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Y3 CORE CONDITIONS > NEUROLOGY > Flashcards

NEUROLOGY Flashcards

1
Q

what is the second most common cause of death worldwide?

A

stroke

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2
Q

where are strokes most common in the world?

A

middle east

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3
Q

what percentage of UK deaths are stroke?

a) 4%
b) 12%
c) 26%
d) 40%

A

b) 12%

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4
Q

what type are 80% of strokes?

A

thromboembolic infarction

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5
Q

what type are 10% of strokes?

A

intracranial haemorrhage

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6
Q

give 3 causes of intracranial haemorrhage

A

hypertension
berry aneurysm burst
trauma
ehlers-danlos

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7
Q

what causes 5% of stroke?

A

SA haemorrhage

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8
Q

give 2 causes of TIA

A

micro embolism

fall in cerebral perfusion

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9
Q

which type of stroke ONLY would you get a headache for?

A

haemorrhage

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10
Q

what classifies a TIA?

A

lasting less that 24 hours

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11
Q

what is recovery like for a TIA?

A

complete

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12
Q

on what side of the body might you expect weakness and numbness in a stroke?

A

contralateral to stroke side

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13
Q

what visual loss might you expect in a stroke?

A

homonymous hemianopia

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14
Q

give neurological symptoms you might expect in a stroke

A

nystagmus
horner’s
dysphagia
Visual spacial disturbance

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15
Q

in what instance could you get dysarthria in stroke?

A

LHS only as speech on that side

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16
Q

what might happen to a patient’s reflexes over the course of a stroke?

A

areflexia to spasticity over time

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17
Q

a brainstem infarct might result in what syndrome?

A

locked in

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18
Q

a cerebellar infarct might result in what syndrome?

A

ataxia

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19
Q

give 3 blood related risk factors for stroke

A

hyper coagulation
thrombocythaemia
thrombophilia

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20
Q

What are the
a) vascular
b) cardiovascular
risk factors for stroke?

A

a) PVD, carotid bruit

b) heart disease (AF etc), endocarditis

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21
Q

What are the lifestyle risk factors for stroke?

A 
Obesity
Smocking
Diet
Hyperlipidaemia
High alcohol intake
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22
Q

give a drug risk factor for stroke

A

COCP

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23
Q

describe the physiological area of an infarct stroke

A

central infarcted area surrounded by swollen ischaemic area (penumbra) which can regain function

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24
Q

hypoxia > fall in ATP > glutamate > calcium channels open > free radical release > inflammation and necrosis is the mechanism for what type of stroke?

A

infarct

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25
Q

what does TACI stand for

A

total anterior cerebral infarction

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26
Q

what are the 4 symptoms present in TACI?

A

hemiplegia
dysphagia
hemianopia
dysphasia

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27
Q

what is a PACI and its symptoms?

A

partial anterior cerebral infarction, 2 of TACI symptoms

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28
Q

what is a LACI?

A

lacunar cerebral infactrion

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29
Q

what part of the brain does a LACI affect?

A

small deep arteries

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30
Q

give 3 symptoms of LACI

A

weakness
hemiplegia
mixed sensory/motor

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31
Q

what symptoms will you never get in a LACI?

A

hemianopia or other higher cortical loss

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32
Q

which arteries could cause a PoCI?

A

vertebral
basillar
Posterior cerebral arteries

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33
Q

what symptoms could you get with a PoCI?

A 
ataxia
brainstem loss
pathway loss
visual loss
Memory loss
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34
Q

how would you use a CT to distinguish different types of a stroke?

A

haemorrhage (white)

infarct (dark)

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35
Q

what imaging would you use to diagnose an early infarct?

A

MRI

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36
Q

which of these symptoms would not indicate a poor prognosis for a stroke?

a) incontinence
b) dense hemiplegia
c) impaired consciousness
d) persistant dysphagia
e) numbness on one side

A

e) numbness on one side

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37
Q

Give example of drug used for thrombolysis and total dose?

within what time frame does it need to be given?

A

Alteplase (t-PA)= 0.9mg/kg

Be given with 4.5 hours of the stroke occuring

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38
Q

Following a stroke what treatment should be given long term to prevent any future complications?

