Neurology Flashcards
1
Q
Migraine - Classification
A
- Migraine w aura
2. Migraine w/out aura
2
Q
Bacterial Meningitis - Clinical presentation
A
Triad
- Headache
- Neck stiffness
- Fever
- Kernig’s (cannot extend knee when hip flexed) and Brudzinski’s sign
- Non-blanching petechial skin rash –> meningococcal septicaemia
3
Q
Meningitis - Aetiology
A
- Neisseria meningitides (gram -ve diplococci)
- Strep pneumoniae /pneumococcus
- Listeria monocytogenes (preg –> cheese)
- E. coli (neonates)
- Group B strep - agalactiae (neonates)
4
Q
Meningococcal septicaemia
A
- Bacteria invades blood
- Endotoxin –> inflammatory cascade
- Petechial rash
- Signs of sepsis
5
Q
Raised intracranial pressure - Treatment
A
Mannitol
6
Q
Bacterial Meningitis - treatment
A
- Start antibiotics before tests
- IV cefotaxime
- IV amoxicillin if >55 or immunocompromised
- Oral dexamethasone (steroid –> oedema)
- IV vancomycin (return travellers)
7
Q
Parkinson’s D - Pathology
A
- Degeneration of dopamingergic neurones in pars compacta of substantia nigra –> project to striatum
- Reduced striatal dopaminergic levels
- Dopamine inhibits inhibitory striatum pathway less
- Decrease in movement
8
Q
Parkinson’s D - Associated condition
A
Lewy body dementia
9
Q
CN3 (oculomotor) palsy
A
- Ptosis (drooping eyelid)
- Fixed dilated pupil (loss of para outflow from Edinger Westphal nucleus –> supply pupillary sphincted + ciliary bodies –> lens accomodation)
- Eye down and out
10
Q
MCA stroke
A
- Contralat arm weakness
- Contralat sensory loss
- Hemianopia
- Aphasia
- Dysphasia
- Facial droop
11
Q
Headache - Red flags
A
- New H w history of cancer
- Cluster H
- Papilloedema
- Seizure
- Alt memory / consciousness / confusion
12
Q
Lower motor neurone signs
A
Down
- Decreased M tone
- Wasting (atrophy)
- Fasciculations (spont involuntary twitching)
- Reduced reflex
13
Q
Upper motor neurone signs
A
Up + contralat 1. Spasticity 2. Brisk reflex 3. Babinski's sign - plantars upturned on stimulation 4. Weakness Upper extensor > flexors Lower flexor > extensors Finer movements impaired
14
Q
Multiple sclerosis - Diagnosis
A
- 2+ attacks of different parts of CNS
- MRI brain + cord
- Periventricular lesions
- Discrete white matter abnormalities - Lumbar puncture
- Oligoclonal IgG bands
- CSF cell count raised - Electrophysiology
- Delayed N conduction studies
15
Q
ABCD2 score risk
A
After TIA --> risk of stroke A - Age >60yrs =1 B- BP >140/90 = 1 C - Clinical features - Unilat weakness = 2 - Speech disturbance w/our weakness = 1 D- Duration of S - >1hr = 2 - 10-59mins = 1 D- Diabetes = 1
16
Q
Multiple sclerosis - Presentation
A
- Unilat optic neuritis (pain in one eye on movement)
- Numbness/tingling in limbs
- Leg weakness
- Intention tremor
- Cognitive decline
17
Q
Homonymous hemianopia
A
Optic tract
18
Q
Parkinson’s Disease- Presentation
A
TRAP T - Tremor (resting) R - Rigidity A - Akinesia / bradykinesia P - Postural instability
19
Q
Trigeminal Neuralgia - Treatment
A
- Anticonvulsant (oral carbamazepine)
- Microvascular decompression
- Gamma knife surgery
- Stereotactic radiosurgery
20
Q
Myasthenia Gravis - Treatment
A
- Anti-cholinesterase (oral pyridostigmine)
- Immunosuppression (oral prednisolone)
- Osteoporosis prophylaxis - biphosphonates (alendronate)
- Oral azathioprine / methotrexate
- Thymectomy
21
Q
SAH - CT head
A
- 5 star sign
22
Q
EDH - CT head
A
- Hyperdense haematoma
- Adjacent to skull
- Biconcave
23
Q
SDH - CT head
A
- Hyperdense - isodense - hypodense
- Crescent shaped
- Over one hemisphere
24
Q
Haemorrhagic stroke - Causes
A
- Trauma
- Aneurysm rupture
- Anticoagulation
- Thrombolysis
- SAH
25
Q
Stroke - thrombolysis
A
- CT first - rule out haemorrhage
- 4.5 hours after onset
- Tissue plasminogen activator (IV alteplase)
- Antiplatelet therapy 24hrs after (clopidogrel)
26
Q
Thrombolysis - Contraindications
A
- Surgery in last 3 mths
- Haemorrhagic stroke
- > 4.5 hours onset
- Brain aneurysm
- Recent arterial puncture
27
Q
Stroke - PH
A
FAST Face Arms Speech Time
