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Year 3 - Exams > Neurological Cases in Medicine AS > Flashcards

Neurological Cases in Medicine AS Flashcards

1
Q

HOW DO YOU ASSESS GCS?

A

EYES 4

VERBAL RESPONSE 5

MOTOR RESPONSE 6

MINIMUM IS 3

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2
Q

LIST THE COMPONENTS OF THE AMTS test for confusion.

A
  1. DOB
  2. AGE
  3. TIME
  4. YEAR
  5. PLACE
  6. RECALL (WEST REGISTER STREET)
  7. RECOGNISE DOCTOR/NURSE
  8. PRIME MINISTER
  9. SECOND WW
  10. COUNT BACKWARDS FROM 20 TO 1
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3
Q

What are the UMN signs?

A

Increased tone/spasticity and reflexes

Upgoing plantars

Decreased power

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4
Q

What are the LMN signs?

A

Decreased tone(flaccid) and reflexes

Decreased power

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5
Q

What anatomy must you consider in neurological diagnosis?

A

Brain + spinal cord

Nerve roots

Peripheral nerves

NMJ

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6
Q

What are the general causes of neurological pathology?

A
  • Vascular
  • Infection
  • Inflammation/autoimmune
  • Toxic/metabolic
  • Tumour/malignancy
  • Hereditary/congenital
  • Degenerative
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7
Q

Describe these visual field defects.

A
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8
Q

Describe these visual field defects.

A
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9
Q
A
  • III, IV, VI - diplopia
  • IX, X - slurred speech and dysphagia
  • This is a problem affecting NMJ
  • This is a LOWER MOTOR NEURONE LESION

Botulism - when addict run out of venous sites for injection they innject under skin. This man needed . Dx: myasthenia gravis (but no lesions).

Not brain - no hemiparesis. Affecting extraocular muscles as well as speech and swallowing.

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10
Q

Describe the disribution of these lesions:

  • Cerebral cortex
  • Spinal cord
  • Nerve roots (radiculopathy)
  • Mononeuropathy
  • Polyneuropathy
A
  • hemisensory loss
  • level (e.g. umbilicus)
  • dermatomes
  • specific area
  • glove and stocking districbution
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11
Q

What is hydroxocobalamin?

A

Vit B12a - dietary supplement

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12
Q

What would you say in front of patient… HIV? Ca?

A

HIV - “retroviral disease”

Cancer = “mitotic disease”

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13
Q

What would you prescribe?

Codeine/duloxetine/hydroxocobalamin/paracetamol/morphine

A

duloxetine

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14
Q

What are the causes of peripheral neuropathy?

A

(Less likely vascular)

Infection

Inflammation/autoimmune

Toxin/metabolic

Tumour/malignancy

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15
Q

What are the toxic/metabolic causes of peripheral neuropathy?

A
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16
Q
A

Young woman - lesion likely in spinal cord

Blurred margins of optic disc - papilloedema or papillitis…

  • Might also complain of pain - papillitis (reduced visual acuity, blurred vision, pain)
  • Less likely papilloedema because she is young - and doesn’t reduce visual acuity

Two lesions

  • Optic nerve - optic neuritis (papillitis) - blurred dic margins/vision, pain on eye movement
  • Spinal cord - corticospinal/spinothalamic tracts - spastic paraparesis - vascular/infection/inflammation (demyelination e.g. transverse myelitis), toxic/metabolic, tumour/malignancy
17
Q

What is TB affecting spinal cord called?

A

Pott disease

18
Q

What characterises MS?

A

Two lesions

Separated in time/space

19
Q
A

Lose weight

20
Q

Describe meralgia paraesthetica. How do you treat it?

A
21
Q

Describe innervation of the hand.

A
22
Q

What is radiculopathy? Use lumbosacral as an example.

A

Disease of nerve roots

E.g. lumbosacral - pain in buttock, radiating down leg below the knee = “sciatica”

23
Q

What is the cause of radiculopathy?(2)

A

Compression

  1. Disc herniation
  2. Spinal canal stenosis
24
Q
A

A

25
Q

List 3 features of Parkinson’s diseae.

A

Tremor rigidity and bradykinesia

(affects dopaminergic neurones, substantia niagra)

26
Q

Name 2 features of PSP.

A

Parkinsonian features, upgaze abnormality

27
Q

What is the general cause?

A

Toxic/metabolic -recently moved house e.g. CO poisoning

28
Q

Name some differentials for apparent confusion/reduced AMTS.

A
29
Q

What test should you do first when investigating metabolic/toxic causes? What others?

A

Glucose

Drugs

U&Es

LFTs

Vitamin deficiencies

Endocrinopathies

30
Q
A
31
Q

What are the most common causes of headache in ED? How do you differentiate between them?

A
32
Q

Should you treat BP acutely in TIA?

A

No, unless it is over 220/120

33
Q

How do you manage stroke?

A
34
Q

How do you manage TIA?

A
35
Q
A

A- if FVC keeps dropping then PT needs to be sent to ITU

36
Q

What are the 2 main causes of collapse?

A
37
Q

What are the different classes of antibiotics?

A
38
Q

What areas of the cell do each of the antibiotic classes affect?

A

Year 3 - Exams (25 decks)

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