Conditions Summary Flashcards
20yo female
unilateral headache with nausea, aura and photophobia
once per month
lasts 4-72 hours
migraine
migraine management (acute and prophylaxis)
acute - NSAIDs, triptans
prophylaxis - reduce triggers, propanolol, topiramide, gabapentin
bilateral headache
no nausea/vomiting/visual loss/photophobia
mild/moderate
feels like a band squeezing round head
tension headache (completely normal)
tension headache treatment (3)
relaxation
beta blockers
antidepressants
theyre fine so nothing major, just symptomatic
young male unilateral headache eye lid oedema ptosis lasts 45-90mins, 1-8 times per day
cluster headache (type of trigeminal autonomic cephalgia)
cluster headaches (acute and prophylaxis)
acute - oxygen and SC sumastriptan
prophylaxis - verapamil
60yo women unilateral headache miosis tearing nasal stuffiness lasts 10-30mins, 1-40 times per day
paroxysmal hemicrania (type of trigeminal autonomic cephalgia)
paroxysmal hemicrania (type of trigeminal autonomic cephalgia)
indomethicin
obese female
vision loss
headache worse in morning
nausea and vomiting
idiopathic intracranial hypertension
idiopathic intracranial hypertension treatment (3)
weight loss
acetazolamide
diuretics
elderly women
severe unilateral stabbing pain in face
<90secs, 1-100 times per day
triggers - chewing, touch face
trigeminal neuralgia
trigeminal neuralgia treatment
drugs (eg carbamazepine)
ablation
surgical decompression
raccoon/panda eyes after head trauma
anterior cranial fossa fracture
battle sign over mastoid process after head trauma
middle cranial fossa fracture
haemorrhagic stroke treatment
acute - surgery
long term - nothing, treat hypertension (if cause)
cardioembolic infarct stroke treatment
acute - thrombolysis and aspirin ASAP
long term - rivaroxaban (NOACs to decrease fibrin clot risk)
atheroembolic/small vessel disease stroke treatment
acute - thrombolysis and aspirin ASAP
long term - clopidogrel (anti platelet to decrease platelet clot formation)
sporting injury causing head trauma
middle meningeal artery haemorrhaged
CT - convex lens shapes bleed
extradural hameorrhage
extradural haemorrhage treatment
surgery - to remove blood
elderly/alcoholic falls over
slow onset confusion
cerebral bridging veins rupture
CT - crescent shaped bleed
subdural haemorrhage
subdural hemorrhage treatment
surgery - to remove blood
1 hour thunderclap headache neck stiffness vomiting photophobia lumbar puncture - with yellow CSF
subarachnoid haemorrhage (with meningitis symptoms)
subarachnoid haemorrhage treatment
symptomatic
surgery - coil/clip
don’t need to remove blood bc will get reabsorbed into CSF
20yo seizure after night out
tongue biting
urinary incontinence
primary generalized epilepsy
65yo loss of auditory sensation last secs-mins
focal sensory seizures
treatment of primary generalized seizure
sodium valproate - teratogenic
lamotrigine
NOT carbamazepine
treatment of focal seizures/secondary generalized epilepsy
carbamazepine
lamotrigine
sodium valproate
acute treatment of epileptic seizure (status epilepticus)
benzodiazepines (anticonvulsants)
4mg IV lorazepam
10ml x 2 buccal midalozam
10mg PR diazepam
seizure with normal EEG
non epileptic attack disorder
treatment of non epileptic attack disorder
NOT anti convulsant (benzodiazepines)
treat cause - CBT, counselling
broad based gait nystagmus slurred speech weight loss headache worse on coughing
cerebellar tumour
seizure memory problems headaches with vomiting problems understanding questions weight loss
temporal lobe tumour
brain tumour treatment
surgery +/- radio +/- chemo (temozolomide (TMZ))
personality changes
hemiparesis
problems saying sentences coherently
frontal lobe tumour
headache worse with coughing hemisensory loss problems with maths R/L confusion dysgraphia
parietal lobe tumour
gertmanns syndrome - problems with maths, problems with writing (dysgraphia), R/L confusion
visual hallucinations
weight loss
headache with vomiting
occipital lobe tumour
headache worse with coughing
raised ICP
potentially tumour, haemorrhage etc
child
tiptoeing gait
headache with vomiting
astrocytoma in kid
couple months ago was fine elderly person dementia shuffling gait urinary incontinence
normal pressure hydrocephalus
normal pressure hydrocephalus treatment
ventriculoperitoneal shunt - will defos improve gait, poss improve dementia
young obese women
headaches worse in morning and when sneezing
presents like a tumour but nothing on MRI
idiopathic benign intracranial hypertension
idiopathic benign intracranial hypertension treatment
lose weight!
