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4th year passmed > neuro > Flashcards

neuro Flashcards

1
Q

condition associated with bilateral acoustic neuromas

A

neurofibromatosis type 2 (NF2)

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2
Q

how can you distinguish between a CSF leak and mucus coming from a patient’s nose?

A

check glucose - CSF has glucose

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3
Q

syringomyelia

A

fluid-filled cavity develop in central canal of spinal cord

|compresses the spinal cord tracts

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4
Q

which part of the spinal cord is compressed first in syringomyelia?

A

anterior white commissure

spinothalamic tract decussates here at level of entry

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5
Q

which sensory fibres are carried in the spinothalamic tract?

A

pain and temperature

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6
Q

which sensory fibres are carried in the dorsal column?

A

light touch, vibration and proprioception

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7
Q

syringomyelia typical presentation

A

bilateral loss of pain and temperature at level of syrinx

  • burns on fingers

-> ‘cape-like’ sensation loss of arms, shoulders and torso

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8
Q

syringomyelia associated malformation

A

chiari type 1 malformation

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9
Q

syringomyelia imaging

A

MRI Full Spine

MRI Brain - check for Chiari malformation

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10
Q

What is tuberous sclerosis

A

autosomal dominant condition with cutaneous, neurological and other features

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11
Q

cutaneous features of tuberous sclerosis? (4)

A

‘Ash leaf’ spots under UV light = depigmented patches

Shagreen patches = roughened skin over lumbar spine

Adenoma sebaceum (angiofibromas) - facial, butterfly distribution

Subungual fibromata
(Cafe au lait spots - more often in NF)

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12
Q

neurological features of tuberous sclerosis? (3)

A

developmental delay

intellectual impairment

infantile spasms/partial seizures

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13
Q

‘other’ features of tuberous sclerosis? (6)

A

Retinal hamartomas = dense white areas on retina
Rhabdomyomas of heart
Gliomatous changes in brain lesions
Polycystic kidneys
Renal angiomyolipomata
Lymphangioleiomyomatosis -> multiple lung cysts

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14
Q

What is mononeuritis multiplex?

A

Simultaneous/sequential involvement of individual, non-contiguous nerve trunks
This causes acute/subacute sensory and motor loss in asymmetrical pattern

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15
Q

What are the Motor scores of GCS?

A 
6 = obeys
5 = localises to pain
4 = withdraws from pain
3 = abnormal flexion
2 = extending from pain
1 = none
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16
Q

What are the Verbal scores of GCS?

A 
5 = orientated
4 = confused
3 = words
2 = sounds
1 = none
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17
Q

What are the Eye scores of GCS?

A 
4 = spontaneous
3 = speech
2 = pain
1 = none
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18
Q

What is Subacute Combined Degeneration of Spinal Cord?

A

Degeneration of dorsal and lateral columns due to vitamin B12 deficiency
Uncommon in UK, very common in the developing world

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19
Q

What type of fibres are carries in the corticospinal tract?

A

Voluntary motor fibre

Upper limbs are medial, lower limbs are lateral

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20
Q

What are the symptoms of Subacute Combined Degeneration of the Spinal Cord?

A

Loss of proprioception and vibration (dorsal column)
Then distal parasthesia
UMN signs in legs - brisk knee reflex, absent ankle reflex

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21
Q

cerebral oedema secondary to a brain tumour Mx

A

Dexamethasone IV

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22
Q

normal pressure hydrocephalus management triad

A

wet, wobbly, wacky

urinary incontinence
gait ataxia
dementia

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23
Q

normal pressure hydrocephalus management

A

ventriculoperitoneal shunting

10% risk of complications eg. seizure, infection, haemorrhage

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24
Q

migraine acute management

A

triptan + paracetamol

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25
Q

migraine prophylaxis

A

topiramate

propranolol

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26
Q

What is an essential tremor?

A

Autosomal dominant tremor
Generally of both upper limbs
Often have family history

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27
Q

What makes an essential tremor better/worse?

A

Worse with arms outstretched

Better with alcohol/rest

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28
Q

What is the management of an essential tremor?

A

Propranolol

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29
Q

What is miosis?

A

Pupil constriction

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30
Q

What is ptosis?

A

Eyelid drooping

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31
Q

What does ptosis + dilated pupil indicate?

A

CN3 palsy

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32
Q

What does ptosis + constricted pupil indicate?

A

Horner’s syndrome

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33
Q

What is Weber’s syndrome?

