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Year 5 > MLA Neurology > Flashcards

MLA Neurology Flashcards

1
Q

What’s an acoustic neuroma?

A

Benign, slow-growing tumours on the vestibular nerve

Symptoms: hearing loss, tinnitus, balance, facial numbness, eye irritation, headaches, confusion

Treatment: surgery or stereotactic radiation

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2
Q

What’s the most common cause of brain abscess?

A

Fungal or bacterial infection that spread through blood

Risks: weakened immune system, chronic disease, corticosteroids, chemotherapy, congenital heart disease, head and neck infections

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3
Q

How does a congenital heart disease contribute to a brain abscess?

A

Eg. left to right shunt

It allows unfiltered blood to get into the brain

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4
Q

How is chronic fatigue syndrome managed?

A
  • Don’t overexert, take rest
  • Balanced diet
  • Vitamin supplements
  • Offer CBT and antidepressants
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5
Q

What are some different types of diabetes neuropathy?

A
  • Peripheral
  • Autonomic: issues with BP, bladder, impotence, sweat glands, heart
  • Focal: single nerve damage. Carpel tunnel is most common
  • Proximal: affects nerve in hip, buttock, or thigh. Very rare, and usually one-sided
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6
Q

What are the different types of epilepsy?

A
  • Generalised
    Eg. tonic-clonic (grand mal), absence (petite mal), atonic (drop attacks), myoclonic
  • Focal
    Eg. focal aware, impaired awareness, bilateral tonic-clonic, parietal lobe, occipital lobe
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7
Q

How in Meniere’s disease diagnosed?

A

Criteria:
- 2+ episodes of vertigo lasting 20min-12 hours
- Hearing issues like tinnitus or fullness feeling
- Balance related issues

MRI/CT would be done to rule out other diseases and electrocochleography to measure electrical activity in the ear

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8
Q

What is Meniere’s disease?

A

Ear disease causing vertigo, nausea, vomiting, tinnitus, hearing loss, balance issues, headaches Caused by endolymphatic fluid build up
- Has autoimmune component

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9
Q

What is the treatment for Meniere’s disease?

A
  • Symptomatic treatment for vertigo and nausea
  • Limiting salt intake
  • Corticosteroid injections

No cure. Gentamycin injection will permanently damage the ear to top symptoms

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10
Q

What is the neurological involvement in malaria?

A

Occurs in severe malaria usually by plasmodium falciparum

Cerebral malaria presents as: coma, impaired consciousness, seizures. Causes long-term neurocognitive impairments

Post-malaria neurological syndromes:
- Acute disseminated encephalopathy
- Delayed cerebellar syndrome
- Acute idiopathic demyelinating polyneuropathy

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11
Q

What are the different types of motor neurone disease?

A
  • Amyotrophic lateral sclerosis (ALS) (most common). Affects upper and lower motor neurons and causes weakness, stiffness, and overactive reflexes.
  • Progressive bulbar palsy (PBP). Affects upper and lower neurons, but speech and swallowing muscles are affected first. Starts as speech changes and slurring
  • Spinal muscular atrophy (SMA)
  • Kennedy’s disease (AKA X-linked spinobulbar muscular atrophy (SBMA). Causes muscle cramps and twitches, weakness in the face, arms, and legs, and difficulty swallowing and speaking.

-Hereditary spastic paraparesis (HSP)

  • Post-polio syndrome (PPS)
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12
Q

What are the different motor neurones?

A

Upper: originate in brain and travel to brain stem

Lower: Begin at spinal cord and travel to muscles

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13
Q

What are the symptoms of upper vs lower MND?

A

Upper: Muscle weakness, atrophy, fasciculations

Lower: Muscle stiffness, overactive reflexes, slow movements

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14
Q

What is the difference between a T1 and T2 contrast MRI?

A

T1: fat appears bright
- Used to identify tumours, injuries, developmental issues

T2: water appears bright
- Used to identify swelling, infarcts, MS

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15
Q

What are the different types of MS?

A

Relapsing remitting MS (most common)
- Symptoms flare up but then go away
- Over time, it develops into secondary progressive MS.

Secondary progressive MS
- Symptoms are present all the time and slowly worsen

Primary progressive MS (least common)
- Symptoms slowly worsen over time and there are no periods of remission

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16
Q

How might MS initially present?

