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Phase 3a Jess > Neuro > Flashcards

Neuro Flashcards

1
Q

Where abouts are neurones most affected in MND?

A

Anterior horn

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2
Q

How does weakness initially present in MND?

A

Starts in one area and gradually spreads

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3
Q

What are some UMN symptoms seen in MND?

A

Hypertonia
Hyperreflexia
Up going plantars
Weakness

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4
Q

What are some LMN symptoms seen in MND?

A

Muscle wasting
Fasciculations
Reduced tone
Reduced reflexes

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5
Q

If you were to see foot drop in an MND patient, what area would you suspect to be affected?

A

Lumbar

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6
Q

What are the bulbar signs in MND?

A

Difficulty speaking and eating

Jaw jerk

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7
Q

Name some non-motor signs of Parkinsons

A
  1. Drooling
  2. Depression
  3. Problems with smell
  4. Sleep problems
  5. Memory problems
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8
Q

Is Parkinsons usually uni or bilateral?

A

Unilateral

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9
Q

Acute causes of headache (5)

A
  1. Meningitis
  2. Encephalitis
  3. Sinusitis
  4. Subarachnoid haemorrhage
  5. Extradural haemorrhage
  6. Acute glaucoma
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10
Q

Chronic causes of headache (5)

A
  1. Migraine
  2. Tension headache
  3. Trigeminal neuralgia
  4. Giant cell arteritis
  5. Medication overuse headache
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11
Q

What MUST be done in all people with trigeminal neuralgia?

A

MRI head

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12
Q

What treatment is given for trigeminal neuralgia?

A

Anti-epileptics

e.g. carbamazepine, phenytoin

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13
Q

What Ix must be done in someone who has suspected giant cell arteritis?

A

ESR
CRP raised
Temporal artery biopsy?

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14
Q

What treatments are given for giant cell arteritis?

A

Prednisolone

PPI / Bisphosphonates (protective)

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15
Q

What symptom is really important to look out for if someone has giant cell arteritis?

A

Visual loss

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16
Q

Name as many risk factors for stroke as you can

A
  1. Hypertension
  2. DM
  3. Obesity
  4. Smoking
  5. COCP
  6. AF
  7. CV disease
  8. Hyperlipidaemia
  9. Alcohol
  10. Previous TIA
  11. Clotting problems
  12. Peripheral vascular disease
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17
Q

What scoring system is used for TIA?

A

ABCD2

18
Q

What drug treatment is given for Mx of TIA?

A

Clopidogrel (75mg)

19
Q

What artery is affected in amourosis fugax?

A

Retinal artery

20
Q

Mx of an ischaemic stroke?

A

300mg aspirin

Thrombolysis

21
Q

Name the drug used as thrombolysis

A

Alteplase

22
Q

When can you use thrombolytic drugs (alteplase)?

A

If it is = 4.5 hours since presentation and HAEMORRHAGE HAS BEEN RULED OUT

23
Q

Define a stroke

A

Sudden onset of focal neurological signs of vascular origin, lasting >24h

24
Q

Someone presents with facial, leg and arm weakness, amaurosis fugal and impaired language - where is the stroke likely to be?

A

Carotid

25
Q

Someone presents with dysarthria, dysphagia, diplopia, dizziness, ataxia and diplegia - where is the stroke likely to be?

A

Posterior circulation

26
Q

What risk score is used to calculate risk of stroke if someone has a TIA?

A

ABCD2

27
Q

Management of TIA?

A 
Aspirin 
Admit
Treat BP
Order CT
Do ABCD2
28
Q

Someone has high risk TIA 2 weeks previously. What treatment should they be started on?

A

Clopidogrel

29
Q

Why would you do a carotid doppler in someone who has high risk TIA?

A

To look for stenosis of the internal carotid artery

30
Q

What intervention should someone with carotid stenosis + stroke/TIA have?

A

Carotid endarterectomy and carotid stent

31
Q

What 3 investigations does someone with a TIA need?

A
  1. MRI
  2. 24 hour ECG
  3. Carotid doppler
32
Q

Differentials for stroke (may mimic it)?

A 
Seizure
Tumour/abscess
Migraine
Metabolic 
Functional 
Spinal cord
Peripheral nerve
Cranial nerve
33
Q

Someone presents and you aren’t sure whether they have had a stroke or not. Should you admit them and if so where?

A

Yes, to the acute stroke unit

34
Q

What time frame do you HAVE to do a CT head in if suspected stroke?

A

24 hours

35
Q

Name some indications for immediate head CT (6 examples)

A
  1. Less than 4.5 hours from onset
  2. Taking anticoagulants
  3. Known bleeding disorder
  4. Decreasing consciousness
  5. Fluctuating symptoms
  6. Papilloedema
  7. Severe headache with symptoms
36
Q

What bloods must you do in stroke? (7)

A
  1. FBC
  2. ESR
  3. Clotting
  4. U and E
  5. LFTs
  6. Glucose
  7. Cholesterol
37
Q

What raised blood would indicate further, non-stroke investigations?

A

ESR

38
Q

If a patient has raised ESR with neuro symptoms, what do you need to exclude?

A

Endocarditis
Myoxoma
Vasculitis

39
Q

What drug is used as thrombolysis?

A

Alteplase

40
Q

What is the key time frame for thrombolysis?

A

4.5 hours !!!!!!!

Phase 3a Jess (8 decks)

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