A

Midbrain stroke

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34
Q

What are the features of Weber’s syndrome?

A

Ipsilateral CN3 palsy

Contralateral hemiplegia

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35
Q

What is a Chiari malformation?

A

Herniation of cerebellar tonsils through foramen magnum

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36
Q

What are the features of neuroleptic malignant syndrome? (6)

A 
Pyrexia
Muscle rigidity
Hypertension
Tachycardia
Agitated delirium
Confusion
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37
Q

What might bloods show in neuroleptic malignant syndrome?

A

Increased WCC, K+ and CK

Decreased Ca2+

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38
Q

What is the management of neuroleptic malignant syndrome?

A

Stop antipsychotic
Transfer to ITU
IV fluids
Dantrolene

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39
Q

What is Spontaneous Intracranial Hypotension?

A

Headache secondary to CSF leak

Generally from thoracic N root sleeve

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40
Q

What is spontaneous intracranial hypotension associated with?

A

Marfan’s

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41
Q

What are the symptoms of spontaneous intracranial hypotension?

A

Headache

Worse on standing, better with lying

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42
Q

What is the management of of spontaneous intracranial hypotension?

A

Fluids and caffeine

Epidural blood patch = 2nd line

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43
Q

What is the treatment of myasthenia gravis?

A

Neostigmine (long-acting AChE inhibitor)

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44
Q

What type of neuromuscular blocks are myasthenia gravis patients more sensitive to?

A

Non-polarising eg. Rocuronium

As fewer post-synaptic ACh receptors

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45
Q

What type of neuromuscular blocks are myasthenia gravis patients resistant to?

A

Polarising eg. Suxamethonium

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46
Q

Which medications may worse myasthenia gravis?

A

Beta-blockers

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47
Q

What may be found in the CSF of Multiple Sclerosis patients?

A

Oligoclonal bands

NOT found in blood

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48
Q

What should you do if a patient has GCS<8?

A

Get anaesthetist

Intubate and ventilate

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49
Q

What is the 1st line management of trigeminal neuralgia?

A

Carbamazepine

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50
Q

What is the management of Degenerative Cervical Myelopathy?

A

Urgent spinal surgery referral

Decompression surgery within 6m

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51
Q

What other neurological condition is frontotemporal dementia associated with?

A

MND

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52
Q

What are the 4 types of MND?

A

Amyotrophic Lateral Sclerosis
Progressive Lateral Sclerosis
Progressive Muscular Atrophy
Bulbar Palsy

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53
Q

What are the main features of MNDs?

A 
Fasciculations
No sensory symptoms
Mixed UMN and LMN signs
Doesn't affect extraocular muscles
No cerebellar signs
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54
Q

What do MND EMGs show?

A

Reduced action potentials with increased amplitude

Not required for diagnosis

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55
Q

What are the main functions of the common peroneal nerve?

A

Dorsiflexion and eversion of ankle

Posterolateral leg sensation

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56
Q

What are the main features of L5 radiculopathy?

A

Foot drop
Weakness of hip abduction
Sensory loss of big toe

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57
Q

Who gets idiopathic intracranial HTN?

A

Overweight females

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58
Q

What is the management of idiopathic intracranial HTN?

A

Lose weight
Acetazolamide/Topiramate
Repeated LPs if these fail

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59
Q

What is Lateral Medullary Syndrome?

A

Posterior Inferior Cerebellar Artery stroke

AKA Wallenberg’s syndrome

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60
Q

What are the features of Lateral Medullary Syndrome?

A

Ipsilateral FACIAL pain and temperature loss
Contralateral BODY pain and temperature loss
Ataxia
Nystagmus

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61
Q

What is Lateral Pontine Syndrome?

A

Anterior Inferior Cerebellar Artery stroke

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62
Q

What are the features of Lateral Pontine Syndrome?

A 
Ipsilateral FACIAL pain/temp loss
Ipsilateral FACIAL paralysis and deafness
Contralateral BODY pain/temp loss
Ataxia
Nystagmus
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63
Q

Where must a lesion by above to result in autonomic dysreflexia?

A

Above T6

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64
Q

What is Lhermitte’s sign?

A

Patient bends their neck -> tingling in hands
Indicates disease near dorsal column
Seen in MS and SCDSc

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65
Q

What is Uhthoff’s phenomenon?

A

Worsening of vision following a rise in body temperature

Seen in MS

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66
Q

What does a CN3 palsy with dilated pupil indicate?

