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CJ CMS > Neurology > Flashcards

Neurology Flashcards

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1
Q

What is a commonly used meausure of consciousness?

A

glasgow coma scale

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2
Q

how is the GCS used?

A

at total score gained between 3-15

the lower the score, the more impaired the consciousness

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3
Q

What does AVPU stand for?

A

Alert?
Verbal?
Pain?
Unresponsive?

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4
Q

What can be possible causes of impaired consciousness?

A

structural damage

global failure

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5
Q

What structural damage can occur?

A

external or internal injury

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6
Q

What global failure can occur?

A

metabolism
infection
drugs and toxins
seizure

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7
Q

What external structural damage can be caused?

A

head injury

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8
Q

what internal strucutral damage can be caused?

A

stroke
ischaemia or bleed
tumour
abscess

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9
Q

with regards to metabolism, what can cause impaired consciousness?

A 
hypoglycaemia
heptic encephalopathy
uremic encephalopathy
hypoxia
hypercapnia- too much c02
hyponatraemia
hypercalcaemia
hypothyroidism
hypotension
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10
Q

What kind of brain infections can cause impaired consciousness?

A

encephalitis
meningitis
malria and other tropical diseases

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11
Q

What other severe infections can cause impaired consciousness?

A

pneumonia
GI infections
urine infection

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12
Q

What prescribedsedating medicines can cause impaired consciousness in overdose?

A 
benzodiazepines
tranquilisers
antidepressants
opiates
anti- epileptics
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13
Q

What is a sezure?

A

excess electrical activity

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14
Q

what is a focal seizure?

A

can be partial or generalised

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15
Q

what is a simple focal seizure?

A

shaking on one side

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16
Q

what is a complex partial seizure?

A

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

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17
Q

What is a generalised seizure?

A

usually grand mal/ tonic- clonic

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18
Q

What is a petit mal seizure?

A

an absence in children

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19
Q

What is myoclonic?

A

limbs jerking, collapse

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20
Q

what is atonic?

A

limbs collapse

21
Q

What is the cause of epilepsy?

A 
often hereditary (primary)
structural/ metabolic (secondary)
22
Q

What invstigations can be carried our re. epilespy?

A

blood tests
brain imaging- MRI
EEG- electroencephalogram

23
Q

What treatment is used re. epilepsy?

A

phenytoin
carbamazepine
sodium valproate
lamotrigine

24
Q

What is the commonest cause of impaired consciousness?

A

airway obstruction

25
Q

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

A 
trauma
rash
seizure activity
focal weakness
signs of co exsistent illness
SEWS
collateral history
26
Q

What should be noted as red flags re. headaches?

A 
severity
sudden onset
features of raised cranial pressure
focal neurology
visual changes
confusion
meningism- fever, rash
27
Q

What are features of raised intracranial pressure?

A

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

28
Q

What are primary headaches disorders?

A 
tension headache
migraine
cluster headache
medication overuse headache
trigeminal neuralgia
29
Q

what are features of a tension headache?

A 
stress related
tight band feeling
symmetrical
chronic, gradual onset
worsens towards the end of the day
treated with conventional analgesia
30
Q

what can be used as prophylaxis for tension headaches?

A

tricyclic antidepressants

31
Q

What is a migraine?

A

temporary reduction in blood flow then compensatory excess blood flow

32
Q

What are classic features of a migraine?

A 
pre headache aura
visual or focal symptoms
headache within one hour
one sided- throbbing
nausea and vomitting
photophobia
33
Q

What are possible treatments for migraines?

A

metoclopramide

serotonin antoagonist- sumatriptan

34
Q

What are preventative medications used for migraines?

A

anti epileptics
amytriptaline
beta blockers

35
Q

what is a cluster headache?

A

dilation of the superficial temporal artery

severe pain round eye- drooping of lid, runny nose

36
Q

What type of pain is trigeminal neuralgia?

A

intense, stabbing pain
precipitated by touch
10/10 scale

37
Q

how should trigeminal neuralgia be managed?

A

carbamazepine

rule out all other causes

38
Q

What can cause raised intracranial pressure?

A

tumour
bleeds
hydrocephalus
abscess

39
Q

How is intracranial pressure diagnosed?

A

CT scanning

40
Q

what is used in treatment of bacterial meningitis

A

empirical antibiotics
urgent hospitalisation
prophylaxis for all contacts

41
Q

What is encephalitis?

A

inflammation of brain parenchyma

42
Q

What is a cerebral abcess?

A 
usually bacterial
sometimes trauma
otitis media
sinusitis
dental infections
43
Q

What are symptoms of cerebral abscess?

A

raised intracranial pressure

44
Q

What is the management of cerebral abscess?

A

drainage

antibiotics

45
Q

What is a non traumatic cerebral bleed?

A

sub arachnoid haemorrhage

46
Q

what are features of sub arachnoid haemorrhage?

A 
blood in sub arachnoid space
age 35-65
sudden severe headache
occipital
vomitting, collapse
47
Q

what is an intracerebral haemorrhage?

A

bleed directly into brain tissue

associated with hypertension

48
Q

what are features of giant cell arteritis?

A 
rare under 55
scalp tenderness
jaw claudication
loss of vision
risk of blindness, stroke or death
49
Q

what is treatment for giant cell arteritis?

A

prednisolone

CJ CMS (17 decks)

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