Neuro 2 Flashcards
Mx of brain abscess?
IV ceftriaxone
metronidazole
++ intracranial pressure management
Mx
surgical - craniotomy and debridement
IV abx: Cef +metronidazole
dexamethasone for pressure
which antidiabetic medication cause hypogylcaemia?
gliclazide and semaglutide
Gliclazide MOA?
sulfonylurea
HSV encephalitis
mx?
affects temporal lobes
> aphasia
HSv1
aciclovir
IX encephalitis
CSF : raised protein and WCC
PCR for HSV
CT
MRi > CT
EEG ; 2hz
Triptans moa
serotonin antagonism
acute mx
why would Indomethacin help with headaches?
inhibits prostaglandin synthesis
NSAID
reduce inflammation
mx of raised intracranial pressure?
acetazolamide - carbonic anhydrase inhibitor
topiramate
anticonvulsant
> inhibits sodium channel gates
what is internuclear opthaloplegia?
lesion which affects fibres crossing between
CN 6 and 3
impaired eye movements nystagmus
failure of adduction in affected eye
neuroleptic malignant syndrome compared to SS?
NMS is very fast / hours
muscle rigidity and raised CK is pointing more to NMS
NMS
massive glutamate release = neurotoxicity and muscle damage
pyrexia
rigidity
delirium
temp
CK raised
leukocytosis
Mx of NMS?
stop antipsychotic
IV fluids for renal
cluster headache?
15- 2 hours
intense sharp pain around one area (eye)
> redness
lacrimation
lid swelling
miosis / ptosis
Mx of cluster headache?
100% O2
subcut triptan
prophylaxis?
> verapamil
unilateral pupillary dilatation in an extradural haemorrhage occurs why?
raised ICP
= transtentorial herniation
raised pressure causes temporal lobe to herniate through tentorial notch
compresses ipsilateral 3rd cranial nerve
= dilated pupil
ptosis
down and out eye deviation
why is the radial nerve particularly vulnerable to compression?
winds around humerous in the spiral groove
‘wrist drop’
inaibility to extend wrist
Ulner nerve innervates?
intrinsic hand muscles
FINGER abductiona nd adduction
sensory medial 1 1/2 fingers
Mx for a thyroid storm?
IV hydrocortisone
propranolol
IV fluids
Mx of Myasthenic crisis?
plasmapheresis to remove circulating abs
IV IG to diminsh activity of disease
Mx of addisonian crisis?
IV hydrocortisone
IV fluids
glucose
ab
Tensilon test
IV edrophonium reduces muscle weakness temporarily
steven johnson syndrome?
rash
confusion
febrile and breathless
MRI with or without contrast to view demyelinating lesions?
with contrast to view plaques
fourth nerve palsy
affected eye appears to deviate upwards when straight ahead
vertical diplopia
drift upwards and rotate outwards
superior oblique muscle paralysis
transverse myelitis?
CNs
hyperreflexia
bladder / bowel dysfunction
