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phase2a medicine > more brain stuff > Flashcards

more brain stuff Flashcards

Mostly nerve disorders.

1
Q

risk factors for giant cell arteritis

A

polymyalgia
rheumatica
age

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2
Q

pathology of giant cell arteritis

A

inflammation of temporal artery due to granulomatous build up

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3
Q

symptoms of giant cell arteritis

A 
claudication of jaw
scalp sensitivity
temple pain 
sudden unilateral blindness 
headache
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4
Q

complications of giant cell arteritis

A

blindness

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5
Q

diagnosis of giant cell arteritis

A

temporal artery biopsy
ESR and CRP up
ACE up

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6
Q

treatment of giant cell arteritis

A

high dose steroid (prednisolone)

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7
Q

risk factors for spinal cord compression

A

osteoporosis
malignancy
slipped disc

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8
Q

treatment of spinal cord compression

A

treat underlying cause

compression relief surgery

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9
Q

diagnosis of spinal cord compression

A

emergency MRI
biopsy
serum electrophoresis
CXR to check for lung cancer

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10
Q

symptoms of a trapped nerve

A

patient feels pain in the distribution of that nerve because the axon spontaneously fires when irritated

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11
Q

lower motor neuron lesion signs

A

signs at the level of the lesion

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12
Q

upper motor neuron signs

A

signs below the level of the lesion

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13
Q

causes of cauda equina syndrome

A

malignancy

disc herniation

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14
Q

signs of cauda equina syndrome

A

mixed UMN and LMN signs
leg weakness
early urinary retention

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15
Q

symptoms of cauda equina syndrome

A

low back pain
pain that radiates down leg
numbness around anus
loss of bowel or bladder control

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16
Q

complications of cauda equina syndrome

A

ongoing bladder/sexual dysfunction

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17
Q

diagnosis of cauda equina syndrome

A

CT/MRI

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18
Q

treatment of cauda equina syndrome

A

surgical relief

laminectomy

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19
Q

risk factors for Brown-Sequard syndrome

A

trauma

septic emboli

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20
Q

pathology of Brown-Sequard syndrome

A

damage to one half of the spinal cord

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21
Q

signs of Brown-Sequard syndrome

A

loss of two point discrimination
ipsilateral UMN weakness
ataxia
ipsilateral Babinski sign

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22
Q

symptoms of Brown-Sequard syndrome

A

ipsilateral paralysis and loss of proprioception

contralateral loss of pain and temperature sensation

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23
Q

diagnosis of Brown-Sequard syndrome

A

MRI

24
Q

risk factors for accessory nerve disorder

A

medical procedures to neck - e.g. cervical lymph node biopsy

25
Q

pathology of accessory nerve disorder

A

palsy of accessory nerve, leading to sternocleidomastoid and trapezius function loss

26
Q

signs of accessory nerve disorder

A

loss of muscle mass
fasciculations
partial paralysis
winged scapula

27
Q

symptoms of accessory nerve disorder

A

muscular weakness in trapezius and sternocleidomastoid

28
Q

treatment of accessory nerve disorder

A

surgical repositioning of muscles

preservation of C2-4

29
Q

risk factors for Bell’s palsy

A

diabetes

pregnancy

30
Q

pathology of Bell’s palsy

A

CN7 palsy, often as a result of a viral infection

31
Q

signs of Bell’s palsy

A 
unilateral facial weakness
numbness/pain around the ear
ageusia (loss of taste)
sagging of mouth 
speech difficulty
unable to wrinkle forehead
32
Q

complications of Bell’s palsy

A

crocodile tears - unilateral lacrimal stimulation

33
Q

diagnosis of Bell’s palsy

A

rule out brainstem lesion, stroke, tumour

bloods - increased Borrelia antibodies in Lyme disease

34
Q

treatment of Bell’s palsy

A

prednisolone (give quickly)

35
Q

symptoms of third nerve palsy

A

pupils down and out
ptosis
diplopia

36
Q

what is the most common mononeuropathy?

A

carpal tunnel syndrome

37
Q

symptoms of carpal tunnel syndrome

A

aching in hand and arm (esp. at night)
paraesthesia in thumb, index, and middle finger
relieved by dangling arm over the bed

38
Q

diagnosis of carpal tunnel syndrome

A

maximal wrist flexion for one minute can induce symptoms

tapping over the nerve can cause tingling

39
Q

treatment of carpal tunnel syndrome

A

splinting
local steroid injection
decompression surgery

40
Q

what percentage of patients over 40 with myasthenia gravis have thyme hyperplasia?

A

70%

41
Q

what percentage of patients with myasthenia gravis have a thymic tumour?

A

10%

they may have antibodies to striated muscle

42
Q

pathology of myasthenia gravis

A

autoimmune disease and B and T cell mediation
antibodies to nicotinic acetylcholine receptors at neuromuscular junctions

some pts have anti-MuSK instead (against tyrosine kinase)

43
Q

signs of myasthenia gravis

A

ptosis
diplopia
myasthenia snarl
symptoms worse at end of day

44
Q

order of muscle fatigue in myasthenia gravis

A 
extraoccular
bulbar
face
neck 
limb
girdle
trunk
45
Q

complications of myasthenia gravis

A

myasthenia crisis - weakness of respiratory muscle

46
Q

diagnosis of myasthenia gravis

A

anti-AChR antibodies in 90%
EMG - decreasing muscular response to repetitive nerve stimulation
single fibre EMG - block and jitter of orbiculares occuli
CT to exclude thymoma
tensilon test

47
Q

treatment of myasthenia gravis

A 
anti cholinesterase (pyridostigmine)
immunosuppresion (prednisolone)
plasma pharesis 
IV immunoglobulin
thymectomy
48
Q

risk factors for peripheral neuropathies

A 
infection 
ischaemia
toxins (e.g. vitamin B6 excess)
inflammatory disease
hereditary
49
Q

characteristics of sensorimotor neuropathy

A

symmetrical

length dependent

50
Q

characteristics of sensory neuropathy

A

asymmetrical

51
Q

symptoms of peripheral neuropathy

A

loss of perception of temperature and pressure
loss of balance (ataxia - worse in the dark)
muscle cramps
muscle weakness
fasciculations
muscle atrophy

52
Q

what should you always check for in patients presenting with asymmetrical sensorimotor neuropathy?

A

vasculitis

53
Q

treatment of peripheral neuropathies

A

amitriptyline, pregabalin, or gabapentin for pain
quinine for cramps
physiotherapy and walking aids to help with balance

54
Q

risk factors for Guillain-Barre syndrome

A

Campylobacter infection

55
Q

signs of Guillain-Barre syndrome

A

rapid ascending paralysis and sensory deficits

GI infection might precede the disease

56
Q

treatment of Guillain-Barre syndrome

A

IVIG - plasma exchange - do immediately

ITU

phase2a medicine (53 decks)

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