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Zero to Finals Medicine > Neurology > Flashcards

Neurology Flashcards

1
Q

How should you refer to a stroke?

A

As a cerebrovascular accident

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2
Q

What are the two types of cerebrovascular accidentws CVA??

A

Ischeamic
or
haemorrhagic (intracranial haemorrhage)

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3
Q

What is a TIA?

A

Transient ischaemic attack, symptoms which reslove after 24 hours. On imaging there is ischaemia but no infarction

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4
Q

What are the symptoms of a stroke?

A

Sudden onsent asymmetrical
weakness of limbs
facial weakness
dysphagia
visual or sensory loss

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5
Q

How do you manage stroke?

A

Managed at stroke centre

ABCDE
exclude hypoglyceamia, review drugs for bleeding risk

CT Head
aspirin 300mg for 2 weeks
Alteplase thrombolysis

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6
Q

What drugs should somone who has had a stroke be on for secondary prevention?

A

clopidogrel 75mg
atorvastatin 80mg

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6
Q

What percentage of strokes are bleeds and which are thrombotic?

A

80% thrombotic
20% ischaemic

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6
Q

How is the GCS scored?

A

Eyes
Spontaneous -4
Speech - 3
Pain - 2
None -1

Verbal response
Orientated - 5
confused - 4
single strange words - 3
sounds - 2
none =1

Motor
obeys commands -6
Localises pain - 5
Normal flexion - 4
abnormal flexion -3
extends - 2
none - 1

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6
Q

How do intracranial bleeds present?

A

sudden onset headache
seizures
weakness
vomiting
altered consciousness

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7
Q

What are the eye components of GCS?

A

Sponaneous - 4
Speech - 3
Pain - 2
None - 1

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8
Q

What are the motor components of GCS?

A

Motor
obeys commands -6
Localises pain - 5
Normal flexion - 4
abnormal flexion -3
extends - 2
none - 1

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9
Q

What are the verbal components of GCS?

A

5 verbal
oriented speech 5
confused speech 4
inapproriate words 3
sounds 2
none 1

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10
Q

Where does a subdural haemorrhage occour?

A

between the dura mater and arachnoid mater

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11
Q

What do extra dural haemorrhages look like on CT?

A

bi-convex and are limited by cranial sutures?

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11
Q

What does a subdural heamrrohage look like on CT scan?

A

cresent shape not limited by cranial sutures

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11
Q

What is a intracerebrall haemorrhage and how does it present?

A

Bleeding into the brain tissue, presents similar to a haemorrhagic stroke

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11
Q

What does a extradural haemorrhage occour?

A

Between the skull and the dura matter.

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11
Q

What is the subarachnoid space?

A

it is where cerebrospinal fluid is located, between the Pia and arachnoid mater

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11
Q

What causes an extradural heamorrhage?

A

Rupture of the middle meningeal artery

12
Q

How does a subarrachnoid haemorrhage present?

A

sudden onset occipital headache during stress associated with neurological symptoms

13
Q

What are the risk factos for a subarachnoid haemorrage?

A

cocaine
alcohol
hypertension

14
Q

How do you investigate for a subarachnoid haemorrhage?

A

CT Head
Lumbar puncture

15
Q

Describe multiple sclerosis

A

Chronic and progresive condition invloving demyelination of the myelinated neurones in the central nervous system. It is an inflammatory disease.

16
Q

How can MS present?

A

Eye movement disorders
eye movement abnormality
focal weakness
focal sensory symptoms
ataxia

17
Q

How is MS diagnosed?

A

made by a neurologist and is a diagonsis of exclusion

18
Q

How are MS relapses treated?

A

steroids - methylprednisolone

19
Q

What are the DVLA requirements for MS

A

Patient must inform the DVLA of their condition and recieve an assesment

20
Q

How does Motor neurone disease present?

A

60 year old man with insidious, progressive weakness of the muscles throughout the body affecting limbs trunk face and speech

21
Q

What is parkinson’s disease?

A

progressive reducition of dopamine in basal ganglia resulting in disordered movements and coordination

22
Q

What is a parkinsons tremour like?

A

resting tremour 4-6hertz worse at rest. unliateral

23
Q

What is an benging essential tremor like?

A

bilateral, worse with intention

24
Q

How is parkinsons disease treated?

A

MDT
levadopa
Monoamine Oxidase-B Inhibitors

25
Q

What do monoamine oxidase enzymes do?

A

breakdown dopamine, seritonin and adrenaline

26
Q

What are seizures?

A

transient episodes of abnormal electical activity in the brain

27
Q

How is epilepsy investigated?

A

EEG
MRI brain
ECG

28
Q

what is the classic shaking seizure called?

A

Tonic clonic seizure

29
Q

What is the first line treatment for tonic clonic seizure?

A

sodium valporate

30
Q

what are the 6 types of seizures

A

Tonic Clonic seizure
Focal seizure
Absence seizure
Atonic seizure
Myoclonic seizure
Infantile spasms

31
Q

What are the notable side effects of the epilepsy medications

A

sodium valporate - teratogenic
Carbamazepine - agranulocytosis
Lamotrogine - safe in pregnancy

32
Q

What happens when a seizure lasts more than 5 minutes

A

Status Epilepticus

33
Q

How do you manage status epilepticus

A

ABCDE
IV lorazepam 4mg, repeated after 10 minutes
Phenytoin

or Buccal midazolam or diazepam

34
Q

What are the four analgesics for use in neuropathic pain?

A

amitriptyline
Duloxetine
Gabapentin
Pregabalin

35
Q

How do you differnetiate between an upper motor neurone or lower motor neurone lesion in the facial nerve and why?

A

if Upper motor neuron suspect stroke, if lower then manage in community

If forehead is spare then upper motor neuron

36
Q

What is Bell’s palsy?

A

unilateral lower motor neurone facial nerve palsy

37
Q

What should you check in suspected Bell’s palsy?

A

Forehead should not be spared

38
Q

How is Bell’s palsy managed?

A

Prednisolone

39
Q
A

Zero to Finals Medicine (10 decks)

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