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Finals > Neurology > Flashcards

Neurology Flashcards

1
Q

What are some causes of transient loss of consciousness?

  1. Cardiac (4)
  2. Neuro (3)
  3. Other (2)
A
  1. Cardiac - vasovagal, arrhythmias, HOCM, postural hypotension
  2. Neuro - epilepsy, NEAD, migraines
  3. Other - hypoglycaemia, vestibular disorders
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2
Q

What are some possible diagnoses for four limb weakness?

A 
GBS
Acute cervical cord syndrome 
Cauda equina 
Myasthenia gravis
Acute myositis
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3
Q

What type of infections can precipitate GBS?

A

Respiratory or GI infections

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4
Q

What would you expect to see on LP for GBS?

What other test can you order to support your diagnosis?

A

Raised protein with normal cells and glucose

Nerve conduction studies

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5
Q

What is the general management for GBS? (4)

A
  1. Frequent obs - peak flow, standing and lying BP (autonomic dysfunction)
  2. IV immunoglobulin
  3. DVT prophylaxis
  4. Pain relief
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6
Q

What antibodies are there in myasthenia gravis? (2)

What other test is required?

A

ACh receptor antibodies
MuSK

CT thymus

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7
Q

Which medications are used in myasthenia gravis? (2)

What treatment is available for exacerbations of myasthenia gravis?

A

Acetylcholinesterase inhibitor e.g. pyridostigmine
Immunosuppression e.g. prednisolone, azathioprine

IV immunoglobulin

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8
Q

How long does it usually take people to recover from Bell’s palsy?
When should steroids be considered?
Differential diagnoses for Bell’s palsy?

A

3-4 months
If presenting within first 72h
Ramsay-Hunt syndrome, Lyme disease, sarcoidosis, trauma, inner ear (e.g. otitis media, cholesteatoma, acoustic neuroma)

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9
Q

What would you expect to find if these nerves are compressed?

  1. Common peroneal nerve
  2. L5 nerve root
A
  1. weakness of dorsiflexion and eversion of foot

2. weakness of inversion and eversion of foot

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10
Q

What are the symptoms of optic neuritis? (4)

What can cause optic neuritis? (6)

A

Pain on eye movements, impaired colour vision, RAPD, scotoma

MS, sarcoidosis, SLE, Lyme, mumps, measles

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11
Q

What are you trying to show when testing for MS?

What are the main tests for MS?

What criteria is used to diagnose MS?

A

Dissemination in time and space

Time - 2 episodes of neurological symptoms OR presence of oligoclonal bands on LP
Space - MRI brain and spine

McDonald criteria

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12
Q

What lifestyle advice should you give those with MS? (4)
When should disease modifying agents be considered?
What is the treatment for a relapse of MS?

A

Inform DLVA, stop smoking, avoid stress, regular exercise

More than 2 relapses in 2 years

PO/IV methylprednisolone

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13
Q

What is the management for migraines?

  1. Acute (3)
  2. Prophylactic (3)
A
  1. NSAIDs, paracetamol or triptans; anti-emetics

2. Propranolol, amitryptiline, topiramate

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14
Q

What is the management for cluster headaches?

  1. Acute (2)
  2. Prophylactic (3)
A
  1. High flow oxygen, SC triptans

2. Verapamil, lithium, prednisolone (short term)

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15
Q

What are some general measures for managing raised ICP? (4)

A

Head tilt
Avoid hypotension
Maintain euvolaemia
Maintain normal CO2 (as causes vasodilation)

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16
Q

What is the most common type of malignant brain tumour?

What is the most common type of benign brain tumour?

A

Glioblastoma multiforme

Meningioma

17
Q

What are the types of focal seizures?

Which medication is used first-line?

A

Simple focal, focal dyscognitive, focal to GTC

Carbemazepine or lamotrigine

18
Q

What are the types of generalised seizures? (4)

What medication is used first-line?

A

Tonic-clonic, absence, atonic, myoclonic
Sodium valproate for all plus:
- ethosuxamide for absence
- lamotrigine for GTC

19
Q

What is the criteria for formally diagnosing epilepsy? (3)

A
  1. 2 or more unprovoked seizures more than 24h apart
  2. 1 unprovoked seizure with probability of further seizures similar to (1)
  3. Diagnosis of epilepsy syndrome
20
Q

Which investigations can you order after a suspected seizure? (4)

A

Exclude reversible causes e.g. blood glucose, infection, electrolytes
ECG
EEG
MRI

21
Q

Which anti-epileptic drug is most likely to cause:

  1. Rash?
  2. Agranulocytosis?
  3. PCOS?
A
  1. Lamotrigine
  2. Carbamazepine
  3. Sodium valproate
22
Q

What should people with epilepsy be told to avoid? (4)

A

Working at height
Cycling in traffic
Working with dangerous machinery
Alone in a bath

23
Q

What are the driving rules for epilepsy?

A

Reapply for licence after 1 year (10 years if lorry driver)

One-off seizure, no risk of another seizures - 6 months (5 years if lorry driver)

24
Q

What conditions are associated with epilepsy?

A

Neurofibromatosis

Tuberous sclerosis

25
Q

Can you remember the scoring for GCS? - eyes

A

Eyes:

  1. No movement
  2. Opens eyes in response to pain
  3. Opens eyes in response to speech
  4. Spontaneous movements of eyes
26
Q

Can you remember the scoring for GCS? - verbal

A

Verbal:

  1. No verbal response
  2. Incomprehensible sounds
  3. Inappropriate words or cannot use language properly
  4. Confused but able to engage
  5. Able to engage in conversation
27
Q

Can you remember the scoring for GCS? - motor

A

Motor:

  1. No motor response
  2. Extension to pain
  3. Abnormal flexion to pain
  4. Normal flexion in response to pain
  5. Localises to pain
  6. Obeys commands
28
Q

Which type of intracranial bleeds causes the following on CT?

  1. Crescent shape
  2. Biconvex shape

Which blood vessels are most likely to be affected?

A
  1. Subdural - bridging veins

2. Extradural - middle meningeal artery

Finals (23 decks)

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