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Phase 3A Quiz > Neuro > Flashcards

Neuro Flashcards

1
Q

Key Points - Subdural Haematoma?

A

Cause: Rupture of bridging following a blunt trauma or fall

Shape: Crescent shape

Presentation: Initially asymptomatic, as haematoma grown, px develops a slow progressive headache with altered mental status

Mainly affects elderly patients

SUBway under the BRIDGE

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2
Q

Why are elderly patients are most increased risk of Subdural haematoma

A

Atrophy of the brain is more common.
More space for bridging veins to rupture.

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3
Q

Key Points - Epidural Haematoma?

A

Cause: Fracture of temporal bone, leads to rupture of the middle meningeal artery.

Shape: Convex Lens (Elipse)

Blood does not cross the suture line

Px experience Lucid Intervals & CN 3 Palsy

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4
Q

Key features of CN3 Palsy

A

Ptsois
Dilation
Down and Out movement of the eyes

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5
Q

Intraparenchymal Haemorrhage

A

Unilateral flailing of extremities
2nd most common cause of stroke after ischemia
Basal ganglia, internal capsule, thalamus, pons & cerebellum
HTN most common cause
Microaneurysms of perforating arteries ( Charcot-Bouchard)

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6
Q

Breakdown Stroke Classification Types

A
  1. Ischaemic
    a -Thrombotic
    b- embolic
    c - Hypotensive
    d - Hypertensive
  2. TIA
  3. Haemorrhagic
    -Subarachnoid
    -Intraparenchymal
  4. Haematoma
    -Extradural(Epidural)
    -Subdural
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7
Q

Subarachnoid Haemorrhage

A

Cause: Rupture of berry aneurysm
Signs: Worst headache of life / Thunderclap
Neck stiffness similar to meningitis

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8
Q

What would you expect from LP of someone who had a Subarachnoid Haemorrage

A

Bloody/Xanthocromic CSF

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9
Q

Key Points - TIA?

(Transient Ischaemic Attack)

A

Transient neurologic dysfunction due to a vascular cause, typically lasting less than an hour.

Caused by ischaemia (focal brain, spinal cord or retina) WITHOUT acute infarction

Symptoms usually lasts for minutes.

3 Types
1. Atherosclerotic (>70% Occlusion - Increased risk (Symptoms lasts for minutes)
2. Embolic (symptoms lasts for hours)
3. Lacunar

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10
Q

What RFs are most at risk for berry aneurysms

A

SHAME

Smoking
HTN
Acute polycystic kidney disease
Marfans syndrome
Ehlers-Danlos syndrome

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11
Q

Ddx for stroke

A

Post-ictal state (Todd’s paralysis)
Migraine headache aura
Vertigo/Meniere’s disease
MS
Brain tumour
Cerebral infection
Conversion disorder/Malingering

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12
Q

Whats the gold standard diagnostic investigation for a stroke

A

Non-contrast CT of head
(Provided the px is stable)

Differentiate between ischaemic or haemorrhagic stroke

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13
Q

Most accurate imaging for a stroke ?

A

Diffusion-weighted MRI (Takes too long in emergency)

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14
Q

Most common occluded artery causing stroke

A

MCA

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15
Q

Ddx of collapse?

A

Neurological -Generalised seizure epilepsy , TIA/stroke, vasovagal syncope, Parkinsons, Situational syncope (Cough, micturition), Raised ICP, Intracranial Haemorrhages, Neuropathy (MS)

Cardiovascular - Aortic stenosis, Postural HTN, Arrythmias, carotid sinus hypersensitivity, Subclavian steal syndrome, vertebrobasillar insufficiency, structural (cardiomyopathy)

Other causes - Diabetes/Hypoglycaemia, Drug OD/Toxicity, Alcohol, Falls Injury, Ruptured AAA, ectopic pregnancy, delirium, Sepsis

Groupings - Epilepsy, Syncope & Non-epileptic attacks

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16
Q

Define Syncope

A

Abrupt and transient LOC
Leads loss of postural tone
As result of fall in cerebral perfusion

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17
Q

What important areas should you consider when FOLLOWING a COLLAPSE?

[Big 6]

A

Eye witness account
Triggers
Prodrome
Description of collapse
Recovery
PMH/Personal Hx

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18
Q

What Neurological Disorders do you need to consider stopping driving/Informing the DVLA

A

Epilepsy/Seizures
Chronic neuro disoders - MS, MND, Narcolepsy
Brain tumour/pituitary tumour
(Complete PK1 form with DVLA)

It is the patient’s responsibility to notify the DVLA in the case of any seizure.

