Neurology Flashcards
Which medications are used for spasticity in MS?
Baclofen
Gabopentin
Other options include diazepam, dantrolene and tizanidine
Cannabis and botox are under investigation
What is Weber syndrome?
Midbrain stroke - ipsilateral CN III palsy and contralateral hemiparesis
Which bug triggers Guillan Barre?
Campylobacter Jejuni
Prophylactic options for migraine and their contra-indications
Propanolol - not in asthma or HF
Topiramate - not in pregnancy
Amitriptyline
Prophylaxis for cluster headaches?
Verapamil
Which headache has an absolute response to indomethacin?
Paroxysmal hemicrania
- Severe unilateral headache with autonomic features
10-30 mins, up to 40x / day
What is the treatment for IIH?
Weight loss
Acetazolamide
Abx for meningitis an option if the patient is pen allergic?
Tx = IV ceftriaxone +IV amox if listeria suspected
Pen allergic - IV chloramphenicol and IV vancomycin
What abx do you give as a single dose as prophylaxis to people who have been in close contact with someone with meningitis?
Ciprofloxacin
What is the most common cause of meningitis in children under the age of 4?
Haemophilus influenza type B
Which patients are at risk of streptococcus pneumonia meningitis?
Which patients are at risk of listeria meningitis?
Hospitalised patients, CSF skull fractures, diabetics, alcoholics - strep pneumo
Pregnant women - listeria
What’s the difference between communicating and non-communicating hydrocephalus?
Communicating hydrocephalus - no obstruction to flow, reduced CSF absorption
Non-communicating hydrocephalus (more common) - obstruction to flow : tumours etc
What is syringomyelia?
Cystic enlargement of the spinal cord
Damage to the spinothalamic + corticospinal tracts
Most commonly caused by Arnold Chiari II malformation
What is CIDP?
Chronic inflammatory demyelinating polyradiculopathy
Peripheral neuropathy that comes on over months - years
Like the chronic version of guillain barre
Which anti-emetic is contra-indicated in PD patients?
Metoclopramide (because it is a dopamine antagonist - so exacerbates symptoms)
What is Sydenham’s syndrome?
Chorea due to previous rheumatic fever
What is degenerative cervical myelopathy?
Central disc prolapse within the cervical spine
Which vessels are involved in the following brain bleeds?
Extradural
Subdural
Subarachnoid
Extradural - middle meningeal
Subdural - bridging veins
Subarachnoid - circle of willis
Why do you get hyperacusis (hear more) in Bell’s Palsy?
The facial nerve supplies the stapedius, which is a muscle that contracts to stabilise the stapes (ear ossicle) when loud sounds are heard, to make them less loud. Paralysis of this muscle means the stapes will be able to move freely and thus sounds are heard louder.
Which anti-epileptic can cause the SE of peripheral neuropathy?
Phenytoin
Expressive (Broca’s) and receptive (Wernicke’s) aphasia correlate with problems in which parts of the brain?
Broca’s - frontal
Wernickes - temporal
Spoken word is heard at the ear. This passes to Wernicke’s area in the temporal lobe (near the ear) to comprehend what was said. Once understood, the signal passes along the arcuate fasciculus, before reaching Broca’s area. The Broca’s area in the frontal lobe (near the mouth) then generates a signal to coordinate the mouth to speak what is thought (fluent speech).
Which anti-emetic is safest in parkinson’s?
Domperidone - doesn’t cross the BBB
Which class of medications used in parkinson’s are most associated with the side effects of: hallucinations, excessive sleepiness and impulse control disorders?
Dopamine agonists eg ropinirole
Which lesions cause superior versus inferior bitemporal hemianopia visual field defects?
PITS: PITuitary tumour = S uperior quadrant defect is worse (ofc the main defect is bitemporal hemianopia)
The same mnemonic can be used for
PITS: parietal inferior, temporal superior
Lower quadrant defect - craniopharyngioma
Which medication is useful for managing tremore in drug induced parkinson’s?
Procyclidine
