Neurology

Question 1

What are the red flag features in Neurology?

Answer 1

LOC

Headaches
Visual changes
Fevers
N/V
Photophobia

Focal neurology (eyes/face/arms/speech)

Amnesia
Balance

Weight loss
Night sweats

Question 2

What are the components of the HASBLED score?

Answer 2

Hypertension
Abnormal LFTs/U+Es
Stroke
Bleeding
Labile INR
Elderly (>65)
Drugs

Question 3

What are the components of the CHADSVASc score?

Answer 3

CHF
Hypertension
Age >65 years
DM
Stroke

Vascular disease
Age 65-74
Sex Category

Question 4

What are some Stroke mimics?

Answer 4

Migraine
Bell’s Palsy

Todd’s Paresis

Head injury
SOL
Demyelinating disorders

Hypoglycaemia
Intoxication

Question 5

What scale can be used in assessing for stroke-related neurological deficits?

Answer 5

NIHSS

0-4 for

LOC
Speech
Motor commands
Visual field loss
Facial palsy
Motor strength
Sensation changes
Ataxia
Visual inattention
Dysarthria
Aphasia

Question 6

What are the potential management options for stroke?

Answer 6

CT-Head (rule out haemorrhagic stroke)

Aspirin 300mg (PO/PR)

Ischaemic haemorrhage:
Alteplase (<4.5 hours)
Thrombectomy (<6 hours)

Intracranial haemorrhage:
Antihypertensives
Anticoagulant reversal
Referral

Question 7

What are the contraindications to thrombolysis?

Answer 7

Previous ICH
Seizure
Intracranial neoplasm
SAH
Stroke or TBI in 3/12 before
LP in last 7/7
GI haemorrhage in last 3/52

Question 8

What is the recommended secondary prevention in Stroke care?

Answer 8

Clopidogrel

Question 9

What are the criteria for a TACS?

Answer 9

Hemiparesis
Homonymous hemianopia
Higher cerebral dysfunction