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sms > Neurology > Flashcards

Neurology Flashcards

1
Q

what type of epilepsy is associated with aura and automatisms?

A

Temporal lobe seizure

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2
Q

How does Jacksonian epilepsy present?

A

focal attacks start in one limb/corner of mouth and rapidly ascend
then preceded with Todd’s paresis

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3
Q

AED used in status epilepticus

A

Lorazepam 4mg IV bolus once and again after 10 minutes

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4
Q

classic EEG finding in absence seizures

A

3Hz spikes

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5
Q

when is AED treatment considered?

A

2 or more seizures within 2 years

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6
Q

first line AED in a) generalised seizures b) partial seizures c) absence seizures

A

a) valproate
b) carbamez
c) valproate

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7
Q

Presentation of optic neuritis

A

usually unilateral pain on movement of eye, blurred vision which may progress to blindness.
RAPD

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8
Q

define the following

a) Lhermitte Phenomenon

b) Uhthoff phenomenon

A

a) tingling down arms and legs on neck flexion

b) all MS symptoms worsen in heat

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9
Q

Investigations in MS

A
  1. MRI- Dawson’s fingers

2. oligoclonal bands in CSF

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10
Q

Management of acute relapses

A

Depends on severity

- use IV/PO methylpred for 3-5days

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11
Q

long-term management of RR-MS

A

DMARDS

  • beta inteferon
  • natalizumab
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12
Q

in which lobes are broca and wernicke’s area?

A

broca- inferior left frontal lobe

wernickes- superior left parietal lobe

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13
Q
  1. TACI
  2. PACI
  3. POCI
  4. LACI
A
  1. hemiparesis, hemisensory loss and homonymous hemianopia
  2. two of TACI
  3. ataxia, diplopia, LMN facial palsy
  4. pure motor/pure sensory/ataxic hemiparesis
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14
Q

in which patients are watershed infarcts more common?

A

pts with carotid stenosis who drop their BP for whatever reason

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15
Q

what is a watershed infarct?

A

ischaemia at borders of vascular territories to aca,mca and PCA

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16
Q

Pt <55 with stroke what tests do you want to do?

A

Coagulation screen for thrombophilias

17
Q

secondary prevention of stroke

A
  1. lifestyle changes
  2. atorvastatin 80mg
  3. aspirin for 2 weeks then clopidogrel
  4. antihypertensive
18
Q

What is Wallenberg syndrome?

A

Lateral medullary syndrome (posterior inferior cerebellar artery)

ipsilateral: ataxia, nystagmus, dysphagia, facial numbness, cranial nerve palsy e.g. Horner’s
contralateral: limb sensory loss

19
Q

What is Weber’s syndrome?

A

branches of the posterior cerebral artery that supply the midbrain
- ipsilateral CN3 palsy and contralateral weakness

20
Q

what are reflexes like in M.Gravis?

A

normal/brisk

21
Q

investigations in m.gravis

A

AchR antibodies
EMG- decrement on repetitive stimulation
CT chest- thymoma

22
Q

Treatment of M. gravis

A
  1. Pyridostigmine

2. immunosuppress: pred/azathiopine

23
Q

M.gravis crisis and what is the treatment?

A

Weakness of resp muscles during relapse
Monitor FVCs
treat with IV Ig

24
Q

Lambert eaton syndrome

  • association
  • features
  • management
A
  • small cell lung cancer/AI
  • Limb girdle weakness, HYPOreflexia, autonomic sx, REVERSE fatiguability
  • immunosuppress with pred
25
Q

medical management of SAH

A

Nimodipine (cause vasospasm)

26
Q

acute and prophylactic Rx of migraine

A 
acute
first line: combo of oral triptan and NSAID
* if young give nasal triptan
prophylaxis
- betablocker or topiramate (2nd line)
27
Q

Cluster headaches

  • classic presentation
  • acute attack Rx
  • prophylactic rx
A
  • like ‘clockwork’ for 2-6 weeks often at night time for 30-60 mins
  • 100% oxygen for 10-15mins/sumitriptan
  • verapamil TDS
28
Q

Venous sinus thrombosis

  • treatment
  • MRI sign?
A
  • anticoag

- Delta sign

29
Q

treatment of choice for trigeminal neuralgia

A

carbamezapine

30
Q

at what ICP is treatment required?

A

exceeds 15mmHg for >5 mins

31
Q

causes of obstructive and communicating hydrocephalus

A

obs: chiari malformation
comm: Meningitis, SAH

32
Q

classic presentation of idiopathic intracranial HTN

- first line rx

A

young obese female with papilloedema, headaches and machinery noise in ears
- weight loss

33
Q

conditions associated with SAH

A
  • PCKD
  • Coarctation aorta
  • Ehlers Danlos
34
Q

surgery in subdural AND extradural haematoma

A

Decompressive craniotomy

35
Q

Encephalitis

  • presentation
  • inv
  • management
  • differential
A
  • infective prodrome followed by worst headache ever, confusion, fevers
  • contrast CT shows focal bilateral temporal involvement if HSV
  • Aciclovir STAT
  • encephalopathy (afebrile)
36
Q

Cerebral abscess

  • presents?
  • CT sign?
  • Rx
A
  • 3-4 hx of progressive fever, headache, focal neurology
  • ring enhancing lesion
  • surgical craniotomy and debride

sms (5 decks)

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