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MED SCHOOL Y4 > Neurology > Flashcards

Neurology Flashcards

1
Q

signs of raised ICP
- treatment ?

A

Papilloedema
- Cushing’s triad : Decreased HR, WIDENED pulse pressure , irregular breathing

1) raise patients head
2) mannitol
3) Dexamethasone to treat cerebral oedema in patients with cancers or abscess

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2
Q

ipsilateral deafness , facial paralysis is indicative of what stroke
+ sudden vomiting and vertigo

A

anterior inferior cerebellar artery
Lateral Pontine Syndrome

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3
Q

cluster headache management

A

symptoms :
pain behind eye = sharp stabbing pain
ACUTE :
+ 100% O2
+subcutaneous triptan

Prophylaxis :
- Verapamil

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4
Q

weakness in legs can be differentiated from organic and non organic by ?

A

organic - where the issue has a cause and biochemical signs

inorganic = manifested in distress and also has no cause = idiopathic or conversion disorder

HOOver’s sign - lift weak leg and see if the other leg pushes down on your hand , if it does = organic cause . if not = conversion disorder (non organic cause)

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5
Q

acute sinusitis + focal neurology ( such as unable to lift limb etc )

A

Cerebral abscess
+ headache
+ fever
+ focal neurology
+ ring enhancing lesions on CT

Treatment : surgery
IV Cephalosporin ( Ceftriaxone) + metronidazole

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6
Q

Acute sinusitis + cranial nerve palsy + opthalmoplegia

A

Cavernous sinus thrombosis

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7
Q

meningitis types and CSF analysis

A

Viral -high protein , normal glucose . lymphocytes and clear /cloudy appearance
Bacterial- cloudy , low glucose , high protein ,POLYmorphs
TB-fibrin web, low glucose , high protein BUT LYMPHOCYTES

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8
Q

neurofibromatosis

NF1 AND NF2

A

NF1 :
- Cafe au lait spots
- Axillary and groin freckles
- iris hematomas ( Lisch nodules)
- Pheochromocytoma

NF2:
- PEOPLE have 2 ears hence NF2 = BILATERAL vestibular schwannomas ( acoustic neuroma )

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9
Q

Normal pressure hydrocephalus

A

urinary incontinence
gait abnormality
dementia
“wet, wobbly and wacky,”
4th “Wentricle,”

management:
ventriculoperitoneal shunting

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10
Q

Sub acute combined degeneratation of the spinal cord

A

due to B12 deficiency
+ sensory ataxia, positive rhombergs test
+ spastic weakness and upping planters (UMNS )
+ Absent ankle jerk and knee jerks (LMNS)

ALWAYS GIVE B12 BEFORE FOLATE

  • giving folate first can exacerbate the degeneration because folate makes new RBCs , which use up the B12 to grow . So if they already have low B12 then it just gets used up and it worsens !
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11
Q

Neuropathic pain treatment

A

1st line - amitriptyline , duloxetine , gabapentin, pregabalin

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12
Q

pituitary apoplexy signs and treatment and managements

A

Pituitary Apoplexy is the sudden enlargement of a pituitary tumour due to haemorrhage or infarct

  • sudden onset headache
  • visual field defect = bitemporal superior quadrant defect
    -evidence of pituitary insufficiency ( low bp , due to the loss ofACTH)

MRI is diagnostic

management :
- Steroid replacement ( loss of ACTH from the macro adenoma )

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13
Q

TACI vs PACI stroke difference

A

TACI :
- unilateral hemiparesis ( hemiparesis of the face and arm or leg)
- homonymous hemianopia
- higher cognitive defect : dysphagia

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14
Q

Beckers muscular atrophy

A

develops after the age of 10
weakness and pseudo hypertrophy of the calf muscles

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15
Q

Duchenne muscular atrophy

A

progressive muscular weakness from age 5
calf pseudo hypertrophy
Gower’s sign - child uses arm to stand up from squatted position
30% HAVE intellectual impairment

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16
Q

webers syndrome ?
branch of the posterior cerebral artery that supply midbrain

A

ipsilateral CN3 palsy
contraleral weakness of the upper and lower limbs

17
Q

middle cerebral artery stroke ?

A

MCA -UPPER > lower , contralateral hemiparesis and
+contralateral homonymous hemianopia

18
Q

Anterior cerebral artery stroke

A

Contralateral hemiparesis and sensory loss
LOWER> UPPER

19
Q

Posterior inferior cerebellar artery stroke signs

A

PICA
- Ipsilateral loss of facial pain and temp
- contralateral : limb and torso pain pain and temperature loss
- ataxia ( wide stance , loss of heel toe strike)
- nystagmus

20
Q

3rd nerve palsy

A
  • down and out

1) big pupil = surgical cause and needs CT HEAD , posterior communicating aneurysm

2) normal down and out due to = cavernous sinus thrombosis , webers syndrome , MS , Amyloid

21
Q

Brown Sequard syndrome

A

ipsilateral weakness, loss of proprioception and vibration sense

contralateral loss of pain and temperature sensation

21
Q

Cerebellar signs

A

DANISH
D- Dysdiadokinesia , Dysmetria, appear DRUNK
A-Ataxia
N-Nystagmus
I-Intention tremor
S-Slurred Staccato speech
H-HYPOTONIA

22
Q

Meningitis in children

A

Antibiotics
< 3 months: IV amoxicillin (or ampicillin) + IV cefotaxime
> 3 months: IV cefotaxime (or ceftriaxone)

23
Q

vestibular schwannoma (acoustic neuroma ) symptoms ?

A

cranial nerve 5,ate 7 (5,8,7)

CN 5- absent corneal reflex
CN 7 -facial palsy
CN 8- vertigo, unilateral sensorineural hearing loss , unilateral tinnitus

investigation : Audiogram and Gadolinium -enhanced MRI head

24
Q

Myasthenia gravis symptoms

A

muscle fatigue of the eyes , which leads to diplopia and ptosis at the end of the day
+ dysphagia

+ thymoma (15%) can cause SVC obstruction so you can see distended neck veins , flushed face sometimes

Investigations :
- antibodies to acetylcholine receptors (and anti-MUSK)

25
Q

Treatment for MG

A

Pyridostigmine ( long acting acetylcholinesterase inhibitor )

CRISIS:
- Plasmapheresis
- IV immunoglobulins

26
Q

bells palsy symptoms and treatment

A

lower motor palsy so forehead is affected ( can’t wrinkle forehead)
- oral prednisolone within 72hrs
- eye care drops to prevent exposure keratopathy
- if no improvement in 3 weeks => URGENT REF TO ENT

27
Q

Autonomic dysreflexia ?

A

Spinal cord injury above T6
+ triggered by fecal impaction or urinary retention
+unbalanced physiological response => extreme HT, flushing, sweating above the chord lesion , agitation

management is to remove the stimulus and treat Bradycardia and life threatening HT

28
Q

pseudo seizures

A

tend to build up and build down gradually
ie: psychogenic non-epileptic seizure

29
Q

MS treatment

A

acute : high dose steroids
reducing risk of relapse: natalizumab (monoclonal antibodies )

fatigue : amantadine
Spasticity : Baclofen or gabapentin
bladder dysfunction : intermittent self catheterisation

30
Q

TIA

A

Brief periods of neurological deficit due to a vascular cause (lasts less than 1 hr)
+ give aspirin 300mg
+ carotid doppler to see if the embolus came from carotid artery
+

31
Q

confusion + ataxia , nyastagmus / ophthalmoplegia is ….

A

Wernickes -> Give Pabrinex

MED SCHOOL Y4 (19 decks)

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