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Year 4 Finals > Neurology > Flashcards

Neurology Flashcards

1
Q

What is the acute management of cluster headaches?

A

100% oxygen + subcutaneous triptan

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2
Q

What medication is used in the prophylaxis of cluster headaches?

A

Verapamil

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3
Q

NICE recommend what for prophylaxis of tension headaches?

A

Acupuncture

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4
Q

Acute management of tension headaches is achieved via what medications?

A

Paracetamol, NSAIDs

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5
Q

In a patient with suspected temporal arteritis, what treatment should be given with:
1. No visual loss
2. Evolving visual loss

A
  1. High dose prednisolone
  2. IV methylprednisolone
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6
Q

Gastrointestinal upset is a common feature of what type of headache in children?

A

Migraine

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7
Q

What is the first line treatment for acute migraines?

A

Oral triptan + NSAID or paracetamol

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8
Q

Name the 3 medications used in prophylaxis of migraines

A

Propranolol, topiramate, amitriptyline

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9
Q

What should be used as prophylaxis in predictable menstrual migraine?

A

Triptans

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10
Q

Why is the oral contraceptive pill contraindicated in migraine with aura?

A

Increased risk of ischaemic stroke

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11
Q

Fundoscopy will show what in temporal arteritis?

A

Swollen pale disc with blurred margins

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12
Q

Through what mechanism does temporal arteritis cause vision loss?

A

Anterior ischaemic optic neuropathy

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13
Q

Acetazolamide is implicated in the management of what?

A

Idiopathic intracranial hypertension

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14
Q

Carboxyhaemoglobin percentage of over what is suggestive of carbon monoxide poisoning in:
1. Non smokers
2. Smokers

A
  1. Over 3%
  2. Over 10%
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15
Q

What is the target for oxygen saturations in carbon monoxide poisoning patients?

A

100%

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16
Q

In raised intracranial pressure, elevation of the head to how many degrees can be carried out?

A

30

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17
Q

Raised intracranial pressure can be temporarily controlled via what respiratory mechanism?

A

Hyperventilation to blow off CO2
Note - causes vasoconstriction of cerebral blood vessels, hence lowering ICP

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18
Q

A headache which is worse on standing up and better on lying down suggests what?

A

Low pressure headache

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19
Q

What type of headache may follow a lumbar puncture?

A

Low pressure

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20
Q

In what type of headache is a lumbar puncture contraindicated?

A

High pressure

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21
Q

Extradural haemorrhage most commonly involves what vessel?

A

Middle meningeal artery

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22
Q

Which type of intracranial bleed is limited by the suture lines of the skull, and which is not?

A
  1. Limited - extradural
  2. Not limited - subdural
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23
Q

What is the definitive treatment for an extradural haemorrhage?

A

Craniotomy + evacuation of haemorrhage

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24
Q

A unilateral dilated pupil indicates compression of which cranial nerve?

A

Third

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25
Q

What is the surgical management involved in subdural haemorrhage?

A

Burr holes

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26
Q

Which renal disease is associated with subarachnoid haemorrhage?

A

Adult polycystic kidney disease

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27
Q

Lumbar puncture should be conducted at least how long after symptom onset in SAH?

A

12 hours

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28
Q

Lumbar puncture should be conducted at least how long after symptom onset in SAH?

A

12 hours

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29
Q

Nimodipine has what effect on cerebral vessels? In what situation may it be used?

A

Prevents vasospasm - used in subarachnoid

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30
Q

Subdural haemorrhage is most commonly due to shearing of bridging veins between what?

A

Cortex and venous sinus

31
Q

Fluctuating consciousness suggests what type of intracranial bleed?

32
Q

A lucid interval indicates what type of intracranial bleed?

A

Extradural

33
Q

Which type of intracranial bleed is associated with shaken baby syndrome?

34
Q

Which electrolyte abnormality is a common complication of SAH?

A

Hyponaetraemia via syndrome of inappropriate antidiuretic hormone secretion

35
Q

Ring enhancing lesion on CT head is suggestive of what?

A

Brain abscess

36
Q

Lymphocytosis and raised protein on LP is suggestive of what?

A

Encephalitis

37
Q

Which bacteria classically causes Guillain Barre syndrome?