acetazolamide
diuretics
shunt
loss of temperature and arm pain sensation back stiffness horners syndrome hyperhidrosis headache
recent spine trauma
syringomyelia
syringomyelia treatment
surgical decompression
child with large head
shiny forehead with visible veins
sunsetting of eyes
failure to thrive
aqueductal stenosis (or other congenital cause of hydrocephalus)
aqueductal stenosis
shunt (as it causes hydrocephalus)
non blanching rash photophobia neck stiffness headache fever seizure cochlear implant fast onset
with purple dots in pairs on histology
strep pneumonia causing meningitis
65yo non blanching rash photophobia neck stiffness headache fever seizure fast onset
with purple rods on histology
listeria monocytogenes causing meningitis
non blanching rash photophobia neck stiffness headache fever seizure child fast onset
with GM-ve rods on histology
haem influenzae causing meningitis
non blanching rash photophobia neck stiffness headache fever seizure student fast onset
with pink intracellular whisps on histology
Neisseria meningococcus causing meningitis
slow onset photophobia neck stiffness headache fever seizure recent foreign travel
aseptic (non bacterial) meningitis
meningitis treatment
ABCDE ceftriaxone and dexamethasone ASAP
change antibiotics when cultures back
amoxicillin for listeria (immunocompromised)
acyclovir for viral
prophylaxis treatment for contacts - ciprofloxacin
encephalitis treatment
acyclovir
brain abscess treatment
ceftriaxone IV and metronidazole IV
women in 30s unilateral optic neuritis fatigue sensory loss moor weakness and spasticity urinary tract dysfunction worse in heat
multiple sclerosis
Uhthoff phenomenon = worse in heat eg shower, exercise
multiple sclerosis acute exacerbation treatment
PO steroids
multiple sclerosis disease modifying drugs
interferon beta
monoclonal antibody
mitoxantrane
forgetfulness
behavior change
nucleus basalis atrophy occurs first
alzheimers dementia
alzheimers dementia treatment
rivastigmine
smoker 65yo PMH stroke sudden onset memory loss depression
vascular dementia
vascular dementia treatment
treat CVD risk - antihypertensives
NOT rivastigmine
80yo 1 year memory loss
recurrent hallucinations of children
now shuffling gait and falls
lewy body dementia
NOTE not parkinsons dementia bc dementia was present first)
lewy body dementia investigation and treatment
investigation - DaT scan to differentiate form parkinsons
treatment - levodopa
55yo with MND
personality change
memory loss
compulsive behavior
frontotemporal lobe dementia
treatment of frontotemporal lobe dementia
nothing
symptomatic
80yo resting tremor shuffling gait cogwheel rigidity depression no memory loss
parkinsons (with no lewy body dementia)
parkinsons treatment
levodopa
40yo autosomal dominant emotional disturbance - depression motor disturbance - chorea cognitive disturbance
huntingtons disease
huntingtons treatment
nothing
symptomatic
babinskis sign
increased tone and muscle wasting (lol)
no sensory loss
no eye involvement
motor neurone disease
bc UMn and LMN signs = amyotrophic lateral sclerosis
babinskis sign = UMN lesion
treatment of motor neurone disease (MND)
nothing
symptomatic
post spine trauma
ipsilateral fine touch and paralysis
contralateral pain and temp loss
brown sequards syndrome
post syringomyelia cape distribution pain and temp loss upper limb weakness no fine touch loss no lower limbs problems
central cord syndrome
diarrhea
pain
progressive paraplegia (lower limb paralysis)
guilliane barre syndrome
post infectious (hence diarrhea) demyelination
30yo female (or 70yo male) autoimmune PMH diplopia ptosis bilateral facial weakness proximal muscle weakness worse as day goes on anti-ACh antibodies
what cancer is associated with this
myasthenia gravis
thymoma
muscle weakness better after exercise
autoimmune PMH, no anti-ACh antibodies
what cancer is associated with this
lambert eaton
lung small cell carcinoma
post food poisoning toxin inhibiting ACh release
causes paralysis
botulism (from botulinum toxin)
young boy
stands up by pushing on knees (what is this called)
woody calves
duhcenne muscular dystrophy
gowers sign
young boy
woody calves, can stand up fine
will live til 40
beckers muscular dystrophy
young boy
muscle weakness
hatchet like face
myotonic dystrophy