A

Surgical cause

Need urgent head CT to rule out bleed/aneurysm

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67
Q

What are some features indicative of temporal lobe epilepsy?

A

Lip-smacking/cloth plucking
Aura
Deja vu
Post-ictal dysphasia

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68
Q

How is the MRC muscle power score scored?

A 
0 = no movement
1 = trace contraction
2 = movement with gravity eliminated
3 = movement vs gravity but not resistance
4 = movement vs resistance but weakened
5 = normal
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69
Q

What are the MOTOR peripheral neuropathies? (6)

A 
Guillain-Barre syndrome
Porphyria
Lead poisoning
HSMN (Charcot-Marie-Tooth)
Chronic Inflammatory Demyelinating Polyneuropathy
Diphtheria
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70
Q

What are the SENSORY peripheral neuropathies? (6)

A 
Diabetes
Uraemia
Leprosy
Alcoholism
B12 deficiency
Amyloidosis
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71
Q

What are the features of a venous sinus thrombosis?

A

Gradual onset headache
N+V
Depends on sinus

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72
Q

What are the features specific to a sagittal sinus thrombosis?

A

Seizures

Hemiplegia

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73
Q

What are the features specific to a cavernous sinus thrombosis?

A

Periorbital oedema
Ophthalmoplegia - CN6 1st
Trigeminal N involvement -> hyperaesthesia of upper face and eye
Central retinal vein thrombosis

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74
Q

What are the features specific to a lateral sinus thrombosis?

A

CN6+7 palsy

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75
Q

What is the gold standard diagnostic investigation for venous sinus thrombosis?

A

MR venogram

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76
Q

What are the myotomes for upper limb reflexes?

A 
Biceps = C5-6
Triceps = C7-8
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77
Q

What are the myotomes for lower limb reflexes?

A 
Knee = L3-4
Ankle = S1-2
78
Q

What is the ideal investigation if you suspect Degenerative Cervical Myelopathy?

79
Q

What is Progressive Supranuclear Palsy?

A

Parkinson’s Plus syndrome

Has poor response to L-dopa

80
Q

What are the features of progressive supra nuclear palsy?

A

Parkinson’s symptoms
Dysarthria
Reduced vertical eye movements

81
Q

What is retinitis pigmentosa?

A

Loss of rods -> night blindness

Loss of peripheral retina -> tunnel vision

82
Q

What may be seen on fundoscopy in retinitis pigmentosa?

A

Black bone spicule-shaped pigmentation of peripheral retina

Mottling of retinal pigment epithelium

83
Q

What are some features of retinitis pigmentosa?

A 
Night blindness
Tunnel vision
Often start in childhood
Often have FHx of early (but incomplete) blindness
Vitamin A may slow progression
84
Q

What is retinitis pigmentosa associated with? (4)

A 
Refsum disease
Usher syndrome
Alport syndrome
Abetalipoproteinaemia
( and others)
85
Q

What is Guillain-Barre syndrome?

A

Immune-mediated demyelination post-infection

Typical campylobacter infection

86
Q

What are the features of GBS?

A 
Progressive weakness of all 4 limbs
Legs progress first
Proximal muscles more than distal
Few sensory symptoms
Diminished reflexes
87
Q

What may an LP show in GBS?

A

Increased protein

Normal WCC

88
Q

What is myasthenia gravis?

A

Auto-antibodies vs ACh receptor on post-synaptic membrane

89
Q

What are the features of myasthenia gravis? (5)

A 
Progressive weakness as day goes on
Proximal muscle weakness
Diplopia - extraocular muscle weakness
Ptosis
Dysphagia
90
Q

What are the associations of myasthenia gravis?

A 
Thymomas (15%)
Thymic hyperplasia (50-70%)
Other autoimmune diseases
91
Q

What investigations should be done for someone with myasthenia gravis?

A 
Single fibre electromyography
CT thorax - exclude thymoma
AChR AutoAb - 85-90% +ve
Anti-muscle-specifc tyrosine kinase Ab - 40% +ve
(Creatinine Kinase is normal)
92
Q

What test is no longer used for those with myasthenia gravis?

A

Tension test
IV edrophium temporarily reduces weakness
Not done anymore

93
Q

What is the management of myasthenia gravis?

A

Pyridostigmine (long-acting AChE inhibitor)
Prednisolone (immunosuppression)
Thymectomy

94
Q

What is the management of a myasthenic crisis?

