Neuro Flashcards
What is the most common complication following meningitis?
Sensorineural hearing loss
What medications should people be sent home on after an ischaemic stroke?
Clopidogrel 75mg (plus statin if cholesterol is high)
Aspirin 300mg for first 14 days and then switch to clopidogrel
What is prophylaxis for cluster headaches
Verapamil
How long do cluster headaches last for
15 mins - 2 hours
What is the treatment of bells palsy
- Prednisolone within 72 hours of onset
2. Eye care (prescription artificial tears and eye lubricants)
What is the best assessment tool for differentiating between stroke and stroke mimics?
ROSIER
How does 3rd nerve palsy present?
ptosis, down & out deviation of the eye, and a dilated pupil known as mydriasis
What should you do if Bells palsy hasnt cleared after 3 weeks of treatment
Urgent referral to ENT
What is the most common form of MND?
Amyotrophic lateral sclerosis
What is the most likely operation to be done in subdural bleeds?
Burr hole evacuation
What are 1st line for spasticity in MS?
Baclofen and gabapentin
What is Lambert-Eaton Syndrome?
A paraneoplastic myasthenia syndrome most commonly associated with small cell lung cancer
What are the features of Lambert-Eaton syndrome
PMH of lung cancer (small cell) Autonomic symptoms Waddling gait Hyporeflexia IMPROVES WITH EXERCISE
When is carotid endartectomy considered?
Patient who has had a TIA with CA stenosis of 70%+
Following a single TIA or stroke, what is the advice on driving?
They can start driving if symptom free for 1 month - no need to tell the DVLA
For patients after their first seizure, what is the advice on driving?
Must inform the dvla AND not drive for 6 months if brain scan/EEG is normal. If abnormal, 12 months.
What is the advice on driving if somebody has had multiple TIAs over a short time period?
Must inform the DVLA and take 3 months off driving
What is the advice on driving with patients with established epilepsy?
Must inform DVLA - may qualify for driving license if seizure free for 12 months.
If withdrawing fro medication, should not drive during or 6 months after the last dose.
Why should you always replace vitamin B12 before folate?
It can cause subacute combined degeneration of the cord
What is 1st line in patients with newly diagnosed Parkinson’s who have motor symptoms affecting their quality of life?
Levodopa
What is the cushings reflex?
A physiological nervous system response to raised ICP that is a triad of:
Bradycardia
Hypertension
Wide pulse pressure
What is the imaging of choice to confirm MS diagnosis?
MRI with contrast
What is usually spared in MND?
Eye movements
What is 1st line secondary prevention in ischaemic stroke and TIA?
Clopidogrel
For seizures in the community, what should be given?
10-20mg rectal diazepam
How is carotid artery stenosis diagnosed?
Duplex ultrasound
What medication is most likely to cause personality changes in Parkinson’s?
Dopamine receptor agonists e.g. Ropinirole
What are the most common triggers of autonomic dysreflexia?
Faecal impaction/Urinary retention
What is the management of Ischaemic stroke?
Thrombolysis within 4.5hrs and thrombectomy within 6 hrs
In trauma, how do you test if the fluid draining from the nose or ear is CSF?
Check for glucose as it is not present in mucus
What is the mechanism of pyridostigmine?
Long acting acetylcholinesterase inhibitor
What is the gold standard test for degenerative cervical myelopathy?
MRI cervical spine
How does an extradural haemorrhage appear on imaging?
Biconvex
What are the risk factors for cluster headaches?
Being male (3x)
Smoking
Alcohol
Nocturnal sleep
What should a GP do if they see somebody within 7 days of TIA?
300mg aspirin and specialist review within 24hrs
Which lobe is wernicke’s area in?
Temporal lobe (near the ear)
What lobe is Broca’s area in?
Frontal lobe (near the mouth)
What is Stevens-Johnson syndrome?
A severe systemic reaction affecting the skin and mucosa - drug reaction
How do you treat Stevens-johnson syndrome?
Hospital admission for supportive treatment and stop causative drug
What is used to treat neuroleptic malignant syndrome?
Bromocriptine
What is the treatment for myasthenia crisis?
Plasmapheresis and Iv IgG
What is 1st line in treating essential tremor?
Propanolol
What innervates the palmar lateral 3 fingers?
Median nerve
What innervates the palmar ring and little finger
ulnar nerve
What would you expect to see in CSF in MS?
Oligoclonal bands
What would you expect to see in CSF in MS?
Oligoclonal bands
What is used to treat cerebral oedema in patients with brain tumours?
Dexamathasone
What antibodies are seen in Lambert-Eaton syndrome?
Antibodies to voltage-gated calcium channels
What are 1st line treatments for neuropathic pain?
Gabapentin, Pregabalin, Amitriptyline and Duloxetine
What kind of bleed is more likely in a trauma young patient?
Extradural haemorrhage - biconvex haemotoma
What does gradual onset headache with decreasing cognition in an older patient suggest?
Subdural haemotoma
What nerve is likely to be injured on a mid humeral fracture?
Radial nerve (wrist drop)
What is the most common cause of encephalitis?
Herpes simplex virus
What is Todd’s paresis?
Weakness following a seizure that wears off within 24 hours
In suspected myasthenia gravis, if serum ACh receptor antibodies are negative/normal, what else should be measured?
Anti-muscle-specific tyrosine kinase
What does movement disorder + atrophy of the caudate nucleus and putamen and generalised atrophy suggest?
Huntingtons disease