A

Campylobacter jejuni

38
Q

What is the difference between Miller-Fisher syndrome and classic GBS?

A

Miller Fisher is a descending paralysis, GBS is ascending

39
Q

Herpes simplex encephalitis most commonly affects which brain lobe? What symptom can this commonly produce?

A

Temporal lobes - aphasia

40
Q

What is the most common organism implicated in meningitis in:
1. Neonates
2. Adults
3. Immunosuppressed

A
  1. Group B strep
  2. Neisseria
  3. Listeria
41
Q

Polymorph dominant cerebrospinal fluid on lumbar puncture suggests what?

A

Bacterial cause of meningitis

42
Q

A fibrin web in cerebrospinal fluid is suggestive of what?

A

Tuberculous meningitis

43
Q

What antibiotics should be used for initial empirical therapy of meningitis in:
1. Aged under 3 months or over 50 years
2. Between 3 months - 50 years

A
  1. Ceftriaxone + amoxicillin
  2. Ceftriaxone
44
Q

Listeria meningitis should be managed with which 2 antibiotics?

A

Amox + gentamicin

45
Q

Meningococcal meningitis is primarily managed with which antibiotic?

A

Benzylpenicillin

46
Q

Isolated rise in protein in cerebrospinal fluid is indicative of what?

A

Guillain barre syndrome

47
Q

What medication should be co-prescribed with antibiotics in bacterial meningitis?

A

Dexamethasone
No longer than 12 hours after antibiotic administration

48
Q

What is the most common complication of non-meningococcal meningitis?

A

Sensorineural hearing loss

49
Q

What is the most common complication of meningococcal meningitis?

A

Waterhouse-Fridirechsen syndrome

50
Q

Prophylaxis for contacts of bacterial meningitis is achieved via what 2 medications?

A

Single dose ciprofloxacin or rifampicin

51
Q

What is the most common organism implicated in viral meningitis?

A

Coxsackie virus

52
Q

Which 2 antibiotics are used together for brain abscess treatment?

A

Ceftriaxone + metronidazole

53
Q

What type of bacteria is neisseria meningiditis?

A

Gram negative diplococci

54
Q

Whilst awaiting transfer in primary care, what medication can be given in suspected meningitis?

A

IM benzylpenicillin

55
Q

Which parameter may be used to monitor respiratory function in Guillain Barre syndrome?

A

Forced vital capacity (FVC)

56
Q

Oligoclonal bands in CSF is suggestive of what?

A

Multiple sclerosis

57
Q

What is given for acute relapses of MS?

A

High dose steroids

58
Q

What is the first line disease modifying drug in MS?

A

Natalizumab

59
Q

What medication can be used for fatigue in MS, once other possible causes have been excluded?

A

Amantadine

60
Q

Thymoma is associated with which neurological disorder?

A

Myasthenia gravis

61
Q

Which antibodies may be present in myasthenia gravis?

A

Acetylcholine receptor antibodies

62
Q

What is the first line treatment for myasthenia gravis?

A

Pyridostigmine

63
Q

What 2 treatments are indicated in myasthenic crisis?

A

Plasmapheresis and IVIG

64
Q

Which imaging modality is used to diagnose MS?

A

MRI with contrast

65
Q

Paraesthesia in the limbs on neck flexion is described as what sign?

A

Lhermitte’s

66
Q

Describe Uhthoff’s phenomenon. Which neurological disorder is this seen in?

A

Worsening in vision following rise in body temperature
Seen in MS

67
Q

What 2 medications can be used for spasticity in multiple sclerosis?

A

Baclofen or gabapentin

68
Q

Myasthenia symptoms which improve after repeated muscle contraction indicates what?

A

Lambert Eaton syndrome

69
Q

Lambert Eaton syndrome is associated with what malignancy?

A

Small cell lung cancer

70
Q

Myasthenia gravis patients are often resistant to which anaesthetic agent?

A

Suxamethonium

71
Q

Which optic manifestation of alcohol excess is most common?

A

Lateral gaze palsy

72
Q

Blood pressure should be lowered to a minimum of what for thrombolysis treatment?

73
Q

Carotid endarterectomy is considered in patients with carotid stenosis above what percentage?

74
Q

Which sign differentiates between organic and functional lower limb weakness?

A

Hoovers sign

Year 4 Finals (15 decks)

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