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Medicine Year 3 - Core Conditions > Neurological > Flashcards

Neurological Flashcards

1
Q

What fraction of Strokes/TIAs occur in over 65 yr olds?

A

2/3

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2
Q

What are the two main types of stroke and which is most common?

A

Ischaemic (most common - 87%)

Haemorrhagic

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3
Q

What can cause a ischaemic stroke?

A

Thrombosis, Embolism, Shock

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4
Q

What can cause a haemorrhagic stroke?

A

Intracerbral bleed, Subarchnoid bleed

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5
Q

Definition of TIA

A

Symptoms appear and last less than 24 hours

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6
Q

Stroke/TIA Risk Factors

A

High BP, Smoking, Obesity, Cholesterol, Diabetes, AF

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7
Q

Stroke/TIA Presentation

A

Hemiplegia, Apraxia, Altered smell/taste/vision, Spasticity, Hyperreflexia, Aphasia

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8
Q

What symptoms are more common in haemorrhagic stroke?

A

Loss of consciousness, Thunderclap headache, Vomiting, Neck stiffness, Seizure

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9
Q

Stroke/TIA Investigations

A

CT/MRI, ECG, Bloods, USS, Angiogram

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10
Q

Stroke/TIA Treatment

A

Aspirin, Statins, Thrombolysis, Surgery

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11
Q

Who is subarachnoid haemorrhage more common in?

A

Elderly Females

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12
Q

What is usually the cause of a spontaneous subarachnoid haemorrhage?

A

Ruptured aneurysm in Circle of Willis

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13
Q

Subarachnoid haemorrhage Risk Factors

A

High BP, Smoking, Family Hx, Alcohol/Cocaine, Blood thinners

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14
Q

What does a lumbar puncture show in subarachnoid haemorrhage?

A

Elevated RBCs

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15
Q

Subarachnoid haemorrhage Treatment

A

Surgery, Labetolol, CCBs (prevent vasospasm), Benzodiazepines, Antiemetics

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16
Q

Most common cause of Peripheral Neuropathy?

A

Diabetes

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17
Q

Causes of Peripheral Neuropathy?

A

Systemic disease, Vitamin deficiency, Medication, Trauma, Genetic, Idiopathic

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18
Q

What medication can cause Peripheral Neuropathy?

A

Chemotherapy, Metronidazole, Fluoroquinolones

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19
Q

Peripheral Neuropathy Presentation

A

Motor = Balance, Weakness

Sensory = Numbness, Tingling

Autonomic = Poor bladder control, Sweating

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20
Q

Peripheral Neuropathy Investigations

A

EMG, Bloods (FBC, B12, TSH, Metabolic panel)

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21
Q

Peripheral Neuropathy Treatment

A

Cause, TCAs, SSRIs, Antiepileptics, Topical capsaicin

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22
Q

How many cases of Epilepsy occur in the developing world?

A

80%

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23
Q

What is Epileptogenesis?

A

When epilepsy occurs due to brain injury (stroke/infection etc.)

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24
Q

Epilepsy Risk Factors

A

Family Hx, Toxins (lithium), Metabolic disturbance, Infection, Degenerative disorders

25
Q

What are the two main categories of seizure?

A

Focal and Generalised

26
Q

What are the types of Generalised Seizure?

A

Tonic-Clonic, Tonic, Clonic, Myoclonic, Atonic, Absense

27
Q

What are the types of Focal seizure?

A

Simple, Complex, Secondary Generalised

28
Q

Epilepsy Presentation

A

Aura, Jerking, Muscle contraction, Loss of consciousness, Loss of bladder control

29
Q

Epilepsy Investigations

A

EEG, CT/MRI, Blood prolactin

30
Q

Epilepsy Treatment

A

Acute = IV lorazepam and then Phenytoin

Chronic = Phenytoin, Carbamazepine, Sodium Valproate, Ketogenic diet

31
Q

What Bacteria most commonly cause Meningitis in different age groups?

A

Babies = Group B Strep

Children = Neisseria meningitis, Strep pneumoniae, Haemophilus Influenzae)

Adults = Neisseria meningitis, Strep pneumoniae

32
Q

What viruses can cause Meningitis?

A

Enterovirus, HSV (type 2), VZV, Mumps, HIV, LCMV

33
Q

Most common fungal cause of Meningitis?

A

Cryptococcus neoformans

34
Q

Meningitis Presentation

A

Headache, Fever, Stiff neck, Vomiting, Photophobia, Confusion, Non-blanching rash

35
Q

Meningitis Investigations

A

Bloods (CRP, FBC, Cultures), Lumbar puncture, CT/MRI

36
Q

Meningitis Treatment

A

Immediate empiric antibiotics (usually cephalosporin)

IV fluids, Ventilation, Anticonvulsants

(Viral = supportive / Fungal = Antifungals)

37
Q

What is the most common type of Headache?

A

Tension Headache

38
Q

Migraine Risk Factors

A

Food, Drink, Exercise, Medication, Stress, Bright lights, Hunger

39
Q

Tension Headache Risk Factors

A

Stress, Sleep deprivation, Hunger, Eyestrain

40
Q

Migraine Presentation

A

One half of head, Pulsating, Nausea/Vomiting, Sensitivity to light/sound/smell

41
Q

4 Stages of a Migraine

A

Prodrome, Aura, Pain, Postdrome

42
Q

Tension Headache Presentation

A

Constant pressure pain, Both sides of head

43
Q

Migraine Treatment

A

Analgesics, Triptans/Ergotamines

Prevention = Metoprolol, Valproate, Topiramate

44
Q

Tension Headache Treatment

A

Water, OTCs, Amitriptyline

45
Q

Who is most likely to get Parkinson’s?

A

Males, Over 60yrs

46
Q

Cause of Parkinson’s?

A

Cell death in Basal ganglia and presence of Lewy Bodies in remaining neurons

47
Q

Parkinson’s Risk Factors

A

Pesticides, Trauma, Never smoked/Drank caffeine, Low urate

48
Q

Parkinson’s Presentation

A

Motor = Tremor, Bradykinesia, Rigidity, Postural instability

Many Non-motor

49
Q

What Imaging is not used in Parkinson’s?

50
Q

Parkinson’s Investigations

A

Neurological exam, MRI, PET/SPECT

51
Q

Parkinson’s Treatment

A

Levodopa, COMT inhibitors, Dopamine agonists, MAO-B inhibitors, Surgery, Rehabilitation

52
Q

Proximal Myopathy Presentation

A

Symmetrical weakness of Upper and/or Lower Limbs

53
Q

Proximal Myopathy Causes

A

Drugs, Alcohol, Thyroid disease, Osteomalacia, Myopathies, Malignancy, Infection, Sarcoidosis

54
Q

Proximal Myopathy Investigations

A

Ca/K/Mg, ESR, Creatinine, TFTs, Vitamin D, Muscle imaging and biopsy

55
Q

What is Multiple Sclerosis?

A

Demyelinating disease = disrupts communication in the nervous system

56
Q

Who is most likely to get Multiple Sclerosis?

A

Women, 20-50yrs

57
Q

Multiple Sclerosis Presentation

A

Double vision, Muscle weakness, Trouble with Sensation and Coordination

58
Q

Multiple Sclerosis Investigations

A

Neuro-imaging, Lumbar puncture, Biopsy

59
Q

Multiple Sclerosis Treatment

A

Acute = IV Corticosteroids

Long term = Rituximab

Medicine Year 3 - Core Conditions (12 decks)

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