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clinical Flashcards

1
Q

allergic conjunctivitis symptoms

A

Itchy
red
discharge
lid swelling and conjunctival swelling

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2
Q

allergic conjunctivitis treatment

A

Topical anti-histamine
Avoid allergens
mast cell stabilisers

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3
Q

corneal abrasion symptoms

A

Blurred vision
Epithelial defect
Watering
pain

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4
Q

corneal abrasion investigations

A 
Slit lamp
penlight
visual acuity
red reflex
extraocular movements
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5
Q

corneal abrasions treatment

A

Topical antibiotics

analgesia

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6
Q

acute anterior uveitis signs

A

Hypopyon
small irregular pupil
past history
cells in anterior chamber

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7
Q

acute anterior uveitis symptoms

A 
Pain
watering
Floaters
blurred vision
Photophobia
red
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8
Q

acute anterior uveitis investigations

A 
Fluorescein angiography
optical coherence tomography
ultrasonography
blood count 
Mantoux
HLA
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9
Q

acute anterior uveitis treatment

A

Topical steroids

dilating drops

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10
Q

scleritis symptoms

A

Very painful
redness
nodule
tender

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11
Q

scleritis investigations

A

Slit lamp
blood tests
MRI

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12
Q

scleritis treatment

A

Systemic steroids

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13
Q

acute angle glaucoma signs

A

Hard eyeball
fixed mid dilated pupil
Hazy cornea

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14
Q

acute angle glaucoma symptoms

A 
Very painful
redness
blurred vision
nausea
vomiting
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15
Q

acute angle glaucoma investigations

A

Slit lamp
ophthalmoscopy
tonometry

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16
Q

acute angle glaucoma treatment

A 
Lower intraocular pressure
constrict pupil
I.V. carbonic anhydrase inhibitors
analgesics, antiemetics
pilocarpine 
steroid eye drops
iridotomy
beta blocker drops
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17
Q

orbital cellulitis symptoms

A 
Pain
redness 
double/blurred vision
malaise
reduced eye movement
pyrexia
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18
Q

orbital cellulitis signs

A

proptosis

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19
Q

orbital cellulitis investigations

A

CT

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20
Q

orbital cellulitis treatment

A

admit
IV antibiotics
drain pus

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21
Q

Glioma symptoms

A

Epilepsy
focal deficit
not encapsulated
no metastatic spread

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22
Q

glioma signs

A

raised ICP

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23
Q

glioma investigations

A

CT/MRI
biopsy
angiography

No lumbar puncture

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24
Q

glioma treatments

A 
corticosteroids
treat epilepsy
analgesics
antiemetics
counselling
debulk or biopsy only cannot remove fully
chemotherapy
radiotherapy
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25
Q

meningioma signs

A

Epilepsy
focal deficit
no metastatic spread
calcification

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26
Q

meningioma investigations

A

CT/MRI/biopsy
PET, angiography

No lumbar puncture

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27
Q

meningioma treatment

A 
corticosteroids
treat epilepsy
analgesics
antiemetics
counselling
surgery
chemotherapy
radiotherapy
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28
Q

pituitary tumours symptoms

A

Visual disturbance
epilepsy
focal deficit

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29
Q

pituitary tumours signs

A

Hormone imbalance

Raised ICP

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30
Q

pituitary tumour investigations

A

CT/MRI/biopsy
PET
angiography
No lumbar puncture

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31
Q

pituitary tumour treatment

A 
Endocrine replacement
corticosteroids
treat epilepsy
analgesics
antiemetics
counselling
surgery
chemotherapy
radiotherapy
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32
Q

raised intracranial pressure signs

A

Papilloedema
6th nerve palsy
3rd nerve palsy

headache
worse in morning and exertional , lying flat, focal signs
falling down in Glasgow coma scale

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33
Q

raised intracranial pressure symptoms

A 
Headache
Nausea
seizures
pulsatile tinnitus
visual disturbance
somnolence
cognitive impairment
altered consciousness
pupillary dilation
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34
Q

raised intracranial pressure investigations

A

Fundoscopy
IVP monitoring
CT

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35
Q

raised intracranial pressure treatment

A 
Mannitol
hyperventilation decrease
barbiturate coma
surgical decompression
head end elevation

Glasgow Coma Scale
reduce temperature
maintain PO2, reduce PCO2

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36
Q

hydrocephalus signs

A 
Older; 
asymptomatic
headaches
Papilloedema
visual problems 
gait
loss of upgaze
impaired consciousness
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37
Q

hydrocephalus symptoms

A

Infants; splaying sutures, bulging fontanelles, abducen’s palsy
exaggerated reflexes
respiratory problems

