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Year 6 > Neuro > Flashcards

Neuro Flashcards

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
Q

Where is the lesion located if there is more weakness in the legs than then arms?

A

anterior cerebral artery

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26
Q

Where is the lesion located if there is more weakness in the arms than then legs?

A

middle cerebral artery

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27
Q

What also do you get when there is a MCA?

A

aphasia
sensory loss
contralateral homonymous hemianopia

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28
Q

What is preferred for secondary prevention following a stroke?

A

clopidogrel

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29
Q

What make up the motor and descending pathways?

A

pyramidal tracts
extrapyramidal tracts

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30
Q

What make up the pyramidal tracts?

A

Lateral and Anterior Corticospinal tracts

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31
Q

What make up the sensory and ascending pathways?

A

dorsal column
spinal cerebral

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32
Q

What is seen in CSF samples of MS patients?

A

oligoclonal bands

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33
Q

What drug used of Parkinson’s is most associated with disinhibition disorder?

A

Dopamine agonist

34
Q

What classification is used for strokes?

A

Oxford Stroke Classification

35
Q

What criteria is used for the oxford stroke classification?

A

1) unilateral hemiparesis and/or hemisensory loss of the face, arm & leg
2) homonymous hemianopia
3) higher cognitive dysfunction

36
Q

What is involved in a total anterior circulation infarct?

A
  • middle and anterior arteries
  • all 3 of Oxford criteria present
37
Q

What is involved in a partial anterior circulation infarct?

A

involves smaller arteries of anterior circulation
2 of the criteria present

38
Q

How does carbamazepine work?

A

binds to sodium channels increases their refractory period

39
Q

What are the adverse effects of carbamazepine?

A

dizziness
ataxia
steven-johnsons
drowsiness
headache
hypoNa

40
Q

What nerve is 4th nerve palsy affecting?

A

Trochlear

41
Q

What does the trochlear nerve do?

A

supplies superior oblique muscle
rotating the eye downward and outward

42
Q

What medication is preferred when managing migraines in childbearing women?

A

propranolol

43
Q

What is the name of a life threatening condition which can occur in patients who have had an ijury above T6?

A

Autonomic dysreflexia

44
Q

What organism is responsible for most encephalitis cases?

A

HSV-1

45
Q

What are the investigations and findings for encephalitis?

A
  • Lumbar puncture –> lymphocytosis, elevated proteins and PCR
  • MRI –> increased swelling
46
Q

Management of encephalitis

A

IV acyclovir as soon as suspected

47
Q

Pneumonic to remember homonymous quadrantanopia

A

Parietal
Inferior
Temporal
Superior

48
Q

What is Wallenbergs syndrome?

A

occlusion of the posterior inferior cerebellar artery

49
Q

What are some features of a cerebellar stroke?

A

ataxia
nystagmus

50
Q

What nerve is involved in foot drop?

A

common peroneal nerve

51
Q

Where does the common peroneal nerve come from?

A

sciatic nerve branches to common peroneal nerve and tibial

52
Q

How does foot drop usually occur?

A

Injury to the neck of femur

53
Q

What are the symptoms of acoustic neuroma?

A
  • tinitus
  • unilateral hearing loss
  • absent corneal reflex
  • vertigo
54
Q

What cranial nerve is affected if the symptoms of an acoustic neuroma are tinnitus, vertigo and unilateral hearing loss?

A

cranial nerve 8

55
Q

What cranial nerve is affected if there is absent corneal reflex?

A

cranial nerve 5

56
Q

What is the first line treatment for ocular myasthenia gravis?

A

Pyridostigmine

57
Q

Management of a brain abscess

A

Surgery
IV 3rd-generation cephalosporin + metronidazole
dexa for swelling

58
Q

Management of trigeminal neuralgia

A

Carbamazepine

59
Q

What nerve is affected with a mid shaft humeral fracture?

A

Radial nerve
wrist drop

60
Q

What is given on acute relapse of MS?

A

IV methylpred

61
Q

Where are acoustic neuromas located?

A

Cerebellopontine angle

62
Q

What are the features of Charcot-Mary-Tooth?

A

frequently sprained ankle
foot drop
muscle wasting in calves and forearms
hammer toes
hyporeflexia

63
Q

Painful third nerve palsy

A

posterior communicating artery aneurysm

64
Q

What medications should you avoid in parkinsons?

A

Metoclopramide
Anti-emetics that affect dopamine
haloperidol

65
Q

Parkinsons disease + postural hypo tension - what other observation do you need to look at to find out the cause?

A

heart rate

compensatory tachycardia - Levodopa
Non - progression of disease ( autonomic dysfunction)

66
Q

What are the 4 causes of compensatory tachycardia with postural hypotension?

A

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
Q

How to help patients with MND with nutrition?

A

PEG

68
Q

What parkinsons medication is associated with high chance of inhibition disorder?

A

dopamine receptor agonists

69
Q

Management of Stroke

A
  • CT scan to check if there is haemorrhage
    <4.5 hours –> alteplase
    <6 hours –> alteplase + thrombectomy in Proximal anterior circulation strokes
70
Q

What are the examination findings for carpal tunnel?

A

wasting of thenar eminence
weakness of thumb abduction

71
Q

What are positive Tinel and Phalen’s sign?

A

tinel’s –> taping causes paresthesia
Phalen’s –> flexion of wrist causes symptoms

72
Q

What blood tests should be performed to assess for reversible causes of memory loss?

A

FBCs
LFT
Vit b12
Folate
U&Es
Glucose
ESR
TFTs

73
Q

What are the nerve routes for these reflexes:
Bicep
Tricep
Knee
Ankle

A

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
Q

How does Tuberous Sclerosis present?

A
  • Epilepsy
  • skin changes
    before the age of 5
75
Q

What are some signs of autonomic dysfunction?

A

Dysphagia
Constipation
Orthostatic hypotension
ED
Weight loss
Xs sweating
Xs salivation

76
Q

What are red flag precipitating factors for a headache?

A

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
Q

What is a common electrolyte abnormality in carbamazepine use?

A

HypoNa

78
Q

Treatment for essential tremour

A

propranolol

79
Q

What nerve supplies the Superior Oblique?

A

CN IV- trochlear

80
Q

What nerve supplies the lateral rectus?

A

CN VI- abducens

Year 6 (19 decks)

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