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Year 6 > Neuro > Flashcards

Neuro Flashcards

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1
Q

What is first line treatment for neuropathic pain?

A

Pregabalin

can also try amitriptyline, duloxetine, gabapentin

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2
Q

What features are characteristic of a seizure in temporal lobe?

A
  • occur with or without impairment of consciousness
  • preceeds with an aura
    -lip smacking/grabbing/plucking
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3
Q

What features are characteristic of a seizure in frontal lobe?

A

Head/leg movements
posturing
post-ictal weakness
Jacksonian march

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4
Q

What features are characteristic of a seizure in parietal lobe?

A

sensory

paresthesia

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5
Q

What is first line treatment for Parkinsons?

A

Levodopa

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6
Q

Second line for Parkinsons

A

Add dopamine agonist, MAO-B inhibitor or catechol-O-methyl transferase (COMT) inhibitor

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7
Q

How to treat myasthenia gravis crisis?

A

Immunoglobulins and plasmapheresis

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8
Q

What is myasthenia gravis?

A

autoimmune condition
antibodies against acetylcholine receptors

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9
Q

What are the investigations for myasthenia gravis?

A

single fibre electromyography ( highly specific)
CT thorax to exclude thymoma
CK normal
antibody test

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10
Q

What is the management of myasthenia gravis?

A

1st line - pyridostigmine ( long acting acetylcholinerase inhibitor)
2nd line - add prednisolone

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11
Q

What is first line investigation of a suspected subarachnoid haemorrhage?

A

CT head without contrast

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12
Q

Features in a headache history that are considered red flags and should do CT Head

A
  • thunderclap
  • new neurological deficit
  • head trauma
  • immunocompromised
  • under 20 + history of malignancy
  • vomiting with no cause
  • headache when coughing, valsalva and sneezing
    -impaired level of consciousness
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13
Q

How does extradural haemorrhage appear on CT?

A

convex ( lemon)

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14
Q

What modality of imaging is used in MS diagnosis?

A

MRI with contrast

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15
Q

What does Urinary incontinence + gait abnormality + dementia suggest?

A

normal pressure hydrocepahlus

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16
Q

How do cluster headaches present?

A
  • headaches last 15 mins to 2 hours
  • intense sharp stabbing pain around one eye
  • lusters last 4-12 weeks
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17
Q

What is used in acute management of cluster headache?

A
  • oxygen
  • subcut triptans
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18
Q

What is used in prophylaxis of cluster headaches?

A

verapamil

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19
Q

What is the drug treatment for tonic clonic seizures?

A

Males - Sodium valproate
females - lamotrigine or levetiracetam

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20
Q

What is the drug treatment for focal seizures?

A

Lamotrigine or Levetiracetam
second line: carbamazepine, oxcarbazepine or zonisamide

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21
Q

What is the drug treatment for absence seizures?

A

Ethosuximide

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22
Q

What is the drug treatment for myoclonic seizures?

A

males - sodium valproate
females - levetiracetam

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23
Q

What is the drug treatment for tonic seizures?

A

males: sodium valproate
females: lamotrigine

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24
Q

What are the management pathway Idiopathic intracranial hypertension?

