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J Neuro > Conditions Summary > Flashcards

Conditions Summary Flashcards

1
Q

20yo female
unilateral headache with nausea, aura and photophobia
once per month
lasts 4-72 hours

A

migraine

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2
Q

migraine management (acute and prophylaxis)

A

acute - NSAIDs, triptans

prophylaxis - reduce triggers, propanolol, topiramide, gabapentin

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3
Q

bilateral headache
no nausea/vomiting/visual loss/photophobia
mild/moderate
feels like a band squeezing round head

A

tension headache (completely normal)

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4
Q

tension headache treatment (3)

A

relaxation
beta blockers
antidepressants

theyre fine so nothing major, just symptomatic

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5
Q 
young male
unilateral headache
eye lid oedema
ptosis 
lasts 45-90mins, 1-8 times per day
A

cluster headache (type of trigeminal autonomic cephalgia)

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6
Q

cluster headaches (acute and prophylaxis)

A

acute - oxygen and SC sumastriptan

prophylaxis - verapamil

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7
Q 
60yo women 
unilateral headache 
miosis 
tearing
nasal stuffiness 
lasts 10-30mins, 1-40 times per day
A

paroxysmal hemicrania (type of trigeminal autonomic cephalgia)

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8
Q

paroxysmal hemicrania (type of trigeminal autonomic cephalgia)

A

indomethicin

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9
Q

obese female
vision loss
headache worse in morning
nausea and vomiting

A

idiopathic intracranial hypertension

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10
Q

idiopathic intracranial hypertension treatment (3)

A

weight loss
acetazolamide
diuretics

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11
Q

elderly women
severe unilateral stabbing pain in face
<90secs, 1-100 times per day
triggers - chewing, touch face

A

trigeminal neuralgia

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12
Q

trigeminal neuralgia treatment

A

drugs (eg carbamazepine)
ablation
surgical decompression

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13
Q

raccoon/panda eyes after head trauma

A

anterior cranial fossa fracture

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14
Q

battle sign over mastoid process after head trauma

A

middle cranial fossa fracture

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15
Q

haemorrhagic stroke treatment

A

acute - surgery

long term - nothing, treat hypertension (if cause)

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16
Q

cardioembolic infarct stroke treatment

A

acute - thrombolysis and aspirin ASAP

long term - rivaroxaban (NOACs to decrease fibrin clot risk)

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17
Q

atheroembolic/small vessel disease stroke treatment

A

acute - thrombolysis and aspirin ASAP

long term - clopidogrel (anti platelet to decrease platelet clot formation)

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18
Q

sporting injury causing head trauma
middle meningeal artery haemorrhaged
CT - convex lens shapes bleed

A

extradural hameorrhage

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19
Q

extradural haemorrhage treatment

A

surgery - to remove blood

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20
Q

elderly/alcoholic falls over
slow onset confusion
cerebral bridging veins rupture
CT - crescent shaped bleed

A

subdural haemorrhage

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21
Q

subdural hemorrhage treatment

A

surgery - to remove blood

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22
Q 
1 hour thunderclap headache 
neck stiffness 
vomiting 
photophobia 
lumbar puncture - with yellow CSF
A

subarachnoid haemorrhage (with meningitis symptoms)

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23
Q

subarachnoid haemorrhage treatment

A

symptomatic
surgery - coil/clip
don’t need to remove blood bc will get reabsorbed into CSF

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24
Q

20yo seizure after night out
tongue biting
urinary incontinence

A

primary generalized epilepsy

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25
Q

65yo loss of auditory sensation last secs-mins

A

focal sensory seizures

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26
Q

treatment of primary generalized seizure

A

sodium valproate - teratogenic
lamotrigine
NOT carbamazepine

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27
Q

treatment of focal seizures/secondary generalized epilepsy

A

carbamazepine
lamotrigine
sodium valproate

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28
Q

acute treatment of epileptic seizure (status epilepticus)

A

benzodiazepines (anticonvulsants)

4mg IV lorazepam
10ml x 2 buccal midalozam
10mg PR diazepam

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29
Q

seizure with normal EEG

A

non epileptic attack disorder

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30
Q

treatment of non epileptic attack disorder

A

NOT anti convulsant (benzodiazepines)

treat cause - CBT, counselling

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31
Q 
broad based gait 
nystagmus 
slurred speech 
weight loss 
headache worse on coughing
A

cerebellar tumour

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32
Q 
seizure
memory problems 
headaches with vomiting 
problems understanding questions
weight loss
A

temporal lobe tumour

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33
Q

brain tumour treatment

A

surgery +/- radio +/- chemo (temozolomide (TMZ))

34
Q

personality changes
hemiparesis
problems saying sentences coherently

A

frontal lobe tumour

35
Q 
headache worse with coughing 
hemisensory loss 
problems with maths
R/L confusion 
dysgraphia
A

parietal lobe tumour

gertmanns syndrome - problems with maths, problems with writing (dysgraphia), R/L confusion

36
Q

visual hallucinations
weight loss
headache with vomiting

A

occipital lobe tumour

37
Q

headache worse with coughing

A

raised ICP

potentially tumour, haemorrhage etc

38
Q

child
tiptoeing gait
headache with vomiting

A

astrocytoma in kid

39
Q 
couple months ago was fine 
elderly person 
dementia 
shuffling gait 
urinary incontinence
A

normal pressure hydrocephalus

40
Q

normal pressure hydrocephalus treatment

A

ventriculoperitoneal shunt - will defos improve gait, poss improve dementia

41
Q

young obese women
headaches worse in morning and when sneezing
presents like a tumour but nothing on MRI

