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Core Conditions > Neurological Conditions > Flashcards

Neurological Conditions Flashcards

1
Q

Who is most typically affected in meningitis?

A

INFANTS and ADOLESCENTS

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2
Q

What is the cause of meningitis?

A

It is an inflammation of the meninges as a result of bacterial infection:

  • NEISSERIA MENINGITIDIS
  • STREPTOCOCCUS PNEUMONIAE
  • HAEMOPHILUS INFLUENZAE B
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3
Q

What are the risk factors for meningitis?

A

NON-MODIFIABLE- young age, winter season
MODIFIABLE- smoking
PMH- splenic dysfunction, splenectomy, immunocompromised, basal skull fractures, otitis media, sinusitis, sickle cell disease, organ dysfunction

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4
Q

What are the symptoms in meningitis?

A 
Infective symptoms- fever, vomiting, nausea, lethargy, irritability, anorexia, headache, muscle ache, chills, shivering, diarrhoea, abdo pain)
NON-BLANCHING RASH 
STIFF NECK
UNUSUAL SKIN COLOUR
SHOCK AND HYPOTENSION
LEG PAIN
BACK RIGIDITY
BULGING FONTANELLE
PHOTOPHOBIA
UNCONSCIOUSNESS
PARESIS
SEIZURES
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5
Q

What are the clinical signs of meningitis?

A

Kernig’s signs (unable to fully extend at the knee when the hip is flexed)
Brudzinski’s sign (flexion of hip and knees when neck is flexed)
Prolonged cap refill time
Focal neurologcal deficit
Raised ICP

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6
Q

What are the differentials of meningitis?

A 
Viral meningitis
Fungal meningitis
Viral encephalitis
Brain and neuro malignancy
Brain and spinal abscess
Parameningeal infection
SLE
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7
Q

What investigations should be done in suspected meningitis?

A

BLOODS: Blood culture
SAMPLING: lumbar puncture
IMAGING: CT

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8
Q

What is the appropriate treatment for meningitis?

A

Antibiotics

  • Benzylpenicillin
  • Cefotaxime
  • Vancomycin
  • Ampicillin
  • Chloramphenicol
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9
Q

Who is most typically affected by migraine and tension headaches?

A

More prevalent in WOMEN

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10
Q

What is the cause of migraines and tension headaches?

A

There are genetic causes and neuroanatomical causes

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11
Q

What are the risk factors associated with tension headaches and migraines?

A

NON-MODIFIABLE- family history, gender- female

MODIFIABLE- stress, certain foods (cheese, salty, processed food), excess heat and dehydration

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12
Q

What are they key symptoms in migraines and tension headaches?

A

Severe paroxysmal headaches that are UNILATERAL
Aura
Nausea
Pain that radiates to the back/occiput of the neck
Dull onset/throbbing
Worse on movement
Seizures

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13
Q

What differentials are associated with migraines and tension headaches?

A

Headaches with TIA, stroke, intracerebral haemorrhage
Temporal arteritis
Dissection of the carotid and verterbral arteries
Meningoecephalitis

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14
Q

What treatment is appropriate for migraines and tension headaches?

A

Analgesics
Rest and symptomatic relief
Triptans (sumatriptan, zolmitriptan, naratriptan)

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15
Q

Who is more likely to be affected by Parkinson’s

A

It is 1.5 times more prevalent in MEN, aged 55-65 years old.

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16
Q

What are the main causes of Parkinson’s

A

IDIOPATHIC
SECONDARY due to vascular reasons, drug induced, post-encephalitic, hydrocephalus
DEGENERATIVE- Alzheimer’s, Parkinson-dementia-MND complex
GENETIC- Wilton’s disease, Huntington’s disease, Dopa-responsive dystonia.

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17
Q

What are the risk factors for Parkinson’s?

A

NON-MODIFIABLE- Increasing age, gender- male

MODIFIABLE- pesticide exposure

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18
Q

What are the symptoms of Parkinson’s?

A 
Impairment of dexterity
Fixed facial expression
Resting tremor
Rigidity- increased tone
Bradykinesia
19
Q

What are the clinical signs associated with Parkinson’s

A

Gait disturbance

4-6Hz resting tremor

20
Q

What are the differential diagnoses of Parkinson’s?

A 
Benign essential tremor
Drug-induced tremor
Huntington's
Wilson's disease
Creutzfeldt-Jakob disease
Lewy-body dementia
Pick's disease
Cerebellar tremor
Psychogenic tremor
21
Q

What investigations should be carried out in suspected Parkinson’s?

