Neuro Flashcards
Rx of ischaemic stroke
Including time windows
If <4.5hrs give alteplase
If beyond, give aspirin 300mg
If <6 thrombectomy
Medication used to treat idiopathic intracranial hypertension
acetozolamide
Sx and signs of IIH
whooshing sound
headaches
b/l papilloedema
intermittent visual loss
obesity
what medication should be prescribed in all cases of suspected encephalitis and to cover for what
acyclovir
cover for HSV (cause of 95% of encephalitis in the UK)
rx of myasthenia crisis
IV Immunoglobulins
ITU for breathing support
first line drugs for muscle spasticity in MS
baclofen and gabapentin
first line ix for suspected acoustic neuroma
audiogram and gadolinium enhanced Mri head
is ophthalmoplegia observed in mnd
nope, eyes are typically spared
what must be measured regularly in pts with MG
What is the target
what is rx plan if below target
FVC every 4 hrs
> 20ml/kg
contact ITU for respiratory support
cause of subacute degeneration of the cord
B12 deficiency
- crohns
- pernicious anaemia
- NO
- vegans
- chronic pancreatitis
- wernickes encephalopathy
presentation of wernickes encephalopathy
confusion, ophthalmoplegia, difficult with balance
may have ascites
triad of Parkinson’s
rigidity
tremor
bradykinesia
common GI issues in Parkinson’s
constipation and volvulus
ix for Gillian barre
lumbar puncture - + proteins
nerve conduction studies
what response failure may myasthenia develop
type 2
airway adjunct in seizures
NPA
lorazepam dose
4mg IV
most common type of MS ie its course
relapsing remitting
causes of ischaemic stroke
afib
valvular heart disease
obesity, htn, carotid athero
difference in presentation between ischaemic and haemorrhage stroke
haemorragic - reduced GCS and seizures
most common cause of deep brain haemorrhage
HTN
what artery damaged in subdural
who is it common in
bridging veins
old, alcoholics
rx of brain bleed fy1
if on anti coags stop
If on warfarin check INR and reversal if needed
give levetiracetam for seizure prevention
what artery damaged in extradural
middle meningeal artery
extradural classic presentation
LOC
Lucid Interval
Confusion +/- LOC
cushings reflex triad
irregular breathing
wide pulse pressure
bradycardia
Pt with a head injury starts to irregularly breathe. What other signs would make this a very concerning case
wide pulse pressure
bradycardia
- bushings reflex - emergency !!!
rx of raised ICP - (not idiopathic)
iv mannitol
head elevation
controlled hyperventilation
how does controlled hyperventilation work in raised ICP
reduce CO2 - vasoconstriction of cerebral arteries causing reduced ICP
rx of acute relapse of MS
high dose steroids
rx of bells palsy
prednisolone an eye care (as can’t close eye)
rx of essential tremor
propanolol
presentation of guillain barre
lower back pain
progressive weakness and peripheral neuropathy
hx of gastroenteritis
hyporeflexia
side effects of levodopa
dyskinesias: dystonia, chorea, athetosis
postural hypotension
n+v
lossof appetitie
sleep problems
where is brocas area
what does brocas do
left lateral frontal lobe
actual enunciation of words ie they can think of them but can’t say them
Where is wernickes
what wernickes do
left posterior aspect of superior temporal lobe
understanding information
Vessesl associated with each stroke type
TACS - MCA, Internal carotid
PACS - branch of MCA
Lacunar - lenticulostriae
POCS - basilar, PCA, cerebellar, vertebral
TACS
Homonymous hemianopia
Higher cortical dysfunction
Unilateral motor or sensory loss
PACS
2/3 of TACS
Lacunar
Pure motor
Pure sensory
ataxic hemiplegia
Sensorimotor
POCS
contralateral hemiparesis with ipsilateral cranial nerve
cerebellar - DANISH
isolated homonymous hemianopia
internuclear ophthalmoplegia
b/l motor and/or sensory
apart from headache, signs and sx of SAH
meninges - photophobia and stiffness
nausea and vomiting
seizures
focal neurology
visual disturbance
collapse
signs to test for meningism
kernigs and brudzinskis
when to perform LP in SAH
if a CT >6hrs was normal but clinical suspicion still high. Must wait at least 12 hrs before performing
what is the role of nimodipine in SAH
reduce vasospasm
within how many hrs should a TIA be referred to a specialist
24hrs
