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Neuro > Green - 1 > Flashcards

Green - 1 Flashcards

1
Q

bells palsy: UMN or LMN

A

LMN

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2
Q

bels palsy nerve

A

CN7

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3
Q

what is ramsay-hunt syndrome

A

varicella voster facial palsy

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4
Q

UMN lesion & facial palsy

A

forehead spared = TIA/stroke/MS

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5
Q

bels palsy & forehead

A

forehead spared (LMN)

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6
Q

symptoms of brown-squad syndrome

A
  • ipsilateral spastic paraparesis

- contralateral pain/temp loss and no platter reflex

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7
Q

Ramsay hunt treatment

A

prenisolone

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8
Q

drug that often leads to delirium

A

anticholinergics

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9
Q

Delirium treatment

A

treat cause, dark quiet side room, haloperidol/lorazapam/antipsychitics if required

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10
Q

MMSE score for dementia

A

<24/30

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11
Q

alzheimers treatment (non severe)

A

donepezil

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12
Q

severe alzheimers treatment

A

memantine

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13
Q

fluctuating confusion, parkinsonism and hallucinations

A

lewy body dementia

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14
Q

drugs to avoid in lewy body

A

anti-psychotics and anti parkinsonian

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15
Q

treatment for lewy body

A

ACE - rivastigmine

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16
Q

generalised seizure treatment

A

sodium valproate

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17
Q

what typeof seizure must you Not give carbamazepine

A

absence

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18
Q

focal seizure treatment

A

carbamazepine

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19
Q

driving and seizures: first seizure

A

6 months off

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20
Q

driving and seizures: epilepsy

A

1 year off that must be seizure free

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21
Q

folic acid and sodium valproate

A

5mg folic acid when trying to conceive

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22
Q

problem when starting anti epileptic drugs

A

increased risk of suicidal thoughts

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23
Q

risk that needs to be explained to those with epilepsy

A

sudden unexplained death in epilepsy

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24
Q

essential tremor treatment

A

propanolol

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25
Q

what condition might you SIADH in

A

Guillain-Barre

hyponatremia: not due to low sodium but due to it being diluted in high plasma volume

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26
Q

Guillain-Barre treatment

A

IV immunoglobulin/plasma exchange/methylprednisolone

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27
Q

complication of Guillain-Barre

A

respiratory failure

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28
Q

Guillain-Barre investigations might show what

A

nerve conduction studies show demyelination

  • SIADH
  • high CSF protein
  • ECG (blocks)
  • spirometry changes
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29
Q

severe pulsatile unilateral headache

A

migraine

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30
Q

who don’t you give sumatriptan to

A

if cardiovascular risk

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31
Q

Migraine risk

A

ischaemic stroke

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32
Q

acute migraine treatment

A

aspirin and sumatriptan

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33
Q

migraine prophylaxis

A

atenolol

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34
Q

acute cluster headache treatment

A

oxygen, sumatriptan

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35
Q

cluster headache prophylaxis

A

verapamil

36
Q

fat bitches get this

A

benign intracranial hypertension

37
Q

triad for horners

A

ptosis
miosis
anhidrosis

38
Q

what is ptosis

A

droopy eye lid

39
Q

what is miosis

A

constricted pupil

40
Q

Horners: total upper anhidrosis suggests what pathology

A

central lesion: stroke, MS, CNS tumour, encephalitis

41
Q

Horners: facial anhidrosis suggests what pathology

A

pre-ganglionic: pan coast tumour (gastric cancer)

42
Q

Horners: no anhidrosis suggests what pathology

A

post-ganglionic - carotid aneurism/disection , cluster headache

43
Q

hunting tons genetics

A

autosomal dominant

CAG repeats > 40

44
Q

MRI brain: large front horns of lateral ventricles

A

Horners

45
Q

what is hydrocephalus

A

excess CSF production: can be communicating (venous blockage/high CSF production) or non-communicating (obstructive)

46
Q

shuffling gait, urinary incontinence, dementia

A

normal pressure hydrocephalus

47
Q

layers of dura from most outer inwards

A

dure => arachnoid => pia

48
Q

what bleeds in extra dural

A

middle meningeal artery

49
Q

extra dural shape on CT

A

convex (egg shaped)

50
Q

extra dural/subdural treatment

A

conservative or burr hole/surgery is large

51
Q

what bleeds in subdural

A

communicating veins

52
Q

who gets subdural

A

old/alchy - brain atrophy

acceleration/deceleration injury

53
Q

subdural on CT

A

concave (slim, flat)

54
Q

sub dural deterioration pattern

A

slow

55
Q

extradural deterioration

A

traume > LOC > lucid period > deterioration

56
Q

thunderclap headache

A

subarachnoid

57
Q

subarachnoid haemorrhage management

A

CCB: nimodipine to reduces vasospasm/ischaemia. surgery required

58
Q

mixed UMN/LMN signs

A

motor neurone disease

59
Q

fasciculations think what diagnosis

A

Motor neurone disease

60
Q

MRI: lesions disseminated in place and time

A

MS

61
Q

what type of immune cell drives MS

A

T cells

62
Q

normal first presentation of MS

A

optic neuritis or horners

63
Q

what is optic neuritis

A

deyelinaton of optic nerve: sudden loss of vision (partial or complete), sudden blurred or “foggy” vision, and pain on movement

64
Q

acute MS treatment

A

methylprednisolone, interferon beta

65
Q

what is myasthenia gravis

A

anti-ACh-receptor antibodies that causes muscle fatiguability

66
Q

Myasthenia gravis treatment

A

pyridostigmine or prenisolone of severe

67
Q

what is myasthenia gravis associated with

A

thymoma

68
Q

myasthenia gravis symptoms

A

diplopia/ptosis, proximal muscle weakness, dysphagia, fatigue that worsens with activity and improves with rest

69
Q

myasthenia gravis investigations

A

anti-AChR antibodies or anti-SM Ab

70
Q

what is radiculopathy

A

damage to sets of nerves at nerve root

71
Q

parkinsons triad

A

resting tremor, rigidity, bradkinesia

72
Q

part of brain is affected in parkinson

A

substantia nigra

73
Q

rule for parkinson treatment

A

avoid giving L-dopa as long as possible

74
Q

what is dyskinesia

A

involuntary muscle movements

75
Q

L-dopa side effects

A

dyskinesia and postural hypotension

76
Q

location of stroke: hemiplegia, sensory loss, homonymous hemianopia, dysphagia

A

Cerebral hemisphere

77
Q

location of stroke: quadriplegia, visual disturbance, locked-in syndrome

A

brainstem

78
Q

location of stroke: isolated deficiency, intact consciousness

A

lacunar infarct

79
Q

stroke investigations

A

CT, ECG/eco looking for AF, carotid doppler, lipid screen

80
Q

stroke management

A

300mg aspirin if CT confirms ischaemic (continued for 2 weeks) and life long clopidogrel and statin

81
Q

ABCD2

A

age > 60, BP > 140/90, clinical feature, duration >1hr, diabetes

82
Q

time frame for thrombolysis on ishchaemic stroke

A

4.5 hours of onset

83
Q

types of thrombolysis given on stroke

A

alteplase or tPA

84
Q

follow up treatment if carotid found to have disease during investigations after stroke/TIA

A

carotid endarterectomy (clearing out of shit) - stand if occlusion > 70%

85
Q

what causes stroke in young people

A

carotid artery dissection

Neuro (20 decks)

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