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5th year OSCE > neurology > Flashcards

neurology Flashcards

1
Q

rapid onset severe unilateral headache
blood shot eyes
facial flushing

A

cluster headache

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2
Q

management of cluster headache

A

acute - sumatriptan
prophylaxis - verapamil

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3
Q

tight band around head
bilateral headache
non throbbing

A

tension headache

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4
Q

management of tension headache

A

analgesia
hot towel to local area

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5
Q

prolonged headache
nausea
decreased ability to function
sensitivity to light
aura - visual changes

A

migraine

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6
Q

management of migraine

A

NSAIDs
hydration
triptans

prophylaxis - propranolol, topiramate

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7
Q

can girls with migraine be given OCP

A

no

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8
Q

severe sudden onset thunderclap headache
decreased consciousness
vomiting
seizures

A

subarachnoid haemorrhage

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9
Q

investigations for subarachnoid haemorrhage

A

non contrast CT - star shaped lesion
lumbar puncture

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10
Q

trauma
headache
diminished eye response
confusion
LOC
personality change

A

subdural haematoma

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11
Q

investigation for subdural haematoma

A

non contrast CT - crosses suture lines, crescentic shape

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12
Q

head trauma
LOC but improves slowly
headache
lucid interval
comiting
bilateral limb weakness

A

extradural haemorrhage

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13
Q

investigation for extradural haemorrhage

A

non contrast CT - biconvex

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14
Q

facial pain, intense sharp unilateral
pain made worse by brushing teeth, eating cold and touch

A

trigeminal neuralgia

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15
Q

investigation for trigeminal neuralgia

A

clinical

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16
Q

management of trigeminal neuralgia

A

carbamezipine

17
Q

differentials for parkinsons

A

parkinsons
drug induced parkinsons
lewy body dementia

18
Q

if someone has reduced sensation and nerve problems what investigation can you do

A

nerve conduction studies

19
Q

MND upper motor neuron

A

increased tone
hyper-reflexia
upward plantar
slowed movement
weak extensors in arm

20
Q

MND lower motor neuron

A

muscle wasting
weakness
fasciculation
absent tendon reflex

21
Q

management of MND

A

riluzole

22
Q

women
loss of vision in one eye
sensory defects in limb, increase muscle tone
ataxia
nystagmus

A

multiple sclerosis

23
Q

investigation for multiple sclerosis

A

MRI
CSF - oligoclonal bands

24
Q

management of multiple sclerosis

A

acute - methylprednisolone
symptomatic:
physio
baclofen
gabapentin, amitriptyline

B- interferon (disease modifying)

25
Q

unilateral onset
bradykinesia - slow movements
resting tremor
rigidity
postural instability
shuffling gait
constipation

A

parkinsons

26
Q

investigation for parkinsons

A

clinical diagnosis

27
Q

management of parkinsons

A

levodopa

28
Q

symmetrical descending flaccid paralysis
blurred vision
diplopia

A

botulism

  • give antidote
29
Q

proximal muscle weakness gets better with movement, diplopia, ptosis, dry mouth

A

lambert eaton myasthenic syndrome

30
Q

investigations for lambert eaton

A

nerve conduction studies
chest CT - small cell lung cancer

31
Q

management of lambert eaton

A

amifampiridine
immunosuppressants

32
Q

muscle fatigability worse with movement, improves with rest
facial weakness

A

myasthenia gravis

33
Q

investigations for myasthenia gravis

A

serum AChR antibodies
pulmonary function test
CT chest - thymoma

34
Q

management of myasthenia gravis

A

pyridostigime
immunosuppresion - prednisolone
thymectomy

35
Q

abrupt onset
unilateral
complete facial weakness
sagging of mouth
drooping

A

bells palsy

36
Q

management of bells palsy

A

within 72 hours - prednisolone
protect eyes use tape at night

37
Q

infection prior
symmetrical ascending weakness
reduced reflexes
facial weakness

A

guillain barre

38
Q

investigation for guillain barre

A

nerve conduction studies
CSF
LFT
CRP

39
Q

what to give if prolonged seizure > 5 minutes

A

IV lorazepam
rectal diazepam

5th year OSCE (14 decks)

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