Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MRCS A > NEURO - Headache, neuro-oncology and CNS infections > Flashcards

NEURO - Headache, neuro-oncology and CNS infections Flashcards

1
Q

What are the 3 types of primary headache

A

Tension
Cluster
Migraine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Features of tension headache

A

COntinuous severe P
Bilateral - band like
Every day and can persist for months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Who gets tension headaches

A

Classically middle aged F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Mx episodic tension headaches (<15d/month)

A

Paracetamol
Aspirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Mx tension headache if meds being used >2xW

A

75mg amitriptylline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Time - cluster headache

A

30mins -2hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Features cluster headache

A

Multiple times/day
Severe unilat pain
Centered on 1 eye
Comes on suddenly
assoc w: red eye, watering eye, vom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is a common precipitant of cluster headaches

A

Alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Mx cluster headaches (2)

A

SC/nasal triptan @ start of attack
Home O2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What % of the population suffer from migraines

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are migraines associated with (4)

A

Menstruation/OCP
Exercise
Alcohol/food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Sx of migraine w/ aura

A

Sense of ill health
Visual aura
Throbbing headache
anorexia
N +V
Photophobia
Begins locally, spreads bilaterally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Neuro examination findings migraine

A

Normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Conservative Mx of migraine (2)

A

Headache diary
Avoid triggers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Mx acute migraine attack (3)

A

NSAIDS/Paracetamol + anti-emetic
PO triptan if severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Preventative Mx migraine - 1st line

A

1st line = Topiramate or propranolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Preventative Mx migraine - 2nd line

A

Amitriptylline/Anticonvulsants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Sinister causes of headache (6)

A

Incr ICP
Idiopathic IC HTN
HTN
SAH/Meningitis
Temporal arteritis
Cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Red flags - headache (9)

A

< 20y/o
Vom w/ no cause
Worsening headache + fever
Thunder clap
Neuro deficit
Cognitive dysfunction
Personality change
LOC
Triggered - cough/valsava

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

who is idiopathic intracranial HTN common in?

A

Obese young women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

S+S Idiopathic IC HTN (3)

A

No mass on imaging
Visual disturbance
Bilateral papilloedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Ix idiopathic IC HTN (2)

A

CT/MRI norm
LP - incr CSF P

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Mx idiopathic IC HTN (3)

A

Decr W
CCS
Surgical shunt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

PS trigeminal neuralgia

A

Agonizing sharp pain over CN V
One sided
O/E = normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Mx trigeminal neuralgia

A

Carbamazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is atypical facial pain?

A

Episodic aching in non-anatomical distrib H+N

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is atypical facial pain associated with?

A

Anxiety/depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Mx atypical facial pain

A

Anti-depressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What does the presentation of a SOL (Intracerebral) depend on? (2)

A

Rate of growth
Anatomical location

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

PS Intracerebral SOL (5)

A

Headache
N+V
Papilloedema
Epileptic seizures
Progressive neurological deterioration e.g. weakness, sensory loss, CN palsies, dysphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Ix suspected SOL

A

Early CT
+ MRI if no mass on CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Mx suspected SOL

A

Dexamethasone 4-6mg
Anticonvulsants
Rx neuro-oncology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is paraneoplastic syndrome?

A

Cluster of Sx
Not explained by tumour, mets or hormones norm secreted by tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

E.g.s of paraneoplastic syndromes in neurology (4)

A

Myasthestenia gravis
Eaton-Lambert syndrome
Paraneoplastic sensory neuropathy
Paraneoplastic cerebellar degeneration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the most common adult brain malignancy

A

Malignant glioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Origin cells malignant glioma

A

Astrocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Prognosis malignant glioma

A

Dead <6months

38
Q

What is the most common cerebral neoplasm

A

Meningioma

39
Q

Is meningioma benign or malignant

A

Benign

40
Q

Mx meningioma

A

Surgical excision + debulking

41
Q

Who gets astrocytomas

A

Young people
Benign + slow growing

42
Q

When brain cancer = 2’ mets, where do 1’ come from? (6)

A

Bronchus
Breast
Kidney
Colon
Thyroid
Malignant melanoma

43
Q

What is the meningitic triad

A

Headache
Neck stiffness
Fever

44
Q

O/E meningitis (4)

A

Kernig’ +ve
Brudzinksi +ve
Incr ICP
CN palsies

45
Q

What is Kernig’s +ve

A

Knee flexion causes pain
(Meningitis)

46
Q

What is Brudzinkski +ve

A

Passive flexion neck –> flexion knees to prevent pain

47
Q

What 2 organisms are 70% meningitis caused by

A

N meningitis
Strep pnuemonia

48
Q

What 4 organisms make up the other 30% causes meningitis

A

Listeria monocytogenes (elderly IC)
H influe
Staph aureus
TB

49
Q

Viral causes meningitis (3)

A

Enterovirus
HSV
VZV

50
Q

How long does viral meningitis last for

A

4-10 days
Self limiting

51
Q

What does TB meningitis follow?