A

1) weight loss
2) acetazolamide ( carbonic anhydrase inhibitor)
3) topiramate

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25
Where is the lesion located if there is more weakness in the legs than then arms?
anterior cerebral artery
26
Where is the lesion located if there is more weakness in the arms than then legs?
middle cerebral artery
27
What also do you get when there is a MCA?
aphasia sensory loss contralateral homonymous hemianopia
28
What is preferred for secondary prevention following a stroke?
clopidogrel
29
What make up the motor and descending pathways?
pyramidal tracts extrapyramidal tracts
30
What make up the pyramidal tracts?
Lateral and Anterior Corticospinal tracts
31
What make up the sensory and ascending pathways?
dorsal column spinal cerebral
32
What is seen in CSF samples of MS patients?
oligoclonal bands
33
What drug used of Parkinson's is most associated with disinhibition disorder?
Dopamine agonist
34
What classification is used for strokes?
Oxford Stroke Classification
35
What criteria is used for the oxford stroke classification?
1) unilateral hemiparesis and/or hemisensory loss of the face, arm & leg 2) homonymous hemianopia 3) higher cognitive dysfunction
36
What is involved in a total anterior circulation infarct?
- middle and anterior arteries - all 3 of Oxford criteria present
37
What is involved in a partial anterior circulation infarct?
involves smaller arteries of anterior circulation 2 of the criteria present
38
How does carbamazepine work?
binds to sodium channels increases their refractory period
39
What are the adverse effects of carbamazepine?
dizziness ataxia steven-johnsons drowsiness headache hypoNa
40
What nerve is 4th nerve palsy affecting?
Trochlear
41
What does the trochlear nerve do?
supplies superior oblique muscle rotating the eye downward and outward
42
What medication is preferred when managing migraines in childbearing women?
propranolol
43
What is the name of a life threatening condition which can occur in patients who have had an ijury above T6?
Autonomic dysreflexia
44
What organism is responsible for most encephalitis cases?
HSV-1
45
What are the investigations and findings for encephalitis?
- Lumbar puncture --> lymphocytosis, elevated proteins and PCR - MRI --> increased swelling
46
Management of encephalitis
IV acyclovir as soon as suspected
47
Pneumonic to remember homonymous quadrantanopia
Parietal Inferior Temporal Superior
48
What is Wallenbergs syndrome?
occlusion of the posterior inferior cerebellar artery
49
What are some features of a cerebellar stroke?
ataxia nystagmus
50
What nerve is involved in foot drop?
common peroneal nerve
51
Where does the common peroneal nerve come from?
sciatic nerve branches to common peroneal nerve and tibial
52
How does foot drop usually occur?
Injury to the neck of femur
53
What are the symptoms of acoustic neuroma?
- tinitus - unilateral hearing loss - absent corneal reflex - vertigo
54
What cranial nerve is affected if the symptoms of an acoustic neuroma are tinnitus, vertigo and unilateral hearing loss?
cranial nerve 8
55
What cranial nerve is affected if there is absent corneal reflex?
cranial nerve 5
56
What is the first line treatment for ocular myasthenia gravis?
Pyridostigmine
57
Management of a brain abscess
Surgery IV 3rd-generation cephalosporin + metronidazole dexa for swelling
58
Management of trigeminal neuralgia
Carbamazepine
59
What nerve is affected with a mid shaft humeral fracture?
Radial nerve wrist drop
60
What is given on acute relapse of MS?
IV methylpred
61
Where are acoustic neuromas located?
Cerebellopontine angle
62
What are the features of Charcot-Mary-Tooth?
frequently sprained ankle foot drop muscle wasting in calves and forearms hammer toes hyporeflexia
63
Painful third nerve palsy
posterior communicating artery aneurysm
64
What medications should you avoid in parkinsons?
Metoclopramide Anti-emetics that affect dopamine haloperidol
65
Parkinsons disease + postural hypo tension - what other observation do you need to look at to find out the cause?
heart rate compensatory tachycardia - Levodopa Non - progression of disease ( autonomic dysfunction)
66
What are the 4 causes of compensatory tachycardia with postural hypotension?
Deconditioning. Dysfunctional heart: aortic stenosis. Dehydration: disease (acute illness, adrenal insufficiency), dialysis, drugs (diuretics, narcotics). Drugs: anti-anginals, anti-parkinsonian medications (levodopa), antidepressants, antipsychotics, anti-benign prostatic hyperplasia drugs (tamsulosin).
67
How to help patients with MND with nutrition?
PEG
68
What parkinsons medication is associated with high chance of inhibition disorder?
dopamine receptor agonists
69
Management of Stroke
- CT scan to check if there is haemorrhage <4.5 hours --> alteplase <6 hours --> alteplase + thrombectomy in Proximal anterior circulation strokes
70
What are the examination findings for carpal tunnel?
wasting of thenar eminence weakness of thumb abduction
71
What are positive Tinel and Phalen's sign?
tinel's --> taping causes paresthesia Phalen's --> flexion of wrist causes symptoms
72
What blood tests should be performed to assess for reversible causes of memory loss?
FBCs LFT Vit b12 Folate U&Es Glucose ESR TFTs
73
What are the nerve routes for these reflexes: Bicep Tricep Knee Ankle
S1,S2 --> buckle my shoe ( ankle) L3,L4 --> kick the door ( Knee) C5,C6--> Pick up sticks ( Biceps) C7,C8 --> Lay them straight ( tricep)
74
How does Tuberous Sclerosis present?
- Epilepsy - skin changes before the age of 5
75
What are some signs of autonomic dysfunction?
Dysphagia Constipation Orthostatic hypotension ED Weight loss Xs sweating Xs salivation
76
What are red flag precipitating factors for a headache?
Preceding head trauma within past 3 years ( could be haematoma) Headache worse on standing - CSF leak headache worse on lying down - SOL Headache triggered by Valsalva
77
What is a common electrolyte abnormality in carbamazepine use?
HypoNa
78
Treatment for essential tremour
propranolol
79
What nerve supplies the Superior Oblique?
CN IV- trochlear
80
What nerve supplies the lateral rectus?
CN VI- abducens

Year 6 (19 decks)

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