A

Antihypertensives
Antiplatelet therapy = 75mg of Aspirin and Clopidogrel (dipridamole alternative)
Anticoagulant =heparin and warfarin
Statin

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39
Q

what surgery might you suggest in an ischaemic stroke?

A

internal carotid endarterectomy (in stenosis)

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40
Q

why might you give dexamethasone in a sub-arachnoid haemorrhage?

A

reduce cerebral oedema

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41
Q

what percentage of patients have another stroke after 5 years?

a) 10%
b) 20%
c) 30%
d) 40%

A

c) 30%

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42
Q

what percentage of stroke patients die within 2 years?

a) 5%
b) 15%
c) 25%
d) 35%

A

c) 25%

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43
Q

how many SAH stroke patients die before they reach hospital?

A

1/2

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44
Q

What causes 70% of all subarachnoid haemorrhage?

A

berry aneurysm

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45
Q

What are the risk factors for berry aneurysm

A 
Polycystic kidneys
coarctation of aorta 
ehlers-danlos
Infective endocarditis
FHx
Smocking, alcohol misusse, illegal drug use
Hypertension
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46
Q

what causes 15% of sub arachnoid haemorrhages?

A

arteriovenous malformations

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47
Q

what infective disease can increase the risk of having a SAH?

A

infective endocarditis

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48
Q

what causes 20% of SAHs?

A

unknown cause

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49
Q

how is the headache of a SAH described?

A

thunderclap

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50
Q

where is the pain often in a SAH?

A

occipital region

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51
Q

give 3 symptoms of SAH

A

vomiting
collapse/seizure
coma
neck stiffness

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52
Q

what is Kernig’s sign? when does it develop in SAH?

A

develops 6 hours after SAH

can’t extend knee when hip and knee flexed

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53
Q

name 3 eye changes you might see in a SAH

A

retinal/subhyaloid haemorrhage
focal neurology
pupillary changes (CN3 palsy)

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54
Q

what gender, age and ethnicity are SAH more likely to affect?

A

women
Median age is 50 and less than 60
Afro-carribean

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55
Q

give 2 lifestyle risk factors for SAH

A

smoking

alcohol misuse

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56
Q

give 3 circulatory risk factors for SAH

A

hypertension
bleeding disorders
SIze of the aneurysm

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57
Q

give a hormonal risk factor for SAH

A

post-menopause (less oestrogen)

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58
Q

does SAH have a familial factor?

A

yes

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59
Q

what medical imaging technique detects 90% of SAHs?

A

CT

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60
Q

what diagnostic technique would be recommended after 12 hours for SAH investigation?

A

lumbar puncture

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61
Q

evidence of what in the CSF sample from lumbar puncture would indicate that a SAH had occurred?

A

billirubin (xanthochromia ) = broken down RBC

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62
Q

give 4 differential diagnoses for SAH

A 
meningitis
migraine
Tension headache
intracranial bleeds
cortical vein thrombosis
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63
Q

what surgical treatment would you recommend for a patient with SAH?

A

clipping/coiling

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64
Q

what 2 drugs would you give for a patient with SAH and why?

A

calcium channel blocker (nimodipine) - prevents vasospasm

analgesia - pain

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65
Q

what complication is a cause of death in 20% of SAH patients?

A

re-bleed

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66
Q

give 3 other complications for SAH

A

cerebral ischaemia due to vasospasm
cortical vein thrombosis
Hydrocephalus

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67
Q

what causes peripheral neuropathy?

A

nerve lesions

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68
Q

give 5 causes of nerve lesions in peripheral neuropathy

A 
B12 and folate deficiency causing severe anaemia
CKd 
trauma
DM
leprosy
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69
Q

what is the name for when two or more peripheral nerves have lesions?

A

mononeuritis complex

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70
Q

what is the WARDS PLC pneumonic for the causes of mononeuritis complex?

A 
wengener's granulomatosis ( inflammed blood vessels)
amyloidosis
rheumatoid arthritis
diabetes mellitus
sarcoidosis
polyarteritis nodosa ( vasculitis of medium sized vessels)
leprosy
carcinomatosis
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71
Q

give 4 symptoms of autonomic nerve lesions

A 
postural hypotension
impotence
reduced sweating
diarrhoea
urinary retention
Horner's
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72
Q

what is radiculopathy?