A

IV immunoglobulin + plasma exchange

95
Q

Where are lesions causing inferior and superior quadrantanopias?

A

Parietal = Inferior
Temporal = Superior
(PITS)

96
Q

What are the 1st line options for migraine prohpylaxis?

A

Topiramate

Propranolol

97
Q

What migraine prophylaxis should be used in women taking COCP?

A

Propranolol

Topiramate can reduce COCP efficacy

98
Q

What are the 2nd and 3rd line options for migraine prophylaxis?

A

2nd line = 10 acupuncture sessions

3rd line = Riboflavin 400mg OD

99
Q

What prophylaxis should be used for predictable menstrual migraines?

A

Frovatriptan or zolmitriptan

100
Q

What is intranuclear ophthalmoplegia?

A

Lesion of Medial Longitudinal Fasciciulus = tract that allows conjugate eye movements

101
Q

What are the features of intranuclear ophthalmoplegia?

A

Ipsilateral impaired adduction of eye

Contralateral nystagmus

102
Q

What is the diagnosis if someone has a painful CN3 plasy with dilated pupil?

A

Posterior Communicating Artery aneurysm

103
Q

What are the causes of CN3 palsy? (7)

A 
DWN ANd OUT
Diabetes
Weber's syndrome
Neuro (MS)
ANeurysm (posterior communicating artery)
Other (SLE, GCA)
Uncal herniation
Thrombosis (cavernous sinus)
104
Q

What are the features of ALS?

A

LMN signs in arms, UMN signs in legs
Most common MND
Familial cases involve Chr21

105
Q

How could you distinguish between ALS and PLS?

A

PLS has UMN signs only

ALS has UMN signs in legs and LMN signs in arms

106
Q

What are the features of Progressive Muscular Atrophy?

A

LMN signs only
Distal to proximal muscles
Best prognosis

107
Q

What is Progressive Bulbar Palsy?

A

MND - loss of brainstem nuclei function

108
Q

What are the features of Progressive Bulbar Palsy?

A

Palsy of tongue, muscles of mastication and facial muscles

Worst prognosis

109
Q

What are the 5 most common primary tumours to metastasise to the brain?

A 
Lung
Breast
Kidney
Melanoma
Colorectal
110
Q

What is the long term management of a stroke?

A

Clopidogrel
Statin if cholesterol >3.5
(Aspirin STAT after bleed excluded)

111
Q

What is the MoA of Ondansetron?

A

5-HT3 antagonist
Acts on medulla oblongata
S/Es = constipation, long QT

112
Q

Which anti-seizure medication may cause peripheral neuropathy?

113
Q

What might be raised following a true seizure but not after a non-epileptic seizure?

A

Prolactin

Raised 10-20mins after epileptic seizure

114
Q

What are the cerebellar signs?

A 
DANISH
Dysdidokokinesis
Ataxia
Nystagmus
Intention tremor
Slurred speech
Hypotonia
(signs are ipsilateral to lesion)
115
Q

Are cerebellar signs ipsilateral or contralateral to cerebellar lesions?

A

Ipsilateral

116
Q

Who should get a thrombophilia screen following a stroke?

A

<55yrs old + no obvious cause

117
Q

What is the ROSIER score?

A

Assesses likelihood presentation is due to a stroke

118
Q

What are the features of Lacunar infarcts?

A

ONE of:
Ataxic hemiparesis
Pure sensory stroke
Unilateral weakness

119
Q

What are the features of Weber’s syndrome?

A

Ipsilateral CN3 palsy

Contralateral weakness

120
Q

What are the features of Lateral Medullary syndrome?

A

Ipsilateral ataxia, nystagmus, facial numbness and dysphagia

Contralateral limb sensory loss

121
Q

What is the acute management of cluster headaches?

A

100% oxygen + subcut Sumitriptan

122
Q

What is the prophylactic management of cluster headaches?

123
Q

What is the 1st line management of trigeminal neuralgia?

A

Carbamazepine

124
Q

What are the Red Flags for trigeminal neuralgia, which may warrant urgent referral? (8)

A 
Age <40yrs
Sensory changes
Deafness/ear problems
Hx of skin/oral lesions which could be perineurial
Pain in ophthalmic division
Pain bilaterally
Optic neuritis
Fix of MS
125
Q

What is the most common sequelae of meningitis?

A

Sensorineural deafness

126
Q

What is Todd’s paresis?

A

Post-seizure focal weakness

Follows focal seizure

127
Q

When does Steven-Johnson syndrome start after starting a new medication?