A

Visual:
- Blurred/double vision
- Loss of vision
- Painful eye movements

Movement:
- Unsteadiness or weakness

Sensation:
- Tingling, numbness, altered sensation

Other: fatigue, depression, sexual dysfunction, bladder/bowel dysfunction

17
Q

What is the pathophysiology of MS?

A

Autoimmune demyelination

Lesions occur when the astrocytes have attempted to heal, producing glial scars (gliosis)

18
Q

What is the pathophysiology of Parkinson’s disease?

A

Neurodegenerations caused by loss of dopaminergic cells is the substantia nigra causing a reduction in direct pathways and therefore a restrictive action of movement (rigidity)

19
Q

What are the Braak stages?

A

Post-mortum staging to classify the degree of pathology in Parkinson’s and Alzheimer’s disease

20
Q

What is the clinical presentation of Parkinson’s disease?

A

-Motor: slowness, stiffness, unilateral tremor
-Autonomic: constipation, hypersalivation, urinary dysfunction, sexual dysfunction
-Cognitive: low mood, anxiety
-Other: sleep disturbance, anosmia

Reported by family: cognitive decline, REM sleep disorder, small handwriting

21
Q

How is Parkinson’s disease diagnosed?

A
  • Lab investigation to rule out other causes
  • Dopamine active transported (DaT) scan is definitive, but reserved only when diagnosis is uncertain because it’s expensive
22
Q

What is the medical management of Parkinson’s disease?

A

(Replace dopamine or stope dopamine breakdown)

1st line: Levodopa
- MOA-B inhibitors (Selegiline) block dopamine breakdown
- Dopamine agonists (Ropinirole) stimulate dopamine receptors
- COMT inhibitors (entacapone) decrease dopamine breakdown

23
Q

What are the key prescribing facts to pass on for Parkinson’s?

A
  • Time-sensitive meds: if late or missed, there will be ‘freezing’ (akinesia)
  • Neuroleptic malignant syndrome is suddenly stopped
  • Response deteriorates over time but higher doses have more side effects
24
Q

What are some complications of Parkinson’s disease?

A
  • Lewy Body dementia
  • Parkinson’s dementia
  • Hallucinations leading to paranoia
  • Aspiration pneumonia (end-stage)
25
Q

What are some different peripheral nerve palsies?

A
  • Carpel tunnel syndrome (median nerve)
  • Ulnar nerve palsy
  • Peroneal nerve palsy: decreased sensation in lower leg, foot drop, slapping gait, muscle loss
  • Sciatic nerve
  • Spinal accessory nerve injury: causes scapular winging and atrophy of trapezius muscle
26
Q

What are some common radiculopathies?

A
  • Cervical: pain and weakness in shoulders, arms, and hands
  • Lumbar (sciatica): pain and weakness in lower back, arms, and legs
  • Thoracic: pain, tinging, and numbness in chest, rib, side, or abdomen
27
Q

What is a radiculopathy?

A

Pinching of the nerve at the root

28
Q

What is the management of myasthenia gravis?

A
  • Corticosteroids (prednisolone) for 2-6 months
  • In generalised MG, Azathioprine is given to keep prednisolone dose minimal
    Alternatives: ciclosporin, methotrexate
29
Q

What’s trigeminal neuralgia?

A

Unilateral, chronic condition causing severe, sudden episodes of pain in the face

Cause: blood vessels pressing on the trigeminal nerve

30
Q

What is the management of trigeminal neuralgia?

A
  • Reduce frequency of attacks using carbamazepine, gabapentin, or phenytoin
  • Microvascular decompression (making hole in skull bigger for the nerve)
  • Psychological interventions for mental health and well-being
31
Q

How can trigeminal neuralgia be diagnosed?

A

History and examination mainly

MRI can confirm structural abnormalities

32
Q

Who presents with trigeminal neuralgia?

A

Women 50+ years
Co-morbidies like MS or hypertension

33
Q

What is Wernicke’s encephalopathy?

A

A neurological emergency caused by thiamine deficiency

Symptoms: altered consciousness, ataxia, eye abnormalities

34
Q

What is Korsakoff’s syndrome?

A

Develops from Wernicke’s encephalopathy but this is permanent damage to memory

Related to alcohol misuse

Year 5 (22 decks)

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