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38
Q

hydrocephalus investigations

A 
CT
MRI
(US kid) 
gait
lumbar puncture
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39
Q

hydrocephalus treatment

A 
Acetazolamide
carbonic anhydrase inhibitor
External ventricular drain in emergency
eliminate obstruction 
CSF diversion
ventriculostomy
Shunt insertion
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40
Q

stroke lacunar symptoms

A

Lacunar; pure motor, pure sensory, dysarthria, ataxic hemiparesis

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41
Q

stroke PCA symptoms

A

PCA; coma, vertigo, nausea, CN palsy, ataxia, visual field defects, vomiting, deficits, hemiparesis, hemisensory loss

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42
Q

stroke ACA symptoms

A

ACA; paralysis of foot, leg loss of sensation. Impairment of gait/stance

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43
Q

stroke MCA symptoms

A

paralysis/sensory loss of face/arm/leg gaze paralysis, aphasia, neglect, homonymous hemianopia

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44
Q

stroke investigations

A 
CT – infarct 
blood tests
MRI – haemorrhage 
ECG
ECHO
carotid doppler
angiogram
hyper-coagulability
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45
Q

stroke treatment

A 
IV TPA <3 – 4.5hr 
stroke unit
Aspirin
thrombectomy
rehab
prevention; 
anti-hypertensives
anti-platelets
Lipid lowering drugs
warfarin for AF
carotid endartectomy
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46
Q

vasogenic cerebral oedema symptoms

A 
Headache
neck pain
dizziness
irregular breathing
vision loss
memory loss
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47
Q

vasogenic cerebral oedema signs

A 
Stupor
seizures
loss of consciousness 
 inability to walk
difficulty speaking
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48
Q

vasogenic cerebral oedema investigations

A 
Blood tests
neurological exam
CT
MRI
blood tests
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49
Q

vasogenic cerebral oedema treatment

A 
Steroids
mannitol 
IV fluids
oxygen therapy
lowering body temperature
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50
Q

cytotoxic oedema symptoms

A 
Headache
neck pain
dizziness
irregular breathing
vision loss
memory loss
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51
Q

cytotoxic oedema signs

A 
Stupor
seizures
loss of consciousness 
 inability to walk
difficulty speaking
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52
Q

cytotoxic oedema investigations

A 
Blood tests
neurological exam
CT
MRI
blood tests
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53
Q

cytotoxic oedema treatment

A

mannitol

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54
Q

corneal ulcer signs

A

bilateral, opacity, decreased vision

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55
Q

corneal ulcer investigations

A

Slit lamp

Microscopy

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56
Q

corneal ulcer treatment

A

corneal transplantation

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57
Q

cataracts symptoms

A

Loss of vision

dazzle glare

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58
Q

cataracts investigations

A 
Visual acuity test
refraction test
contrast sensitivity testing 
colour vision testing 
slit lamp
glare testing 
tonometry
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59
Q

cataracts treatment

A

surgery

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60
Q

primary open angle glaucoma symptoms and signs

A

Optic disk changes

Asymptomatic, bilateral, visual field defects

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61
Q

primary open angle glaucoma treatment

A

Eye drops; prostaglandins, beta blockers, carbonic anhydrase inhibitors, laser trabeculoplasty, trabeculectomy

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62
Q

dementia assessment

A

Neuropsychological assessment
MMSE
MOCA

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63
Q

dementia investigations

A

Bloods, CT/MRI, CSF, EEG, functional imaging, genetic

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64
Q

dementia treatment

A 
Treatable causes; B12, endocrine, infection. 
symptomatic
support
therapy
cholinesterase inhibitors
NMDA antagonist
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65
Q

Parkinson’s signs

A

Bradykinesia
rigidity
tremor
postural instability

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66
Q

Parkinson’s investigation

A

diagnosed from >2 symptoms but a SPECT can be done

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67
Q

treatment for Parkinsons

A 
Levodopa 
MAOB inhibitors
COMT inhibitors
apomorphine 
functional neusurgery
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68
Q

