Neuro Flashcards
on a head CT is ischaemic events
1)hypodense
2)hyperdense?
cortical hypodensity shows ischaemia
carotid artery stenosis is imaged?
duplex ultrasound - uses sound waves and combines both below USS technology
Traditional ultrasound: Uses sound waves to create pictures of blood vessels
Doppler ultrasound: Records sound waves reflecting off moving objects, like blood, to measure their speed and flow
management of TIA?
aspirin 300mg immediately except for contraindications
assessment by a stroke specialist in 24hours
clopidogrel 300mg followed by 75mg +aspiririn
followed by clopidogrel monotherapy
myasthenia gravis is associated with?
thymoma
autoimmune disorders - PA
SLE, Rheumatoid
how to investigate Myasthenia gravis?
single fibre electromyography
CT thorax thymoma
CK normal
tensilon test - iV edrophonium
mx of myasthenia gravis?
long acting acetylcholinesterase inhibitors
pyridostigmine
immunosuppresion can be achieved with prednisolone
azathiopirine
mx of myasthenic crisis?
plasmapheresis
IV immunoglobulins
where does the posterior cerebral artery supply?
occipital cortex ; situated posteriorly to the optic tract
A 67-year-old woman attends the emergency department complaining of a disturbance to her vision. She explains that her symptoms developed suddenly around 20 minutes ago, and adds that she struggles to identify objects on her right side.
PMHx: DM2, HTN
this is a contralateral homonymous hemianopia with macular sparing and visual agnosia - characteristic of PCA infarct
Lacunar strokes
isolated hemiparesis, hemisensory loss or hemiparesis with limb ataxia
mononeuritis multiplex
sporadic
non consistent nerve trunks
both sensory
and motor
has a systemic cause
WARDS PLC
wegener’s, amyloidosis, Rheumatoid arthritids, Diabetes, Sarcoid, PAN, leprosy
seizure types
generalised tonic clonic > sodium Valproate
lamotrigine
levetricetam
focal
lamotrigine
myoclonic
M: SV
F: Levetiracetam
tonic / atonic seizure
M: Sodium valproate
F: lamotrigine
when should you start antiepileptic
pt has neurological deficit
brain imaging shows structural abnormality
EEG unequivocal epileptic activity
myasthenia exarcebated by LAB-QT-MG
lithium
abx
betablockers
quinolones
tetracyclines
macrolides
gentamycin
guillain barre sydnrome
peripheral neuropathy
nerves outside fo CNS (the brain and spinal cord)
= LMN signs: hyporeflexia
Aphasia
supplied by superiro division of left MCA
comprehension is normal
expressive - BROCA
inferior frontal gyrus
comprehension is impaired but speech remains fluent?
receptive aphasia
WERNICKE
conduction aphasia?
speech is fluent but repetition is poor
aware of errors
what comes first? korsakoff or wernickes
Wernicke’s encephalopathy
Trid of
nystagmus, ataxi,encephalopathy
MRI
replace thiamine
Korsakoff- antero-retrograde amnesia
lateral medullary syndrome
cerebeller signs
contraletral sensory loss
same side Horner’s
posterior inferior cerebellar artery infarct
GCS
M?
M6
6. Obeys commands
5. Localises to pain
4. Withdraws from pain
3. Abnormal flexion to pain (decorticate posture)
2. Extending to pain
1. None
GCS
verbal?
- Orientated
- Confused
- Words
- Sounds
- None
degenerative cervical myelopathy
smoking
pain
los of motor function
The most characteristic feature of a common peroneal nerve lesion is
foot drop.
Intubate if the GCS is less than 8
This patient’s GCS = 7 (E1, V2, M4). Therefore he requires emergency intubation by a suitably trained clinician to secure his airway, as his GCS is less than 8. This is the most immediate action that needs to be taken as he is otherwise at risk of losing his airway and deteriorating rapidly within seconds to minutes.
what is a PEG
Percutaneous gastrostomy tube (PEG) is the preferred way to support nutrition in patents with motor neuron disease
MND
location of seizures?
aura
> rising sinking feeling in tummy
>deja vu
> hallucinations
seizure
>lip smacking
temporal lobe
frontal lobe seizure?
head/leg movement
psoturing
post ictal weakness
pareital lobe seizures?
parastehsia
most common primary brain tumour kids?
pilocytic astrocytoma
rosenthal fibres/ corkscrew
arise from arachnoid cao cells?
symptoms are compressive
spindle cell in concenteric whorls and calcified psamomma bodies?
meningioma
what is subacute combined degeneration of the spinal cord ?
Dorsal columns and lateral corticospinal tracts are affected
from a b12 deficiency
proprioception and vibration sense comes from?
dorsal columns
lateral corticospinal tract involvemen
Bells Palsy
Forehead affected is bells / LMN sign
Sometimes associ w HSV
mx prednisoalome
Management of Parkinson’s?
Levodopa
Dopamine agonist
Stroke management
Fluid management
Hydration status
Isotonic saline wi dextrose
Glycaemic control
Normal pressure hydrocephalus
Urinary incontinence
Gait abnormality
Dementia
