Neurology Flashcards
Bradykinesia, unilateral pill-rolling tremor and rigidity are 3 of the core symptoms of parkinson’s disease, name 8 other characteristic features.
Micrographia
Hypersalivation
Mask-like facies
Impaired olfaction
Psychiatric features: depression, dementia and psychosis.
Sleep disorders.
Fatigue
Autonomic dysfunction
What are the features of drug-induced Parkinsonism?
Motor sx are usually rapid onset and bilateral.
Rigidity and rest tremor are uncommon.
Levodopa is one of the medications used to treat the motor sx of parkinson’s disease, name 2 other classes of medications used to treat Parkinson’s with three examples of each.
Dopamine agonists: Ropinirole, Rotigotine and Cabergoline.
Monoamine Oxidase B Inhibitors: Selegiline, Rasafiline and Safinamide.
Which medication can be used to treat the dyskinesia associated with treatment of Parkinsons?
Amantadine
What are two examples of COMT inhibitors used in the treatment of Parkinson’s?
Tolcapone
Entacapone
What can be prescribed to help prevent the hypersalivation that is associated with Parkinson’s?
Glycopyronium bromide
Dry mouth, anorexia and palpitations are 3 side effects assoicated with levodopa, name 2 more.
Postural hypotension
Psychosis
What are the ergot-derived dopamine agonists and what side effects are they associated with?
Cabergoline
Bromocriptine
Pulmonary, retroperitoneal and cardiac fibrosis.
Which drugs are used in the treatment of drug-induced Parkinsonism?
Anti-muscarinics which help with tremor.
Procyclidine
What are the features of progressive supranuclear palsy?
Postural instability and falls (stiff broad-based gait)
Impairment of vertical gaze.
Parkinsonism - prominent bradykinesia
Cognitive impairment (primarily frontal lobe dysfunction)
Unilateral upper and lower facial nerve palsy and dry eyes are two features of Bell’s palsy, name 3 more.
Post-auricular pain
Altered taste
Hyperacusis
When should people with Bell’s palsy be referred?
If the paralysis is persistent after 3 weeks with no signs of improvement.
Which class of drug can worsen the symptoms of myasthenia gravis?
Beta blockers
Lithium
Phenytoin
Antibiotics - macroldies, quinolones
What is the most common complication following meningitis?
Sensorineural Hearing loss
What is the most appropriate initial management if a cerebral infarction transforms into a cerebral haemorrhage?
Stop anticoagulation
Control BP
Which nerve is most likely to be damaged in a mid-shaft humeral fracture and how would this present?
Radial nerve
Wrist drop
What is the most common form of motor neuron disease?
Amyotrophic lateral sclerosis
What specific abnormalities can topiramate cause if taken during pregnancy?
Cleft lip and palate.
What are the three key features of normal pressure hydrocephalus?
Gait abnormalities (often similar to Parkinson’s)
Urinary incontinence
Dementia and bradyphenia (slowness of thought)
Guillain-Barre Syndrome causes progressive, symmetrical weakness of all the limbs, name 3 more features that may be found on examination of the limbs.
Ascending weakness (legs affected first)
Reflexes reduced or absent
Mild sensory sx (distal paraesthesia) - may not be present
Patients with Guillian-Barre syndrome may suffer from respiratory muscle weakness, name 5 more features that may be present.
Diplopia
Bilateral facail nerve palsy
Oropharyngeal weakness (common)
Urinary retention
Diarrhoea
What investigatons are carried out for a suspected case of Guillain-Barre syndrome and what would positive results show?
LP - rise in protein with normla WBC count (found in 66%)
Nerve conduction studies - decreased motor nerve conduction velocity (prolonged distal motor latency, increaded F wave latency).
Nasal discharge, red swollen watering eye and eyelid drooping are common features of a cluster headache, name 2 more features.
Pupil constriction
Facial sweating
What is the management for an acute cluster headache?
IM triptans
High flow oxygen