A

lesions of nerve roots and plexus

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73
Q

what is myelopathy?

A

lesions in spinal cord

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74
Q

what action is lost in a radial nerve lesion (C5-T1)

A

Wrist drop and can’t open fist (weakness of finger extension)

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75
Q

which muscles would a sciatic nerve lesion affect?

A

hamstring

muscles below knee

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76
Q

what 3 symptoms would you get with a common fibular nerve lesion?

A

foot drop, weakness of eversion and sensory loss on dorsum

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77
Q

what 3 symptoms would you get with tibial nerve loss?

A

can’t invert foot
can’t flex toes
sensory loss on sole

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78
Q

what classic symptoms might you get on hands and feet with polyneuropathies?

A

glove/stocking anaesthesia

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79
Q

what is guillain-barre?

A

demyelinating motor neurons

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80
Q

which muscles does guillan-barre affect?

A

Start in feet and hands then spread to arms and legs.

Later spread to lungs (cause of death)

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81
Q

what is the treatment for guillan-barre?

A

intubate

IV immunoglobulin

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82
Q

is recovery for Guillain-barre good or bad?

A

good

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83
Q

what is the main cause for charcot-marie-tooth?

A

Group of inherited genetic conditions that damage the peripheral nerves

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84
Q

what types of polyneuropathy are present in charcot-marie-tooth?

A

motor and sensory (generalised weakness and loss of sensation)
Also get high arched foot and abnormal gait

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85
Q

name one lifestyle cause of polyneuropathy

A

alcohol abuse

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86
Q

name 2 endocrine causes of polyneuropathy

A

diabetes

hypothyroidism

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87
Q

name 3 infective causes of polyneuropathy

A

leprosy
syphillis
lyme’s disease
HIV

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88
Q

name a renal cause of polyneuropathy

A

renal failure

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89
Q

what causes epilepsy/seizures?

A

intermittent abnormal electrical activity in the brain

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90
Q

what is the cause of 2/3 of epilepsy and seizures?

A

idiopathic

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91
Q

give 5 causes of symptomatic epilepsy

A 
cortical scarring
developmental
severe head injury 
stroke
hippocampal sclerosis
Alcohol and drug induce 
meningitis
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92
Q

give 4 causes of non-epileptic seizures

A 
trauma
stroke
haemorrhage
increased ICP
alcohol/withdrawal
BZDP withdrawal
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93
Q

what are seizures often preceded by?

A

aura

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94
Q

what is the difference between a tonic and a clonic seizure?

A 
tonic = stiff
clonic = jerky
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95
Q

what is a myoclonic seizure?

A

one sudden jerk of a muscle group while the patient is still awake

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96
Q

a seizure in which area of the brain would be characterised by a deja vu, rising feeling in stomach, strange taste and smell and intense joy or fear?

A

temporal

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97
Q

in which area of the brain would a seizure be characterised by twitching and a wave?

A

frontal

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98
Q

in which area of the brain would a seizure be characterised by numbness, tingling, and a feeling that one limb is bigger or smaller than the others?

A

parietal

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99
Q

in which area of the brain would a seizure be characterised by flashing lights and visual hallucinations?

A

occipital

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100
Q

what is the prevalence of epilepsy?

a) 1%
b) 10%
c) 15%
d) 20%

101
Q

what is a simple seizure?

A

awake with a strange sensation

102
Q

what is the consciousness of a patient having a complex seizure?

A

loses consciousness

103
Q

does a patient remember the seizure in a complex seizure?

A

no & is without warning

104
Q

what is a petit mal seizure?

A

looks like daydreaming ‘abscence’

105
Q

who do petit mal seizures occur in?

106
Q

What is status epilepticus?

A

Epileptic seizure that last for 30 minutes
or
Two or more seizures that occur one after the other without the patient regaining consciousness

107
Q

give 2 extrinsic causes of status epilepticus

A

alcohol withdrawal

BZDP withdrawal

108
Q

give 3 pathological causes of status epilepticus

A

trauma
stroke
electrolyte imbalance
uraemia

109
Q

give 3 infective causes of status epilepticus

A

HIV
syphillis
encephalitis

110
Q

what is the name of a seizure that occurs in one hemisphere?

