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Phase 2a Yellow Conditions > Neurology > Flashcards

Neurology Flashcards

1
Q

What is frontotemporal dementia

A
  • progressive dementia
  • atrophy of frontal and temporal lobes
  • loss of neurons but no plaque formation
  • 50% dominant inheritance
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2
Q

Presentation of frontotemporal dementia

A

often tends to be insidious and progressive

  • behavioural issues
  • progressive aphasia
  • semantic dementia

Picks bodies

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3
Q

Investigations for frontotemporal dementia

A
  • bloods
  • FBC and LFTS for encephalopathy
  • MMSE
  • MRI
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4
Q

Treatment for frontotemporal dementia

A
  • no cure
  • supportive therapy
  • SSRIs → behaviour symptoms
  • levodopa/carbidopa if Parkinson’s symptoms
  • stop exacerbating drugs
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5
Q

What is vascular dementia?

A

result of multiple, small infarcts

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6
Q

Risk factors for vascular dementia

A
  • smoking
  • history of TIAs
  • AF
  • HTN
  • T1DM
  • hyperlipidaemia
  • obesity
  • coronary heart disease

one stroke doubles risk of vascular dementia

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7
Q

Presentation of vascular dementia

A
  • stepwise progression → periods of stable symptoms then sudden increase in severity
  • visual disturbances
  • UMN signs
  • attention deficit
  • depression
  • incontinence

if infarct was subcortical → dysarthria, pakinsonisms

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8
Q

Investigations for vascular dementia

A
  • full history → previous stroke/TIA
  • cognitive impairment screen
  • medication review
  • MRI → previous infarcts
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9
Q

Treatment for vascular dementia

A
  • supportive therapy
  • SSRIs/anti-psychotics to control symptoms
  • prognosis 3-5yrs
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10
Q

What is dementia with Lewy Bodies?

A
  • characterised by Lewy bodies in brainstem and neocortex
  • substantia nigra depigmentation and amyloid deposits
  • on a spectrum
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11
Q

Presentation of dementia with Lewy Bodies

A
  • initial presentation = dementia
  • Parkinsonisms
  • visual hallucinations
  • sleepless disorders/restless leg syndrome
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12
Q

Diagnosis of dementia with Lewy Bodies

A

presence of dementia with 2 of:

  • fluctuating attention/concentration
  • recurrent visual hallucinations
  • spontaneous Parkinsonism
  • SPECT/PET scan → low dopamine transporter uptake in basal ganglia
  • MMSE
  • bloods
  • MSU → urine infection
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13
Q

Treatment for dementia with Lewy Bodies

A
  • supportive therapy
  • cholinesterase inhibitors for cognitive decline
  • avoid neuroleptic drugs
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14
Q

What is carpal tunnel syndrome?

A
  • compression of median nerve in carpal tunnel
  • median nerve → sensation to thumb/index/middle/half of ring finger
  • causes unknown
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15
Q

Presentation of carpal tunnel syndrome

A
  • pins and needles
  • pain in index/middle finger → reaches shoulder
  • numbness
  • weakness, loss of grip
  • worse a night
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16
Q

Diagnosis of carpal tunnel syndrome

A
  • based on symptoms
  • nerve conduction test
  • US/MRI
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17
Q

Treatment of carpal tunnel syndrome

A
  • pregnancy cases resolve postpartum
  • rest wrist
  • splint
  • steroid injections
  • surgery if severe
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18
Q

What is foot drop?

A
  • difficulty lifting front part of foot → toes drag
  • permanent/temporary
  • damage to common peroneal/fibular nerve
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19
Q

Causes of foot drop

A
  • injury
  • lower back damage
  • tumour
  • cauda equina syndrome
  • MS
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20
Q

Presentation of foot drop

A
  • unilateral symptoms
  • one foot drags across floor
  • tripping
  • numbness/weakness
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21
Q

Diagnosis of foot drop

A
  • clinical diagnosis
  • find cause using xray/US/CT/MRI/nerve conduction studies
22
Q

Treatment of foot drop

A
  • brace/splint
  • physiotherapy
  • special shoes
  • nerve stimulation
  • surgery
23
Q

Causes of spinal cord compression

A
  • trauma
  • tumours → common spinal metastases = breast, prostate, lung
  • central disc protrusion
  • prolapsed disk
  • infection
  • epidural haematoma
24
Q

Signs and symptoms of spinal cord compression

A

red flag signs

  • loss of bladder/bowel function
  • UMN signs in lower limbs eg clonus
  • LMN signs in upper limbs eg atrophy

symptoms depend on injury type and site

  • paraplegia
  • pain
  • paraesthesia
25
Q

Diagnosis of spinal cord compression

A
  • xray whole spine
  • MRI if indicated
  • renal function
  • Hb → monitor blood loss
26
Q

Treatment of spinal cord compression

A
  • acute = emergency
  • dexamethasone until treatment confirmed
  • catheterisation
  • analgesi
  • surgical decompression
  • chemo
27
Q

What is the cauda equina?