disc prolapse symptom

A

Acute onset pain

numbness and weakness involved in Root nerve

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69
Q

disc prolapse investigations

A

MRI

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70
Q

disc prolapse treatment

A

Rehabilitation
nerve root injection
discectomy

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71
Q

cauda equina syndrome

A

Bilateral sciatica
saddle anaesthesia
urinary dysfunction

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72
Q

cauda equina investigation

A

MRI

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73
Q

cauda equina treatment

A

Emergency lumbar discectomy

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74
Q

cervical spondylosis symptoms

A

Myelopathy or radiculopathy

months to years

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75
Q

cervical spondylosis investigation

A

MRI

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76
Q

cervical spondylosis treatment

A

conservative

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77
Q

lumbar stenosis symptoms

A

Spinal claudication

Worse on walking relieved by standing

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78
Q

lumbar stenosis investigations

A

MRI

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79
Q

lumbar stenosis treatment

A

lumbar laminectomy

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80
Q

malignant cord compression symptoms

A

Pain, weakness, sphincter disturbance

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81
Q

malignant cord compression investigation

A

MRI

82
Q

Malignant cord compression treatment

A

decompression or radiotherapy

83
Q

epidural abscess symtpoms

A

back pain
pyrexia
focal neurology

84
Q

epidural abscess investigation

A

MRI

85
Q

epidural abscess treatment

A

surgical decompression and IV antibiotics

86
Q

spinal cord stroke symtpoms and sigsn

A 
Onset over hours or sudden 
Back pain, visceral
paraparesis
quadriparesis 
numbness
paraesthesia
urinary symptoms
87
Q

spinal cord stroke investigation

A

MRI

88
Q

spinal cord treatment

A

Maintain BP, reverse hypovolaemia/ arrhythmia
OT and Physio
manage vascular factors

89
Q

epilepsy signs

A

Myoclonic jerks in morning, déjà vu, lip smacking, fiddling

90
Q

epilepsy symptoms for focal

A

Spontaneous recurring seizures

Focal; aura, motor features, autonomic, awareness

91
Q

epilepsy symptoms primary general

A

Spontaneous recurring seizures

Primary generalised no warning

92
Q

epilepsy investigations

A 
Blood sugars
ECG
alcohol/drugs
CT
MRI <50 focal 
video-telemetry
93
Q

epilepsy treatment for primary general

A

Sodium valproate for primary general

94
Q

epilepsy treatment for partial

A

lamotrigine for partial

95
Q

status epilepticus signs/symptoms

A

Seizure no stopping >30 minutes

96
Q

status epileptics investigations

A

Blood tests, liver function, oxygen saturation, blood gas, toxicology, electrolytes, anti-convulsants
X-ray
, CT, lumbar puncture

97
Q

status epilepticus treatment

A

1st line lorazepam, diazepam
2nd line phenytoin, valproate
3rd line anaesthesia

98
Q

Migraine signs

A

triggers and aura

99
Q

migraine symptoms

A 
Very disabling 
unilateral
throbbing
nausea
osmophobia
phonophobia
photophobia
100
Q

migraine investigations

A 
Imaging tests if red flags 
blood tests
urinalysis 
EEG
eye exam
lumbar puncture
101
Q

abortive treatment for migraine

A

aspirin triptans

102
Q

prophylactic treatment for migraines

A

prophylactic; propranolol, anti-epileptics, tricyclic anti-depressants, venlafaxine

103
Q

cluster headache signs

A 
Unilateral
prominent ipsilateral autonomic symptoms 
aura 
episodic
circadian rhythm
chronic 
minutes to hours
104
Q

cluster headache symtpoms

A 
Orbital and temporal pain 
rapid onset
rapid cessation of pain
severe
agitation
105
Q

cluster headache abortive treatment

A

subcutaneous sumatriptan + O2
abortive bout;
depomedrone injection, oral prednisone

106
Q

preventative cluster treatment

A

verapamil, lithium, topiramate

107
Q

paroxysmal hemicrania signs

A

Duration 2-30 minutes
rapid onset
chronic

108
Q

paroxysmal hemicrania symptoms

A

Orbital and temporal

precipitated by bending or rotating head

109
Q

paroxysmal hemicrania investigations

A

Indomethacin test

MRI

110
Q

paroxysmal hemicrania 1st line treatment

A

indomethacin

111
Q

paroxysmal hemicrania prophylaxis

A

topiramate

COX 2 inhibitors

112
Q

SUNCT signs

A

10-240 seconds
trigger cutaneous
3-200 attacks a day

113
Q

SUNCT symptoms

A

Unilateral, supraorbital, temporal stabbing, pulsating pain

conjunctival injection and lacrimation

114
Q

SUNCT prophylaxis

A

lamotrigine
topiramate
gabapentin
carbamazepine

115
Q

trigeminal neuralgia signs

A

5-10 second triggers

116
Q

trigeminal neuralgia symptoms

A

Unilateral maxillary or mandibular division pain

stabbing

117
Q

prophylaxis for trigeminal neuralgia

A

carbamazepine

118
Q

treatment for trigeminal neuralgia

A

surgical intervention
glycerol ganglion injection
stereotactic radiosurgery
decompressive surgery