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19
Q

Driving guidelines for epilepsy/seizures?

A

First unprovoked/isolated seizure: 6M off if there are no relevant structural abnormalities on brain imaging and no definite epileptiform activity on EEG. 12M off if otherwise

Patients with established epilepsy or those with multiple unprovoked seizures:

May qualify for a driving licence if they have been free from any seizure for 12 months

No seizures for 5 years (with medication if necessary) a ’til 70 licence is usually restored

Withdrawal of epilepsy medication: should not drive whilst anti-epilepsy medication is being withdrawn and for 6 months after the last dose

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20
Q

Explain Driving guidelines for syncope?

A

Simple faint: no restriction
Single episode, explained and treated: 4 weeks off
Single episode, unexplained: 6 months off
Two or more episodes: 12 months off

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21
Q

Define Parkinsons Disease?

A

Chronic progressive neurodegenerative disorder characterised by motor symptoms of:

RESTING TREMOR
RIGIDITY
BRADYKINESIA
POSTURAL INSTABILITY

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22
Q

Onset of Parkinson’s?

A

Gradual

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23
Q

Characteristics of Migraine?

A

Recurrent, severe headache which is usually unilateral and throbbing in nature

May be be associated with aura, nausea and photosensitivity

Aggravated by, or causes avoidance of, routine activities of daily living. Patients often describe ‘going to bed’.

In women may be associated with menstruation

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24
Q

Characteristics of Tension Headache?

A

Recurrent, non-disabling, bilateral headache, often described as a ‘tight-band’