111
Q

give a differential diagnosis for epilepsy/seizures

A

vasovagal syncope

hypoglycaemia

112
Q

what treatment might you recommend for a tonic/clonic seizure? (3)

A

sodium valproate
lamotrigine
carbamazepine

113
Q

what treatment might you recommend for an absent seizure? (2)

A

sodium valproate
lamotrigine
Ethosiximide

114
Q

a) why should carbamazepine be avoided in a myoclonic seizure?
b) What is the treatment for myoclonic seizure?

A

a) worsens symptoms

b) sodium valproate and topiramate

115
Q

what treatment might you recommend for a partial seizure? (3)

A

sodium valproate
lamotrigine
carbamazepine

116
Q

give 2 non-infective causes of meningitis

A

malignant cells

blood following a SAH

117
Q

what 2 bacterial organisms are the cause of 70% of meningitis cases?

A

neisseria meningitides A,B,C, W135 and Y capsule types

strep pneumoniae

118
Q

give 3 other bacterial causes of meningitis

A 
staph a
pneumoccocal = 2nd most common 
h influenzae ( class b)
group b strep
listeria monocytogenes
TB mycobacterium
119
Q

What are the most common bacterial infections for neonatal meningitis?

A

Group B strep
Listeria monocytogenes
E.coli

120
Q

what are 2 enterovirus cause of meningitis?

A

echo
coxsackie
enterovirus 70

121
Q

what are the 5 herpes viral cause of meningitis?

A 
1
2
VZV
CMV
EBV
122
Q

give 4 other viral causes of meningitis

A

HIV
polio
mumps
leptospirosis

123
Q

give a fungal cause of meningitis

A

candida albicans

Cryptococcus neoformans

124
Q

what is the classical triad of symptoms for meningitis?

A

headache
neck stiffness
fever

125
Q

give a specific meningeal symptoms

A 
photophobia
Vomiting 
Severe headache
Rigor
Fever
Malaise
126
Q

what is Kernig’s sign?

A

meningitis - can’t extend the knee when the hip is flexed

127
Q

what is brudzinski’s sign?

A

hip flexes when the head is bent forwards

128
Q

what is the characteristic of a meningeal rash?

A

non-blanching

129
Q

what is the most severe form of meningitis?

130
Q

give 4 signs that meningitis has lead to raised ICP

A

headache
vomiting
papilloedema
fits

131
Q

What happens in acute bacterial meningitis in the brain?

A

Pus is congested between the pia and arachanoid layer causing adhesions and consequently CN palsy and hydrocephalus

132
Q

what is the characteristic exudate of TB meningitis (chronic)?

A

green-grey exudate with tubercles leading to cerebral oedema

133
Q

what is a risk factor for the development of meningitis?

A

immunocompromised

134
Q

what is an essential diagnostic test for meningitis?

A

lumbar puncture

135
Q

what is the immediate treatment of meningococcal meningitis?

A

benzylpenicillin IV 1200mg or Cefotaxime (penicillin allergy)

136
Q

which meningitis instance is lumbar puncture unnecessary?

A

When the patient has petechial rash and their is blood culture which confirms meningococcal has been confirmed

137
Q

what prophylaxis for kissing contacts of meningitis patients should be used?
Neisseria meningococcal
h.influenza

A

rifampicin and ciprofloxacin

138
Q

what is the progression of viral meningitis?

A

self limiting, benign

139
Q

what two stages in life are migraines most likely to occur?

A

Infants, young children and the elderly

140
Q

what is the CHOCOLATE pneumonic for a migraine?

A 
cheese
HRT
oral contraceptive
caffeine
alcohOL
anxiety
travel
exercise
141
Q

what is the characteristic headache of a migraine?

A

unilateral severe pain

142
Q

What other symptoms as well pain do patients usually get with migraine?

A

Nausea and vomiting
Photophobia
Allodynia

143
Q

what is allodynia?

A

all sensory stimuli causes the pain of a migraine

144
Q

what is the main risk factor for a migraine?

A

family history

145
Q

What drugs are given as prophylaxis of migraine?

A 
propranolol
sodium valproate
metoclopramide
Pizotifen 
Amitriptyline
Botulinum toxins
146
Q

Triptans ( 5-HT1 agonists) are specific painkiller medication for migraine, how does it work?