119
Q

thunderclap headache symptoms

A

Rapid collapse and death

extremely painful, rapid onset headache

120
Q

thunder headache investigation

A

CT

121
Q

hypotension investigation

A

MRI

122
Q

hypotension treatment

A

Bed rest, fluids, analgesia, caffeine, epidural blood patch

123
Q

giant cell arteritis signs

A

50 new headache
tenderness of superficial temporal arteries
raised inflammatory markers

124
Q

giant cell arteritis symtpoms

A 
Diffuse unwell
severe
scalp tenderness
jaw claudication
visual disturbance
beading temporal arteries 
loss of appetite
125
Q

giant cell arteritis investigations

A

biopsy
CRP
raised ESR

126
Q

giant cell arteritis treatment

A

high dose prednisolone

127
Q

meningitis signs

A

Cerebral dysfunction
focal deficits
petechial skin rash

128
Q

meningitis symptoms

A 
Stiff neck 
fever
altered mental status
photophobia
nausea
vomiting
129
Q

meningitis investigations

A

Blood cultures

lumbar punctures

130
Q

meningitis treatment

A

Antibiotics
IV fluids
analgesia

131
Q

encephalitis signs

A

Meningism
cerebral dysfunction
seizures
focal symptoms

132
Q

encephalitis symptoms

A

Flue like prodrome

prog. Headache

133
Q

encephalitis investigations

A 
Blood cultures
imaging CT/MRI
lumbar puncture 
EEG
PCR
134
Q

encephalitis treatment

A

aciclovir for HSV

135
Q

brain abcess signs

A

Raised ICP

+/- meningism

136
Q

brain abcess symptoms

A

Fever, headache, focal symptoms

137
Q

brain abcess investigations

A

CT/MRI
source
blood culture
biopsy

138
Q

brain abcess treatment

A

Drainage
penicillin for step
metronidazole for anaerobes

139
Q

lyme disease signs and symptoms

A

Erythema migrans + flu
multi system MSK + neuro
encephalomyelitis
stages

140
Q

lyme disease investigation

A

Serology
CSF lymphocytosis
MRI
nerve conduction studies/ EMG

141
Q

lyme disease treatment

A

Prolonged antibiotic treatment
I.V. ceftriaxone
oral doxycycline

142
Q

neurosyphilis signs

A

Staged
years decades latency

vision problems

143
Q

neurosyphilis symptoms

A

Nausea, vomiting

stiff neck, headache, mood swings, weakness, early onset dementia

144
Q

neurosyphilis investigations

A

Treponema
non-treponemal specific antibody tests
CSF lymphocytes increased

145
Q

neurosyphilis treatment

A

high dose penicillin

146
Q

CJD signs

A

Insidious onset >60
myoclonus
motor abnormalities
cortical blindness

147
Q

CJD symptoms

A

Rapid progressive dementia
behavioural abnormalities
seizures

148
Q

CJD investigations

A

EEG MRI CSF

149
Q

CJD treatment

A

Full time care
pain meds
anti-seizure medication and muscle relaxers

150
Q

Age related macular degeneration signs

A

Distortion on amsler chart
drusen
Pigment epithelial changes

151
Q

Age related macular degeneration symptoms

A

Progressive loss of central vision

distortion

152
Q

Age related macular degeneration investigations

A

OCT

fluorescein angiography

153
Q

Age related macular degeneration treatment

A

Low vision aids dry

wet- intravitreal anti VEGF
low vision aids

154
Q

diabetic retinopathy signs

A

Microaneurysm
retinal haemorrhages and exudate
neovascularisation

155
Q

diabetic retinopathy investigations

A

Flurescein angiography

OCT

156
Q

diabetic retinopathy treatment

A

Laser
low vision aids
intravitreal anti VEGF

157
Q

MS signs

A

Variable and severity in a series of relapses

158
Q

MS progressive signs

A

sensory, fatigue, temperature, stiffness, spasms, slurred speech, swallowing, bladder, bowel, cognitive, oscillopsia, diplopia, visiual loss (older

