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Human Disease > Neurology > Flashcards

Neurology Flashcards

1
Q

What is the dental impact on neurological illness?

A

Movement problems
Reduced manual dexterity
Drooling of saliva if swelling difficult

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2
Q

What causes a ‘blackout’ ?

A

Vasovagal “faint”
Postural hypotension
Aortic stenosis
Cardiomyopathy
Cardiac arrhythmia

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3
Q

What happens during a faint?

A

Nausea
Visual fields close in
Loss of consciousness
Fall to ground

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4
Q

Why might fainting be common in a dental practice?

A

It’s caused by emotion, heat and hunger

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5
Q

How is a patients BP and HR at the time of a faint?

A

Both low

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6
Q

How long does it take to recover from a faint?

A

2 minutes

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7
Q

How to manage a faint?

A

Lie flat + elevate legs

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8
Q

What causes postural hypotension?

A

Low BP reducing cerebral perfusion

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9
Q

Who is postural hypotension more common in?

A

Old people

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10
Q

What is the significant cause of morbidity and mortality?

A

Head injury

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11
Q

Why are sequential assessments of conscious level vital?

A

To recognise a deteriorating patient

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12
Q

What are some complication of head injury?

A

Extradural haemorrhage
Subdural haemorrhage
Axonal injury and coma
Maxillofacial and skull injuries

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13
Q

What are the 2 main ways to assess conscious level?

A

GCS
AVPCU Scale

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14
Q

In the GCS scale what 3 things are scored?

A

Eye opening
Motor
Verbal

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15
Q

What does AVPCU scale stand for?

A

Alert
Verbal
Pain
Confusion
Unresponsive

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16
Q

What are the metabolic causes of conscious level?

A

Hypoglycaemia
Hypoxia
Hypercapnia
Hyponatraemia

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17
Q

What are infection causes of conscious level?

A

Encephalitis
Meningitis
Cerebral abscess
Malaria
Sepsis

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18
Q

Drugs and alcohol affect conscious level T or F?

A

True

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19
Q

Impaired consciousness medical emergency?

A

ABCDE
Airway obstruction
Recovery position
Oxygen
Grade from scale
Check blood sugar level

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20
Q

What is epilepsy?

A

Excessive electrical discharge in the brain

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21
Q

What 2 ways can epilepsy present?

A

Focal (partial) seizures
Generalised seizures

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22
Q

How might focal seizures present?

A

Shaking on one side
olfactory hallucinations
odd behaviour
lip smacking
odd posture

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23
Q

What are the 2 phases of a seizure?

A

Tonic phase
Clonic phase

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24
Q

What happens during the tonic phase of a seizure?

A

Loss of consciousness
Becomes rigid
Fall
May cry

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25
Q

What happens during the clonic phase of a seizure?

A

After 30 seconds
Jerking
May bite the tongue
Frothing
Urinating

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26
Q

How may an absence seizure present?

A

Blank stare
Zoning out
Usually short lasting

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27
Q

What does “grand mai” mean?

A

Tonic-Clonic seizure

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28
Q

What does post ictal mean?

A

Headache, drowsy

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29
Q

How would epilepsy be investagated?

A

Blood tests
Brain imaging (MRI)
Electroencephalogram (EEG)

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30
Q

What are some medications for epilepsy?

A

Phenytoin
Carbamazepine
Sodium Valproate
Pregabalin

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31
Q

What is a side effect of phenytoin - dental aspect?

A

Gingival overgrowth

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32
Q

When would an epileptic seizure being a medical emergancy?

A

Lasts longer than 5 minutes or repeats

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33
Q

What would you do during a medical emergency of a seizure?

A

High flow oxygen
Midazolam oralmucoal - 10mg buccally
999 if needed

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34
Q

What are 2 types of headache?

A

Primary
Secondary

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35
Q

What is a primary headache disorder?

A

unpleasant, goes away easily

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36
Q

What is a secondary headache disorder?

A

Associated with mortality or disability

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37
Q

What are some red flags in regards to a headache?

A

Sudden onset
Severe
Worse with positional change
Present on walking

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38
Q

What are the primary headaches?

A

Tension
Migraine
Cluster
Medication overuse
Trigeminal neuralgia

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39
Q

What is a tension headache?

A

Stress related

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40
Q

How does a tension headache present?

A

“tight band”
Symmetrical
Chronic, gradual onset

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41
Q

What is the treatment for a tension headache?

