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Neuro Flashcards

1
Q

Primary care antibiotic for suspected meningitis

A

IM benzylpenicillin

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2
Q

Hospital immediate antibiotic for meningitis

A

IV ceftriaxone/cefotaxime

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3
Q

Causative organism of meningitis in immunocompromised & treatment

A

Listeria meningitis. Ceftriaxone & amoxicillin

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4
Q

Prophylactic antibiotics for N. Meningitidis

A

Ciprofloxacin/rifampicin

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5
Q

Additional treatment in bacterial meningitis

A

Steroids (IV dexamethasone) reduced inflammation & damage in pneumoniae meningitis

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6
Q

Bacterial causes of meningitis in neonates

A

Listeria, group B strep, ecoli

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7
Q

Bacterial causes of meningitis in children

A

Neisseria meningitisis, strep pneumoniae, HiB

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8
Q

Bacterial meningitis causes adults

A

Neisseria meningitidis, strep pneumoniae

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9
Q

Bacterial causes of meningitis in elderly

A

Neisseria meningitidis, strep pneumoniae, listeria

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10
Q

Viral meningitis causes

A

Enterovirus

HSV, VZV

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11
Q

Encephalitis vause

A

Usually viral, HSV, VZV

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12
Q

Encephalitis treatment t

A

Supportive. IV acyclovir

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13
Q

Acute migraine treatment

A

Oral Triptan & nsaid

Antiemetic

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14
Q

Preventative migraine treatment

A

Topiramate or propranolol
Acupuncture
Gabapentin/amitryptiline; high dose B2 (riboflavin)
Botulinum toxin type A

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15
Q

SAH treatment

A

Surgical/radiological intervention to prevent rebleeding
Resuscitation
Nimodipine
Monitor

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16
Q

MS acute relapse management

A

Steroids (methylprednisolone)

Plasma apheresis if contraindicated

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17
Q

Management of frequent MS relapses

A

Disease modifying (beta interferon, nataluzimab, ocrelizumab)

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18
Q

Common pathway of glioma

A

Mutation of isocitrate dehydrogenase (IDH1) results in build up of 2-hydroxyglutarate -> genetic instability of glial cells & inappropriate mitosis.
&1p19q mutation in oligodendrogliomas

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19
Q

Less common glioma pathway

A

No IDH mutation, catastrophic genetic mutation, poor prognosis

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20
Q

High grade glioma treatment

A

Steroids (reduce oedema), surgery, radiotherapy, chemotherapy (temozolamide)

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21
Q

Low grade glioma treatment

A

Surgery, radio & chemo

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22
Q

What drugs are used in thrombolysis

A

Tissue plasminogen activator e.g. alteplase

Within 4.5 hours

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23
Q

Thrombolysis contraindications

A

Due to haemorrhage risk

Hypertension, major surgery within 3 months, other bleeding, brain malignancies

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24
Q

Time limit for mechanical thrombectomy

A

6 hours. Or more for basilar

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25
Prevention of another stroke
Antiplqtelts (aspirin for 2 weeks then clopidogrel for life) Anticoagulatjon if in AF (chadsvasc & hasbled) Treat hypertension slowly. Statins
26
TIA assessment
ABCD^2 Age >60, BP >140/90, clinical features (unilateral weakness 2pts, just speech disturbance 1pt), diabetes, duration (>60mins 2 pts, 10-59 1pt). High risk: >4 pts
27
Essential tremor treatment
Beta blockers, primidone, gabapentin, clonezapam
28
A alpha
Proprioception
29
A beta
Light touch, pressure, vibration.
30
A delta
Cold, pain | Myelinated
31
C fibres
Pain, warm | Unmyelinated
32
First line tia investigation
Diffusion weighted MRI/CT
33
Second line tia inv
Carotid imaging
34
ACA stroke
Lower limb Incontinence, drowsiness Thinking and personality Truncal ataxia
35
MCA stroke
Upper (&lower) limb Hemiparesis Speech issues Facial droop
36
PCA stroke
Perception | Homonymous hemianopia
37
Verterbrobasilar artery stroke
Coordination & balance
38
Lateral medullary syndrome
Sudden vomiting & vertigo | Ipsilqteral horners syndrome (reduced sweating, facial numbness, dysarthria, limb ataxia, dysphagia)
39
Brainstem infarction
``` Quadriplegia Facial paralysis Coma Locked in Altered consciousness Vertigo, vomiting ```
40
Immediate stroke management
Ct/mri to rule out haemorrhage
41
Extra dural h
Middle meningeal a | Fracture of temporal or parietal
42
SAH
Star shaped lesion on CT Berry Aneurysm rupture Nimodipine 3 weeks
43
Sub dural H
Banana shaped Grey/hypodense over time Bleeding from dural bridging veins
44
Epilepsy diagnostic criteria
2 unprovoked seizures occurring more than 24h apart Or one unprovoked seizure & probability of future seizures Epileptic syndrome diagnosis
45
Epilepsy investigations
EEG MRI/CT to exclude tumours Bloods
46
Epilepsy treatment
Sodium valproate. But if female of child bearing potential: lamotrigine Myoclonic: lecetiracetam/topiramate Absence: ethosuximide Partial seizure: lamotrigine/carbamazepine
47
Status epilepticus treatment
IV lorazepam -1st line | If ineffective phenytoin
48
Parkinson’s investigation
DaTscan
49
Parkinson’s presentation
Tremor, cog wheel walk, stooped gait, difficulty with fine/repetitive movement (Have beta amyloid plaques)
50
Parkinson’s management
Young/biologically fit: Da agonist then MOAB inhibitor then Ldopa Biologically frail: L dopa then Moab inhibitor
51
Huntington’s
Loss of gaba (inhibits dopamine) so too much dopamine Repeated CAG >35. HTT gene Autosomal dominant
52
Huntington’s investigation
MRI/CT for loss of striata volume | Genetic testing
53
Alzheimer’s
Beta amyloid plaques & neurofibrillaty tangles Progressive & global onset Investigation: MRI Treatment: cholinesterase inhibitors
54
Vascular dementia
Multiple infarcts Sudden onset, stepwise deterioration, patchy deficits Investigation: MRI - infarcts Treatment: manage predisposing factors
55
Lewy Body dementia
Lewibodies in occipito parietal region Fluctuating cognitive dysfunction, visual hallucinations, Parkinsonism Treatment: cholinesterase inhibitors
56
Frontotemporal/Picks dementia
Pick Bodies Disinhibition, personality change, early memory preservation, progressive aphasia Investigation: MRI frontal or temporal atrophy
57
Sentinel headache
Rare warning headache before SAH
58
Migraine triggers
CHOCOLATE | chocolate, hangovers, orgasms, cheese, ocp, lie ins, alcohol, tumult, exercise
59
Cluster headache risk factors
Male, smoker, alcohol, genetics
60
Cluster headache prevention
CCBs | Prednisolone
61
Multiple sclerosis presentation
TEAM | Tingling, Eye (optic neuritis) Ataxia, Motor (paraparesis)
62
MG
Normal reflexes But weakness everywhere else Worsened by pregnancy, infection, emotion, drugs Positive tensilon Test

2a (10 decks)

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