neruology pass med Flashcards by Becca Salmon

symptoms of progressive supranuclear palsy

parkinsonism, falls, slurred speech, impaired vertical gaze, poor response to l dopa

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symptoms of ulnar nerve damage

lack of adductor policies for thumb adduction and wasting of hypothenar, claw hand, wasting of 1st web space

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where is the lesion in a pure sensory presentation

lucunar infarct

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investigation used to differentiate location of stroke

carotid endarterectomy

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symptoms of a total anterior circulation infarct

homonymous hemianopia
unilateral hemiparesis
higher cognitive dysfunction

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symptoms of partial anterior circulation infarct

2 of TACS criteria

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arteries involved in posterior circulation

vertebrobasilar

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what is definition of TIA based on

tissue appearance, not duration

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cluster headache symptoms

episodic eye pain, autosomal symptoms (lacrimation and nasal stuffiness), around eye

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treatment of cluster headache

100% o2 and SC triptan, CCB prophylaxis

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where is the lesion in bitemporal hemianopia

optic chiasm

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dorsal column accounts for what

light touch, proprioception, vibration

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spinothalamic tract accounts for what

pain and temperature

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symptoms of meningitis

photophobia, headache, fever, rash, papilloedema

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nerve involvement of horners

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nerves involved in erbs palsy (pronated and medically rotated arm)

C5-6

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nerve in danger at neck of humerus fracture

axillary

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anti epileptic causing macrocytic anaemai

pheytoin as alters folate metabolism

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symptoms of 3rd nerve palsy

down and out
ptosis
dilated pupil

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causes of 3rd nerve palsy

DM
vasculitis
riased ICP due to herniation

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upper quadrant bitemptal hemianopia

pituitary tumour with inferior compression

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lower quadrant bitemporal hemianopia

cranipharyngioma

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prophylaxis of migraines

topiramate or propanolol

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treatment of migraines

triptans, NSAIDs

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eye defect in acromeagly

bitemporal hemianopia

most common muscular dystrophy

Becker's

what is gower's sign

using arms to stand up in duchennes muscular dystrophy

dystrophinopathies type of genetics

x linked

plucking of clothes is seen in what type of seizure

temporal lobe - also have lip smacking, aura, dejavu

jacksonian movements are in which type of seizure

frontal lobe

what drugs can cause myasthenia crisis in MG

BBs, lithium, pheytoin, antibiotics, penicillamine

what is a MRC power of 2

movement of joint with gravity eliminated

eye defect in left parietal lobe infarct

right inferior quadrantopia

immediate treatment of TIA

aspirin 300mg and review in 24hours

what isn hoover's sign

differentiates between organic and non organic leg weakness organic = feel effort in trying to lift left non organic = fails to feel effort

what is roberts test

investigates cause of ataxia

what is hoffmann signs

reflex to investigate corticospinal tract lesions

what is jendrassik manorvveure

comapres a reflex with reinforcement

when is the latest a thrombectomy can be performed in acute stroke management

6 hours later (thrombolysis = 4.5 hours)

causes of weak dorsiflexors /foot drop

common peroneal nerve lesion L5 radiculopathy sciatic nerve lesion

symptoms of L5 nerve lesion

weak dorsiflexors/inversion and eversion of ankle

what is ROSIER

used to assess stroke in acute setting

GCS

``` Motor response 6. Obeys commands 5. Localises to pain 4. Withdraws from pain 3. Abnormal flexion to pain (decorticate posture) 2. Extending to pain 1. None Verbal response 5. Orientated 4. Confused 3. Words 2. Sounds 1. None Eye opening 4. Spontaneous 3. To speech 2. To pain 1. None ```

what is the most important thing to rule out as a cause for status epillepticus

hypoxia

how to terminate a status eppillepticus

``` diazpam/lorazepam then phenytoin/sodium valproate then induction ```

causes of siezure

``` subdural haematoma hypoxia alcohol withdrawal meningitis epilepsy ```

diagnosing investigation for MS

MRI with contrast to see demyelinating lesions with dissemination in time and space

dopamine antagonist anti emetics

metaclopramide and domperidone

how does onsanserton work as an anti emetic

5-HT3 antagonist

complication of meningitis in children and should be tested for

sensorineural hearing loss

how does pyridostigmine work

MG drug | long acting anti cholinesterase inhibitor

treatment of degenerative cervical myelopathy with increasing neurological symptms

decompressie surgery

MND with worst progosis

progressive bulbar

migraine triggers

chocolate, hangovers, orgasms, cheese, caffeine, COCP, alcohol, travel, exercise

what is autonomic dysrefelxia

severe HTN and flushing and sweating above level of spinal cord injury

treatment of acute MS relapse

high dose steroids (methylprednisolone)

treatment of long term MS

B-IFN

first line treatment for spasticity in MS

baclofen

treatment for bladder dysfunction in MS (residual volume dependent)

intermitted self catheterisation if residual volume anticholinergics if no residual volume

symptoms of T1 lesion

finger abduction weakeness | medial epicondyle weakness

treatment of trigmeinal neural

carbamazepine

when could trigeminal neuralgia be more sinister

<40years, sensory changes, ear problems, optic neuritis, FHx of MS

management after first seizure

refer to epilepsy clinic for specialist review

best management for idiopathic intracranial HTN

lose weight | then acetazolamide

symptoms of essential tremor

worse if arms outstretched, improved at rest, can lead to vocal cord changes

treatment of essential tremor

propranolol

symptoms of MND

mixed UMN and LMN symptoms with no sensory loss

symptoms of wernickes encephalopathy

nystagmus, ophthalmoplegia, ataxia

how does acetazolamide work

a carbonic anhydrase inhibitor

antiemetic for parkinsons

doperidone as does not cross BBB

symptoms of tuberous sclerosis

``` ash leaf spots siezures developmental delay cafe au lait spots shagreen patches sublingual fibroma ```

symptoms of ataxic gait

wide based gait with loss of heel to toe walking

causes of ataxic gait

ceberallar lesion

most common cause of GBS

campylobacter jejune

what type of headache is linked to diffuculty from getting up in chair

temporal arteritis due to link with polymyalgia rheumatic

first line treatment for parkinson's if motor symptoms are effecting life

LEVODOPA

symptoms of multi system atrophy

parkisonism with autonomic disturbance

what is bells palsy and symptoms

LMN facial nerve palsy so can't raise eyebrow

treatment of bells palsy

prednisolone

treatment if meningitis with seizuresq

start acyclovir IV

what veins are affected in subdural haemorrhage

bridging veins between cortex and venous sinus

what veins affected in extra dural haemorrhage

middle meningeal

what veins affected in SAH

subarachnoid haemorrhage

post stroke, when should they be started on statin

>3.5 cholesterol

what dementia is linked to MND

frontotemproal

CI of triptans

CVD

what nerve adducts the fingers

ulnar

what nerve extends the fingers

radial

what will MRI show linked to NFM2

vestibular schwannomas