agonists tend to end in what letters
-ine
which Parkinson drug group is associated with pulmonary fibrosis
dopamine receptor agonists
what is dyskinesia
involuntary writhing movements
drug given in motor neuron disease
Riluzole
how does Riluzole (motor neuron drug) work
prevents stimulation of glutamate receptors
Fluctuating confusion/consciousness following fall
subdural haematoma
risk factors for a subdural haematoma
old age, alcoholism and anticoagulation
what is genetic anticipation
hereditary diseases have an earlier age of onset through successive generations.
most common presentation of MS
optic neuritis
2 main categories of seizure
primary and partial
types of primary seizure (3)
simple partial
complex partial
partial with secondary generalised
types of primary (4)
absent
tonic-clonic
myoclonic
atonic
describe simple partial seizure
remain aware
focal symptoms
NO post ictal
remain aware
focal symptoms
NO post ictal
simple partial
describe complex partial
impaired awareness
post-octal symptoms
usually temporal lobe affected
lobe most commonly affected in complex partial
temporal
how do simple and complex partial seizures differ
in complex you lose awareness and have post-ictal symptoms, where in simple you do not
seizure: stops mid sentence, pause, then carries on from where they left
absence seizure
time an absence seizure lasts
less than 10 seconds
seizure: loss of consciousness, stiff limbs, jerking
tonic-clonic seizure
which seizures do you get post-ictal confusion
- tonic-clonic
- complex
jerk in seizure called
clonic
stiff limbs in seizure called
tonic
seizure: jerk of limb, face or trunk
myoclonic seizure
seizure: disobedient limb
myoclonic seizure
seizure: sudden loss of sucre tone causing a fall
atonic seizure
focal seizure of temporal lobe with have what symptoms
- no recollection
- deja vu
- jambs vu
- dysphagia
- terror/panic/elation (hippocampus)
- delusional behaviour
focal seizure of frontal lobe with have what symptoms
motor features
focal seizure of parietal lobe with have what symptoms
sensory disturbance (tingling, numbness)
focal seizure of occipital lobe with have what symptoms
visual phenomena (spots, lines, flashes)
seizure, what lobe of brain: visual
occipital
seizure, what lobe of brain: motor
frontal
seizure, what lobe of brain: sensory
parietal
part of brain if emotional disturbance seizure
hypocampus
when do you consider drugs for epilepsy
after 2nd fit (unless reasons such a structural etc for first fir)
what frequency of fit will you consider not using drugs
if every 2 years
drug for generalised tonic clonic fit
sodium valproate or lamotrigine (lamot better tolerated)
drug for absence seizures
sodium valproate, lamotrigine, ethosuximide
drug for partial seizure +/- secondary general
carbamazepine
teratogenic anti epileptic
sodium valproate
must not give sodium valproate to woman of child bearing age, give…
lamotrigine
anti-epileptics that DO NOT go into breast milk
carbamazepine and valproate
which anti-epileptic does go into milk but is safe for baby
lamotrigine
which seizure do NOT give lamotrigine because it makes it worse
tonic, atonic, myoclonic
carbamazepine for which
all partial
first line for all general
valproate or lamotrigine (lamotrigine for woman of child bearing age)
process for switching epileptic drugs
over lap. build up new drug dose and reduce previous drug dose
howling do you take to build up epileptic drug dose
2-3 months
which epileptic drug causes increased appetite and weight gain
sodium valproate
which drugs are liver enzyme inducing
carbamazepine and phenytoin
