Neurology

Question 1

What is a commonly used meausure of consciousness?

Answer 1

glasgow coma scale

Question 2

how is the GCS used?

Answer 2

at total score gained between 3-15

the lower the score, the more impaired the consciousness

Question 3

What does AVPU stand for?

Answer 3

Alert?
Verbal?
Pain?
Unresponsive?

Question 4

What can be possible causes of impaired consciousness?

Answer 4

structural damage

global failure

Question 5

What structural damage can occur?

Answer 5

external or internal injury

Question 6

What global failure can occur?

Answer 6

metabolism
infection
drugs and toxins
seizure

Question 7

What external structural damage can be caused?

Answer 7

head injury

Question 8

what internal strucutral damage can be caused?

Answer 8

stroke
ischaemia or bleed
tumour
abscess

Question 9

with regards to metabolism, what can cause impaired consciousness?

Answer 9

hypoglycaemia
heptic encephalopathy
uremic encephalopathy
hypoxia
hypercapnia- too much c02
hyponatraemia
hypercalcaemia
hypothyroidism
hypotension

Question 10

What kind of brain infections can cause impaired consciousness?

Answer 10

encephalitis
meningitis
malria and other tropical diseases

Question 11

What other severe infections can cause impaired consciousness?

Answer 11

pneumonia
GI infections
urine infection

Question 12

What prescribedsedating medicines can cause impaired consciousness in overdose?

Answer 12

benzodiazepines
tranquilisers
antidepressants
opiates
anti- epileptics

Question 13

What is a sezure?

Answer 13

excess electrical activity

Question 14

what is a focal seizure?

Answer 14

can be partial or generalised

Question 15

what is a simple focal seizure?

Answer 15

shaking on one side

Question 16

what is a complex partial seizure?

Answer 16

affects temporal lobe
aura- olfactory hallucinations
followed by odd behaviour- lip smacking, odd posture, staring

Question 17

What is a generalised seizure?

Answer 17

usually grand mal/ tonic- clonic

Question 18

What is a petit mal seizure?

Answer 18

an absence in children

Question 19

What is myoclonic?

Answer 19

limbs jerking, collapse

Question 20

what is atonic?

Answer 20

limbs collapse

Question 21

What is the cause of epilepsy?

Answer 21

often hereditary (primary)
structural/ metabolic (secondary)

Question 22

What invstigations can be carried our re. epilespy?

Answer 22

blood tests
brain imaging- MRI
EEG- electroencephalogram

Question 23

What treatment is used re. epilepsy?

Answer 23

phenytoin
carbamazepine
sodium valproate
lamotrigine

Question 24

What is the commonest cause of impaired consciousness?

Answer 24

airway obstruction

Question 25

what examination should take place re. identifying a cause of impaired consciousness?

Answer 25

``` trauma rash seizure activity focal weakness signs of co exsistent illness SEWS collateral history ```

Question 26

What should be noted as red flags re. headaches?

Answer 26

``` severity sudden onset features of raised cranial pressure focal neurology visual changes confusion meningism- fever, rash ```

Question 27

What are features of raised intracranial pressure?

Answer 27

worse headache on positional changes/ strain present on walking nausea and vomitting

Question 28

What are primary headaches disorders?

Answer 28

``` tension headache migraine cluster headache medication overuse headache trigeminal neuralgia ```

Question 29

what are features of a tension headache?

Answer 29

``` stress related tight band feeling symmetrical chronic, gradual onset worsens towards the end of the day treated with conventional analgesia ```

Question 30

what can be used as prophylaxis for tension headaches?

Answer 30

tricyclic antidepressants

Question 31

What is a migraine?

Answer 31

temporary reduction in blood flow then compensatory excess blood flow

Question 32

What are classic features of a migraine?

Answer 32

``` pre headache aura visual or focal symptoms headache within one hour one sided- throbbing nausea and vomitting photophobia ```

Question 33

What are possible treatments for migraines?

Answer 33

metoclopramide | serotonin antoagonist- sumatriptan

Question 34

What are preventative medications used for migraines?

Answer 34

anti epileptics amytriptaline beta blockers

Question 35

what is a cluster headache?

Answer 35

dilation of the superficial temporal artery | severe pain round eye- drooping of lid, runny nose

Question 36

What type of pain is trigeminal neuralgia?

Answer 36

intense, stabbing pain precipitated by touch 10/10 scale

Question 37

how should trigeminal neuralgia be managed?

Answer 37

carbamazepine | rule out all other causes

Question 38

What can cause raised intracranial pressure?

Answer 38

tumour bleeds hydrocephalus abscess

Question 39

How is intracranial pressure diagnosed?

Answer 39

CT scanning

Question 40

what is used in treatment of bacterial meningitis

Answer 40

empirical antibiotics urgent hospitalisation prophylaxis for all contacts

Question 41

What is encephalitis?

Answer 41

inflammation of brain parenchyma

Question 42

What is a cerebral abcess?

Answer 42

``` usually bacterial sometimes trauma otitis media sinusitis dental infections ```

Question 43

What are symptoms of cerebral abscess?

Answer 43

raised intracranial pressure

Question 44

What is the management of cerebral abscess?

Answer 44

drainage | antibiotics

Question 45

What is a non traumatic cerebral bleed?

Answer 45

sub arachnoid haemorrhage

Question 46

what are features of sub arachnoid haemorrhage?

Answer 46

``` blood in sub arachnoid space age 35-65 sudden severe headache occipital vomitting, collapse ```

Question 47

what is an intracerebral haemorrhage?

Answer 47

bleed directly into brain tissue | associated with hypertension

Question 48

what are features of giant cell arteritis?

Answer 48

``` rare under 55 scalp tenderness jaw claudication loss of vision risk of blindness, stroke or death ```

Question 49

what is treatment for giant cell arteritis?

Answer 49

prednisolone