Not aggravated by routine activities of daily living

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25
Characteristics of Cluster Headache?
Pain typical occurs once or twice a day, each episode lasting 15 mins - 2 hours with clusters typically lasting 4-12 weeks Intense pain around one eye (recurrent attacks 'always' affect same side) Patient is restless during an attack Accompanied by redness, lacrimation, lid swelling More common in men and smokers
26
Characteristics of Temporal arteritis?
Typically patient > 60 years old Usually rapid onset (e.g. < 1 month) of unilateral headache Jaw claudication (65%) Tender, palpable temporal artery Raised ESR
27
Causes of Acute single episode of headache?
Meningitis encephalitis subarachnoid haemorrhage head injury sinusitis glaucoma (acute closed-angle) tropical illness e.g. Malaria
28
Contraindication of Sumitriptan
Patients with a history of, or significant risk factors for, ischaemic heart disease or cerebrovascular disease
29
Characteristics of Huntington's disease
Chorea - Abnormal involuntary movement (Abrupt Dance like) Personality changes (irritability, apathy, depression) Dystonia Saccadic eye movements
30
What inheritance pattern is Huntington's Disease?
Autosomal dominant Trinucleotide CAG repeat Defective Huntington gene - Chromosome 4
31
Aetiology of Huntington's?
Degeneration of cholinergic and GABAergic neurons in the striatum of the basal ganglia
32
Basilar artery Stroke Effects?
'Locked-in' syndrome A condition in which a patient is aware but cannot move or communicate verbally due to complete paralysis of nearly all voluntary muscles in the body except for vertical eye movements and blinking.
33
AICA stroke effects?
Ipsilateral: facial paralysis and deafness
34
PICA stroke effects?
Ipsilateral: facial pain and temperature loss Contralateral: limb/torso pain and temperature loss Ataxia, nystagmus
35
Retinal/ophthalmic artery stroke effects?
Amaurosis fugax
36
PCA stroke effects?
Contralateral homonymous hemianopia with macular sparing Visual agnosia
37
MCA stroke effects?
Contralateral hemiparesis and sensory loss, upper extremity > lower Contralateral homonymous hemianopia Aphasia
38
ACA stroke effects?
Contralateral hemiparesis and sensory loss, lower extremity > upper
39
Lacunar stroke effects?
Present with either isolated hemiparesis, hemisensory loss or hemiparesis with limb ataxia Strong association with hypertension common sites include the basal ganglia, thalamus and internal capsule
40
What is Normal Pressure Hydrocephalus (NPH) ?
NPH is an accumulation of CSF that causes the ventricles in the brain to become enlarged. "normal pressure" because despite the excess fluid, CSF pressure as measured during a spinal tap is often normal. Little/no increase in ICP in most cases.
41
Classic Triad of symptoms for NPH?
urinary incontinence dementia and bradyphrenia (slower thinking and processing of information) gait abnormality (may be similar to Parkinson's disease)
42
Treatment for NPH?
Ventriculoperitoneal shunting
43
Aetiology of NPH?
2* to reduced CSF absorption at arachnoid villi due to: Head injury, SAH, Meningitis
44
Most commonly first-line medication for terminating acute seizures?
Benzodiazepines
45
What area of the Brain does Herpes simplex (HSV) encephalitis affect?
Temporal lobes predominately Also can affect inferior frontal lobes
46
What are signs/symptoms of HSV Encephalitis?
Fever, headache, psychiatric symptoms, seizures, vomiting focal features e.g. aphasia
47
What Characteristic signs on imaging do you see for HSV Encephalitis?
Petechial haemorrhages
48
Tx for HSV Encephalitis?
IV Aciclovir
49
Drugs causing peripheral neuropathy?
Amiodarone Isoniazid Vincristine Nitrofurantoin Metronidazole
50
Pharmalogical Tx for Alzheimer's Disease (AD)
AcH-Inhibitors - 1st Line Rivastagmine, Donepezil NMDA antagonist - 2nd Line Memantine
51
Aetiology of AD
cortical plaques due to deposition of type A-Beta-amyloid protein and intraneuronal neurofibrillary tangles caused by abnormal aggregation of the tau protein. Causes widespread cerebral atrophy (particularly cortex & hippocampus) Reduced acetylcholine from damage to ascending forebrain projection
52
Common causes of dementia
Alzheimer's Lewy body dementia ~ Approx 10-20% Cerebrovascular disease (Multi-infarct dementia) ~Approx 10-20%
53
Key Differentials of dementia [8 Marks]
hypothyroidism, Addison's B12/folate/thiamine deficiency syphilis brain tumour normal pressure hydrocephalus subdural haematoma depression chronic drug use e.g. Alcohol, barbiturates
54
Lamotrigine Indications?
2nd Line Tx for generalised and partial seizures.
55
Carbamazepine indications?
Partial seizures Trigeminal neuralgia Bipolar disorder
