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Phase 2a Questions > Neurology > Flashcards

Neurology Flashcards

1
Q

Migraine - Classification

A
  1. Migraine w aura

2. Migraine w/out aura

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2
Q

Bacterial Meningitis - Clinical presentation

A

Triad

  1. Headache
  2. Neck stiffness
  3. Fever
  4. Kernig’s (cannot extend knee when hip flexed) and Brudzinski’s sign
  5. Non-blanching petechial skin rash –> meningococcal septicaemia
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3
Q

Meningitis - Aetiology

A
  1. Neisseria meningitides (gram -ve diplococci)
  2. Strep pneumoniae /pneumococcus
  3. Listeria monocytogenes (preg –> cheese)
  4. E. coli (neonates)
  5. Group B strep - agalactiae (neonates)
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4
Q

Meningococcal septicaemia

A
  1. Bacteria invades blood
  2. Endotoxin –> inflammatory cascade
  3. Petechial rash
  4. Signs of sepsis
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5
Q

Raised intracranial pressure - Treatment

A

Mannitol

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6
Q

Bacterial Meningitis - treatment

A
  1. Start antibiotics before tests
  2. IV cefotaxime
  3. IV amoxicillin if >55 or immunocompromised
  4. Oral dexamethasone (steroid –> oedema)
  5. IV vancomycin (return travellers)
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7
Q

Parkinson’s D - Pathology

A
  1. Degeneration of dopamingergic neurones in pars compacta of substantia nigra –> project to striatum
  2. Reduced striatal dopaminergic levels
  3. Dopamine inhibits inhibitory striatum pathway less
  4. Decrease in movement
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8
Q

Parkinson’s D - Associated condition

A

Lewy body dementia

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9
Q

CN3 (oculomotor) palsy

A
  1. Ptosis (drooping eyelid)
  2. Fixed dilated pupil (loss of para outflow from Edinger Westphal nucleus –> supply pupillary sphincted + ciliary bodies –> lens accomodation)
  3. Eye down and out
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10
Q

MCA stroke

A
  1. Contralat arm weakness
  2. Contralat sensory loss
  3. Hemianopia
  4. Aphasia
  5. Dysphasia
  6. Facial droop
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11
Q

Headache - Red flags

A
  1. New H w history of cancer
  2. Cluster H
  3. Papilloedema
  4. Seizure
  5. Alt memory / consciousness / confusion
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12
Q

Lower motor neurone signs

A

Down

  1. Decreased M tone
  2. Wasting (atrophy)
  3. Fasciculations (spont involuntary twitching)
  4. Reduced reflex
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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
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14
Q

Multiple sclerosis - Diagnosis

A
  1. 2+ attacks of different parts of CNS
  2. MRI brain + cord
    - Periventricular lesions
    - Discrete white matter abnormalities
  3. Lumbar puncture
    - Oligoclonal IgG bands
    - CSF cell count raised
  4. Electrophysiology
    - Delayed N conduction studies
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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
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16
Q

Multiple sclerosis - Presentation

A
  1. Unilat optic neuritis (pain in one eye on movement)
  2. Numbness/tingling in limbs
  3. Leg weakness
  4. Intention tremor
  5. 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
  1. Anticonvulsant (oral carbamazepine)
  2. Microvascular decompression
  3. Gamma knife surgery
  4. Stereotactic radiosurgery
20
Q

Myasthenia Gravis - Treatment

A
  1. Anti-cholinesterase (oral pyridostigmine)
  2. Immunosuppression (oral prednisolone)
  3. Osteoporosis prophylaxis - biphosphonates (alendronate)
  4. Oral azathioprine / methotrexate
  5. Thymectomy
21
Q

SAH - CT head

A
  1. 5 star sign
22
Q

EDH - CT head

A
  1. Hyperdense haematoma
  2. Adjacent to skull
  3. Biconcave
23
Q

SDH - CT head

A
  1. Hyperdense - isodense - hypodense
  2. Crescent shaped
  3. Over one hemisphere
24
Q

Haemorrhagic stroke - Causes

A
  1. Trauma
  2. Aneurysm rupture
  3. Anticoagulation
  4. Thrombolysis
  5. SAH
25
Q

Stroke - thrombolysis

A
  1. CT first - rule out haemorrhage
  2. 4.5 hours after onset
  3. Tissue plasminogen activator (IV alteplase)
  4. Antiplatelet therapy 24hrs after (clopidogrel)
26
Q

Thrombolysis - Contraindications

A
  1. Surgery in last 3 mths
  2. Haemorrhagic stroke
  3. > 4.5 hours onset
  4. Brain aneurysm
  5. Recent arterial puncture
27
Q

Stroke - PH

A 
FAST
Face
Arms
Speech
Time

Phase 2a Questions (14 decks)

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