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Medicine > Neuro > Flashcards

Neuro Flashcards

1
Q

Ant Stroke Features

A 
Unilat weakness +/- sensory loss 
(full homunculus unilaterally)​
Homonymous hemianopia​
Cerebral dysfunction 
(dysphasia, visual spatial defect)
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2
Q

Post Stroke Features

A 
Isolated homonymous hemianopia 
(with macula sparing)​
Cerebellar dysfunction 
(DANISH, Horners syndrome)​
CN Palsy​
Bilateral motor/sensory loss​
Conjugate eye movement disorder​
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3
Q

Lacunar Stroke Features

A

Motor/sensory/motor-sensory Loss​

Ataxia​

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4
Q

(Gen) Epilepsy Mx

A

Tonic-Clonic:​
New diagnosis: Sodium-Valporate, Lamotrigine​
Established: Lamotrigine​

Absence:​
Ethosuximide, Sodium-Valproate​

Myoclonic:​
Sodium-Valproate​

Tonic/Atonic:​
Sodium-Valproate ​

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5
Q

(Focal) Epilepsy Mx

A

Carbamazepine, Lamotrigine​

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6
Q 
Status Epilepticus Mx:
Pre-Hosp
Early
Established
Refractory
A

Pre-hospital:
PR Diazepam 10mg,
Buccal Midazolam 10mg
(Repeat every 15mins)

Early:
IV Lorazepam 4mg Bolus
(Repeat every 10mins)

Established:
IV Phenytoin
IV Phenobarbital

Refractory (ICU):
IV Gen Anaesthesia
(Propofol, Midazolam, Thiopental-Na+)

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7
Q

Headache Red Flags - 8

A 
Thunderclap​
Meningism (Rash, Neck stiffness, Photophobia, Fever)​​
New Neurological Def​/Cog Dysfunct
Papilloedema
Loss of consciousness, Head injury​
New onset (esp w/ elderly)​
History of Malignancy/Immunosuppression​
Positional​
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8
Q 
Headache Mx:
Tension
Migraine
Cluster
Subarachnoid Haem
A

Tension:
Acute: NSAIDs, Paracetamol, Aspirin (Prophylaxis: Amitriptyline)

Migraine:
Acute: Sumatriptan
Prophylaxis: Propanolol, Topiramate, Amitriptylline

Cluster:
Acute: 100% O2, Sumatriptan, IN Lidocaine
Prophylaxis: Verapamil (CCB)

Sub-arachnoid Haem:
Nimodipine 60mg, (Surg clipping, Endovasc Embolisation)

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9
Q 
Cranial Bleeds Features
Intraparenchymal/Intracerebral
Intraventricular
Subarachnoid
Subdural
Extradural
A

Intraparenchymal/Intracerebral:
Round w/in Hemisphere
=> Acute Headache w/ N+V

Intraventricular:
Confined to Ventricles
=> Acute Headache w/ N+V

Subarachnoid: (Arterial Aneurysms)
Tracks along Sulci + Fissures
=> Thunderclap H

Subdural: (Bridging V)
Crescent (Not limited by Sutures)
=> Grad worsening H

Extradural: (Skull # => Middle Meningeal A)
Biconvex (limited by Sutures)
=> Acute Cog changes

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10
Q

GCS

A 
Motor (6):
Obeys commands 
Localises 
Normal Flexion 
Abnormal Flexion 
Extension 
None
Verbal (5):
Orientated 
Confused 
Words 
Sounds 
None 
Eye (4):
Spontaneous 
Sound 
Press 
None
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11
Q

Benign IC HT Sx - 4

A

General throbbing headache (Positional: relieved on standing, worse while straining)​
Gradual vision defects and papilloedema​
Nausea and vomiting,
Drowsiness ​

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12
Q

Benign IC HT Ix + Mx:
Cure
Acute
Chronic

A

CT/MRI (Reduced size of ventricles)​
LP (Increased opening pressure)​
​

Mx:
Therapeutic LP:​ Relieve pressure

Acute:
Prednisolone (Reduce headache and papilloedema)​

Chronic:
Acetazolamide (Reduce ICP),
CSF shunt​

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13
Q

LP Indications + Contraindications

A

Indications:​
Subarachnoid haemorrhage​
Meningitis/encephalitis​
Autoimmune Neuro diseases (MS, GBS)​

​
Contraindications:​
Focal neurological deficit​
Raised ICP​

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14
Q

PD Patho

A

Lewy-body formation w/in Neurones​

Loss of neurones w/in Brainstem and basal ganglia (esp w/in Substantia nigra)​

=> Reduced Dopamine transmission

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15
Q

PD Criteria

A

Bradykinesia​ (Micrographia, Hypophonia)
Muscular rigidity (Lead-pipe)​
Resting (inactive) tremor​
(postural instability)

