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Finals > Neurology > Flashcards

Neurology Flashcards

1
Q

Name some of the treatable causes/mimics of dementia

A
  • Vitamin deficiency
  • Thyroid disease
  • Infective: HIV, syphilis etc.
  • Hydrocephalus
  • Tumour
  • Depression
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2
Q

Name some of the key features of Alzheimer’s disease

A
  • Early memory disturbance
  • Language and visuospatial problems
  • Preserved personality
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3
Q

Name some of the key features of frontotemporal dementia

A
  • Early changes in personality/behaviour
  • Changes in eating habits
  • Early dysphasia
  • Preserved memory and visouspatial
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4
Q

How can the symptoms of dementia be managed?

A
  • Non pharmalogical (OT, social work etc.)
  • Insomnia treatment
  • Behaviour treatment
  • Depression treatment
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5
Q

Name the specific treatments for Alzheimers and Lewy body dementia

A
  • Cholinesterase inhibitors (Donepezil, rivastigmine, galantamine)
  • NMDA antagonist (memantine)
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6
Q

How does parkinsonism present?

A
  • Bradykinesia
  • Rigidity
  • Tremor
  • Postural instability
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7
Q

How can Parkinson’s disease be treated?

A
  • Levodopa
  • COMT inhibitors
  • Dopamine agonists (e.g. ropinirole)
  • MAO-B inhibitors (selegiline etc.)
  • Deep brain stimulation
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8
Q

Name the cognitive features of dementia

A
  • Memory
  • Dysphasia
  • Dyspraxia
  • Dysgnosia (not recognising objects)
  • Dysexecutive functioning
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9
Q

How does a tension headache present?

A
  • Mild
  • Bilateral headache
  • Pressing or tightening
  • No associated features
  • Not aggravated by routine physical activity
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10
Q

How can a tension headache be managed?

A
  • Abortive: paracetamol, NSAIDs or aspirin

- Preventative: TCAs

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11
Q

How can a migraine be treated?

A
  • Abortive: aspirin, NSAIDs and triptans

- Prophylactic: propranolol, candersartan, anti-epiletics, TCAs and venlafaxine

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12
Q

Which type of headache has an absolute response to indometacin?

A

Paroxysmal hemicrania

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13
Q

How can cluster headaches be managed?

A
  • Abortive: SC sumatriptan, nasal zolmatriptan, oxygen and occipital depomedrone injection or oral prednisolone
  • Preventative: verapamil, lithium, methysergide and topiramate
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14
Q

How can SUNCT/SUNA be managed?

A

Prophylaxis: lamotrigine, topiramate, gabapentin, carbamazepine/ oxcarbazepine

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15
Q

How can trigeminal neuralgia be managed?

A

Prophylaxis: carbamazepine and oxcarbazepine
Surgical: glycerol ganglion injection, steriotactic radiosurgery and decompressive surgery

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16
Q

How can paroxysmal hemicrania be managed?

A

Prophylaxis: indometacin, COX-II inhibitors and topiramate

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17
Q

What are the “sinister” features of headaches?

A
  • Associated head trauma
  • First or worst
  • Thunderclap
  • New daily headache
  • Change in headache pattern
  • Returning patient
  • Focal neurological symptoms
  • Abnormal examination
  • Neck stiffness
  • Headache worse on lying down/ waking up/exertion
  • Jaw claudication or visual disturbance
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18
Q

Name the three categories of syncope

A
  • Reflex: medical situations, cough etc.
  • Orthostatic: dehydration,anti-hypertensives, endocrine etc.
  • Cardiogenic: arrhythmias, aortic stenosis etc.
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19
Q

Which investigations would you do for someone presenting with epilepsy?

A
  • EEG
  • MRI for <50yrs
  • CT for >50 yrs
  • Video-telemetry
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20
Q

Name the first line treatments for primary generalised epilepsies

A
  • Sodium Valproate
  • Lamotrigine
  • Levetiracetam
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21
Q

Name the first line treatments for focal and secondary generalised seizures

A
  • Lamotrigine
  • Carbamazepine
  • Levetiracetam
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22
Q

Name the first line treatment for absence seizures

A

Ethosuximide

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23
Q

Name the treatment options for status epilepticus

A
  • First line: midazolam/ lorazepam/ diazepam
  • Second line: phenytoin and valproate
  • Third line: propofol or thiopentone
24
Q

How can an ischaemic stroke be managed acutely?

A
  • Thrombolysis
  • Thrombectomy (anterior only)
  • Aspirin 300mg
25
Q

How can a haemorrhagic stroke be managed acutely?

A
  • Manage hydrocephalus
  • Blood pressure control
  • Reverse anticoagulation
26
Q

How can a TIA be managed acutely?

A

Aspirin 300mg

27
Q

What medications should be used for stroke prevention after a TIA?

A
  • Aspirin

- Dipyridamole

28
Q

Name the types of skull fractures

A
  • Linear
  • Depressed
  • Comminuted
  • Ring fracture
  • Contre-coup (orbital plates)
29
Q

How does raised ICP present?

A
  • Headaches (worse in the morning and coughing/straining)
  • Papilloedema
  • Visual disturbance
  • Loss of upgaze
  • Impaired consciousness
30
Q

How can hydrocephalus be managed?

