Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Phase 2a Knowledge > Neurology > Flashcards

Neurology Flashcards

1
Q

Stroke definition

A

Syndrome of rapid onset of cerebral deficit lasting >24 hours or leading to death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Aetiology ischaemic stroke

A

Thrombus, large artery stenosis, small vessel disease, atherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Ischaemic stroke RF

A 
HTN
Smoking 
Alcohol 
Obesity
Cholesterol 
DM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Ischaemic stroke investigations

A

NCCT = will demonstrate haemorrhage immediately
MRI
Brachial BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Ischaemic stroke acute treatment

A
  • Thrombolysis is within 4.5 hrs onset

- IV alteplase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Ischaemic stroke long term management

A
  • Anti HTN therapy
  • Antiplatelet therapy = aspirin, clopidogrel
  • Statin
  • Surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Haemorrhagic stroke aetiology

A 
HTN
Aneurysm rupture 
AV malformations 
Anticoagulants 
Trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Haemorrhagic stroke Ix

A

Urgent head CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Management haemorrhagic stroke

A
  • Stop anticoagulant immediately
  • IV prothrombin complex and vitamin K
  • IV mannitol to reduce ICP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

SAH aetiology and RF

A

Berry aneurysm rupture
Smoking
HTN
Alcohol misuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

SAH S+S

A 
Thunderclap headache 
Vomiting 
Seizures
Coma/drowsiness
Photophobia 
Neck stiffness
Kernig's sign Brudzinski's sign
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

SAH Ix

A

CT = star shaped lesion

LP if doubt after CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

SAH Mx

A

Nimodipine = Ca antagonist = reduces vasospasm and morbidity from cerebral ischaemia
Dexamethasone
Endovascular coiling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Extradural haemorrhage RF

A

Trauma = classic after head injury with brief duration of unconsciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Extradural haemorrhage pathophysiology

A

Fractured temporal or parietal bone causing MMA laceration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Extradural haemorrhage S+S

A

Lucid pattern then rapid deterioration
Increasingly severe headache
Vomiting, seizures
Ipsilateral pupil dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Extradural Ix

A
  • CT = lens/lemon shaped

Skull XR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Extradural Mx

A

Neurosurgery = clot evacuation or ligation
AP stopped
IV mannitol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Subdural RF

A

Falls
Anticoagulation
Age
Large latent interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Subdural S+S

A 
Fluctuating consciousness 
Headache 
Unsteadiness 
Confusion 
Seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Subdural Ix

A

CT = crescent/banana

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Subdural Mx

A

Irrigation/evacuation
AC/AP cessation
IV mannitol
IV prothrombin and Vit K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

TIA definition

A

Ischaemic neurological event with symptoms lasting <24 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

TIA RF/aet

A 
Atherothromboembolism 
AF
Valve disease 
Stenosis 
HTN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

TIA S+S

A 
Sudden loss of function 
Carotid 90%
- Amourosis fugax 
- Aphasia 
- Hemiparesis 
Vertebrobasilar 
- Diplopia, vertigo, vomiting 
- CHoking
- Ataxia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Ix TIA

A

CT or diffuse weighted MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Mx TIA

A

Immediate = loading dose aspirin

Antiplatelet therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Epilepsy clinical definition

A
  • At least 2 unprovoked seizures >24 hrs apart
  • 1 unprovoked seizure and probability of further seizures
  • Diagnosis of an epilepsy syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Epilepsy medical definition

A

Recurrent tendency to spontaneous, intermittent, abnormal electrical activity in part of brain, manifesting in seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Definition of priamry generalised seizure

A

Simultaneous electrical discharge throughout the whole cortex, with no features tht suggest localisation to only 1 hemisphere/lobe
- Bilateral and symmetrical motor manifestations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Types of primary generalised seizure

A 
Tonic 
Clonic
Tonic clonic 
Myoclonic 
Atonic 
Absence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Tonic seizure

A

High tone - stiff rigid limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Clonic seizure

A

Rhythmic muscle jerking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Tonic clonic

A

Combination of tonic stiffness and clonic jerking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Myoclonic seizure

A

Isolated jerking of a limb/face/trunk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Atonic seizure

A

Loss of muscle tone = floppy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Absence seizure

A
  • Common in childhood

- Pale and stare blankly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Definition of partial (focal) seizure

A

Focal can be referable to a single lobe, as electrical discharge limited to one lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Simple partial (focal) seizure

A
  • No affect to consciousness or memory
  • No post ictal sx
  • Focal motor, sensory or autonomic sx depending on lobe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Complex partial (focal) seizure

A
  • Memory affected before, during or immediately after

- Most common temporal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Temporal lobe Sx