56
Wernicke's Encephalopathy Triad ?
Nystagmus/Opthalmoplegia Ataxia Confusion, Altered GCS Peripheral sensory neuropathy
57
Causation of Wernicke's Encephalopathy? (WE)
Thiamine deficiency. Petechial haemorrhages occur in brain structures (ventricle walls, mamillary bodies) Commonly seen in alcoholics
58
Investigations for WE?
Investigations Serum Thiamine level Therapeutic trial of Parenteral thiamine Blood Glucose UE FBC LFTs MRI
59
WE Differentials?
Alcohol intoxication- (elevated blood alcohol >100mg/dl) Alcohol withdrawal Viral encephalitis
60
Management for WE?
Thiamine (IV) Magnesium sulphate Multivitamin
61
Wernicke's encephalopathy association with Korsakoff syndrome?
Wernicke-Korsakoff syndrome Development of additional symptoms alongside WE. IF WE ISN'T TREATED. [Long-term Thiamine deficiency] Amnesia (Retrograde and anterograde) Confabulation (Memory error in which gaps in a person's memory are unconsciously filled with fabricated, misinterpreted, or distorted information)
62
What Drugs are used for migraine prophylaxis?
Toprimate (Teratogenic) or Propanolol (B-blocker) Patients experiencing 2 or more attacks per month.
63
Management for acute migraine?
Triptan + NSAID (Sumitriptan/almotriptan + Aspirin/Ibuprofen) Triptan + Paracetamol Anti-emetic - Metoclopramide (if above doesn't work)
64
A wide-based gait with loss of heel to toe walking WHICH GAIT IS THIS?
Ataxic gait. Cerebellar hemisphere lesions cause peripheral ataxia. ('finger-nose ataxia') Cerebellar vermis lesions cause gait ataxia.
65
Difference between syncope & seizures?
Syncope - Rapid recovery and short post-octal Seizure - Greater post-ictal period is due to a transient loss of cerebral blood flow (Cardiogenic) Seizure - neurogenic or intracranial in origin - although it can be a result of cerebral hypoxia if blood flow is impaired.
66
How could you differentiate between meningitis and encephalitis?
Meningitis - Cerebral function remains normal Encephalitis - Abnormalities in brain functioning (Altered mental status)
67
If encephalitis is suspected. IMMEDIATE MANAGEMENT?
Prompt IV ACICLOVIR to cover HSV-1 infection.
68
Clinical features of Encephalitis?
Fever Headache Seizures Vomiting Focal features (Aphasia)
69
Which areas of the brain are commonly affected by encephalitis?
Temporal Inferior frontal lobes
70
Investigations for encephalitis?
LP- CSF: Elevated protein, lymphocytosis PCR - For HSV CT/MRI - Medial temporal + inferior frontal changes / - Presence of petechial haemorrhages EEG - 2hz spike
71
Most common pattern in bloods for someone with suspected neuroleptic malignant syndrome (NMS)?
Raised creatine kinase and leukocytosis (raised wbc).
72
Mnemonic for NMS Clinical findings?
FEVER F-Fever E-Encephalopathy V- Vitals (Symp NS activity increased). HTN,Tachy,++RR E- Elevated CK R- Rigidity ('lead pipe')
73
Who is NMS most likely to be seen in?
Individuals taking antipsychotic medication (Atypicals) Also occur in people with cessation of dopaminergic drugs (L-dopa) e.g. Parkinson. Dopamine blockage -> Massive glutamate release -> Neurotoxity and muscle damage.
74
Management for NMS?
Stop antipsychotics IV Fluids to prevent Renal Failure Dopamin agonist - Bromocriptine Muscle relaxant - Dantrolene
75
Mnemonic for Phenytoin SE?
PHENYTOIN P- P450 interactions (Inducer) H- Hirsutism E- Enlarged gums (Bleeding/Gingival hyperplasia) N- Nystagmus Y- Yellow (Jaundice) T- Teratogenic O- Osteomalacia I- Interference w/ B12 metabolism N- Neuropathies
76
Immediate management of TIA?
A patient who presents within 7 days of a clinically suspected TIA should have 300mg aspirin immediately (and be referred for specialist review within 24h) Unless C/I - Bleeding disorder / Existing Anticoagulant therapy - Urgent CT Scan Needed to R/O Haemorrhage
77
What Antiplatlet therapy is given long term following stroke
Clopigrel 75mg / [Aspirin + dipyridamole (c/I patients)] Atorvastain
78
Indications and Criteria for Carotid Artery endarterectomy?
>70% carotid stenosis Patient has suffered stroke/TIA in carotid territory and not severely disabled.
79
Sodium Valproate SE HINT: WHAT THAT PIG E?
W- Weight gain H- Hepatitis A- Ataxia T- Thrombocytopenia T- Teratogenic H- Hyponatraemia A- Alopecia T- Tremor P- Pancreatitis I- Inhibits P450 G- GI: Nausea E- Encephalopathy (due to high ammonia) -
80
Reflexes 1. Ankle 2. Knee 3. Biceps 4. Triceps
1. S1-S2 - Button my shoe 2. L3-L4 Kick the door 3. C5-C6 Pick up the sticks 4. C7-C8 Close the gate
81
What is the most common worldwide cause of epilepsy?
Neurocysticercosis -Parasitic infection of the central nervous system -Tapeworm(Taenia solium) -Humans affected by eating undercooked food (Pork)
82
Define Epilepsy
Syndrome of recurrent, unprovoked seizures
