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T 3.1 > neuro hx > Flashcards

neuro hx Flashcards

1
Q

mj pres symptoms

A

headaches, seizures, loc/altered conc, motor/sens dysfunction, mental/cognitive decline, incontence

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2
Q

types of headache

A

1’- pain that occurs in absence exact cause. migraine, tension, cluster

2’- known cause. trigem, sinnusitis etc

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3
Q

inc icp headache

A

dull ache
worse on waking in morning, improves throughout day
worse by coughing/sneezing, bending, lying down
assoc with morning vom

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4
Q

subarachnoid haem headache

A

sudden onset (thunderclap)
irritability, photosenstivity
altered mental state, syncope

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5
Q

meningitis symo

A

headache
neck stiff - meningism
fever nausea
photophobia
drowsiness
confusion

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6
Q

acute headache

A

min to hours- vascular problem eg haem or mig

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7
Q

subacute headache

A

hours to days- infective/inflam cause eg mening, abcess

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8
Q

chronic headache

A

weeks to months- neoplastic
months to years- degen process

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9
Q

seizures cause

A

abn elect dishcarge
epilepsy is recurrent seizure

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10
Q

risk factors of seizures

A

electrolyte abnormalities, brain infection, congenital/peri-partum abnormalities, drug abuse, smoking (tumours) etc

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11
Q

seizures classification

A

localized- partial seizures
generalized seizures- all inclusde loc

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12
Q

types of localized seizures

A

Simple partial - if consciousness not affected
Complex partial - if consciousness is affected

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13
Q

types of generalizedf seizures

A

divided according to the effect on the body -include absence, myoclonic, clonic, tonic, tonic–clonic, and atonic seizures.

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14
Q

gen seizures symptoms

A

Tonic-clonic phases
Cry and fall
Tongue biting
Frothing at the mouth during the clonic phase
Cyanosis
Urinary/faecal incontinence
Rhythmic jerking movements of limbs
LOC (+ drowsiness + post-ictal confusion, amnesia and headache)

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15
Q

tonic phase

A

extension of body
30 sec
may have apnea

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16
Q

clonic phase

A

alternating muscles cont and rel
30-60 sec
tongue biting
sphincter rel

17
Q

recovery phase

A

neuro normal
30 min headache and confusion
transient weakness

18
Q

typical absence attack (petit mal)

A

childhood
activity ceases
staring + pallor
eyelid twitch
brief and may be frequent

18
Q

Vaso-vagal syncope

A

provoked by emotionally charged event e.g venepuncture

18
Q

Cardiac syncope

A

sudden decline in cardiac output and hence cerebral perfusion e.g severe aortic stenosis or heart block

18
Q

temp lobe seizure

A

simple or complex seizures
may prod aura - olfactory - unsual smell
may loc
tingling limbs
may be assoc with confusion and drowsiness

18
Q

cranial nerve dysfunction symp

A

Loss of vision, smell, taste
Alteration in facial feeling
Double vision / visual symptoms
Problems with swallowing / chewing
Speech alterations
Vertigo / hearing abnormalities
Bulbar dysfunction
Pain / difficulty with neck movements

18
Q

hx of seizures qs

A

description of seizure, feeling before during after
From patient and witness (NB blackouts, faints, fits, loss of consciousness)
What happens at the onset of the fit?
What happens during the fit?
Does the patient fall or remain standing or sitting?
How does the fit end?
Confusion or other post-ictal symptoms?
Is there incontinence, any injury or tongue biting?
Frequency of seizures?
When do the seizures occur?
What medication is taken?
Low glucose levels/Diabetes?
History of past/ current medication, compliance and response to medication
Change in seizure pattern
Family history of seizures
Head trauma or brain illness
(especially in adult-onset epilepsy)
Birth history
(especially in early onset seizures)

19
Q

Symptoms of Motor Dysfunction

A

Weakness – ask about ability to lift arms / objects, grip strength, getting up from a chair / bed, going upstairs
Wasting / loss of muscle bulk
Stiffness of limbs
Gait abnormalities - limping or dragging of legs

19
Q

CEREBROVASCULAR DISEASE types

A

Ischaemic -e.g blockage of blood flow as in cerebral venous thrombosis, cerebral arterial embolism
Haemorrhagic - accumulation of blood in the brain tissue (intraparenchymal or intraventricular haemorrhage) or between the brain and the skull vault (epidural haematoma, subdural haematoma and subarachnoid haemorrhage)

20
Q

Signs/symptoms of stroke

A

Acute onset of focal neurologic deficits
Symptoms vary by the area of circulation affected
Visual, language, motor/sensory disturbances
CN deficits, co-ordination, drop attacks, altered consciousness

21
Q

Lesion in cerebral hemisphere -

A

unilateral motor deficit (hemiplegia), higher cerebral function deficit (aphasia or neglect), hemisensory loss or a visual field defect.

22
Q

Carpel Tunnel syndrome

A

The carpal tunnel, a narrow, rigid passageway of ligament and bones in the wrist, houses the median nerve and tendons. Swelling of structures within this tunnel causes median nerve compression and CTS results. It is characterised by pain, weakness and numbness in the wrist and hand.

22
Q

Lesion in brain stem or cerebellum -

A

ataxia, diplopia, vertigo and/or bilateral weakness

23
Q

Symptoms of changes in mental state or cognitive decline - dementia

A

hanges in memory
State of alertness / drowsiness
Changes in mood and affect, loss of spontaneity
Loss of spatial orientation
Language changes
Diminished ability to carry out routine activities of daily living

23
Q

Large volume lesion in cerebral hemisphere

A

reduced level of consciousness

23
Q

Symptoms of Co-ordinatory Dysfunction or Balance disturbance

A

Difficulty in walking
Unsteadiness
Falls
Staggering
Loss of balance in the dark

23
Q

Symptoms of Bladder Dysfunction

A

Urinary retention (spinal cord compression or trauma)

Loss of awareness of bladder distension (damage to the frontal lobe as in frontal tumours, bifrontal subdural haematomas)

Frequency, urgency and urge incontinence (damage to the pons or spinal cord resulting in an upper motor neuron lesion)

Overflow incontinence (damage to the pudendal nerve leading to flaccid paralysis of the detrusor muscle of the bladder, resulting in a lower motor neurone lesion)

24
Q

summary

A

Demographics
Presenting complaint and duration
Most likely diagnosis/system involved
Any underlying condition causing the disease *
Can include any important associated symptoms *
Risk factors for that particular system involved

T 3.1 (11 decks)

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