A

1’/miliary TB infection

52
Q

RF TB meningitis (2)

A

IC
Malnourished

53
Q

PS TB meningitis

A

Insidious onset
Wt loss
Progressive confusion

54
Q

Ix TB meningitis

A

Zeihl Neelson stain
PCR

55
Q

Mx TB meningitis

A

RIPE 12 months

56
Q

Ix meningitis (11)

A

Bloods: FBC, U+E, LFT, clotting, glucose, lactate
Serum PCR
Blood cultures
LP
CT
Throat swab

57
Q

CSF results: (meningitis) Gram +ve intracellular cocci

A

Pneumococcus

58
Q

CSF results: (meningitis) Gram -ve cocci

A

Meningococcus

59
Q

Normal CSF values

A

Clear,
<5 cells
Low protein 0.2-0.4
Glucose- ½- 2/3rds

60
Q

CSF: Appearance - Bacterial

A

Cloudy

61
Q

CSF - Appearance - Viral

A

Clear/cloudy

62
Q

CSF - Appearance - TB

A

Slightly cloudy + fibrin web

63
Q

CSF - Glucose levels - Bacterial

A

Decreased

64
Q

CSF - Glucose levels - Viral

A

normal

65
Q

CSF - glucose levels - TB

A

Very low

66
Q

CSF - protein levels - bacterial

A

High

67
Q

CSF - protein levels - viral

A

Norm-high

68
Q

CSF - protein levels - TB

A

High

69
Q

CSF - WCC - Bacterial

A

Polymorphs incr

70
Q

CSF - WCC - Viral

A

Lymphocytes incr

71
Q

CSF - WCC - TB

A

Lymphocytes + polymorphs

72
Q

If you suspect meningitis - within what time frame must an LP be done

A

<1hr

73
Q

Mx meningitis w/ non-blanching rash

A

BEN PEN 1.2g IM
2.4mg 4hrly

74
Q

Mx meningitis w/ non blanching rash - PEN ALLERGY

A

Cefotaxime

75
Q

Mx meningitis <60 y/o

A

IV ceftriaxone 2g bd
IV dexamethasone

76
Q

Mx meningitis <60 y/o PEN ALLERGY

A

IV chloramphenicol

77
Q

Mx meningitis >60 or ICC

A

IV ceftriaxone
IV amoxicillin
IV dexamethasone

78
Q

Acute complications meningitis (3)

A

Sepsis/DIC
Hydrocephalus
Adrenal haemorrhage (Waterhouse Friedericschen syndrome)

79
Q

Long term complications meningitis (4)

A

Brain abscess
Seizure disorder
CN palsy
Ataxia

80
Q

Def encephalitis

A

Inflammation of brain parenchyma

81
Q

Causes encephalitis (3)

A

Usually viral
Enterovirus
HSV
VZV

82
Q

PS Encephalitis (5)

A

Mild
Headache
Drowsiness
Fever/malaise
Confusion

83
Q

Mortality rate - herpes simplex encephalitis

A

20%

84
Q

PS herpes simplex encephalitis

A

High fever
Mood changes
Progressive drowsiness
Seizure/coma

85
Q

Ix encephalitis

A

CT/MRI headh
LP
Viral serology

86
Q

LP findings herpes simplex encephalitis (5)

A

Incr P
Incr lymphocytes
Incr protein
Normal glucose
+ve on PCR

87
Q

Mx herpes simplex encephalitis

A

IV acyclovir 10 days at least

88
Q

Cause - epidural spinal abscess

A

S aureus

89
Q

DDx epidural spinal abscess

A

Osteomyelitis

90
Q

PS epidural spinal abscess (3)

A

Fever
Back pain
Lateral spinal root lesion

91
Q

Mx epidural spinal abscess (3)

A

Emergency imaging
ABx
Surgical decompression

MRCS A (36 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions