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Year 4 - Elderly, Neuro & MSK > Neurology > Flashcards

Neurology Flashcards

1
Q

Give at least 5 main headaches

A
  1. Cluster
  2. Tension
  3. Giant cell arteritis
  4. Migraine
  5. Subarachnoid or intracranial haemorrhage
  6. Glaucoma
  7. Encephalitis or ICP
  8. Tumour
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2
Q

5 main red flag symptoms

A

Fever
Photophobia
Photophonia
Neck stiffness
Visual disturbances
Vomiting
Trauma
Cancer
Worse coughing and in different positions
Sudden occipital pain
Pregnancy

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3
Q

What can fundoscopy be used to detect?

A

Papilloedema

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4
Q

What can papilloedema suggest?

A

Raised ICP

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5
Q

What is papilloedema

A

Swelling of optic discs due to pressure

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6
Q

Initial investigations for headache?

A
  1. History and red flag symptoms
  2. Fundoscopy?
  3. CT/ neuro imaging?
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7
Q

What is a cluster headache

A

Unilateral throbbing behind an eye that can be red and swollen lacrimating and recurrent/reappearing

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8
Q

How long does a cluster headache last

A

15mins -3hrs

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9
Q

4 key signs of cluster headache

A

Miosis (pupillary constriction), ptosis (drooping eye), nasal discharge, facial swelling

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10
Q

management of cluster headache? (2?)

A

High flow oxygen 100%
Triptans

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11
Q

What prevents cluster headaches?

A

Verapamil

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12
Q

What’s a tension headache

A

Mild band pressure around the head, develops gradually and goes gradually

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13
Q

3 main causes of tension headaches

A

Dehydration, skipping meals, alcohol

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14
Q

3 management?

A
  1. Reassurance
  2. Water
  3. Simple analgesia (paracetamol ibuprofen)
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15
Q

What is used for chronic tension headaches

A

Amitriptyline

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16
Q

How many stages of migraine are there?

A

5

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17
Q

How many classes of migraines are there??

A

4

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18
Q

List the classes of migraines

A

Migraine with aura
Migraine without aura
Silent migraines
Hemiplegic migraines

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19
Q

What’s a silent migraine

A

Migraine with aura no headache

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20
Q

What’s a Hemiplegic migraine

A

Migraine that paralyses one side, resembles tia or stroke

21
Q

5 stages of migraine?

A

Prodromal/pre - days before mood changes etc
Aura - visual/sesation/language
Headache - 4-72hrs
Resolution
Postdromal/recovery

22
Q

What is aura

A

Visual disturbances or hallucinations
Sensations of tingling or numbness
Dysphasia

23
Q

Can you have menstrual migraine?

A

Yes, 2 days before

24
Q

Tx for migraine?

A

NSAIDs, paracetamol, Triptans and antiemetics if vomiting

25
Q

What makes migraines worse?

26
Q

What are Triptans

A

5-ht receptor agonists, cause cranial vasoconstriction, inhibit pain signals, release inflammatory neuropeptides

27
Q

What can prevent migraines?

A

Propanolol, amitriptyline

28
Q

What is a stroke?

A

Ischaemia or infarction or intracranial haemorrhage

29
Q

What is a TIA

A

Transichaemic attack

30
Q

What risk does TIA pose with relation to stroke

A

Crescendo TIA (2+) within a week = stroke risk

31
Q

What tools can be used to identify stroke?

A

FAST or ROSIER

32
Q

What is the classification system for stroke called?

A

Oxford/bamford

33
Q

3 criteria for oxford

A
  1. Unilateral hemiparesis and/or hemisensory loss of face/arm/leg
  2. Homonymous hemianopia (field loss deficient in the same halves of the visual field of each eye)
  3. Higher cognitive dysfunction (speech)
34
Q

What signs does anteriro lesions have?

A

Contralateral hemisensory and hemiparesis

35
Q

What signs does middle lesion have?

A

Hemisensory and hemiparesis (anterior - but of upper more common)
+
Contralateral homonomymous hemianopia
Aphasia

36
Q

What would posterior lesion present as?

A

Contralateral homonymous hemianopia with macula sparing + visual agnosia
(LOTS OF VISION)

37
Q

What would Webers region legion affect ?

A

Same sided CN3 palsy
Weakness of opposite upper and lower extremity

38
Q

What would wallenbergs lesion suggest?

A

Same side face pain and temp loss
Opposite sensation change/temp loss
Ataxia
Nystagmus
DANVAH!!!!

39
Q

What causes Amaurosis fugax

A

Retinal/opthalamic lesion

40
Q

What causes locked in syndrome

A

Pons affected, basilar artery

41
Q

What causes Wallenberg and facial paralysis and deafness (same side)?

A

Lateral pontine, anterior inferior

42
Q

Risk assessment for stroke?

43
Q

Medical option for stroke prevention?

A

Anticoag/platelet, aspirin and statins

44
Q

Tx for suspected TIA?

A

300mg aspirin, specialist tx within 24 hrs and lifestyle advice BP/HTN monitored

Clopidogrel + aspirin lastly

45
Q

3 investigations for stroke

A
  1. FAST/ROSIER
  2. CT/MRI
  3. Carotid endartectomy
46
Q

How does haemorrhage show on CT

47
Q

How does ischamia show on ct

48
Q

Tx for acute stroke?

A

Alteplase (haemorrhage cause excluded)
Aspirin asap
Ppi for those with reflux/gord

49
Q

Tx for acute haemorrhagic stroke

A

Surgical intervention, hTN tx and anticoag stopped and reversed (NO LMWH)

Year 4 - Elderly, Neuro & MSK (3 decks)

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