A

Typically 2 months

Flu-like prodrome initially

128
Q

What are the features of a low pressure headache post-LP?

A

Develop 24-48hrs post-LP
Worse on standing
More common in women with low BMI

129
Q

What is the management of a low pressure headache?

A

Caffeine and fluids (stay hydrated)

130
Q

What are the symptoms of a subdural haematoma?

A

Generalised headache with fluctuating GCS

131
Q

What is the first investigation you order if you suspect a stroke?

A

Non-contrast CT head

132
Q

What role do Diffusion-weighted MRIs have in stroke management?

A

Can help diagnose a vascular stroke

133
Q

What role do T2-weighted FLAIR MRIs have in stroke management?

A

Can help with estimate if stroke onset is within thrombolysis window

134
Q

What are the side effects of sodium valproate? (11)

A 
Nausea
Weight gain
Alopecia with curly regrowth
Ataxia
Tremor
Thrombocytopenia
Pancreatitis
Hepatotoxicity
Hyponatraemia
Hyperammonic encephalopathy
TERATOGENIC
135
Q

What relevance does sodium valproate have for other medications?

A

P450 inhibitor

136
Q

When can someone drive again after having a TIA?

A

Must be symptom-free after 1 month

137
Q

What can be used as a ‘rescue medication’ for neuropathic pain?

138
Q

What is the new definition of TIA?

A

Neurological dysfunction caused by focal CNS ischaemia without infarct
Tissue-based, not time-based

139
Q

What are 4 MS risk factors?

A

Smoking
Previous glandular fever
Genetics
Low vitamin D

140
Q

What is procyclidine?

A

Antimuscarinic
Used to treat tremor and rigidity
Most useful in drug-induced parkinson’s

141
Q

What is carbergoline associated with?

A

Pulmonary fibrosis

142
Q

What is Hoover’s sign?

A

Differentiates between organic and non-organic leg weakness

Organic = feels normal leg pushing down to try and raise weak leg

143
Q

What is Romberg’s test?

A

Differentiates between sensory and cerebellar ataxia
Stand with eyes closed, +ve if they fall
+ve result indicates sensory ataxia
Cerebellar ataxia will have +ve result with eyes open and closed

144
Q

What is the characteristic gait of sensory ataxia?

A

High-stepping gait

145
Q

What is the characteristic gait of cerebellar ataxia?

A

Broad-based, staggering gait

146
Q

What are the acute causes of sensory ataxia? (3)

A

Miller-Fisher syndrome
Sensory variant of GBS
Semisynthetic penicillins

147
Q

What are the subacute causes of sensory ataxia? (3)

A

Lyme disease
Neurosarcoidosis
Posterior spinal cord lesions

148
Q

What are the chronic causes of sensory ataxia? (6)

A 
CIDP
Paraproteinaemia
Diabetes
Coeliac disease
Vitamin E deficiency
Isoniazid
149
Q

What are 5 examples of posterior spinal cord lesions?

A 
MS
Cervical spondylosis
Tumours
Vitamin B12 deficiency
Tabes dorsalis (syphilis)
150
Q

What are the replacement thresholds for low phosphate during refeeding?

A 
<0.80 = low
0.32-0.80 = oral replacement
<0.32 = IV replacement
151
Q

When do you need to worry about refeeding syndrome?

A

If not eaten for 5+ days

152
Q

What is the usual replacement regime in refeeding?

A 
10kcal/kg/day - increase to needs over 4-7 days
Oral thiamine 300mg OD
K+ 2-4mmol/kg/day
PO4 0.3-0.6mmol/kg/day
Mg 0.2-0.4mmol/kg/day
153
Q

What drugs should be used for nausea in those with Parkinson’s?

A

Domperidone

Doesn’t cross BBB

154
Q

What is the time window for thrombolysis in strokes?

A

<4.5hrs from onset

Combined with thrombectomy if CONFIRMED proximal circulation occlusion

155
Q

What is the time window for thrombectomy in strokes?

A

<6hrs from onset

Must have CONFIRMED proximal circulation occlusion

156
Q

When should you consider thrombectomy +/- thrombolysis for posterior circulation strokes?

A

If known to be well in the last 24hrs and proximal circulation occlusion

157
Q

What should you do if you suspect a diagnosis of Parkinson’s disease?

A

Urgent neurology referral

All treatment should be initiated by specialist

158
Q

What degree of stenosis is required for a carotid endarterectomy?