A

IMAGING: CT, MRI, PET SCAN, transcranial sonography

22
Q

What is the management for Parkinson’s?

A

Monoamine-oxidase-B (MAO-BIs), selegine, rasagiline
Levodopa
Dopamine agonists
Apomorphine

23
Q

What is the cause of peripheral neuropathy?

A

CONGENITAL
PMH- diabetes, malignancy, chronic vascular disease, metabolic problems, chronic inflammatory demyelinative, infection
Drugs
OTHER- heavy metal poisoning

24
Q

What are the risk factors associated with peripheral neuropathy?

A

Diabetes
Alcohol abuse
Family history
Repetitive motion

25
Q

What are the symptoms of peripheral neuropathy?

A 
Numbness, burning pain, extreme sensitivity to touch
Lack of coordination and falling
Muscle weakness and wasting
Loss of bladder contro;
Orthostatis hypotension
26
Q

What are the clinical signs of peripheral neuropathy?

A

Positive Romberg’s sign.

27
Q

What are the differentials for peripheral neuropathy?

A 
Guillain-Barré syndrome
Charcot-Marie-Tooth syndrome
Porphyria
Lead poisoning
Diptheria
28
Q

What investigations are done in suspected peripheral neuropathy?

A

BLOODS: FBC, ESR, vitamin B12, folate, fasting glucose, renal, liver, thyroid function tests.
URINE: glucose, protein

29
Q

What is the treatment/management for peripheral neuropathy?

A

Good management of diabetes

Amitryptiline, gabapentin, pregabalin

30
Q

Who is mostly likely to suffer from a stroke?

A

Patients over 65

31
Q

What are the causes of stroke?

A

ISCHAEMIC STROKE

  • thrombotic (blood clot)
  • embolic (atherosclerotic blocakge)

HAEMORRHAGIC STROKE

  • intracerebral bleeding within brain
  • subarachnoid bleeding between brain surface and arachnoid layer
32
Q

What are the risk factors associated with stroke?

A

MODIFIABLE- smoking
PMH- hypertension, diabetes, heart disease, peripheral arterial disease, polycythaemia vera, carotid occlusion, clotting disorders
IATROGENIC- combined oral contraceptive pill

33
Q

What are the presenting symptoms of stroke?

A 
Contralateral hemiplegia
Contralateral sensory loss
Homonymous hemianopia
Dysphagia
Ataxia imbalance, unsteadiness, disequilibrium
34
Q

What are the differentials for stroke?

A 
Hypoglycaemia
CNS tumour
Subdural bleed
Todd's palsy
Drug overdose
35
Q

What are the investigations involved in suspected stroke?

A

BLOODS: FBC, ESR
IMAGING: CT, MRI, CXR, ECG

36
Q

What is the line of treatment for stroke?

A

LIFESTYLE MANAGEMENT of CVD factors
Antiplatelet therapy: Aspirin, Clopidogrel (Ticagrelor)
Thrombolytic therapy: Streptokinase

37
Q

Who is most likely to suffer from a sub-arachnoid haemorrhage?

A

WOMEN
AFRO-CARIBBEAN
50

38
Q

What is the general cause of a subarachnoid haemorrhage?

A 
Intracranial arterial aneurysms
Non aneurysmal peri-mesencephalic haemorrhage
Arteriovenous malformation
Vasculitis
Tumours causing abnormal vessels
39
Q

What are the risk factors of subarachnoid haemorrhage?

A

NON-MODIFIABLE- family history
MODIFIABLE- smoking, excessive alcohol use, cocaine use
PMH- hypertension, diabetes, heart disease, peripheral arterial disease, polycythaemia vera, carotid occlusion, clotting disorders
IATROGENIC- combined oral contraceptive pill

40
Q

What are the symptoms of subarachnoid haemorrhage?

A

THUNDERCLAP headache- sudden, explosive
Lasts 1-2 weeks
seizure
dizziness, impaired consciousness

41
Q

What are the differentials for Subarachnoid haemorrhage?

A 
Meningitis
Trauma
Primary sexual headache
Cerebral venous sinus thrombosis
cervical artery dissection
carotid artery dissection
hypertensive emergency
pituitary apoplexy
42
Q

What investigations are carried out in suspected SAH?

A

IMAGING: CT, ECG, angiography
SAMPLING: lumbar puncture

43
Q

What treatment is needed for SAH?

A

Endovascular obliteration- coiling
Clipping
Oral nimodipine

Core Conditions (11 decks)

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