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phase 3a > Neuro > Flashcards

Neuro Flashcards

1
Q

Parkinsons Management

A

Levodopa + decarboxylase inhibitor (co-beneldopa)

MAO-B selegiline

oral dopamine agnoists - ropinirole

PT, OT, SALT

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2
Q

Huntingtons disease patho

A

repeat of CAG on chromosome 4

autosomal dominant

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3
Q

Huntingtons presentation and investigations

A

middle age

mildly psychotic -> chorea -> personality changes (aggressive) -> dementia -> seizures -> death (15 years after diagnosis)

clinical diagnosis

CT shows caudate nucleus atrophy in later disease

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4
Q

Huntingtons management

A

symptomatic

chorea - benzos, valproic acid, tetrabenazine

?anti-psychotics

genetic counselling

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5
Q

MS investigations

A

MRI

LP - oligoclonal bands

Electrophysiological tests - prolonged evoked potential

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6
Q

MND types and symptoms

A

1) amyotrophic lateral sclerosis
- UMN and LMN
- fronto-temporal dementia
2) Progressive bular palsy
- UMN and LMN
- dysarthria, dysphagia, tongue fasciculations
3) progressive muscular atrophy
- LMN
- wasting and fasculations of hand small muscles
4) Primary lateral sclerosis
- UMN
- tetraparesis

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7
Q

MND ix and Mx

A

Ix: clinical diagnosis, EMG(electromyography) /nerve conduction

Mx: riluzole, baclofen

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8
Q

ALS diagnostic criteria

A
  • Signs of LMN degen
  • Signs of UMN degen
  • Progressive spread of signs
  • All without other cause
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9
Q

Which CN are affected in progressive bulbar palsy MND?

A

CN 9-12

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10
Q

Bacterial, viral, neonatal, preg, causative organisms for meningitis

A

bacterial - neisseria meningitides, strep pneumonia, mycobacterium TB

viral - enterovirus, poliomyelitis

Neonates- E.coil, GpB haemolytic strep

Preg/older - listeria monocytogenes

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11
Q

Chronic and viral meningitis presentations

A

viral = self limiting 4-10 days

chronic = long Hx headache, anorexia, vomiting, weary

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12
Q

CSF findings meningitis

A

bacterial: neurophils, raised protein, low glucose

Viral: lymphocytes, normal protein and glucose

TB: lymphocytes, raised protein, low/normal glucose

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13
Q

Meningitis management

A

IV cefotaxime, benpen if in community

+ampicillin to cover listeria if older patient

?meningococcal sept ASAP benpen or cefotaxime IV and blood culture to confirm

Prophylaxis: rifampicin or ciprofloxacin

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14
Q

Encephalitis causes

A

viral

herpes simplex, EBV, mumps

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15
Q

Encephalitis presentation

A

viral infection (fever, headache, nausea, drowsy)

-> decreased conc, focal neuro signs

seizures, coma, death

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16
Q

Encephalitis investigations

A

LP and CSF

Lymphocytes, raised protein, normal/low glucose

EEG- slow wave activity

17
Q

Encephalitis management

A

ASAP acyclovir IV 2 /52

benpen ? meningitis

18
Q

Migraine management

A

triptan (sumatriptan) + NSAID/para ±anti emetic

-BB or topiramate

19
Q

Cluster headache management

A

acute: 100% 15L 02 10-20 mins

sumatriptan or zolmitriptan

prevention: verapamil, prednisolone

20
Q

Myasthenia Gravis management

A

pyridostigmine

prednisolone

methotrexate

21
Q

GCA patho

A

inflam granulomatous vasculitis of large cerebral arteries

22
Q

GCA presentation

A

temporal pulsating headache

scalp tenderness

jaw claudication

superficial temporal artery (tender, firm, pulseless)

systemic (fever, fatigue, breathlessness)

23
Q

GCA investigations

A

FBC (normochromic normocytic anaemia)

raised ESR, biopsy

24
Q

GCA management

A

prednisolone ASAP to prevent ischaemic optic neuropathy

PPI+bisphosphonate

IV methylpred if visual sx

25
Q

Status Epilepticus management

A

1st - buccal midazolam

PR diazepam

IV lorazepam

26
Q

Clinical presentation of trigeminal neuralgia

A

sudden unilat paroxyms of knife/electric pain

lasts seconds to mins, many a day

triggers = washing, shaving, eating, talking, cold winds

27
Q

Trigeminal neuralgia management

A

carbamazepine (suppresses attacks)

Thermocoagulation of trigeminal ganglion of section of sensory distribution

surgery - neurovascular decompression

28
Q

CT results for diff brain haemorrhages

A

SAH - star

SDH- cresent

EDH - lemon

29
Q

Symptoms of older person with SDH

A

cognitive decline, personality change, headache, decreased GCS

30
Q

Carotid territory TIA symptoms

A

amaurosis fugax

hemianopic visual loss

aphasia

hemiparesis

hemisensory loss

31
Q

Vertebrobasilar territory TIA symptoms

A

binocular blindness

diplopia

dysarthria

bilat motor/sensory dysfunction

vertigo

rarely loss of consciousness

phase 3a (9 decks)

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