Neurology Flashcards
Patient with stroke symptoms since less than 4.5 hours, imaging confirms blockage of proximal anterior or posterior circulation, treatment:
Thrombolysis with alteplase and thrombectomy.
Aphasia characterised by fluent but incoherent speech, comprehension and repetition are abnormal:
Wernicke’s aphasia.
Aphasia characterised by non-fluent and effortful speech, reading comprehension is okay:
Broca’s aphasia.
Sodium valproate adverse effects:
Teratogenic, neural tube defects
P450 inhibitor
gastrointestinal: nausea
increased appetite and weight gain
alopecia: regrowth may be curly
ataxia
tremor
hepatotoxicity
pancreatitis
thrombocytopaenia
hyponatraemia
hyperammonemic encephalopathy: L-carnitine may be used as treatment if this develops
Crescent shaped haemorrhage on CT head, diagnosis and damaged vessel:
Subdural haemorrhage, bridging veins.
Phenytoin side effects:
Gingival hyperplasia, hirsutism, coarsening, megalblastic anaemia, peripheral neuropathy, etc.
Status epilepticus patient, not responding after 2 doses of IV lorazepam:
Levetiracetam, phenytoin, sodium valproate.
Main difference between MND and myasthenia gravis:
MND spares eye movements.
Triptan contraindications
Ischaemic heart disease or cerebrovascular disease.
Parkinson’s drugs that may cause pulmonary, retroperitoneal or cardiac fibrosis:
Ergot-derived dopamine receptor agonists (bromocriptine, cabergoline).
Treatment for drug-induced parkinsonism:
Antimuscarinics: procyclidine, benzotropine, trihexyphenidyl (benzhexol).
Stroke patient intolerant of clopidogrel, secondary prevention:
Aspirin + dipyridamole lifelong.
First line treatment for trigeminal neuralgia:
Carbamazepine
Patient with brain abscess, ejection systolic murmur, diagnosis:
Infective embolism frominfective endocarditis
Obese, young female with headache and blurred vision, diagnosis and treatment:
Idiopatic intracranial hypertension. Weight loss, topiramate, acetazolamide.
TIA that resolved completely before 24h treatment:
300 mg aspirin and urgent stroke review.
Prevention treatment for luster headache:
Verapamil
Initial management for patients with suspected TIA who are taking anticoagulants or have bleeding disorders:
Urgent imaging
Impaired adduction of one eye and nystagmus on abduction on the other eye, diagnosis:
Internuclear ophthalmoplegia
Parkinson’s group of drugs that cause more adverse events like sleepiness, hallucinations and impulse disorders:
Dopamine agonists: bromocriptine, cabergoline, ropirinole.
In what lobe is Broca’s and Wernicke’s areas located?
Inferior frontal gyrus and superior temporal gyrus.
Ipsilateral CN III paralysis and contralateral hemiparesis, diagnosis, occluded branch and area of infarction:
Weber’s syndrome, posterior cerebral artery, midbrain.
Neuropathic pain 1st line (4 meds).
Amitriptyline, gabapentin, duloxetine, pregabalin. All as monotherapy.
Pain in neck or extremities, loss of motor or sensory function or autonomic function, may have been diagnosed with resistant carpal tunnel syndrome, diagnosis:
Degenerative cervical myelopathy
Bilateral acoustic neuromas are typically seen in which condition:
Neurofibromatosis type 2
MS spasticity treatment:
Baclofen / gabapentin.
Type of stroke that presents with purely motor, purely sensitive or mixed deficit?
Lacunar stroke
Total anterior circulation infarct symptoms:
Unilateral weakness of face, arm and leg, homonymous hemianopia, and a symptom of higher cerebral disfunction.
Management for nausea in migraine:
Metoclopramide because of prokinetic effects:
Most common complication following meningitis:
Sensorineural hearing loss
DVLA seizures:
1st unprovoked, no abnormalities:
1st, epilepsy or unprovoked:
6 months
12 months
DVLA Syncope:
- simple faint
- single episode, explained and treated:
- single episode, unexplained
- two or more episodes
No restriction
4 weeks off
6 months off
12 months off
DVLA Stroke or TIA:
1 month
First line for epilepsy tonic-clonic seizures in male and female:
male: sodium valproate
female: lamotrigine or levetiracetam
First line for focal epilepsy
lamotrigine or levetiracetam or carbamazepine
What is used to treat cerebral oedema in patients with brain tumours?
Dexamethasone
When to start anticoagulation after a non-haemorrhagic stroke?
2 weeks after the event, antiplatelets for those 2 weeks
TIA treatment:
Aspirin + clopidogrel for 21 days, then clopidogrel monotherapy
Treatment for status epilepticus:
Buccal midazolam, rectal diazepam or IV lorazepam
How to differentiate cauda equina syndrome from spinal cord compression?
Cauda equina syndrome is below L2, and can present with urinary and bowel incontinence and buttock numbness, weakness is usually in feet and toes. Whereas weakness in upper or lower limb may be cause by spinal cord compression.