A
  • Aura
  • Anxiety, out of body
  • Automatisms = lip smacking
  • Temporal = memory, understanding, speech
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Frontal lobe Sx

A
  • Motor features
  • Jacksonian march = seizures march up and down motor homunculus
  • Post ictal todds palsy
  • Frontal = motor, thought processing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Focal Seizure Mx

A

Carbamazepine or Lamotrigine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Generalised tonic clonic Mx

A

SV or lamotrigine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Absence Mx

A

SV or ethosuximide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Myoclonic Mx

A

SV or levetiracetam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Tonic Mx

A

SV or lamotrigine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Status epilepticus

A

A seizure that lasts more than 5 minutes, or more than 1 seizure in 5 minute period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Status epilepticus Mx

A
  • Buccal midazolam in community or rectal diazepam

- IV lorazepam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Parkinsons definition

A

Progressive neurodegenerative movement disorder due to decreased DA in SN, causing triad or tremor, rigidity and bradykinesia

51
Q

PD pathophysiology

A

Decreased dopamine levels –> mitochondrial dysfunction and oxidative stress on SN –> degeneration of dopaminergic neurones of SN –> decreased DA synthesis in striatum –> decreased thalamus activity –> decreased movement

52
Q

PD Sx

A
  • Bradykinesia plus one of tremor, postural instability
  • Brady = buttons, writing, slowness of involuntary movement
  • Hypokinesia = poverty of movement
  • Tremor = unilateral, rest
53
Q

PD Mx

A
  • Levodopa with dopa decarboxylase inhibitor like co-beneldopa
  • MAOB inhibitors
54
Q

Sx of migraine without aura

A 
At least 2 of:
- Unilateral pain (4-72hrs)
- Throbbing 
- Moderate>severe intensity 
- Motion sensitivity 
Plus at least 1 of 
- N+V
- Photophobia/phonophobia
55
Q

Sx of migraine with aura

A
  • One or more typically fully reversible aura Sx
    At least 3 of
  • at least 1 aura Sx spreads gradually over 5 mins
  • 2 or more aura sx in succession
  • 5-60 minute duration of aura sx
    At least 2 aura sx unilateral
  • At least 1 aura sx positive
  • aura accompanies or followed in 1 hr by headache
56
Q

Migraine Mx

A
  • NSAIDS or analgesics
  • Triptans
  • Frequent = BB
57
Q

Sx cluster headache

A
  • Unilateral orbital, retro-orbital, temporal or mandibular headache with rapid onset
  • Lacrimation
  • Swollen eyelid
  • Facial flushing
  • Rhinorrhoea
  • Miosis
  • Ptosis
58
Q

Mx cluster headache

A
  • Acute = oxygen and sumatriptan
  • Prevention = CCB, prednisolone
  • Smoking cessation
59
Q

MS definition

A

Inflammatory demyelinating disease characterised by presence of episodic neurological dysfunction in at least 2 areas of CNS disseminated in time and space

60
Q

MS Pathophysiology

A
  • Inflammatory plaques demyelination in CNS
  • Demyelination heals poorly –> axonal loss
  • Demyelination disrupts axonal support –> destabilisation of axonal membrane potentials
61
Q

MS S+S

A
  • Optic neuritis
  • Spasticity
  • Lhermittes sign
  • Bladder dysfunction
  • UMN signs
  • Uhthoff = heat worse
62
Q

MS IX

A
  • MRI = sensitive but not specific for plaque detection
63
Q

MS Mx

A
  • Disease modifying drugs = dimethyl fumarate in mild RR
  • Monoclonal abs
  • Methylprednisolone for acute relapses
    Relapse = oral pred, IV hydrocortisone
64
Q

UMN signs

A
  • Hypertonia
  • Hyperreflexia
  • Spasticity
  • +ve babinski
  • Clonus
65
Q

LMN signs

A
  • Hypotonia
  • Hyporeflexia
  • Flaccid weakness
  • Fasciculations
  • Muscle atrophy
66
Q

Anterior circulation stroke Sx

A
  • Aphasia/dysphasia
  • Hemiparesis
  • Sensory loss
  • Amaurosis fugax
67
Q

Posterior circulation sx

A
  • Diplopia, vertigo, vomiting
  • Swallowing difficulty
  • Hemianopic visual loss
  • Sensory loss
  • Transient global amnesia
68
Q

MCA stroke Sx

A

Contralateral

  • Hemiparesis
  • Hemiplegia
  • Facial weakness
  • Hemianopia
  • Aphasia
69
Q

ACA stroke Sx

A

Contralateral weak leg +/- shoulder

70
Q

Anterior circulation stroke sx

A
  • Aphasia/dysphasia
  • Hemiparesis
  • Amaurosis fugax
  • Sensory loss
  • Hemianopia vision loss
71
Q