A
  • Acetazolamide
  • External ventricular drain (in emergencies)
  • 3rd ventriculostomy
  • Shunt insertion
31
Q

How does normal pressure hydrocephalus present?

A
  • Dementia
  • Gait disturbance
  • Urinary incontinence
32
Q

How can raised ICP be managed?

A
  • Avoid pyrexia
  • Manage seizures
  • CSF drainage
  • Elevated head of bed
  • Analgesia and sedation
  • Mannitol
  • Hypertonic saline
  • Hyperventilation
  • Hypothermia
  • Decompressive craniectomy
33
Q

How does Bell’s Palsy present?

A
  • Facial sag
  • Asymmetrical smiling
  • Voluntary eye closure not possible
  • No forehead sparing
34
Q

What is Ramsay Hunt Syndrome?

A

LMN facial nerve palsy due to Herpes Zoster

35
Q

How can Bell’s Palsy be managed?

A
  • Eye care (lubricating eye drops)
  • Steroids
  • Surgery if no response to medical treatment
36
Q

How can Ramsay Hunt Syndrome be managed?

A
  • Aciclovir

- Steroids

37
Q

How does an essential tremor present?

A
  • Distal symmetrical tremor of the upper limbs

- Can sometimes effect the neck muscles

38
Q

How can an essential tremor be managed?

A
  • Propranolol or primidone

- Deep brain stimulation

39
Q

How does Guillian-Barre syndrome present?

A
  • Progressive ascending symmetrical weaknesss starting in the lower extremities
  • Facial weakness, dysphasia or dysarthria
  • Neuropathic pain
  • Reduced or absent reflexes
  • Parasthesiae or sensory loss
  • Autonomic symptoms
40
Q

How can Guillian-Barre be investigated?

A
  • Electrolytes
  • Lumbar puncture
  • Antibody screen
  • Spirometry
  • Nerve conduction studes
  • ECG
41
Q

How can Guillian-Barre be managed?

A
  • Plasma exchange
  • IV immunoglobulin
  • Steroids
  • DVT prophylaxis
  • Pain relief
  • Admission to ITU may be required
42
Q

How does MS present?

A
  • Optic neuritis
  • Sensory symptoms
  • Limb weakness
  • Diplopia/vertigo/ataxia
  • Bladder symptoms
  • Brainstem involvement
43
Q

Name the 1st line disease modifying treatments for MS

A
  • Beta-interferons
  • Glatiramer acetate
  • Teriflunomide
  • Dimethyl fumarate
44
Q

How does peripheral neuropathy present?

A
  • Parasthesiae
  • Neuropathic pain
  • Loss of vibration sense and position sense
  • Muscle wasting
  • Autonomic: Incontinence and orthostatic hypotension
45
Q

Name the causes of peripheral neuropathy

A
  • Guillian Barre, Charcot-Marie-Tooth
  • Alcohol
  • Diabetes
  • Vitamin
  • Thiamine or B12 deficiency
  • Carcinoma
46
Q

How can peripheral neuropathy be managed?

A
  • Foot care, weight reduction and sensible footwear
  • Glucose and blood pressure control
  • Steroids
  • IV immunoglobulins
  • Amitriptyline, pregabalin or gabapentin
47
Q

What causes a radiculopathy?

A
  • Intervertebral disc prolapse
  • Degenerative diseases of the spine
  • Fracture
  • Malignancy
  • Infection
48
Q

How does a radiculopathy present?

A
  • Paraesthesia
  • Numbness
  • Weakness
49
Q

How can a radiculopathy be managed?

A
  • Analgesia
  • Amitriptyline
  • BZDs
  • Baclofen
  • Physiotherapy
  • Surgery
50
Q

How does Wernicke’s Encephalopathy present?

A
  • Visual changes
  • Loss of co-ordination
  • Profound memory loss
  • Hallucinations
  • Polyneuropathy
  • Muscle atrophy
  • Confabulation
51
Q

How can Wernicke’s encephalopathy be managed?

A
  • Thiamine
  • Rehydration and diet
  • OT assessment
  • Assess capacity and insight
52
Q

How can brain metastases be managed?

A
  • Steroids
  • Surgery
  • Radiosurgery
  • Chemotherapies
53
Q

Name the types of brain tumours

A
  • High grade: gliomas, glioblastoma multiforme , primary cerebral lymphomas and medulloblastomas
  • Low grade: meningiomas, acoustic neuromas, neurofibromas, pituitary tumours, pineal tumours and craniopharyngiomas
  • Metastases
54
Q

How can brain tumours be managed?

A
  • Resection
  • Radiotherapy
  • Chemotherapy (particularly in CNS lymphoma)
  • Analgesics, anticonvulsants, anticoagulants and steroids
55
Q

How do lumbosacral disc prolapses present?

A
  • Unilateral leg pain
  • Numbness, parasthesia and weakness in one nerve root distribution
  • A positive straight leg test
  • Pain relieved by lying down
56
Q

How can disc prolapses be managed?

A
  • Analgesia
  • Keeping active
  • Heat and massage
  • Physiotherapy
  • Discectomy

Finals (18 decks)

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