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neurology Flashcards

1
Q

which PD drug causes hallucinations

A

Ropinirole, pramipexole (dopamine agonists)

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2
Q

What 1st line drug would you use for PD if motor sx affecting QOL

A

levodopa

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3
Q

What should levodopa be combined with

A

Peripheral decarboxylase inhibitor e.g. carbidopa

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4
Q

examples of dopamine receptor agonists?
Common side effects?

A

cabergoline, ropinirole, apomorphine, bromocriptine,

Pulmonary, retroperitoneal and cardiac fibrosis (cabergoline and bromocriptine only)

Impulsive behaviour, hallucinations, sleepiness, postural hypotension, nasal congestion

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5
Q

examples of MAO B inhibitors

A

selegiline

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6
Q

COMT inhibitor examples

A

entacapone, tolcapone

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7
Q

What is De clerambault syndrome

A

delusional idea that a person whom they consider to be of higher social and/or professional standing is in love with her.

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8
Q

How to remember GCS M bit

A

NEF
no response - 1
Abnormal Extension - 2
Abnormal flexion 3

(Flex to withdraw from pain 4)
Localises to pain 5
Obeys command 6

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9
Q

What vessel is affected in a subdural haemorrhage

A

Bridging veins

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10
Q

What vessel is affected in an extradural haemorrhage?
How might this present?

A

Middle meningeal artery

Lucid period.

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11
Q

What would you see on CT with Herpes simplex encephalitis

A

bilateral temporal lobe changes - these are pathognomic

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12
Q

How long can’t you drive for after a seizure?

A

12 months if diagnosis of epilepsy or EEG/imaging abnormality
6 months if imaging/EEG ok

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13
Q

How long can’t you drive for after a stroke/TIA

A

1 month if no neuropathy deficit or if isolated

3 months if multiple TIAs

If lorry/ bus driver - 1 yr

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14
Q

What vessels are affected in an anterior stroke?

A

Middle cerebral and anterior cerebral

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15
Q

When would you do thrombolysis and thrombectomy

A

If you have an ischaemic proximal anterior stroke and
within 4.5h for thrombolysis
within 6 hours for thrombectomy.

Consider if posterior circulation

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16
Q

when would you do thrombectomy

A

if they have had a stroke within 24h of symptom onset and the scan suggests there’s salvageable brain tissue
Can be anterior or posterior circulation

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17
Q

When would you refer for TIA in what scenarios

A

Immediate admission if on a blood thinner (exclude haemorrhage)

Refer to specialist within 24h if symptoms within the last 7 days and give 300mgs aspirin

Refer to specialist within 7 days if symptoms happened over a week ago

18
Q

Where is Broca and Wernike area

A

Broca - near mouth at front so frontal

Wernike near ears so temporal

19
Q

What would you worry about with an absent corneal reflex?
What condition do you get these with

A

Acoustic neuroma

Neurofibromatosis type 2 get bilateral acoustic neuroma

20
Q

How can you treat an acute MS relapse?

A

High dose steroids

21
Q

How to treat fatigue in MS

A

amantadine (once other causes e.g. anaemia ruled out).

22
Q

How to treat spasticity in MS?

A

baclofen and gabapentin are first-line.
Other options include diazepam, dantrolene and tizanidine

23
Q

How to treat bladder dysfunction in MS? what should you be careful with

A

be careful with anticholinergics - could worsen sx. Used if low residual vol. Otherwise ISC

24
Q

How to treat Oscillopsia in MS

A

gabapentin

25
Q

What is used for cluster headache prophylaxis?
What can trigger attacks?

A

Verapamil
Alcohol can trigger

26
Q

First line management of absence seizures

A

ethosuximide

27
Q

First line management of tonic clonics

A

males: sodium valproate
females: lamotrigine or levetiracetam

28
Q

First line management of focal seizures

A

Lamotrigine or levetiracetam

29
Q

What’s the first line anti platelet after a stroke/TIA

A

clopidogrel

30
Q

Most common GBS trigger

A

Campylobacter jejuni

31
Q

What is Miller Fisher syndrome

A

A type of guillan barre where the eye muscles are affected first and weakness travels down .
Usually with GBS get ascending paralysis

32
Q

Migraine prophylaxis

A

Propranolol.
Topirimate can be used but not in women of childbearing age.
Amitriptyline can also be used

33
Q

Trigeminal neuralgia management

A

carbamazepine

34
Q

Neuroleptic malignant syndrome features and management

A

Usually after starting antipsychotics.
Onset - days (hours in serotonin syndrome)
Decreased reflexes (increased in serotonin syndrome).
Pyrexia, rigidity, tachy, high RR (same as serotonin syndrome)
High CK
Dantrolene

35
Q

Serotonin syndrome

A

Onset = hours

36
Q

POCI vessel

A

vertebrobasilar

37
Q

Total Anterior Circulation Infarct - Vessels affected and presentation?

A

Anterior and middle cerebral arteries

  1. unilateral hemiparesis and/or hemisensory loss of the face, arm & leg
  2. homonymous hemianopia
  3. higher cognitive dysfunction e.g. dysphasia
38
Q

Partial Anterior circulation stroke - vessels and features

A

involves smaller arteries of anterior circulation e.g. upper or lower division of middle cerebral artery

Need 2 of:
1. Homonymous hemianopia
2. Unilateral Hemiparesis+/- hemisensory loss
3. Higher cognitive dysfunction e.g. speech impaired

39
Q

Lacunar circulation stroke - vessels and features

A

Perforating arteries around the internal capsule, thalamus and basal ganglia

presents with 1 of the following:
1. unilateral weakness (and/or sensory deficit) of face and arm, arm and leg or all three.
2. pure sensory stroke.
3. ataxic hemiparesis

40
Q

Posterior circulation stroke - vessels and features

A

involves vertebrobasilar arteries
presents with 1 of the following:
1. cerebellar or brainstem syndromes
2. loss of consciousness
3. isolated homonymous hemianopia

Revision (29 decks)

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