Neurology Flashcards
Give examples of 5HT3 antagonists?
Anti-emetics - Ondansetron, Palonestron
What is the main use of 5HT3 antagonists?
management of chemotherapy related nausea
Where does 5HT3 antagonists act on?
in the chemoreceptor trigger zone of the medulla oblongata
List the side effects of 5HT3 antagonists?
- QT prolongation
- constipation
What injury causes Broca’s (expressive) aphasia
lesion in the inferior frontal gyrus
supplied by the superior division of the Left MCA
what are the signs of Broca’s (expressive) aphasia?
speech is non-fluent, laboured and halting
repetition is impaired
comprehension is relatively intact
What injury causes Global aphasia
injury to Broca’s, Wernike’s and arcuate fascicles
What are the signs of Global aphasia?
severe expressive and receptive aphasia
may be able to communicate using gestures
What injury causes Conduction Aphasia
damage to the arcuate fascicles (connection between Wernicke’s and Broca’s area)
What are the signs of Conduction Aphasia?
speech is fluent
repetition is poor
person is aware of errors they are making
comprehension is normal
What injury causes Wernicke’s (receptive) aphasia?
- lesion in the superior temporal gyrus
supplied by the inferior branch of the left MCA
What are the signs of Wernicke’s (receptive) aphasia?
- lesion results in sentences that make no sense, word substitution and neologism
- speech remains fluent (word salad)
- comprehension impaired
What type of inheritance trait is Ataxia Telangiectasia?
autosomal recessive disorder
it is an inherited combined immunodeficiency disorder
Which gene is affected in Ataxia telangiectasia?
defect aTM gene which encodes for DNA repair enzymes
When is the onset of Ataxia telangiectasia?
onset in childhood (age 1-5 years)
What are the features of Ataxia telangiectasia?
- cerebella ataxia
- telangiectasia (spider angiomas)
- IgA deficiency resulting in recurrent chest infections
What are the features of Ataxia telangiectasia?
- cerebella ataxia
- telangiectasia (spider angiomas)
- IgA deficiency resulting in recurrent chest infections
what is the risk of having ataxia telangiectasia?
10% risk of developing malignancy - lymphoma/ leukaemia
Define Bell’s palsy?
acute, unilateral idiopathic facial nerve palsy
What is the incidence of Bell’s palsy?
20-40 years
more common in pregnant women
What type of motor neurone condition is Bell’s palsy?
What happens to the forehead?
It is a Lower Motor Neurone facial palsy
The forehead is affected
What are the features of Bell’s palsy?
- LMN facial palsy
- forehead is affected
- post auricular pain (may precede paralysis)
- altered taste
- dry eyes
- Hyperacusis (increased sensitivity to sound)
What is the initial management of Bell’s palsy?
Prednisolone within 72 hours of onset (+/- anti-viral)
Eye care
What is the secondary management of Bell’s palsy?
if no improvement after 3 weeks - refer urgently to ENT
list possible causes of a brain abscess
what may the symptoms of a brain abscess
what are the main investigations for a brain abscess
CT head +/- MRI
echocardiogram - aid in diagnosis of infective endocarditis
what procedure may be perfromed for a brain abscess
craniotomy + abscess cavity debridement
what antibiotics may be prescribed for treatment of a brain abscess
IV 3rd gen cephalosporins + Metronidazole
what medication is prescribed to manage intracranial pressures in a brain abscess?
dexamethasone