A

idiopathic benign intracranial hypertension

42
Q

idiopathic benign intracranial hypertension treatment

A

lose weight!
acetazolamide
diuretics
shunt

43
Q 
loss of temperature and arm pain sensation
back stiffness 
horners syndrome 
hyperhidrosis 
headache

recent spine trauma

A

syringomyelia

44
Q

syringomyelia treatment

A

surgical decompression

45
Q

child with large head
shiny forehead with visible veins
sunsetting of eyes
failure to thrive

A

aqueductal stenosis (or other congenital cause of hydrocephalus)

46
Q

aqueductal stenosis

A

shunt (as it causes hydrocephalus)

47
Q 
non blanching rash 
photophobia 
neck stiffness 
headache 
fever 
seizure 
cochlear implant
fast onset

with purple dots in pairs on histology

A

strep pneumonia causing meningitis

48
Q 
65yo 
non blanching rash 
photophobia 
neck stiffness 
headache 
fever 
seizure 
fast onset

with purple rods on histology

A

listeria monocytogenes causing meningitis

49
Q 
non blanching rash 
photophobia 
neck stiffness 
headache 
fever 
seizure 
child
fast onset

with GM-ve rods on histology

A

haem influenzae causing meningitis

50
Q 
non blanching rash 
photophobia 
neck stiffness 
headache 
fever 
seizure 
student 
fast onset

with pink intracellular whisps on histology

A

Neisseria meningococcus causing meningitis

51
Q 
slow onset 
photophobia 
neck stiffness 
headache 
fever 
seizure 
recent foreign travel
A

aseptic (non bacterial) meningitis

52
Q

meningitis treatment

A

ABCDE ceftriaxone and dexamethasone ASAP
change antibiotics when cultures back
amoxicillin for listeria (immunocompromised)
acyclovir for viral

prophylaxis treatment for contacts - ciprofloxacin

53
Q

encephalitis treatment

A

acyclovir

54
Q

brain abscess treatment

A

ceftriaxone IV and metronidazole IV

55
Q 
women in 30s
unilateral optic neuritis 
fatigue 
sensory loss 
moor weakness and spasticity 
urinary tract dysfunction 
worse in heat
A

multiple sclerosis

Uhthoff phenomenon = worse in heat eg shower, exercise

56
Q

multiple sclerosis acute exacerbation treatment

A

PO steroids

57
Q

multiple sclerosis disease modifying drugs

A

interferon beta
monoclonal antibody
mitoxantrane

58
Q

forgetfulness
behavior change
nucleus basalis atrophy occurs first

A

alzheimers dementia

59
Q

alzheimers dementia treatment

A

rivastigmine

60
Q 
smoker 
65yo
PMH stroke 
sudden onset memory loss 
depression
A

vascular dementia

61
Q

vascular dementia treatment

A

treat CVD risk - antihypertensives

NOT rivastigmine

62
Q

80yo 1 year memory loss
recurrent hallucinations of children
now shuffling gait and falls

A

lewy body dementia

NOTE not parkinsons dementia bc dementia was present first)

63
Q

lewy body dementia investigation and treatment

A

investigation - DaT scan to differentiate form parkinsons

treatment - levodopa

64
Q

55yo with MND
personality change
memory loss
compulsive behavior

A

frontotemporal lobe dementia

65
Q

treatment of frontotemporal lobe dementia

A

nothing

symptomatic

66
Q 
80yo 
resting tremor
shuffling gait 
cogwheel rigidity
depression
no memory loss
A

parkinsons (with no lewy body dementia)

67
Q

parkinsons treatment

A

levodopa

68
Q 
40yo 
autosomal dominant 
emotional disturbance - depression 
motor disturbance - chorea 
cognitive disturbance
A

huntingtons disease

69
Q

huntingtons treatment

A

nothing

symptomatic

70
Q

babinskis sign
increased tone and muscle wasting (lol)
no sensory loss
no eye involvement

A

motor neurone disease

bc UMn and LMN signs = amyotrophic lateral sclerosis
babinskis sign = UMN lesion

71
Q

treatment of motor neurone disease (MND)

A

nothing

symptomatic

72
Q

post spine trauma
ipsilateral fine touch and paralysis
contralateral pain and temp loss

A

brown sequards syndrome

73
Q 
post syringomyelia 
cape distribution pain and temp loss 
upper limb weakness 
no fine touch loss 
no lower limbs problems
A

central cord syndrome

74
Q

diarrhea
pain
progressive paraplegia (lower limb paralysis)

A

guilliane barre syndrome

post infectious (hence diarrhea) demyelination

75
Q 
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

A

myasthenia gravis

thymoma

76
Q

muscle weakness better after exercise
autoimmune PMH, no anti-ACh antibodies

what cancer is associated with this

A

lambert eaton

lung small cell carcinoma

77
Q

post food poisoning toxin inhibiting ACh release

causes paralysis

A

botulism (from botulinum toxin)

78
Q

young boy
stands up by pushing on knees (what is this called)
woody calves

A

duhcenne muscular dystrophy

gowers sign

79
Q

young boy
woody calves, can stand up fine

will live til 40

A

beckers muscular dystrophy

80
Q

young boy
muscle weakness
hatchet like face

A

myotonic dystrophy

J Neuro (32 decks)

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