A

formed by nerve roots caudal to spinal cord termination

28
Q

What is cauda equina syndrome?

A

sudden severe compression of cauda equina

29
Q

Causes of cauda equina syndrome

A
  • herniation of lumbar
  • tumours
  • trauma
  • infection
  • late stage ankylosing spondylitis
  • post op haematoma
  • sarcoidosis
30
Q

Presentation of cauda equina syndrome

A
  • sudden onset → hrs
  • saddle paraesthesia
  • bladder/bowel dysfunction
  • sexual dysfunction
  • motor problems
  • lower back pain
  • bilateral LMN weakness, absent ankle reflex
31
Q

Diagnosis of cauda equina syndrome

A
  • medical emergency
  • rectal exam → loss of anal tone/sensation
  • MRI spine
32
Q

Treatment of cauda equina syndrome

A
  • surgical decompression
  • immobilise spine
  • anti-inflammatory agents
  • Abs if infection
  • chemo
33
Q

What is Wernicke’s encephalopathy?

A

depletion of thiamine → vitB1

34
Q

Causes of Wernicke’s

A
  • chronic alcoholism
  • severe starvation
  • prolonged vomiting
35
Q

Presentation of Wernicke’s

A

classic triad

  • confusion
  • ataxia
  • ophthalmoplegia
  • asterixis = liver flap → general sign of metabolic encephalopathy
  • diagnosis = clinical
36
Q

Management of Wernicke’s

A
  • pabrinex → IV b-vitamins incl thiamine
  • complication = Korsakoff’s syndrome
37
Q

What is Korsakoff’s sybdrome?

A
  • irreversible
  • long term brain damage due to B1 deficiency
  • decreased ability to acquire new memorites
  • retrogade amnesia
  • confabulation
38
Q

Primary brain tumours

A
  • less common

gliomas

  • astrocytoma
  • oligondendroglioma

others

  • ependymoma
  • meningioma
  • schwannoma
  • craniopharyngiomas
39
Q

Secondary brain tumours

A
  • much more common

originate from

  • non-small cell lung cancer
  • small cell lung cancer
  • breast
  • melanoma
  • renal cell carcinoma
  • GI
40
Q

What is encephalitis?

A
  • inflammation of brain parenchyma due to viral infection
  • other causes = TB, lume disease, toxoplasmosis
41
Q

Viruses that cause encephalitis

A
  • most common = HSV1
  • CMV
  • EBV
42
Q

Presentation of encephalitis

A
  • fever
  • headache
  • altered mental status
  • can present with signs of meningitis
  • confusion/drowsiness
  • symptoms of raised ICP
  • if caught late, coma
43
Q

Symptoms of raised ICP

A
  • vertigo
  • nausea
  • headache
  • photophobia
44
Q

Diagnosis of encephalitis

A
  • bloods
  • CSF → viral PCR to detect virus
  • CT/MRI
  • blood cultures/gram stain
45
Q

Treatment of encephalitis

A
  • urgent admission
  • acyclovir
  • stat IV benzylpenicillin
  • careful with fluids → cerebral oedema
46
Q

What is Herpes Zoster?

A
  • shingles
  • painful rash caused by reactivation of nerve infection caused by varicella-zoster virus
  • first presents as chickenpox as a kid
  • remains dormant in dorsal root ganglia
  • travels through peripheral sensory nerves to skin
47
Q

Risk factors of herpes

A
  • immunocompromised
  • HIV
  • malignancy
48
Q

Presentation of herpes

A

rash

  • red, painful
  • dermatomal distribution → cervical, trigeminal, thoracic, lumbar
  • fluid filled blisters
  • stabbing/burning pain
  • fever, headache, fatigue
  • itching
49
Q

Diagnosis of herpes

A
  • PCR
  • CSF analysis
  • bloods
  • diagnosis often clinical
50
Q

Treatment of herpes

A

antiviral therapy

  • acyclovir
  • valacyclovir
  • famiciclovir
  • if immunocompromised → IV acyclovir
  • analgesia
  • antipyretics

Phase 2a Yellow Conditions (12 decks)

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