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Phase 2b > Neuro histories > Flashcards

Neuro histories Flashcards

1
Q

What is a Space occupying lesion?

A

A pathological lesion within the brain that causes symptoms. Is usually a tumour, but can be an anneurysm, abscess, cyst or granuloma.

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2
Q

What is the characteristic headache with a space occupying lesion?

A

Headache worse on waking, lying down and coughing

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3
Q

What are the main signs/symptoms of a space occupying lesion?

A

Headache worse on lying down, vomitting, papilloedema, seizures, subtle personality changes.

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4
Q

Differentials for a space occupying lesion?

A

Stroke, head trauma, vasculitis, MS, encephalitis, post ictal state

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5
Q

What is encephalitis?

A

Inflammation of the brain parenchyma

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6
Q

What are some causes of encephalitis?

A

Viral: Herpes simplex, EBV, West nile virus
Other: Toxoplasmosis, metabolic causes, autoimmune causes

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7
Q

Who usually gets encephalitis?

A

Extremes of age (very young and very old)
Immunocompromised patients
Exposure to infective vectors in endemic areas

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8
Q

What are the prodromal signs and symptoms of encephalitis?

A

Severe headache, myalgias, malaise

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9
Q

What are the typical symptoms of encephalitis?

A

Fever, headache, altered mental status

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10
Q

What is meningitis?

A

Inflammation of the meninges surrounding the brain and spinal cord

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11
Q

Which bacteria and viruses most commonly cause meningitis?

A

Bacteria: Group B strep, N.meningitidis, strep pneumonia
Viruses: Enterovirus, Coxsackie, HSV

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12
Q

What are the signs and symptoms of meningitis?

A

Headaches, fever, neck stiffness, photophobia, phonophobia, N+V

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13
Q

What would a lumbar puncture show in someone with bacterial meningitis?

A

Raised protein and neutrophils

Low glucose

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14
Q

Which patients most commonly get GCA?

A

Over 50, female

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15
Q

Key symptoms of GCA?

A

Headache over temporal areas and scalp tenderness (when brushing hair)
Polymyalgia rheumatica symptoms
Claudication in extremities or jaw
Visual loss

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16
Q

Investigations for GCA?

A

Raised ESR and CRP

Temporal artery biopsy (gold standard)

17
Q

Differentials for GCA?

A

Takayasu’s arteritis

Polymyalgia rheumatica

18
Q

Treatment for GCA

A

Start on prednisolone then gradually wean once the symptoms start to remit.

19
Q

What is MS?

A

Episodic neurological dysfunction caused by demyelination of neurons

20
Q

What people usually get MS?

A

20-40 year old females

21
Q

Signs and symptoms of MS?

A

Transient motor, sensory, cerebellar symptoms not associated with fever.
Usually an odd patch of wetness or burning, may be in a band shape.
Visual disturbance in once eye
Symptoms worse in a hot shower or bath

22
Q

Differentials for MS?

A

Fibromyalgia, guillain barre, sjogrens

23
Q

Treatment for MS?

A

Interferon beta, methyl pred during attacks

24
Q

How do you diagnose ALS?

A

Clinically from examination and signs

25
Q

What are the key diagnostic factors for ALS?

A 
Upper extremity weakness
Stiffness, poor coordination and balance 
Spastic unsteady gait 
foot drop
difficulty breathing 
etc
26
Q

What drug can help prolong life in ALS?

A

Riluzole

27
Q

What is myasthenia gravis?

A

Antibodies against acetyl choline esterase inhibitors.

28
Q

What are the characteristics of MG?

A

Weakness that increases with exercise and improves on rest

29
Q

Signs and symptoms of MG?

A 
Muscle fatigueability 
Ptosis 
Diplopia (double vision)
Dysarthria 
Proximal muscle weakness
30
Q

Differentials for MG?

A

Lambert eaton syndrome

31
Q

Treatment for MG?

A

Pyridostigmine and immunosuppressants

32
Q

What is lambert eaton syndrome?

A

Antibodies are produced against the voltage gated calcium channels

33
Q

Signs and symptoms of LEMS?

A

Gait difficulties (gait before occular muscles)
Dry mouth
Constipation
Limb weakness

Phase 2b (6 decks)

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