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Blurting > Neurology > Flashcards

Neurology Flashcards

1
Q

Pathophysiology of Migraine

A

Cerebral vessel dilation results in inflammation

Problem spreads across the cortex

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2
Q

Prophylaxis of Migraine

A

1st - B-blocker

2nd - Amytriptyline

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3
Q

When does aura usually occur in migraine?

A

Usually before onset of headache

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4
Q

Management of Tension Headache

A

Simple analgesics

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5
Q

Trigeminal Autonomic Cephalgia

What is included?

A

Cluster Headache
Tension Headache
Paroxysmal Hemicrania
SUNCT

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6
Q

Presentation of Cluster Headaches

Associations

A

Unilateral headache around the eye, last 45-90 minutes

Occur near sleep, usually young men

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7
Q

Management of Cluster Headache
Acute
Cover

A

Oxygen, triptan

Course of steroids should cover the cluster

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8
Q

Epidemiology of Paroxysmal Hemicrania

A

Older women

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9
Q

Management of Paroxysmal Hemicrania

A

Indomethacin 50mg 3 times a day

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10
Q

What is SUNCT

A 
Short lived - seconds 
Unilateral headache 
Neuralgiform 
Conjunctival injections
Tearing
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11
Q

Management of SUNCT

A

Gabapentin

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12
Q

Associations of Meningioma

A

NF Type II

Breast Cancer

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13
Q

Meningioma on CT

A

Densely enhancing lesion surrounded by oedema

Signs often due to large amount of oedema as opposed to the tumour

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14
Q

Management of meningioma

A

Surgery - often needs pre-surgical embolisation

+ Radiotherapy

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15
Q

Oligodendrial tumours on CT

A

Calcifications

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16
Q

Site of oligodendrial tumours

A

Cerebral cortex

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17
Q

Management of oligodendrial tumours

A

Radiotherapy and PVC chemotherapy

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18
Q

Spread of astrocytoma

A

Usually white matter tracking

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19
Q

Grading of Astrocytoma

A

I - truly benign
II - low grade
III - anaplastic
IV - gliobastoma multiforme

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20
Q

Management of Astrocytoma

Consideration

A

PVC chemotherapy

Can only perform surgery if there is a cyst present

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21
Q

Epidemiology of Brain Germ Cell Tumours

A

Usually under 12 years old

Male

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22
Q

Non-germinatous germ cell tumorus

A

Yolk sac
Teratoma
Choriocarcinoma

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23
Q

Management of Germinoma

A

Radiotherapy + Cisplatin

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24
Q

Collision tumours =

A

Astrocytoma + Oligodendrial Tumours

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25
Q

Presentation of sagittal venous thrombosis

A

Headaches and seizures

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26
Q

Presentation of transverse venous thrombosis

A

Focal CNS signs

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27
Q

Presentation of cavernous venous thrombosis

A

Headache and proptosis

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28
Q

Management of dural sinus venous thrombosis

A

Anti-coagulation - heparin

ENT referral to determine cause

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29
Q

Causes of intracerebral haemorrhage

A

AVM
Hypertension
Cocaine

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30
Q

Investigation of intracerebral haemorrhage

A

CT angiography

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31
Q

Posterior cerebral artery stroke (2)

A

Contralateral homonymous hemianopia
WITH macular sparing

Visual agnosia

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32
Q

Management of TIA

A

Bloods
ECG
Carotid Doppler
- Suspect referral to TIA clinic indicated

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33
Q

Location of lacunar infarcts

A

Basal ganglia
Thalamus
Brain stem

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34
Q

Presentation of lacunar infarcts (3)

A

1 of following:
Unilateral weakness face/arm/leg
Pure sensory stroke
Ataxic hemiparesis

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35
Q

Presentation of basilar artery stroke

A

Locked in syndrome

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36
Q

Presentation of lateral medullary stroke

A

Ipsilateral facial spinothalamic loss

Contralateral body spinothalamic loss

37
Q

Artery blocked in lateral medullary syndrome

A

Posterior inferior cerebellar artery

38
Q

Anterior cerebral artery stroke

A

Contralateral hemiparesis and sensory loss

Lower limb MORE

39
Q

Syringomyelia =

A

= fluid filled cyst in spinal cord

40
Q

Pathophysiology and Presentation of Syringomyelia

A

Destruction of spinothalamic neurons

- Sensory loss and loss of upper limb reflexes

41
Q

Management of syringomyelia

- Include investigation

A

VP or LP shunt

Seen on MRI

42
Q

Mechanisms of Hydrocephalus (3)

A

Over-production of CSF
Reduced absorption of CSF
Compensatory e.g. fronto-temporal dementia

43
Q

Causes of hydrocephalus (4)

A

Arnold-chiari
Dandy-walker complex
Haemorrhage
Tumour

44
Q

Types of Partial Seizures

A

Simple

Complex

45
Q

Presentation of simple partial seizures

A

No loss of consciousness, no post-ictal phase

46
Q

Presentation of complex partial seizures

A

Impaired consciousness

May have post-ictal phase

47
Q

Temporal lobes - what do you see in epilepsy?

A

Complex phenomena

48
Q

Parietal lobes - what do you see in epilepsy?

A

Sensory phenomena

49
Q

Occiptal lobes - what do you see in epilepsy?

A

Visual phenomena

50
Q

Frontal lobes - what do you see in epilepsy?

A

Motor phenomena

51
Q

Pathophysiology of epilepsy

A

Abnormal, spontaneous and intermittent electrical activity - tends to stay in the lobe
Can spread = generalisation

52
Q

What to avoid in myclonic and atonic seizures?

A

Carbamazepine

Oxacarbazepine

53
Q

Types of Generalised Seizure

A

Myoclonic
Atonic
Tonic-clonic
Absence

54
Q

EEG findings in generalised seizures

A

Generalised spike wave abnormalities

55
Q

Presentation of mononeuritis multiplex

A

Unilateral neuropathy
Thenar wasting
= must involve two separate nerve areas

56
Q

Investigation findings in spontaneous intracranial hypotension

A

MRI - meningeal enhancement

LP - low pressure

57
Q

Genetics of Charcot Marie Tooth Disease

A

Duplication error on Ch 17

Causes synaptic problems

58
Q

Presentation of Charcot MT Disease (3)

A

Pes cavus
Foot drop
Distal limb wasting

59
Q

Problem in pseudobulbar palsy

A

UMN lesion

Will be bilateral if lesion above the pons

60
Q

Presentation in pseudobulbar palsy

A

Slow speech
Tongue movement
Increased jaw jerk

61
Q

Contraindication in brain abscess

A

Don’t do an LP

62
Q

Management of brain abscess

A

IV ceftriaxone and metronidazole

63
Q

What do you need to diagnose MS?

A

Two distinct sensory deficits

64
Q

What shouldn’t you use in Lewy Body Dementia?

A

Neuroepileptics

Make it worse

65
Q

Presentation of Lewy Body Dementia

A

Visual hallucinations

Parkinsonism

66
Q

Findings in fronto-temporal dementia

A

Atrophy of lobes
Pick bodies
Neurofibrillary tangles

67
Q

Association of fronto-temporal dementia

A

ALS

68
Q

Presentation of fronto-temporal dementia

A

Personality change

Aphasia

69
Q

Presentation of cervical myelopathy

A

Clumsy hands
Paraesthesia
Usually bilateral - progresses in severity

70
Q

UMN signs in MND

A

Reflex changes

Spasticity

71
Q

LMN signs in MND

A

Wasting

72
Q

Specific signs in ALS

A

Thenar wasting

73
Q

Specific signs in progressive bulbar palsy

A

CN IX-XII presentations

74
Q

Specific signs in PLS

A

UMN signs

Pseudobulbar palsy

75
Q

Specific signs in progressive muscular atrophy

A

Distal muscles

76
Q

Pathophysiology of progressive muscular atrophy

A

Lesion only affects the anterior horn cells

77
Q

Management of trigeminal neuralgia

A

Carbamazepine

78
Q

Investigation of choice for narcolepsy

A

Multiple sleep latency test

79
Q

CSF finding in narcoplepsy

A

Hypocretin

80
Q

Middle cerebral artery stroke presentation (3)

A

Contralateral hemiparesis and sensory loss
Upper limb MORE

Contralateral homonymous hemianopia

Aphasia

81
Q

What artery is blocked in Weber’s Syndrome?

What does this supply?

A

Posterior cerebral artery branches which supply the midbrain

82
Q

Anterior inferior cerebellar artery stroke presentation (2)

A

Ipsilateral facial paralysis and deafness

Contralateral weakness of upper and lower limb

83
Q

Acetylcholinesterase inhibitors

A

Donepezil
Galantamine
Rivastigmine

84
Q

NMDA Antagonist

When used

A

Memanitine

Severe alzheimer’s as adjuvant or monotherapy

85
Q

Initial medication in parkinson’s

A

Levodopa

86
Q

Dopamine agnoists used in parkinson’s

A

Cabergoline
Bromocriptine
Ropinirole
Apomorphine

87
Q

Side effect of levodopa (3)

A

Dyskinesia
Palpitations
Postural hypotension

88
Q

Management of essential tremor

A

Propranolol

89
Q

Medication used in Huntington’s Disease

A

Tetrabenazine

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