A

Constrict cranial arteries.

As dilation of the vessels are thought to contribute to the symptoms

147
Q

what is the characteristic pain of a tension headache?

A

Recurrent tight band with pressure behind eyes and bursting pain.

148
Q

where does the pain of a tension headache radiate to?

A

neck and scalp

149
Q

what is the frequency of parkinson’s in over 65s?

a) 1 in 50
b) 1 in 100
c) 1 in 200
d) 1 in 500

A

b) 1 in 100

150
Q

degeneration of what is characteristic of parkinson’s disease?

A

Presence of Lew body which causes substantia nigra loss of dopaminergic neurons affecting the basal ganglia

151
Q

give 3 other causes of parkinsonism

A

lewy body dementia
neurodegeneration
neuroleptics (metoclopramide, haloperidol, sodium valproate and MTPP)
arteriosclerosis (vascular)

152
Q

what is the name of rigidity that occurs in parkinsonism?

A

cog wheel rigidity ( lead pipe rigidity plus tremor)

153
Q

what is the type of tremor that occurs in parkinsonism?

How does it spread?

A

Coarse pill rolling (4-6HZ)
Begins usually in the hand unilaterally then spreads
Worse at rest and better on movement

154
Q

what is the word to describe the movement characteristic of parkinson’s?

A

bradykinesia

festination

155
Q

what type of reflexes are lost in parkinsonism?

156
Q

what kind of tremor could be confused with a parkinsonian tremor?

A

cerebellar

157
Q

what drug is recommended for parkinson’s?

158
Q

why are anticholinergics useful in parkinson’s?

A

help promote motor systems

159
Q

what drug will be given to prevent daytime sleepiness in parkinson’s?

160
Q

what invasive treatment might you recommend for parkinson’s?

A

deep brain stimulation

161
Q

give 5 symptoms of proximal myopathy

A 
muscle wasting
cataracts
heart defects
endocrine changes
myotonia
162
Q

what kind of illness is proximal myopathy?

a) chronic, slow progressing
b) acute, slow progressing
c) chronic, rapid onset
d) acute, rapid onset

A

a) chronic slow progressing

163
Q

what kind of inheritance pattern does proximal myopathy have?

A

autosomal dominant

164
Q

what is steinert disease?

A

type 1 proximal myopathy
more severe
more common

165
Q

when is the onset of Steinert disease?

166
Q

what is the difference between Steinert disease and type 2 proximal myotonic myopathy?

A

type 2 is rarer and more mild

167
Q

is there a cure for proximal myopathy?

168
Q

give 2 visual symptoms of multiple sclerosis

A

double vision

blindness

169
Q

give 2 throat symptoms of multiple sclerosis

A

dysarthria

dysphagia

170
Q

give 2 neurological symptoms of multiple sclerosis

A

loss of sensation
loss of coordination
ataxia

171
Q

is multiple sclerosis in isolated attacks or progressive?

A

can be either

172
Q

What occurs to your muscles in MS?

A

Stiffness, spasm and weakness

173
Q

what occurs to the neurons in MS?

A

Autoimmune attack causing demyelination of the nerves

Causing reduced protection of the nerves and affecting electrical signalling of the nerves

174
Q

what causes the demyelination of cells in MS?

A

Autoimmune:
immune destruction
failure of myelin producing cells

175
Q

What are the risk factors for MS?

A

genetic
Smocking
Viral infection = EBV
Lack of sunlight = vitamin D defeciency

176
Q

what is Lhermitte’s sign and in what condition is it present?

A

MS

electrical sensation that runs down back when the neck is bent

177
Q

how much shorter is the life expectancy of a patient with MS than the general population?

a) 1-2 years
b) 5-10 years
c) 15-20 years
d) 25-30 years

A

b) 5-10 years

178
Q

What is the chads2 score used for?

A

The risk of a patient with AF having a stroke

179
Q

What is the ABCD2 score used for?

A

The risk of a developing a stroke after a TIA

180
Q

What does ABCD2 stand for?

A

Age >60
BP = 140/90
Clinical features = Uniltateral weakness (2) or speach loss (1)
Duration of symptoms= >60 min (2), 10-59 min (1)
Diabetes

181
Q

Score of what in ABCD2 indicates high risk of developing stroke after TIA?

