neuro DPD Flashcards
Bacterial meningitis causative organisms in neonates
Group B strep
E.coli
Listeria
Bacterial meningitis causative organisms in children
Haemophilus influenzae
Neisseria meningitis
Strep pneumoniae
Bacterial meningitis causative organisms in adults
Neisseria meningitis
Strep pneumoniae
TB
Bacterial meningitis causative organisms in elderly
Strep pneumoniae
Listeria
Viral meningitis causative organisms
Enteroviruses Mumps HSV VZV HIV
Cryptococcus meningitis
Fungal cause of meningitis
aseptic meningitis is another cause
AMTS score
- DOB
- Age
- Time
- Year
- Place
- Recall address (42 west st)
- Recognise doctor/nurse
- WW2 end date (1945)
- Prime minister
- Count back from 20 to 1
Bacterial lumbar puncture for meningitis
Cloudy CSF
High neutrophils
High protein
Low glucose
Viral lumbar puncture for meningitis
High lymphocytes
High protein
Normal glucose
TB meningitis lumbar puncture
Fibrinous CSF
High lymphocytes
High protein
Low glucose
Where is the lesion if there is abnormal sensation in distribution of:
hemisensory loss
Cerebral cortex
Where is the lesion if there is abnormal sensation in distribution of:
dermatomes
Nerve roots (radiculopathy)
Where is the lesion if there is abnormal sensation in distribution of:
glove and stocking
peripheral nerves
polyneuropathy
Where is the lesion if there is abnormal sensation in distribution of:
level e.g. of umbilicus
spinal cord lesion
Where is the lesion if there is abnormal sensation in distribution of:
specific area e.g. first 3.5 fingers
peripheral nerves
mononeuropathy
e.g. median nerve in carpal tunnel syndrome
What to prescribe for peripheral neuropathy for diabetic patient?
Duloxetin
Pregabalin
These treat neuropathic pain
What is hydroxocobalamin
Vit B12 injection
Metabolic causes of peripheral neuropathy
Alcohol Vit B12 deficiency Diabetes Hypothyroidism Uraemia Drugs Amyloidosis
Non-metabolic causes of peripheral neuropathy
Infection - HIV
Inflammation/AI - vasculitis, connective tissue disease
Malignancy - paraneoplastia, paraproteinaemia
Hereditary sensory motor neuropathy
Papillitis (optic neuritis) signs and symptoms
- optic nerve pathology
Blurred optic disc margins on fundoscopy
Reduced pressure
Blurred vision
Painful on eye movement
Feature of MS
Corticospinal tracts determine
Voluntary motor control
Lesions result in spastic paraparesis
Meralgia paraesthetica definition
Lateral femoral cutaenous nerve compression
Mononeuropathy sensory loss
Rx: reassure, avoid tight garments, lose weight.
If persistent give carbamazepine and gabapentin
Causes of radiculopathy/ nerve root compression
Disc herniation
Spinal canal stenosis
Stroke Rx <4.5hours
CT - haemorrhage excluded
Thrombolysis
Stroke Rx >4.5hours
CT - haemorrhage excluded
Aspirin 300mg
Swallow assessment
Maintain hydration, O2 and monitor glucose
TIA Rx
Aspirin
Only treat BP >220/110
ECG, echo, carotid doppler USS, modify RFs
34 yr presented with a fit. He has no PMH, takes no drugs. He is originally from Somalia but worked in UK for 10 yrs. What blood test do you want to perform?
Test for all possible electrolyte fitting causes:
- hypoCa2+
- hypoNa+
- hypoK+
- hypoglycaemia
and do CT head.
What colour is CSF on CT scan?
Black
What drug to give for space occupying lesion causing cerebral oedema and midline shift?
Dexamethasone
Allows for oedema to decrease a few days before surgical intervention
Commonest brain tumours
Glioblastoma
Meningioma
Haemangioblastoma
Craniopharyngioma
(mets)
Commonest causative organism in encephalitis
HSV
A patient presents with SAH signs and symptoms. CT head is normal. Next appropriate investigation?
Lumbar puncture to check CSF
This will present with xanthochromasia
A 29yr old man presents with 2 mobile fusiform-shaped lumps on the forearm. Each feels like firm rubber and causes tingling in the hand on pressure.
Neurofibromas
Often multiple, at any age - usually in adults. Autosomal dominant. Forearm is frequently affected. Multiple neurofibromas = neurofibromatosis (n.b. cafe-au-lait spots, Lisch nodules in eyes, acoustic neuromas etc).
