Neuro/Ophthal/Psych Flashcards
Acute treatment for Migraine
Oral triptan and an NSAID/Paracetamol
Prophylaxis of Migraine
Propranolol
Topiramate
Amitriptyline
Candesartan
Herpes simplex (HSV) encephalitis affects which lobes
Temporal lobes (characteristically)
Treatment for Herpes simplex (HSV) encephalitis
Intravenous aciclovir
First-line for Guillain-Barre syndrome
IVIG
Bilateral vestibular schwannomas
Multiple intracranial schwannomas, mengiomas and ependymomas
Neurofibromatosis 2
Lateral medullary syndrome
Posterior inferior cerebellar artery
(Wallenberg’s syndrome)
Ipsilateral: ataxia, nystagmus, dysphagia, facial numbness, cranial nerve palsy e.g. Horner’s
Contralateral: limb sensory loss
Progressive multifocal leukoencephalopathy (PML) - define
Demyelinating disease of the CNS characterised by widespread lesions due to brain infection of oligodendrocytes by the JC Virus
Features of Horner’s syndrome
Miosis (small pupil)
Ptosis
Enophthalmos (sunken eye)
Anhidrosis (loss of sweating one side)
Generalised tonic-clonic seizures
Males: sodium valproate
Females: lamotrigine or levetiracetam
Focal seizures
First line: lamotrigine or levetiracetam
Second line: carbamazepine, oxcarbazepine or zonisamide
Absence seizures (Petit mal)
First line: ethosuximide
Second line:
Male: sodium valproate
Female: lamotrigine or levetiracetam
? may exacerbate absence seizures
Carbamazepine
Myoclonic seizures
Males: sodium valproate
Females: levetiracetam
Tonic or atonic seizures
Males: sodium valproate
Females: lamotrigine
Features of Creutzfeldt-Jakob disease
Dementia (rapid onset)
Myoclonus
1st line drug in the management of ocular myasthenia gravis
Pyridostigmine
Management of myasthenic crisis
Plasmapheresis
Intravenous immunoglobulins
Combination of ophthalmoplegia, ataxia and areflexia
Miller-Fisher syndrome
Miller-Fisher syndrome - antibodies
Anti GQ1b antibodies
Absolute contraindication for electroconvulsive therapy
Raised intracranial pressure
First line for prophylaxis of cluster headaches
Verapamil
Anterograde amnesia - define
The inability to form new memories
Acute management of cluster headaches
100% oxygen
Subcutaneous triptan
Sudden painless loss of vision, severe retinal haemorrhages on fundoscopy
Central retinal vein occlusion
Triad of Normal Pressure Hydrocephalus
Urinary incontinence
Ataxia
Memory impairment
Management of NPH
Ventriculoperitoneal shunting
Management of Proliferative retinopathy
Panretinal laser photocoagulation
Intravitreal VEGF inhibitors (ranibizumab)
Typical antipsychotics
Haloperidol
Chlorpromazine
Atypical antipsychotics
Clozapine
Risperidone
Olanzapine
Extrapyramidal side-effects (EPSEs)
Parkinsonism
Acute dystonia
Akathisia (severe restlessness)
Tardive dyskinesia
Antibodies for Myasthenia gravis
Antibodies to acetylcholine receptors
Anti-muscle-specific tyrosine kinase antibodies
Antibodies against the voltage-gated Ca2+ channels
Lambert-Eaton syndrome
Anterior uveitis - treatment
Steroid + cycloplegic (mydriatic) drops
Agoraphobia
Fear of open spaces
Management of scleritis
Same-day assessment by an ophthalmologist
Oral NSAIDs are typically used first-line
Oral glucocorticoids may be used
Treatment of hepatotoxicity or hyperammonemic encephalopathy in the context of an acute or chronic overdose of sodium valproate
L-Carnitine
Thrombolysis in patients with a proven ischaemic stroke of less than ? hours duration.
4.5 hours
Disorder in which a person holds a delusion that a friend or partner has been replaced by an identical-looking impostor.
Capgras Syndrome
Treatment for Herpes zoster ophthalmicus
Oral antiviral for 7-10 days
Definitive treatment for acute angle-closure glaucoma
Laser peripheral iridotomy
Which virus is responsible for 95% of cases of viral encephalitis in adults
HSV-1
MELAS
Mitochondrial Encephalopathy lactic acidosis and stroke-like episodes
Patients ≤ 25 years who have been started on an SSRI should be reviewed after ?
1 week
Preferred modality in patients with suspected TIA who require brain imaging
MRI brain with diffusion-weighted
Retinal + cerebellar haemangiomas
Von Hippel-Lindau syndrome
Older man + quadriceps and finger/wrist flexors weakness + raised CK
Inclusion body myositis
Uncal herniation results in pressure on the midbrain resulting in
Ipsilateral CN III palsy (mydriasis is the earliest sign) and contralateral hemiparesis
Cerebellar ataxia
Telangiectasia (spider angiomas)
IgA deficiency resulting in recurrent chest infections
Ataxia telangiectasia
Bilateral spastic paresis and loss of pain and temperature sensation
Anterior spinal artery occlusion
Recombinant monoclonal antibody that antagonises alpha-4 beta-1-integrin
Natalizumab
Oxford Stroke Classification
- Unilateral hemiparesis and/or hemisensory loss of the face, arm & leg
- Homonymous hemianopia
- Higher cognitive dysfunction e.g. dysphasia
Treatment of Essential tremor
Propranolol
Primidone (2nd line)
Postural tremor: worse if arms outstretched
Improved by alcohol and rest
Most common cause of titubation (head tremor)
Essential Tremor
Surgical management of refractory trigeminal neuralgia
Microvascular decompression
Vitamin B12 - AKA
Cobalamin
Drug causes of Idiopathic intracranial hypertension
Combined oral contraceptive pill
Steroids
Tetracyclines
Retinoids (isotretinoin, tretinoin) / vitamin A
Lithium
Aquaporin 4 positive serum antibody
Neuromyelitis optica
Management of Restless legs syndrome
Dopaminergic agents (eg, pramipexole, ropinirole, bromocriptine, levodopa-carbidopa, and rotigotine)
Contralateral hemiparesis and sensory loss with the upper extremity being more affected than the lower
Middle cerebral artery
Lateral medullary syndrome
Wallenberg’s syndrome,
Posterior inferior cerebellar artery.
Cerebellar features:
Ataxia
Nystagmus
Brainstem features
Ipsilateral: dysphagia, facial numbness, cranial nerve palsy e.g. Horner’s
Contralateral: limb sensory loss