Posterior circulation stroke Sx

A
  • Diplopia, vertigo, vomiting
  • Swallowing difficulty
  • Hemianopia
  • Sensory loss
  • Transient global amnesia
  • Tetraparesis
72
Q

MCA stroke Sx

A
  • Weak arm and face, contralateral
  • Hemianopia
  • Aphasia
  • Hemiplegia
  • Visuospatial
  • Hemiparesis
73
Q

Genetics of Huntington’s

A
  • Autosomal dominant neurodegenerative disorder
  • Expanded CAG repeat
  • 100% penetrance
74
Q

Pathophysiology of HD

A
  • CAG repeat generated elongated polyglutamine tail on huntingtin protein
  • Extended glutamine translation in H gene
  • Progressive cerebral atrophy
  • Progressive degeneration of GABAnergic and cholinergic neurones of corpus striatum
  • Therefore decreased GABA and Ach synthesis in striatum
  • Decreased inhibition of DA release, so increased DA release and increased thalamus activity
  • THerefore increased movement
75
Q

Chorea definition

A
  • Excessive irregular movements flitting from 1 part of body to another
76
Q

HD clinical S+S

A
  • Change in personality and psych issues
  • Restlessness
  • Chorea
  • Dystonia
  • Incoordination
  • Dysarthria
77
Q

HD Ix

A
  • CAG genetic testing
  • Head MRI = caudate nucleus atrophy
  • MRI/CT = loss of striatal volume
78
Q

HD Mx

A
  • Drugs don’t affect progression
  • Benzos for chorea
  • Treat psych issues
79
Q

MG definition

A

Autoimmune disease mediated by antibodies to ACH receptors

80
Q

MG Pathophysiology

A
  • Autoantibodies to ACH receptors form
  • ACHR lost on postsynaptic membrane of NMJ
  • Result in decrease in receptors –> endplate potential decrease in amplitude and failure to trigger muscle action potential
81
Q

MG Presenting features

A
  • Ocular
  • Limb weakness
  • Generalised muscle weakness
  • Dysphagia, dysarthria and dysphonia
  • Jaw and neck weakness
82
Q

MG S+S

A
  • Increasing muscular fatigue, top down
  • Proximal and asymmetrical
  • Diplopia
  • Snarl
  • Deterioration of voice count to 50
  • Reflexes normal
83
Q

MG Ix

A
  • Tensilon test
  • Anti ACHR test
  • CT thymus - thymoma
  • Nerve conduction
84
Q

MG Mx

A
  • Anticholinesterase = pyridostigmine
  • Prednisolone
    CRISIS
  • Plasmanephrines or IV Ig
85
Q

Amyotrophic lateral sclerosis

A
  • Form of MND
  • UMN signs and LMN wasting
  • Asymmetric onset
  • Tongue fasciculations
  • Most common
  • Progressive focal muscle weakness and wasting
86
Q

Progressive bulbar pasly

A
  • Form of MND
  • 1st affected muscles = talking, swallowing, chewing
  • Present with palsy of tongue, difficulty swallowing and pasly of facial muscles
87
Q

MND Mx

A
  • Antiglutamatergic drugs = riluzole
88
Q

Bacterial meningitis

  • Neonates
  • <2yo
  • up to 50
  • Over 50
A
  • Neonates = Group B Strep = S agalactiae
  • <2 = S. Pneumoniae
  • up to 50 = N Men and S. Pneumoniae
  • > 50 = S pneumoniae
89
Q

Early meningitis S+S

A
  • Headache
  • Fever
  • Leg pains
  • Cold hands and feet
  • Abnormal skin colour
90
Q

Meningitis S+S

A 
Fever
Headache
Neck stiffness
Photophobia 
N+V
Kernig's sign 
Can progress to confusion, delirium, coma
Petechial non blanching rash
91
Q

Meningitis Ix

A
  • Full bloods
  • Cultures
  • Lumbar puncture after CT
92
Q

CSF if bacterial

A
  • Cloudy purulent
  • Elevated cell count
  • Increased granulocytes
  • High lactate and protein
  • Decreased glucose
  • Positive cultures
93
Q

CSF if viral

A
  • Clear fluid
  • Variable cell count with Increased lymphocytes
  • Normal or low lactate
  • Normal protein and glucose
  • No organisms
94
Q

Meningitis Mx

A
  • Primary care, if NB rash = 1.2mg benzylpenicillin IM
  • MRI head, LP
    1st line Abx before LP or after CT = ceftriaxone or cefotaxime <55, amoxicillin >60
95
Q