159
Q

MS relapses signs and symptoms

A

optic neuritis, sensory, weakness, diplopia, vertigo, ataxia, bladder
CN involvement, nystagmus, UMN

afferent pupillary defect, plantars extensor, hyperreflexia

160
Q

MRI criteria and additional investigations for MS

A

MRI

Macdonald criteria
Posers criteria

CSF oligoclonal bands
Visual/somatosensory response
bloods
CXR

161
Q

MS diagnosis

A

lesions on MRI

162
Q

MS relapse treatment

A

relapse; oral prednisolone, rehab

163
Q

MS disease modifying treatment

A

injections B interferons, glatiramer acetate, oral dimethyl fumarate

164
Q

MS symptom modifying treatment

A

antispasmodics

physio, amitriptyline, gabapentin, anticholinergic, laxatives, sildenafil, CBT, carbamazepine

165
Q

MS inflammation treatment

A

immunosuppression

166
Q

muscle disease signs

A

Atrophy, reduced tone + reflexes
no sensory
Motor weakness

167
Q

muscle disease symptoms

A

Weakness, SOB, poor swallow, cardiomyopathy, cramp, pain, stiffness

168
Q

muscle disease investigations

A

Creatine kinase
EMG
biopsy
genetic testing

169
Q

myasthenia gravis symptoms

A 
Fatigable weakness 
SOB
diplopia
ptosis
difficult chewing
170
Q

myasthenia gravis treatment

A 
Symptomatic; AChesterase inhibitor
prednisolone
steroid
immunoglobulin
Thymectomy
171
Q

myasthenia gravis investigations

A

AChR ab
Anti MuSK ab
neurophysiology
CT

172
Q

generalised peripheral neuropathy signs

A

Nerve root; myotomal wasting, weakness, reflex + dermatomal change
individual nerve
general – distal moving proximal

173
Q

generalised peripheral neuropathy investigations

A 
Blood tests
genetic
nerve conduction 
CSF
biopsy
174
Q

generalised peripheral neuropathy treatment

A 
Pain relief
anti-seizure medication
topic treatments
anti-depressants 
transcutaneous nerve stimulation
plasma exchange
physio
175
Q

motor neurone disease signs

A

UMN + LMN
no sensory involvement
cognitive decline

176
Q

motor neurone disease investigation

A

EMG

177
Q

motor neurone disease treatment

A

Supportive
PEG
riluzole
palliative care

178
Q

acoustic neuroma signs

A

unilateral deafness

179
Q

acoustic neuroma symptoms

A

impaired facial sensation

balance problems

180
Q

acoustic neuroma investigations

A

Audiology

MRI

181
Q

acoustic neuroma treatment

A

Microsurgery

stereotactic radiosurgery

182
Q

normal pressure hydrocephalus signs and symptoms

A

> 60
Dementia
gait disturbance
urinary incontinence

183
Q

normal pressure hydrocephalus investigations

A

MRI
CT
lumbar puncture
intraventricular pressure monitoring

184
Q

normal pressure hydrocephalus treatment

A

Carbonic anhydrase inhibitors
repeated lumbar puncture
CSF shunt

185
Q

idiopathic intracranial hypertension

A

Headaches and visual disturbance

186
Q

idiopathic intracranial hypertension sign

A

young obese female

187
Q

idiopathic intracranial hypertension investigation

A

Fundoscopy
visual field screening
CT MRI
lumbar puncture

188
Q

idiopathic intracranial treatment

A

Lose weight
Acetazolamide
CSF diversion
optic nerve sheath fenestration

189
Q

extra dural haemorrhage sign

A

concave/convex on CT

190
Q

extradural/subdrual haemorrhage treatment

A

Craniotomy
laminectomy
epidural drain

191
Q

subdural haemorrhage sign

A

convex ellipse on CT

192
Q

diffuse traumatic axonal injury signs and symptoms

A 
Headache
dizzy
sleeping
nausea
fatigue
comatose
193
Q

diffuse traumatic axonal injury diagnosis

A

microscopy

194
Q

diffuse traumatic axonal injury treatment

A

Steroids
Rehabilitation and support
speech, physical and recreational therapy

195
Q

locked in syndrome symptoms

A

Total paralysis below level of third nerve nuclei

196
Q

locked in syndrome sign/diagnosis

A

Recognising patient can open eye voluntarily and signal numerically

197
Q

coma investigations no focal/menigism

A

No meningism/focal – toxicology, bloods, hepatic/renal, acid base, ABG, B.P. CO poisoning.

198
Q

coma investigations menigism

A

meningism; CT, lumbar

199
Q

coma investigation focal

A

CT, MRI, lumbar, metabolic screen, EEG

200
Q

coma treatment

A 
Skin care
bladder/bowel function
control of seizures
DVT prophylaxis
prevention of contractures
peptic ulceration prevention

neurology (6 decks)

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