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Finals revision > Neurology > Flashcards

Neurology Flashcards

1
Q

Define stroke

A

Sudden onset focal neurological deficit lasting >24hrs due to vascular aetiology

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2
Q

Define ischaemic stroke

A

Blood supply to cerebral territory compromised due to complete occlusion ro secondary to stenosis

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3
Q

What is the ischaemic penumbra

A

Surrounding area with ischaemia but no necrosis

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4
Q

4 causes of an ischaemic stroke

A

AF

Atherosclerosis - small and large vessel
- large vessel: carotid artery stenosis

thrombophillia - Anti phospholipid syndrome

MI

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5
Q

Give 4 RF for ischaemic stroke

A

Male
Age
FHx

Smoke
Alcohol
Hyperlipidaemia
HTN
DM
AF

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6
Q

CT head findings on a stroke

A

Hypoattenuation of brain parenchyma

Loss of grey white matter differentiation

Hyperattenuation in artery - indcates clot

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7
Q

Blood requests for ischaemic stroke

A

FBC
TFT
U+E - Electrolyte disturbance
Glucose - stroke mimic
Troponin - rule out concominant MI
Vasculitis screen - ESR
Lipid profile

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8
Q

Post acute stroke investigations

A

Carotid USS - carotid artery stenosis
CT angiography
ECHO - cardiac emboli suspected

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9
Q

What is the time frame windom for thrombectomy
- what is it done following
- what is the full name of it

A

6-24hrs

Anterior circualtion stroke (PAC) - salvagable tissue on CT perfusion scan or DW MRI

CT angiography with mechanical thrombectomy

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10
Q

How is an ischaemic stroke managed if over >4.5 hours

A

Aspirin 300mg - 2 weeks
Clopidogrel 75mg lifelong

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11
Q

Secondary prevention for a stroke

A

HALTS
Anti-hypertensive
Anti-platelet
Statin - high dose
Tobacco - smoking cessation
Sugar - screen for and manage DM
Surgery - carotid artery stenosis

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12
Q

How is a patient with AF causing stroke managed

A

Manage acute stroke sx

Initiate anti-coag 2 weeks post stoke

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13
Q

Define haemorrhagic stroke

A

Weakness of cerebral vessels leading to cerebra vessel rupture - neuronal injury leads to a clinical deficit

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14
Q

RF for haemorrhagic stroke

A

Male
Age
Haemophillia
HTN
Anticoagulation
Cocaine / Amphetamines
Alcohol

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15
Q

Causes of haemorrhagic stroke

A

Repurfusion injury
ruptured cerebral artery
trauma
AV malformation

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16
Q

Bloods for haemorrhagic stroke

A

FBC - Thrombocytopenia
Glucose
U+E
Clotting screen
Serum toxicology

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17
Q

Management of hemorrhagic stroke

A

ABCDE
BP control - Betal blockers
Stop / revere anti-coag
Cryoprecipitate / FFP
Nimodipine - prevent vasospasm

Surgical - clipping / coiling

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18
Q

Give 5 sx of stroke

A

Motor weakness
Dysphasia
Swallowing issues
Visual field defects
Sensory disturbance
Balance

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19
Q

Give 3 sx of each cerebral teritory:
- Anterior
- Middle
- Posterior
- Brianstem

A

Contralateral weakness and sensory deficit of lower limb
Apraxia
Dysphasia
Dysarthia
Homonymous heminaopia

Contralateral motor weakness and seosnry loss - upper limb
Facial droop
Dysphasia
Aphasia
contralateral homonymous heminaopia

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20
Q

Give 3 sx of each cerebral teritory:
- Anterior
- Middle
- Posterior
- Brianstem

A

Contralateral weakness and sensory deficit of lower limb
Apraxia
Dysphasia
Dysarthia
Homonymous heminaopia

Contralateral motor weakness and seosnry loss - upper limb
Facial droop
Dysphasia
Aphasia
contralateral homonymous heminaopia

Contralateral homnymous heminaopia - macualr sparing
vertigo
memory defictis
visual agnosia

quadraplegia
facial paralysis
coma
locked in
decreased GCS

21
Q

Describe TAC - Bamford classifcation

A

ALL 3
unilateral hemiparesis and/or hemisensory loss of the face, arm & leg
homonymous hemianopia
higher cognitive dysfunction e.g. dysphasia

22
Q

Describe a PACI

A

2/3 present
unilateral hemiparesis and/or hemisensory loss of the face, arm & leg
homonymous hemianopia
higher cognitive dysfunction e.g. dysphasia

23
Q

Describe a PCI

A

1 present

Cranial nerve palsy + contralateral motor / sensory deficit
bilateral motor sensory deficit
conjugate eye movement disorder
cerebellar dysfucntion - vertigo / nystagmus / ataxia
Isolated homonymous heminaopia

24
Q

2 other distinguishing features of haemorrhagic stroke from hsiotry

A

headache
N+V

25
Describe a lacunar stroke
Pure motor pure sensory sensorimotor ataxic hemiparesis
26
Define a TIA
Sudden onset neurological deficit due to temporary cerebrla ischaemia without infarction - full resolution in 24 hours
27
Investigations for TIA
MRI with diffusion weighting Bloods FBC Glucose clotting screen Lipids U+E ECG Carotid doppler
28
causes of cerebellar syndrome
infarction MS Alcoholism Neoplastic BET Cerebral plasy Fredrichs ataxia
29
What is Friedrichs ataxia assosciated with
HOCM
30
Give 3 features of friedrichs ataxia
AR - Trinucleotide repeat cerebellar ataxia high arched palet spinocerebllar degeneration optic atrophy
31
describe a 3rd nerve palsy
down and out double vision ptosis - complete proptosis fixed dilated pupil - surgical
32
Give a cause of a surgical 3rd nerve palsy
PCA aneurysm
33
Give 4 causes of non surgical 3rd nerve palsy
MS DM HTN
34
Describe a 4th nerve palsy
UP AND OUT vertical diplopia torsional diplopia - tilting of objects head tilt
35
describe an argyll-robertson pupil
small irregualr pupil no repsonse to light but can accommodate
36
Give 3 clasifcations for TLoC
Neurally mediated reflex syncope Orthostatic hypotenison cardiogenic syncope
37
outline neurally mediated reflex syncope
vasovagal - reflex bradycardia and peripheral vasodilatation in response to: strong emotion / fear / needles situational - post cough / micturition / exercise carotid sinus hypersensitivity - tight collar
38
prodromal features of faint
dizzy sweaty blurred vision pallor
39
primary causes of orthostatic hypotension
PD Lewy body dementia
40
secondary causes of orthostatic hypotension
DM Uraemia alcohol diuretics
41
cardiogenic causes of syncope
Long QT HOCM Heart block SVT AF Aortic stenosis
42
Investigations fro syncope
Lying and standing BP ECG Full CVS exam Tilt table test
43
what is vasovagal syncope
reflex bradycardia and peripheral vasodilation in response to stress/fear/needles
44
What is neurally mediated reflex syncope
symptomatic hypotension due to neural reflex vasodilation and bradycardia
45
Sx of neurally mediated syncope
narrowing of vision blurred vision sweating pallor dizziness
46
What is orthostatic hypotension
insufficeincy of baroreceptors to respond to drop in BP
47
Seizure triggers
lack of sleep alcohol drugs stroke SOL Low sodium haemorrhage
48
Which seizures does carbamazepeine affect
Absence and myoclonic

Finals revision (17 decks)

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