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16
Q

PD (+) Sx

A

Asymmetrical (Unilat Onset),
Progressive (=> Bilat),
Responds to Levodopa

17
Q

PD Mx

A

Levodopa (Exogenous Dopamine)
+ DOPA Decarboxylase Inhib:
(Benserazide: Co-beneldopa)
(Carbidopa: Co-careldopa)

Dopamine Agonists:
Pramipexole, Ropinirole
Rotigotine (TD Patch)

MAOi-B:
Rasagiline, Selegiline

COMTi:
Entacapone

18
Q

PD Mx SE

A 
Sedation/Drowsiness, 
Dizziness, 
N+V 
Hallucinations 
Impulse control D (Shopping, Gambling, Sex)
19
Q

MND Patho + Sx

A

Degeneration of Ant horn cells within spinal-cord and brainstem​
=>
Mix of upper/lower motor neuron signs ​

(No affect on Senses or Bladder/Bowel)​

20
Q 
Types of MND:
ALS
PMA
PLS
PBP
A

Amyotrophic lateral sclerosis (Mixed):​
M wasting + Stiffness/Spasticity (-> Severe Weakness)​

Progressive muscular atrophy (LMND):​
M wasting​
​
Primary lateral sclerosis (UMND):​
Stiffness/Spasticity​

Progressive Bulbar Palsy:​
Diff talking/swallowing/breathing (+/- => ALS)​

21
Q

MND Ix

A

Electromyography:
Spontaneous Electrical Act (Progress M Atrophy)
Normal (Primary Lat Sclerosis)

Nerve Conduction Studies (Normal)

22
Q

MND Mx:
Tx - 3
Supp - 3

A

Riluzole (Anti-glutamate)​
Baclofen (Muscle spasms)​
Anticholinergics (Drooling/Sialorrheoa)​

Support:​
NIV (Prevent T2 Resp Fail)​
PEG tube (Nutrition)​
Speech and language therapist, Dietician​

23
Q

MS Patho + Sx

A

Auto-Immune demyelination of nerves w/in Brain + Spinal cord (CNS)

=> Asc Sens Disturbances, Desc Motor Weakness, Neuropathic Pain
=> Neuro Dysfunction (Ataxia, Bulbar palsy/Dysarthria, Diplopia)
=> Cog Impairment (Fatigue, Incontinence, Emotional lability)

24
Q

MS Criteria - 5

A

(McDonald 2010):

Inflamm lesions 
Multiple lesions in time (Recurrent), 
Multiple lesions in place (MRI) 
Progressive Neuro Deterioration (> 1yr) 
No Alt Diagnosis
25
Q

MS Ix

A

LP (CSF: Oligoclonal bands of IgG)​

MRI (Demyelinating plaques)​

26
Q

MS Sx Mx

A

Fatigue: - Amantadine (NMDA-R Antag.)​

Balance disorder/Oscillopsia: - Vestibular Rehab, Gabapentin​

Spasticity: - Baclofen, Gabapentin (Increase GABA)​

Emotional lability/depression/neuropathic pain: - Amitriptyline (TCA), Gabapentin, Naproxen​

27
Q

MS Relapse Criteria + Mx

A

New/Worsening Sx > 24hrs, After a stable 1 month, (All other causes/Inf Excl)

Mx:
PO Methylpred 0.5g/day (5 days)

28
Q

MS Supp (Non-Med) Mx - 5.

A

Fatigue:​ (Improve Diet + Exercise)​

Mobility: ​(Exercise programs with PT​)

Constipation:​ (Laxatives​)

Incontinence:​ (Catheter​)

Dysphagia:​ (SLT, Feeding tubes)​

29
Q

GBS Patho

A

Rapid onset, Auto-immune Demyelination of Nerves w/in PNS

wks after Viral Illness, Immunisation or Allergic reaction

30
Q

GBS Sx + Ix

A

=> Symmetrical Paraesthesia + Weakness (Digits -> Limbs -> Trunk)
=> Neuropathic Pain

Ix:
LP (Increased proteins, Reduced WBCs)

31
Q

GBS Mx

A

IVIg (Reduce Inflamm),
Plasmapheresis (Filter blood)
Neuropathic Pain: Amitriptylline, Gabapentin, Naproxen

32
Q

MG Patho + Sx

A

Chronic, Autoimmune condition targeting nAChR (in Young Adult Women)

=> M weakness (esp Eyes + Mouth)
(Worse w/ Act, Improves w/ Rest)

33
Q

MG Ix + Mx

A

(+): ACh Antibodies

Mx:
Acetylcholinesterase Inhib
(Neostigmine, Pyridostigmine),

Immunosupp (Pred, Azathioprine),

Thymectomy,

(IVIg + Plasmapheresis)

Medicine (13 decks)

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