182
Q

Is the symptoms more severe in a anterior or posterior artery cerebral infarction?

183
Q

If thrombolysis is contradictory to treating cerebral infarction what drug should you give?

A

Aspirin 300mg/day for 2 weeks

184
Q

What is the most common artery to be occluded in TACI?

A

Middle cerebral artery

185
Q

Before thrombolysis is given for stroke what investigation should be done on the patient?

A

Immediate CT to ensure it is an infarction and not a hemorrhage

186
Q

What past conditions would indicate the use of anticouagulants such as heparin and warfarin for a patient who has had a stroke?

A

If they have AF, any lower leg DVT or history of blood clots.

187
Q

What are the treatment options for haemorrhagic stroke?

A

Lower BP

Surgery if need to relieve pressure or treat hydrocephalus

188
Q

What is Kernig’s sign indication of?

A

SAH

Meningitis

189
Q

Why does B12 deficiency lead to peripheral neuropathy?

A

Due to damage to the myelin sheath ( protective layer)

190
Q

What are the symptoms in sensory neuropathy?

A

Tingling and shooting pain
Loss of ability to detect pain
Loss of ability to detect change in temperature
Loss of coordination

191
Q

What are the symptoms of motor neuropathy?

A

Muscle wasting and weakness
Muscle twitching
Muscle paralysis

192
Q

Damage to the ulnar nerve (C7-T1) due to direct impact causes what?

A

Cubital tunnel syndrome= Wasting of interosei and hypothenar muscles, sensory loss in little finger and clawing of the hand

193
Q

Describe the distrubution and affect of polyneuropathy?

A

Bilateral, symmetrical and widespread distribution

Causing muscle and sensory loss

194
Q

Patient with Guillain -Barre usually have a history of what?

A

Previous infections such as EBV, CMV, campylobacter (food poisoning) and HIV

195
Q

What are the two categories of seizures?

A

Partial

Generalised

196
Q

What are the two sub types of partial seizures?

A

Simple

Complex partial seizures

197
Q

What is partial seizures?

A

Where abnormal electrical activity is confined to a single area of the cortex in one hemisphere

198
Q

What is a generalised seizure?

A

Abnormal electrical activity to both hemispheres and always involves loss of awareness or consciousness

199
Q

What is the difference between simple and complex partial seizures?

A

Simple partial seizure you don’t lose awareness for example Jacksonian which involves single limb
Complex= loose awareness

200
Q

Give example of complex partial seizures?

A

Temporal lobe seizures are the most common

Frontal lobe is next

201
Q

If a patient has a partial seizure with a secondary general seizure what precedes the general seizure?

A

Feeling of aura

202
Q

Who does absent seizure affect?

203
Q

What is a absent seizure?

A

It is a primary generalised seizure with no lesion in the brain usually

204
Q

What are the symptoms of a absent seizure?

A

Very little motor component maybe a flicker of the eye.
Last lest than 10 seconds and the patient will loose awareness and feel vacant. Patient is not always aware of the seizure

205
Q

What are the 3 stages of generalised tonic clonic seizure?

A

 Prodrome
 Tonic Clonic stage
 Post-ictal phase

206
Q

What occurs in the prodrome phase?

A

Usually no warning sign

May have aura if its a secondary generalised seizure occur

207
Q

What happens in the tonic clonic stage?

A

Last about two minutes
First have stiffness followed by jerking,
The patient will usually bite their tongue, eyes will be open and they may become incontinent.

208
Q

What happens in the Post-ictal phase

A

Flaccid unresponsiveness followed by coming back round

Confusion and drowsiness = 15min- hour long

209
Q

What are common symptom of brain tumor, encephalopathy and meningitis?

A

Epileptic seizures

210
Q

How can alcohol cause seizures?

A

By causing hypoglycaemia or head injury

211
Q

How do you diagnose epilepsy?

A

Mainly clinically, try to differentiate from syncope

212
Q

What is the recovery speed after

a) seizure
b) syncope

A

a) Confusion and headache with slow recovery

b) rappid recovery

213
Q

What is the colour change in

a) seizure
b) syncope

A

a) cyanotic

b) pallor

214
Q

What are the triggers for

a) seizures
b) syncope

A

a) Sleep deprivation, alcohol, drugs

b) Heat, pain and prolonged standing

215
Q

What are the risk factors for epileptic seizures?