A

Conventional analgesia

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42
Q

What is a migraine?

A

Prolonged reduction in cerebral blood blow following a brief spell of increased flow

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43
Q

What is cortical spreading depression?

A

A slow wave of altered brain activity

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44
Q

Who is more commonly affected by migraines?

A

Females

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45
Q

What are some triggers of a migraine?

A

Wine
Cheese
Chocolate
Anxiety

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46
Q

A migraine is split into 2 parts - pre headache and headache. What happens during pre headache?

A

first 15 mins - aura
flashing lights
dora
wavy lines

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47
Q

What happens during the main headache part of a migraine?

A

within 1 hour
one sided throbbing

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48
Q

What is the treatment of a migraine?

A

Conventional analgesia
Metoclopramide
Serotonin agonists

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49
Q

What is a cluster headache?

A

Severe pain around the eye

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50
Q

Who is more commonly affected by cluster headaches?

A

Males who smoke

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51
Q

How would you describe the onset of a cluster headache?

A

Episodic

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52
Q

What is the treatment of a cluster headache?

A

Sumatriptan
Oxygen

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53
Q

What is trigeminal neuralgia?

A

Intense stabbing pain caused by nerve distribution

54
Q

How would you describe the onset of trigeminal neuralgia?

A

Spontaneous

55
Q

What is the treatment of trigeminal neuralgia?

A

Carbamazepine
Surgery

56
Q

What are some secondary headache disorders?

A

Head injury
CNS tumours
CNS infections
Inteacerebral or subarachnoid bleeds
Giant cell arteries
Glaucoma

57
Q

How does giant cell arteritis present?

A

headache
scalp tenderness
loss of temporal pulse
jaw claudication

58
Q

What can giant cell arteritis lead to?

59
Q

How does glaucoma present?

A

Constant ache around one eye
Reduced vision

60
Q

How may the eye present in someone with glaucoma?

A

Red
Congested
Dilated, non reactive
Cornea may be cloudy

61
Q

What is the treatments for glaucoma?

A

Urgent ophthalmology referral

62
Q

How does bacterial meningitis present?

A

Headache
photophobia
Neck stiffness and pain
Impaired consciousness

63
Q

How would bacterial meningitis be diagnosed?

A

Lumber puncture
Blood cultures
CT or MRI scan

64
Q

What is the treatment for bacterial meningitis?

A

Empirical antibiotics
Urgent hospitalisation
Prophylaxis for contacts

65
Q

What is encephalitis?

A

Inflammation of the brain parenchyma

66
Q

How does Encephalitis present?

A

Headache
Impaired consciousness
Change in personality
Meningism
Seizures

67
Q

How is encephalitis diagnosed?

A

Lumber puncture
EEG
MRI scan

68
Q

What’s the treatment for encephalitis?

A

Hospitalisation
Anti viral therapy

69
Q

What is a cerebral abscess?

A

A puss filled pocket in the brain

70
Q

Some examples of cerebral abscess are?

A

Otitis media
Mastoiditis

71
Q

What can cause a cerebral abscess?

A

Dental infections
Skull trauma
Ineffective endo

72
Q

What are symptoms of a cerebral abscess?

A

Headache
Sepsis
Focal neurology

73
Q

How is a cerebral abscess diagnosed?

A

CT or MRI scan
Biopsy

74
Q

What is the treatment for a cerebral abscess?

A

Neurological drainage
Antibiotics

75
Q

What causes a subarachnoid haemorrhage?

A

Blood in the subarachnoid space

76
Q

What is the most common cause of a subarachnoid haemorrhage?

A

Rupture of the berry aneurysm of a cerebral artey

77
Q

What age group is more commonly affected by a subarachnoid haemorrhage?

78
Q

How does a subarachnoid haemorrhage present?

A

Sudden and severe headache
Neck stiffness
Vomiting
Impaired consciousness

79
Q

How is subarachnoid haemorrhage diagnosed?

A

CT scan
angiography to identify aneurysm
Lumbar puncture

80
Q

What is the management after a subarachnoid haemorrhage?

A

Prevent re bleeding (occurs in 30%)
Colis or surgical clipping

81
Q

What can the outcome of a subarachnoid haemorrhage be?

A

Fatal
Disability

82
Q

What does an intracerebral haemorrhage affect?

A

It goes directly into the brain tissue

83
Q

What is intracerebral haemorrhage associated with?

