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
What is used for cluster headache prophylaxis? What can trigger attacks?
Verapamil Alcohol can trigger
26
First line management of absence seizures
ethosuximide
27
First line management of tonic clonics
males: sodium valproate females: lamotrigine or levetiracetam
28
First line management of focal seizures
Lamotrigine or levetiracetam
29
What's the first line anti platelet after a stroke/TIA
clopidogrel
30
Most common GBS trigger
Campylobacter jejuni
31
What is Miller Fisher syndrome
A type of guillan barre where the eye muscles are affected first and weakness travels down . Usually with GBS get ascending paralysis
32
Migraine prophylaxis
Propranolol. Topirimate can be used but not in women of childbearing age. Amitriptyline can also be used
33
Trigeminal neuralgia management
carbamazepine
34
Neuroleptic malignant syndrome features and management
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
Serotonin syndrome
Onset = hours
36
POCI vessel
vertebrobasilar
37
Total Anterior Circulation Infarct - Vessels affected and presentation?
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
Partial Anterior circulation stroke - vessels and features
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
Lacunar circulation stroke - vessels and features
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
Posterior circulation stroke - vessels and features
involves vertebrobasilar arteries presents with 1 of the following: 1. cerebellar or brainstem syndromes 2. loss of consciousness 3. isolated homonymous hemianopia