A 
Childhood febrile convulsions
Brain tumours
Significant head injury
encephalitis and meningitis 
Fhx of epilepsy
216
Q

What test are done after a seizure?

A
  • Bloods and ecg
  • EEG
  • MRI brain
217
Q

Why is EEG useful for epileptic seizures ?

A

Allows you to understand the cause and categorize the epileptic seizure

218
Q

What is the recurrence rate of somone who has a had a seizure?

A

70-80% recurrence with highest risk in first 6 months

219
Q

What is the most common cause of epileptic seizures in the elderly?

A

Stroke or small cerebrovascular disease

220
Q

How does status epilepticus causing renal failure?

A

It triggers rhabdomyolysis which can lead to acute kidney injury

221
Q

What is a clinical feature of meningococcal meningitis?

A

Petechial rash that is non blanching

222
Q

What is the infective route in which bacteria infects meninges?

A

Via direct extension from the ears, nasopharynx, cranial injury, congenital meningeal defect or blood stream infection

223
Q

What is the cause of aseptic meningitis and how severe is it?

A

Viral cause and symptoms are less severe than bacterial infection.
Patients usually recover within 2 weeks

224
Q

Why should CT scan be done before Lumbar puncture?

A

If their is a risk of coning on the cerebellar tonsils due to raised ICP

225
Q

What bloods should be done in meningitis management?

A

Blood culture, routine bloods and glucose

226
Q

What changes occur in viral meningitis?

A

lymphocytic inflammatory CSF reaction without pus formation or adhesions

227
Q

What is the management of septicaemia meningitis?

A

No LP
Treat shock
Cefotaxime IV

228
Q

What two bacterial infections of meningitis is prophylaxis used for?

A

H. influenzae

Neisseria meningitis

229
Q

What is the treatment for H. influenzae meningitis?

A

Cefotaxime main treatment

Alternative is chloramphenicol

230
Q

What age group does H.influenzae cause meningitis?

A

2months–> 2 year olds

231
Q

What are the two types of migraine?

A

Migraine without aura (most common)

Migraine with aura

232
Q

What is a hemiplegic migraine?

A

Affects one side of the face and looks like stroke symptoms

233
Q

What drug should not be given with hemiplegic migraine and why?

A

Amitriptyline as it increases the risk of stroke

234
Q

What is initial treatment for migraines?

A

Avoid triggers
Analgesia such as NSAIDS and aspirin
Anti emetics

235
Q

What are common causes of tension headache?

A

High BP
Noise
Depression and anxiety
Analgesia over use

236
Q

Is migraine more common in males or females?

A

Females 2:1

237
Q

What are the symptoms of bradykinesia?

A 
Slow initiating movement (gait)
Emotionless face
Monotonous speech
Dribbling
Slow handwriting
238
Q

What are the risk factors for parkinson’s?

A 
Age >60
Fhx
Male
Caucasian
Rural living and farmers (pesticides)
239
Q

What drug is given with L-dopa to prevent circulatory dopamine side effects?

A

Dopa decarboxylase inhibitor

240
Q

Give alternative or additional drug treatment for parkinsons?

A

Dopamine agonist

Monoamine oxidase B inhibitors

241
Q

Give examples of dopamine agonist?

A

Pergolide
Bromocriptine
Activate dopamine receptors in the absence of dopamine

242
Q

Give examples of monoamine oxidase B inhibitors?

A

Selegiline
Rasagiline
Prevent the breakdown of dopamine in the brain

243
Q

Why is MRI done for patients with potential MS?

A

Too look at the damage done to the myelin sheath and where the damage is

244
Q

What is the treatment for increasing recovery time in Ms relapse?

245
Q

What is the treatment to reduce the severity and number of Ms relapse?

A

Disease modify therapy such as
 Beta interferon
 Natalizumab

246
Q

What are the two most common cause of weakened blood vessel to cause haemorrhagic stroke?

A

arteriovenous malformation and aneurysm

247
Q

In what age do you see symptomatic epilepsy commonly?

A

Over 60’s

248
Q

Is viral or bacterial meningitis more common?

Y3 CORE CONDITIONS (15 decks)

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