Neurology Flashcards
What tumour is most associated with myasthenia gravis?
Thymoma
How does an anterior inferior cerebellar artery stroke present? (Lateral pontine syndrome)
Ipsilateral: facial pain and paralysis, temperature loss, deafness
Contralateral: facial pain and temp loss
Ataxia, nystagmus
What do GBS nerve conduction studies show?
Decreased motor nerve conduction velocity
What is the management for idiopathic intracranial hypertension?
Weight loss (if overweight)
(Specialist): Carbonic anhydrase inhibitors
Topiramate
How does MCA stroke present?
Contralateral hemiparesis and sensory loss
Upper extremity > lower
Contralateral homonymous hemianopia
Aphasia
What is used for spasticity in MS?
Baclofen and gabapentin 1st line
PT important
How to test if a fluid is CSF in trauma?
Check for glucose at bedside
Blood tests in neuroleptic malignant syndrome?
Raised CK and leukocytosis
How does neuroleptic malignant syndrome present?
FEVER
Fever
Encephalopathy
Vitals (SNS activity inc)
Elevated CK
Rigidity
Initial treatment for PD?
Levodopa
What is the most common complication of meningitis?
Sensorineural hearing loss
Which nerve is affected in ‘Saturday night palsy’?
Radial nerve
What is the management for myasthenia gravis?
Long acting acetylcholinesterase inhibitors eg pyridostigmine
Medical management in paediatric status epilepticus?
- Buccal midazolam
- IV lorazepam
- IV phenytoin, keppra or sodium valproate
- Rapid sequence induction of anaesthesia using thiopental sodium
what are the 4 1st line medications for neuropathic pain?
duloxetine, amitriptyline, gapapentin and pregabalin
if one doesn’t work, try the others
what is the management for an acute myasthenic crisis?
IVIg, plasmapheresis
what type of brain bleed does fluctuating consciousness suggest?
subdural haemorrhage
trigger for cluster headaches?
alcohol
what is the test for carotid stenosis?
carotid USS
what is the management for carotid stenosis?
endarterectomy
which blood vessel causes extradural haemorrhage?
middle meningeal artery
which bone injury is associated with extradural haemorrhage?
fracture of temporal bone
which vessels cause subdural haemorrhage?
bridging veins
what is the shape of a subdural haemorrhage on CT?
crescent
at what GCS should securing the airway be considered?
> /8
what illicit drug is associated with SAH?
cocaine
what blood condition is associated with SAH?
sickle cell anaemia
what kidney condition is associated with SAH?
PKD
first line ix for SAH?
CT head
next test in SAH if CT head is negative? findings?
LP
- raised red cell count
- xanthochromia
medication to prevent vasospasm in SAH?
nimodipine
what is the abnormal pupil response in optic neuritis?
relative afferent pupillary defect
visual field defect in optic neuritis?
central scotoma
what is a single episode of MS called?
clinically isolated syndrome
pathophysiology of MS?
demyelination in the CNS
3 disease patterns in MS?
relapsing-remitting
secondary progressive
primary progressive
ix for MS?
MRI
LP
finding in the CSF in MS?
oligoclonal bands
tx of relapses in MS?
methylprednisolone
most common type of MND?
amylotropic lateral sclerosis
how is MND diagnosed?
clinically
licensed medication to slow progression of MND?
riluzole
tx to support breathing at night in MND?
NIV
LMN signs in MND?
fasciculations
muscle wasting
UMN signs in MND?
brisk reflexes
spasticity
upgoing plantars
classic triad of parkinsons features?
rigidity
bradykinesia
resting tremor
name for facial masking in PD?
hypomimia
PD plus syndrome with autonomic dysfunction?
multiple system atrophy
PD plus syndrome with varying alertness?
lewy body dementia
what is levodopa usually combined with in PD tx?
peripheral decarboxylase inhibitor
eg carbidopa and benserazide
3 examples of dyskinesias in PD?
dystonia, chorea and athetosis
what type of drug is entacapone?
COMT inhibitor
what type of drug is bromocriptine?
dopamine agonist
what type of drugs are selegiline and rasagiline?
MAO-B inhibitors
what type of tremor is 4-6Hz?
PD tremor
what type of tremor is worse at rest?
PD
what type of tremor improves with alcohol?
essential tremor
what type of tremor is asymmetrical?
PD
what type of tremor worsens on intentional movements?
essential tremor
mgt options for essential tremor?
propranolol
primidone
diagnostic tests for epilepsy?
EEG and MRI
additional features of tonic-clonic seizures?
tongue biting
incontinence
post ictal period
groaning
first line to prevent tonic-clonic seizures?
sodium valproate
type of seizure associated with memory flashbacks?
focal seizures
type of seizure associated with unresponsive staring?
absence seizures
type of seizure associated with ‘drop attacks’?
atonic seizure
type of seizure associated with muscle jerks?
myoclonic seizure
highly teratogenic epilepsy drug?
sodium valproate
first line generalised epilepsy medication for women of childbearing potential?
lamotrigine or levetiracetam
first line for focal seizures?
lamotrigine or keppra
first line for absence seizures?
ethosuximide
first line for myoclonic seizures?
sodium valproate (men)
levetiracetam (FCP)
drug for status epilepticus in community?
buccal midazolam or rectal diazepam