Mx meningitis with typical rash

A
  • IV benzylpenicillin or cefotaxime
96
Q

Mx meningitis without typical rash

A
  • Iv cefotaxime plus IV vancomycin
97
Q

Encephalitis S+S

A
  • Triad of fever, headache and altered mental status
98
Q

Encephalitis Ix

A
  • LP
    Cultures
    FBC (leucocytosis)
    Brain high contrast CT
99
Q

Encephalitis Mx

A
  • Empirical IV acyclovir ASAP

- Benzylpenicillin

100
Q

GBS definition

A
  • Acute inflammatory demyelinating neuropathy
101
Q

GBS causes

A
  • Campylobacter

- EBV, CMV

102
Q

GBS pathophysiology

A
  • Antibodies to preceding pathogen are autoantibodies for Schwann cells
  • Autoimmune demyelination of Schwann cells
103
Q

GBS S+S

A
  • Toes to nose weakness = symmetrical ascending
  • Weakness, paraesthesia and hyporeflexia
  • Autonomic nervous system involvement
  • Back and leg pain
  • Proximal muscles more affected
104
Q

GBS Ix

A
  • Nerve conduction studies
  • L4 LP = raised protein, Normal WCC
  • Spirometry
105
Q

GBS Mx

A
  • Vital capacity and ECG monitored
  • Ventilation
  • Iv Ig for 5 days
  • Corticosteroids make worse
106
Q

Causes of cauda equina

A
  • Central lumbrosacral disc protrusion
  • Vertebral body metastasis
  • Trauma
  • Spina bifida
107
Q

Cauda equina S+S

A
  • Bilateral leg pain or sensory disturbance
  • Perianal, perineal or sensory disturbance
  • Urinary +/- faecal incontinence
  • Low back pain
  • Sexual dysfunction
  • Bilateral motor and reflex deficits
  • Decreased sphincter tone
108
Q

Cauda equina Ix

A
  • Spine MRI
  • Femoral stretch
  • Knee flexion
  • Straight leg raise
  • Plantar flexion
109
Q

Cauda equina Mx

A
  • Surgery! decompression
110
Q

Brain tumours metastasise from?

A
  • Bronchus
  • Breast
  • Stomach
  • Prostate
  • Thyroid
  • Kidney
111
Q

Clinical effects of tumours

A
  • Headache
  • Progressive neurological deficit
  • Cognitive and behavioural changes
  • Seizures
  • Raised ICP
112
Q

Red flag tumour

A
  • Headache with features of raised IC pressure
  • Headache with focal neurology
  • New onset focal seizure
  • Rapidly progressive focal neurology
  • Past Hx Cancer
113
Q

NEAD features

A
  • Gradual onset
  • Prolonged duration
  • Abrupt termination
  • Resistance to eye opening
  • Fluctuating motor activity
  • Hx childhood abuse
  • Triggered by stress
114
Q

GCA pathophysiology

A
  • Immune mediated vasculitis

- Granulomatous inflammation in wall of medium and large arteries

115
Q

S+S GCA

A
  • Headache
  • Temporal artery and scalp tenderness
  • Jaw claudication
  • Sudden blindness 1 eye
  • Dyspnoea, morning stiffness, weak pulses
    Need 3 of
  • > 50
  • TA abnormality
  • Abnormal TA biopsy
  • Elevated ESR >50mm/hr
  • New headache
116
Q

GCA Mx

A
  • Prednisolone immediately

- Tocilizumab

117
Q

Shingles (HZ) definition

A
  • Viral infection of an individual nerve and the dermatome

- Reactivation of varicella zoster

118
Q

HZ pathophysiology

A
  • VZ remains latent in sensory dorsal root ganglia
  • Reactivates due to decline in cell mediated immunity
  • Travels down sensory afferent neurones to infect dermatomes
119
Q

HZ S+S

A
  • Localised dermatome pain
  • Vesicular rash in dermatomal distribution
  • Fluid filled blisters
  • Itching
  • systemic Sx
120
Q

Definition of dementia

A

Acquired loss of higher mental function, affecting 2 or more cognitive domains

  • Episodic memory
  • Language function
  • Frontal executive function
  • Visuospatial function
  • Apraxia
121
Q

Alzheimer’s pathology

A
  • Generalised cortical atrophy
  • Deposits of amyloid A4 protein in cortex with neuritic plaques
  • Neurofibrillary tangles contain tau
122
Q

Normal Pressure hydrocephalus triad

A
  • Gait instability
  • Urinary incontinence
  • Cognitive impairment
123
Q

Peripheral Neuropathy sensory symptoms

A
  • Loss of touch, proprioception, temperature/pain, sensation, paraesthesia
  • Numbness, tingling,, burning
  • +ve Romberg
124
Q

Peripheral neuropathy motor symptoms

A
  • Distal weakness
  • Proximal weakness
  • Muscle wasting
  • Fasciculations
  • Absent tendon reflexes

Phase 2a Knowledge (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions