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MSRA > Neuro > Flashcards

Neuro Flashcards

1
Q
A

Extradural (middle meningeal)

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2
Q
A

Subdural (bridging vein)

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3
Q

what type of bleed has loss of consciousness (typically immediately after a head injury) followed by a period of lucidity

A

Extradural

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4
Q
A

Sub arach

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5
Q

When is endarterectoy indicated

A

stroke/TIA

+

mod/severe stenosis on USS (>50% stenosed)

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6
Q

TACI has which of:
1. unilateral hemiparesis and/or hemisensory loss of the face, arm & leg
2. homonymous hemianopia
3. higher cognitive dysfunction e.g. dysphasia

A

All 3

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7
Q

PACI has which of:
1. unilateral hemiparesis and/or hemisensory loss of the face, arm & leg
2. homonymous hemianopia
3. higher cognitive dysfunction e.g. dysphasia

A

2 of them

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8
Q

LACI has what presentation (lacunar infarct)

A

presents with 1 of the following:
1. unilateral weakness (and/or sensory deficit) of face and arm, arm and leg or all three.
2. pure sensory stroke.
3. ataxic hemiparesis

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9
Q

POCI presents with

A

presents with 1 of the following:
1. cerebellar or brainstem syndromes
2. loss of consciousness
3. isolated homonymous hemianopia

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10
Q

How long is the thrombolysis window

A

4.5 hours

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11
Q

how long to avoid driving after a stroke

A

at least a month

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12
Q

what is ROSIER for

A

stroke mimics

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13
Q
A
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14
Q

Mx of a TIA

A

300mg aspirin if no CI and 24h review in TIA clinic (if it happened in the last 7 days, if >7 days then 7 days until clinic)

If they already take low dose aspirin then just continue that until specialist review.

Specialist will prob start clopi and high dose statin, plus MRI and carotid USS

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15
Q

Brocas aphasia description and what lobe of brain?

A

Comprehension normal but speech impaired, frontal lobe

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16
Q

Wernickes aphasia description and what lobe of brain?

A

Fluent speech but poor comprehension. Temporal lobe (near ears)

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17
Q

What is malignant MCA sydrome

A

cerebral oedema following MCA stroke

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18
Q

type of headache worsened by physical activity

A

migraine

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19
Q

Seizure where still aware but have focal motor/sensory/autonomic sx, no post ictal

A

simple focal

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20
Q

seizure where awareness impaired, have focal motor/sensory/autonomic sx, post ictal confusion

A

complex focal eg TLE

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21
Q

seizure that begins focally but then becomes convulsive generally

A

secondary generalised (still a type of focal)

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22
Q

seizure with sudden jerk of limb

A

myoclonic (generalised)

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23
Q

seizure with sudden loss of muscle tone, ‘drop attacks’

A

atonic (generalised)

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24
Q

seizure of baby <1 with clusters of sudden tonic flexion

A

infantile spasms (generalised)

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25
Q

generalised seizure generally first line

A

valproate

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26
Q

focal seizure generally first line

A

carbamaz/lamotrigine

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27
Q

Kernigs and brudzinskis which is which

A

kernigs legs
brudz- neck

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28
Q

Benpen doses for stat IM in meningococcal meningitis in the community

A

<1y 300mg
1-9y 600mg
>10y and adult 1200mg

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29
Q

Central venous thrombosis rx

A

thrombolysis and long term warfarin

30
Q

Neck pain, ataxic gait, UMN signs in legs

A

cervical spondylitic myleopathy

31
Q

cervical spondylitic myleopathy rx

A

surgical decompression

32
Q

Weakness and sensory deficit developing over more than 8 weeks
CSF shows high protein and low leukocytes

A

Chronic inflammatory demyelinating polyneuropathy

33
Q

Cluster headache rx

A

100% O2
SC triptan

verapamil for prophylaxis

34
Q

bilat intention tremor that is relieved by alcohol

A

essential tremor

35
Q

mx options for essential tremor

A

propranolol or primidone could reduce it

36
Q

What classically precedes GBS

A

campylobacter

37
Q

What is the neurology in GBS

A

ascending weakness of all 4 limbs but proximal before distal

No sensory features

Areflexia

38
Q

headaches, visual disturbances and pulsatile tinnitus

A

Idiopathic IC HTN

39
Q

IICH rx

A

weight loss
acetazolomide if visual loss on presentation

40
Q

Upper and lower motor neuron signs
No sensory features
Fasciculations

A

Motor neurone

41
Q

MND rx

A

riluzole can prolong life in AML

BIPAP at night

42
Q

3 types of MS

A

relapsing remitting - can progress to secondary progressive

primary progressive

43
Q

Rx acute MS relapse

A

steroids (reduces length of flare only)

44
Q

General MS rx

A

DMARDs

or symptomatic

45
Q

Rx for fatigue in MS

A

amantidine

46
Q

Rx of spacisity in MS

A

baclofen/gabapentin

47
Q

Rx of bladder dysfunction in MS

A

intermittent self catheterisation

Anticholinergics

48
Q

Rx visual field oscillations in MS

A

gabapentin

49
Q

Urinary incontinence
Erectile dysfunction
Parkinsonism
REM sleep disorder

A

Multi system atrophy

50
Q

Severe unilateral headache associated with lacrimation that completely resolves with indomethacin

A

Paroxysmal hemicrania

51
Q

Fluctuating muscle weakness that is worse on repetitive movements and improves with rest

A

myaesthenia gravis

52
Q

MG rx

A

AChEi
Immune suppression
Plasma exchange/IVIg
Thymectomy

53
Q

What nerve is damaged:
motor: paralysis of knee flexion and all movements below knee
sensory: loss below knee
reflexes: ankle + plantar lost, knee jerk intact

A

Sciatic (L4-S3)

54
Q

Horizontal diploplia nerve

A

CN6 (Lateral rectus 6- lateral like horizontal)

55
Q

Vertical diploplia nerve

A

CN4 (contralateral side as it crosses, superior oblique- superior like vertical)

56
Q

Mx acute ischaemic stroke of proximal anterior circulation who present within 4.5 hours

A

thrombolysis AND thrombectomy

57
Q

triptans are c/i in hx of

A

IHD

58
Q

migraine prophylaxis

A

propranolol or topiramate (propran in childbearing age woman)

59
Q

Acute migraine treatment

A

triptan (nasal in teens)

second line: metoclopramide or prochlorperazine

60
Q

Confusion, gait ataxia, nystagmus + ophthalmoplegia

A

wernickes

61
Q

the homonymous hemianopia and the paresis are always on the same or different sides

A

same side

62
Q

Bitemporal hemianopia, upper quadrant defect

A

pituitary tumour

63
Q

Bitemporal hemianopia, lower quadrant defect

A

craniopharyngioma

64
Q
A

tuberous sclerosis- benign tumours can be in brain, can cause epilepsy

65
Q

eponymous sign: multiple sclerosis complains of tingling in her hands which comes on when she flexes her neck

A

Lhermittes

66
Q

Dysphagia plus eye weakness/ptosis =?

A

Myaesthenia Gravis

67
Q

Encephalitis symptoms with bilat temporal lobe changes on CT suggests

A

Herpes simplex encephalitis

68
Q

Autoimmune encephalitis is typically the result of ..?

A

A paraneoplastic syndrome (usually secondary to small cell lung cancer or ovarian teratoma)

69
Q

Cryptococcal meningoencephalitis typically affects what demographic?

A

Those with severe immunodeficiency (especially AIDS).
It has a subacute presentation, with symptoms progressing over several weeks (as opposed to a few days).

70
Q

CMV encephalitis typically affects?

A

almost always occurs in patients with severe immunodeficiency. In those with HIV, it typically occurs once the CD4 count is <50.

71
Q

first line AEDs for diff types of epilepsy

A

Give sodium valproate for all unless your female (preg/repoductive age) or they’re focal.
Lamotrigine/Levetriacitem otherwise

Ethosuximide for absence (avoid CBZ)

72
Q

After stroke if aspirin and clopi c/i what to give

A

MR dipyridamole

MSRA (21 decks)

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