83
Define Seizure?
Acute, Transient (<5min) neurological event caused by abnormal electrical discharges within the brain.
84
Define Status Epilepticus?
Seizure activity that fails to terminate within the anticipated time period (5-30 minutes) OR SERIES OF CONSECUTIVE SEIZURES w/o recovery in between them
85
Causes of Epilepsy?
Stroke Brain tumour Brain injury CNS Infection
86
Define Brain Death (Cerebral death) ? 3 Characteristic findings?
Irreversible loss of all function of the brain including the brainstem. Coma Absence of brainstem reflexes Apnoea
87
Define Brain Death (Cerebral death) ? 3 Characteristic findings?
Irreversible loss of all function of the brain including the brainstem. Coma Absence of brainstem reflexes Apnoea
88
Criteria for brainstem death testing? Method of brain death testing?
Deep coma of known aetiology + failure to respond to external stimuli Reversible causes excluded No sedation Normal electrolytes Person's heartbeat and breathing can only be maintained using a ventilator Clear evidence that serious brain damage has occurred and it cannot be cured TESTS -No corneal reflex -No fixed pupil response to any light intensity stimulation. -Absent oculo-vestibular reflects (No eye movements following injection of ice-cold water (50ml) into each ear [CALORIC TEST] -No response to supraorbital pressure -No cough/gag reflex - Pharyngeal/bronchial stimulation -No observed respiratory effect off ventilation (5 minutes) 2 DOCTORS, TEST ON SEPARATE OCCASIONS
89
Define Raised Intracranial pressure? Normal Values for ICP -Adults -Children -Neonates
Sustained elevation in pressure exerted on the brain tissue by external forces (CSF and blood) above 20mmhg. >20+ (Intracranial HTN) Normal Values Adults (10-15mmhg) Children (3-7mmhg) Neonates (<2mmhg) Increase in any of components leads to rICP [Brain/ Blood /CSF]
90
Differentials for ICP?
Hydrocephalus CNS Infectiosn - Meningitis/Encephalitis/Abcess Trauma - Intracranial Haematoma Cerebrovascular - SAH, Intracerebral/ventricular haemorrage Status epileptics Idopathic intracranial HTN
91
Define Coma?
A person is in a coma if they are unconscious and unaware of what is going on around them and they do not open their eyes even in response to pain.
92
High -altitude cerebral oedema. What the most important management step? What is considered high altitude?
DESCENT [FIRST LINE] + O2, Analgesia/ Dexamethasone >1500m altitude
93
What Index is used to assess Disability following a stroke?
Barthel Index Assess the functional status of a patient post-stroke and level dependancy to do tasks. 10 Tasks -Feeding, moving from wheelchair to bed, personal toileting, getting on/off toilet, bathing, walking on level surface, ascending/descending stairs, dressing, controlling bowels and controlling bladder 0-100 (Completely dependent - Completely independent)
94
What assessments should be done on stroke patients that are hospitalised.
Feeding assessment - Screening for safe swallowing needs to occur. (Reduce aspiration risk + complications) Disability Scales- Barthel Index Fluid management - Fluid status assessment (Maintain Normovolaemia BP Management - Only be used in HYPERTENSIVE emergencies as (Don't want to compromise collateral blood flow to affected regions by lowering bp) Glycaemic control - diabetes (IV Insulin & glucose infusions / nil by mouth px (swallowing concerns)
95
Stroke Fluid Assessments Considerations
Oral hydration is preferable - Patients who are able to safely swallow IV Hydration- In those who have difficulties swallowing Isotonic saline (No dextrose) Monitor - Electrolytes Monitor fluid status to prevent OVERHYDRATION (cerebral oedema, cardiac failure and hyponatraemia) / HYPOVOLAEMIA ( infection, deep vein thrombosis, constipation and delirium)
96
For Individuals eligible for thrombotic therapy what is the IDEAL BP Range PRE & POST TREATMENT
<185/110 (Pre- treatment) <180/105 (Post treatement)
97
Stroke Feeding Assessments Considerations
NIL By Mouth Until assessment Assessment of any oral intake of food, fluids, and/or medication Swallowing specialist assent within 24-72 hours if any concerns. Recommendations for patients deemed unsafe for oral intake: Patients should receive nasogastric tube feeding, ideally within 24 hours of admission, unless they have had thrombolytic therapy If nasogastric tube feeding is not tolerated, patients should be considered for a nasal bridle tube/gastrostomy instead Medications need to be assessed to determine if formulations are available for NG feeding/ conversion to subcut or IV. Nutritional support need to reduce malnutrition risk post-stroke (due to dysphagia, poor oral health/ reduced self-feeding ability from weakness/paralysis)