A

hypertension

84
Q

How does an intracerebral haemorrhage present?

A

Sudden headache
Nausea and vomiting

85
Q

What are the 2 parts of a cerebral infarction?

A

Transient ischaemic attack (TIA)
Completed stroke

86
Q

When is a stoke classed as TIA?

A

Symptoms resolve within 24 hours

87
Q

What is the treatment of TIA?

A

Urgent medical assessment to reduce the progression to a permanent stoke

88
Q

When is a stoke classed as completed?

A

Longer than 24 hours

89
Q

What are the long term features after a stoke?

A

Unilateral weakness
Unilateral sensory loss
Speech problems
Visual problems
Higher cortical function

90
Q

What does FAST stand for?

A

Face
Arms
Speech
Time

91
Q

What is the long term treatment after a stoke?

A

Antiplatelets
Anticoagulant

92
Q

What is a short term treatment for someone who has had a stroke?

A

Nasogastric tube for nutrition and hydration

93
Q

What is a long term treatment for someone who has had a stoke?

A

Percuraneous endoscopic gastronomy (PEG)

94
Q

What rehabilitation is there for someone who has had a stroke?

A

Physiotherapy
Occupational therapy
Speech therapy
Social workers

95
Q

What is Bell’s palsy?

A

Loss of peripheral nerve function

96
Q

What does Bell’s palsy most commonly affect?

A

“glove and stocking”
Hands and legs

97
Q

What can cause Bell’s palsy?

A

Diabetes
Drugs SE (chemotherapy)

98
Q

What are the symptoms of Bell’s palsy?

A

Sensory loss
Neuropathic pain

99
Q

Bell’s palsy affects 2 nerves what are they?

A

Motor
Autonomic

100
Q

What happens when the motor nerves are affected?

A

Muscle weakness in the hand and feet

101
Q

What happens when the autonomic nerves are affected?

A

Bowl/bladder dysfunction
BP control

102
Q

What can be given to someone with Bell’s palsy?

A

Oral steroids within 72 hours

103
Q

What eye care can be given to someone when Bells Palsy has affected their face?

A

Eye drops and tape closed at night

104
Q

How long does it take to recover from Bell’s palsy?

A

Within 9 months

105
Q

What is multiple sclerosis? (MS)

A

An auto immune destruction of myelin sheath of neurons

106
Q

Who is more commonly affected by MS?

A

White women >30

107
Q

How does MS present?

A

Loss of vision in one eye
Changes in sensation
Ataxia
Weakness

108
Q

What are the 2 forms of MS?

A

Relapse
Chronic progressive

109
Q

What happens in the relapse stage of MS

A

Different areas affects at different times
Partial recovery in between
More treatment options available

110
Q

What happens during the chronic progressive stage of MS?

A

Cumulative damage

111
Q

How is MS diagnosed?

A

Lumbar puncture
MRI scan

112
Q

What are treatment options for MS?

A

High dose steroids
Disease modifying drugs to reduce and slow down progression
Rehabilitation

113
Q

What is motor neurone disease? (MND)

A

Destruction of motor neurons

114
Q

What causes MND?

115
Q

Who is more commonly affected by MND?

A

Male > female

116
Q

How does MND present?

A

Limb weakness
Swallowing problems
Respiratory muscle weakness

117
Q

How is MND diagnosed?

A

Clinical
Neurophysiology

118
Q

What treatment is available for MND?

A

Medication (limited value)
Supportive

119
Q

What supportive treatment is available for MND?

A

Feeding tubes
Mobility aids

120
Q

What are the 2 most common movement disorders?

A

Parkinson’s
Tremor

121
Q

What causes parkinson’s?

A

Degeneration of dopaminergic neurons in the basal ganglia

122
Q

How does parkinson’s become more common?

123
Q

How does parkinson’s present?

A

Bradykinesia
Increased muscle tone
Swallowing problems
Low frequency tremor

124
Q

What does bradykinesia mean?

A

Slowness in movement
Slow initiation
Reduce range of movement

125
Q

What treatment is available for parkinson’s?

A

Dopaminergic drugs
Support
Surgery

126
Q

What surgery is for parkinson’s?

A

Deep brain stimulation

127
Q

How does a tremor present?

A

High frequency
Unilateral

128
Q

What makes tremors worse?

129
Q

What makes tremors better?

130
Q

What treatment is there for tremors?

A

B blocker ameliorate

Human Disease (16 decks)

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