neurology Flashcards
what is the most common type of Glioma
astroctytoma
give 2 examples of non-gliomas
Meningioma
pituitary adenoma
what is the grading system used for brain tumours
WHO classification - histology and molecular genetic features
what are the main features of a low grade tumour
slow growing
relatively contained
Unlikely to spread
less chances of returning
what are the main features of a high grade tumour
fast growing
cancerous growth
more likely to spread
may comeback no matter what
what is the average prognosis for grades 2-4
grade 2 = 10 years
grade 3 = 3.5 years
4 = 12 months
what is the cause of majority of brain tumours
unknown
5% family history
occasionally ionising radiation contributes
3 SIGNIFICANT symptoms of brain tumour
Raised ICP
Progressive neurological deficit
Epileptic seizures
what are specific symptoms of headaches that a patient with brain tumour may experience
woken by headache, worse in morning, lying down, associated with nausea and vomitting (also caused by raised ICP), worse with coughing, sneezing and drowsiness
signs: name some focal neurological deficits. Do you know wha they are?
- Hemiparesis
- Hemisensory loss
- Visual field
which of the 3 significant symptoms do patients with low grade brain tumour more likely to experience
seizures
which is better for the investigation of Brain tumours; MRIs or CT scans
MRIs - they produce a more detailed image of soft tissues including the brain
what are the 4 different routes of treatment mainly considered for brain tumours
steroids (reduces oedema)
surgery - biopsy or resection
radiotherapy
chemotherapy
what is awake craniotomy
it is open skull surgery where the patient is woken up after the exposure of the brain, and instructed to do certain movements, in order to map areas of response and avoid damage of vital areas when removing tumours.
symptoms of parkingsons disease
!!RESTING tremors postural instability !!bradykinesia (slow movement) !!rigidity (stiff pain movement) masked faces (minimal movement) shuffling gait
What may you see on examination of their walk
small stepped gait with: - stooped posture - reduced armswing - may lean more to one side increase rigidity rest tremor
what is the first line of treatment
levodopa
what is Is levodopa taken in combination with and why
carbidopa or benserazide. these prevent the levodopa from breaking down in the blood stream and reduces peripheral effects of L-dopa, reducing side effects
when may levodopa not be taken and what are the alternative treatment
when the patients quality of life isn’t effected or when L-dope is causing motor dysfunction (or general serious side effects)
- dopamine agonist
- monoamine oxidase-B inhibitor
name some non-pharmaceutical treatment
deep brain simulation physiotherapy occupational therapy speech and language therapy Diet advice
which mental illness is commonly associated with Parkinson’s disease
Depression
give example of a levodopa-carbidopa drug
sinemet
what is ataxia
a persons inability to a perform a task with complete coordination
what is apraxia
can understand an instruction of motor movement but has difficulty performing it.