98
STROKE MANAGEMENT
A-E Assessment Maintain - BG, O2 Sats, Temp, Hydration BP Monitoring - LOWER ONLY IF HTN EMERGENCY/complication CT SCAN - RULE OUT HAEMORRAGIC Stroek Yes - Aspirin 300mg PO/PR Thrombolysis <4.5 hrs + Haemorrhage has been excluded (+Thrombectomy if criteria is met) 2nd Prevention Clopigogrel Aspirin/Dipyridamole (C/I of clopidogrel) Statin
99
Contraindications to Thrombolysis
Suspected SAH Previous ICH Active Bleeding Seizure at onset of stroke Uncontrolled HTN > 200/120 (Above 185/110) Prev stroke/ traumatic brain injury past 3M Pregnancy LP in last 7 days GI Haemorrhage past 3 weeks Oesphageal varices Things to be aware of INR levels (>1.7) Major Surgery Prev 2 weeks Bleeding diathesis (Cogulation defects - VWB, Hamophillia..)
100
Criteria for Thrombectomy?
Acute Ischamic stroke Within 6hrs of symptom onset Confirmed occlusion of - Proximal Anterior Circulation (CTAngiography/MRAngiography) Proximal posterior circulation (Basillar/PCA) - confirmed by CTA/MRA Potential to salvage brain tissue imaging -CT perfusion /DW MRI +IV thrombolysis (Within 4.5 hrs)
101
What scale can be used to test pre-stroke functional status (ADLs) ?
Modified Rankin Score
102
What Pre-screening tools can be used to identify stroke
FAST (Face, Arms, Speech, Time to call 999) ROSIER (ED stroke recognition) LOC/Syncope (-1/0) Seizure activity (-1/0) Asymmetric facial weakness Asymmetric arm weakness Asymmteric leg weakness Speech disturbance VF defect [1/0 mark for each] Stroke is unlikely if <0 /= 0 NIHSS - Objectively QUANTITY THE IMPAIRMENT SEVERITY OF A STROKE
103
Rankin Score
[ADD]
104
What organism is responsible for neurosyphilis? What disease process can neuosyphillis symptoms mimic?
Treponema Pallidum Meningitis
105
What are signs of rICP (Raised Intracranial Pressure)?
Papilloedema Focal Neurological signs Continuous/uncontrolled seizures Reduced GCS (<12)
106
When would you not do a LP?
Infection is present at LP site
107
What are focal neurological signs/deficits
Set of symptoms or signs in which causation can be localised to an anatomic site in the central nervous system (Brain/SC/Nerve) e.g. Paresis, Plegia
108
What blood test can differentiate between a pseudoseizure and true seizure?
Serum Prolactin - Raised following true seizures (Spread of electrical activity to ventromedial hypothalamus -> leads to release of prolactin)
109
Clinical signs indicating pseudo seizure?
Pelvic thrusting Crying after seizure
110
Essential Tremor (Benign essential Tremor) Clinical features Mangagement
Autosomal dominant, affects both upper limbs Clinical features - Postural tremor -> Worse when hands are outstretched -Improved with alcohol and rest -Can cause head tremor Management -Propranolol
111
What is important pre-step before doing an LP with a Space Occupying lesion?
CT Head -Check that there is no shift/asymmetry in the brain as this increases risk of herniation (pressure coming from one side is at risk)
112
RF for Idiopathic Intracranial Hypertension (IIH)?
Obese Female Pregnancy
113
Clinical features of IIH?
Headache Blurred vision Papillodeama 6th nerve palsy enlarged blind spot
114
Management of IIH?
Weight loss Diuretics - Acetazolamide (IIH + Glaucoma) Repeated LPs Surgery - Optic nerve sheath decompression
115
Red flag criteria that indicates further imaging?
Vomiting more than once with no other cause. Progressive headache with a fever. New neurological deficit (motor or sensory). Reduction in conscious level (GCS) Valsalva (associated with coughing or sneezing) or positional headaches. SCANIT S - Sudden-onset headache (reaching max. intensity within 5 minutes) C - Characteristics (Orthostatic, Valsalva, Change in chronic headache) A - Age (>50), Arteritis, Acute Narrow-angle glaucoma N - Nausea (2+ Vomiting episodes w/o cause), Neurological deficit I - Impaired consciousness, Immunocompromised T - Tumour (History of malignancy), Temperature (Systemic fever), Thinners (Anticoagulated)
116
What might help you to differentiate between
Unilateral symptoms More severe/early onset autonomic dysfunction (postural hypotension/erectile dysfunction).
117
What is used to treat cerebral oedema in patients with a brain tumour?
Dexamethasone
118
What is the most common long-term complication following meningitis?
Sensorineural loss.
119
DVLA RULES Epileptic patient changes medication and has a seizure. Is put back on original medication and is seizure free for 6M Are they able to drive?
Apply to DVLA to reinstate licence. 6M seizure free period after changing medication. License can be reinstated.
120
What is the main treatment for ALS (MND)?
Riluzole

Phase 3A Quiz (7 decks)

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