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Year 2 > Neurology > Flashcards

Neurology Flashcards

1
Q

What scoring system is used to stratify the risk of stroke after a TIA?

A

ABCD2

  • Age (>60) - 1 point
  • BP (>140/90) - 1 point
  • Clinical features (Unilateral weakness - 2 points) (Speech deficit no weakness - 1 point)
  • Duration (>60mins - 2 points) (10-60mins - 1 point)
  • Diabetes - 1 point
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2
Q

What is high risk on ABCD2 score and what does it mean?

A

6-7 points is high risk

8.1% two-day recurrent stroke risk

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3
Q

Gold standard treatment for stroke due to thrombus?

A

Alteplase - recombinant tissue plasminogen activator

WITHIN 3 HOURS (or 4.5hrs if >80yrs)

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4
Q

Treatment for haemorrhagic stroke?

A
  • Reduce blood pressure (CCB, nitrites)

- Correct clotting if off

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5
Q

Raised lymphocytes (Monocytes)
Normal protein
Normal glucose
CSF of which meningitis?

A

VIRAL

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6
Q

Lyme disease in neuro disease?

A

Neuroborreliosis

Long term lyme disease. Presentation is varied

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7
Q

Contra indication to lumbar puncture?

A

Raised global CNS pressure due to risk of coning. Purely intracranial pressure is not a contraindication.

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8
Q

Treatment of suspected meningococcal disease in secondary care. <3 months and >3 months old?

A

< 3 months = cefotaxime + amoxicillin/ampicillin

> 3 months = ceftriaxone

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9
Q

Raised lymphocytes (PMN)
Raised protein
Low glucose
CSF of which meningitis?

A

Bacterial

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10
Q

Initial morphine dose?

A

10mg (elderly/frail = 5mg)

Every 4 hrs

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11
Q

WHO analgesic ladder?

A
  1. Paracetamol
  2. ADD mild opiod e.g. co-codamol
  3. Substitute morphine 10mg/4hrs titrate up
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12
Q

Septic shock unresponsive to fluid resuscitation?

A

Epinephrine/norepinephrine

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13
Q

When to add Vancomycin for bacterial meningitis?

A

Young people/children who have:

  • Recently travelled outside of UK
  • Multiple/prolongued exposure to antibiotics in last 3 months
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14
Q

When to use corticosteroids in bacterial meningitis?

A

Dexamethasone upto 10mg QD

  • Frankly purulent CSF
  • CSF WBC >1000/mcl
  • Bacteria on gram stain
  • Raised protein (>1g/L) and WBC
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15
Q

Analgesia in children?

A 
< 16yrs
Not together, but can be administered alternately
- Paracetamol
OR
- Ibuprofen

Other NSAIDs and aspirin and codeine are not
- NB codeine can be used 3rd line if > 12 yrs

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16
Q

When to treat epileptic seizure?

A

After 5 minutes of tonic-clonic
OR
3 seizures in 1 hour

17
Q

What to treat epileptic seizure with in community?

A

Buccal midazolam
OR
Rectal diazepam

18
Q

Other treatment for epileptic seizure?

A

IV Lorazepam (in hospital)

19
Q

Anti-epileptic drugs?

A 
Taken everyday to prevent seizure
Eg. Sodium valproate
Carbemazapine
Phenytoin
Phenobarbital
Lamotrigine
20
Q

What nociceptors are there? And what are they responsible for?

A

A-delta fibres - FAST, non-specific involved in reflex arc (unmyelinated)
C-fibres - SLOW, (myelinated)

21
Q

AED drugs for absence seizures?

A

Ethosuximide or sodium valproate

lamotrigine if unsuitable, not tolerated etc

22
Q

General tonic-clonic seizures AED drugs?

A

Sodium valproate

Lamotrigine 2nd

23
Q

Focal seizures AED drugs?

A

Carbemazapine or lamotrigine

24
Q

Myoclonic seizures AED drugs?

A

Sodium valproate

25
Q

Tonic or atonic seizures AED drugs?

A

Sodium valproate

26
Q

Spinothalamic tract pathway and transmit?

A

Pathway:
1st order neurons enter via dorsal roots, synapse and decussate in cord.
Up to thalamus.
Primary sensory cortex.

Transmit:
Pain, temperature, touch

27
Q

Syringomyelia presentation?

A

Bilateral loss of pain, temperature, fine touch.

Due to expanding lesion in central canal, where fibres decussate.

28
Q

Corticospinal tract pathway and transmit?

A

Pathway:
Arise in motor cortex
Through internal capsule
In medulla - pyramidal decussation

Transmit:
Control of muscles

29
Q

Brown-Sequard definition and presentation?

A

Damage to a hemisection of the spinal cord.

Loss of proprioception ipsilateral side to lesion
Paralysis ipsilateral side to lesion
Loss of temperature and pain contralateral side to lesion

30
Q

ALS definition and presentation?

A

Progressive degeneration of coricospinal tracts and ventral horn cells

Progressive weakness/atrophy (lower limbs first)
Leading to loss of function, fasciculations,
eventually loss of swallow, respiratory muscles etc

31
Q

Most common pathogen in bacterial neonatal meningitis?

A

Group B streptococcus

32
Q

Common pathogens of bacterial meningitis in babies and children?

A

Strep pneumoniae

Neisseria meningitidis

33
Q

Common pathogens of bacterial meningitis in teens/young adults?

A

Neisseria meningitidis

Strep pneumoniae

34
Q

Common pathogens of bacterial meningitis in older adults?

A

Strep pneumoniae
Neisseria
HIb

35
Q

Treatment for trigeminal neuralgia?

A

Carbamazepine

36
Q

Treatment for neuropathic pain?

A

Amitryptiline
Duloxetine
Pregabalin
Gabapentin

Year 2 (21 decks)

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