159
Q

How long is L-dopa usually effective for?

160
Q

What are the side effects of L-dopa? (7)

A 
Dyskinesia
On-off effect
Postural hypotension
Arrhythmias
N&amp;V
Psychosis
Red urine of standing
161
Q

What is complex regional pain syndrome?

A

Progressive pain in area which is disproportionate to original injury

162
Q

What are some features of complex regional pain syndrome? (6)

A 
Progressive pain
Allodynia
Temperature and skin changes
Oedema
Sweating
Motor dysfunction
163
Q

What scoring system is used to diagnose complex regional pain syndrome?

A

Budapest Diagnostic Criteria

164
Q

What is the management of complex regional pain syndrome?

A

Early physio and pain team input

Gabapentin/amitriptyline are 1st line

165
Q

Who is at an increased risk of Bell’s palsy?

A

Pregnant women - 3x increased risk

166
Q

What are the two types of Multiple System Atrophy?

A

Predominantly Parkinsonian

Predominantly cerebellar

167
Q

What are the features of Multiple System Atrophy?

A

Parkinsonism
Autonomic disturbance eg. erectile dysfunction, postural hypotension, atonic bladder
Cerebellar signs - DANISH

168
Q

Who gets idiopathic intracranial hypertension?

A

Fat pregnant females

169
Q

What are the features of idiopathic intracranial hypertension?

A

Headache + blurred vision
Papilloedema
Enlarged blind spot
Occasionally CN6 palsy

170
Q

What is the management of idiopathic intracranial hypertension?

A

Weight loss = 1st line
Acetazolamide
Topiramate = 2nd line, may aid weight loss
Repeated LPs if these unsuccessful

171
Q

What are the features of an acoustic neuroma?

A 
CN8 = unilateral sensorineural hearing loss, tinnitus, vertigo
CN5 = absent corneal reflex
CN7 = facial palsy
172
Q

What is cataplexy?

A

Strong emotions cause transient loss of muscle tone
Eg. laughing -> fall
2/3 people with narcolepsy have cataplexy

173
Q

What is the triad of symptoms for normal pressure hydrocephalus?

A

Urinary incontinence
Dementia and bradyphrenia
Gait abnormalities

174
Q

What would imaging show in normal pressure hydrocephalus?

A

Hydrocephalus with enlarged 4ht ventricle

175
Q

What is the management of normal pressure hydrocephalus?

A

Ventriculoperitoneal shunting

176
Q

What are pulling clothes, lip-smacking, aura and deja vu all features of?

A

Temporal lobe epilepsy

177
Q

What can the acute withdrawal of L-dopa precipitate?

A

Neuroleptic malignant syndrome

178
Q

What are the features of absence seizures?

A

Last few seconds, quick recovery
Child often unaware they have had one
May be precipitated by hyperventilation

179
Q

Who gets absence seizures?

A

Onset generally 3-10yrs

90% seizure-free in teens

180
Q

What is the characteristic EEG feature of absence seizure?

A

Bilateral symmetrical 3Hz spike and wave pattern

181
Q

What is the management of absence seizures?

A

Sodium valproate or Ethosuximidie

182
Q

What is a common feature of migraines in children but not adults?

A

GI symptoms

183
Q

What is riluzole?

A

Glutamate receptor antagonist
Prolongs life by about 3m in MND
Used mainly in ALS

184
Q

What symptoms does olivopontinecerebellar atrophy cause?

A

Parkinsonism and cerebellar signs

185
Q

What symptoms does Progressive Supranuclear Palsy cause?

A

Parkinsonism and ophthalmoplegia

186
Q

What symptoms does Lewy body dementia cause?

A

Parkinsonism and visual hallucinations

187
Q

What are symptoms of autonomic dysreflexia?

A

Sever hypertension, flushing and sweating WITHOUT HR increase
Due to spinal cord injury above T6

188
Q

What is Hoffman’s sign?

A

Flicking the distal phalanx of the patient’s middle finger causes an exaggerated thumb flexion
+ve suggests DCM or MS

189
Q

Why the COCP contraindicated in those with Hx of migraine with aura?

A

Significantly increases risk of ischaemic stroke

190
Q

If a headache is worse on coughing and lying, what does that suggest?

A

Raised ICP

Need head CT

191
Q

What 4 medications are 1st line treatments of neuropathic pain?

A

Amitriptyline
Duloxetine
Gabapentin
Pregabalin

4th year passmed (28 decks)

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