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Medicine > Neurology 🧠 > Flashcards

Neurology 🧠 Flashcards

1
Q

What are Argyll-Robinson pupils?

A

2 different sized pupils

Associated with Syphilis

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2
Q

What is Uthoff’s phenomenon?

A

Symptoms being worse with heat.

Seen in pts with MS

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3
Q

A young woman presents with arm pain on movement and visual disturbances. She has had these symptoms before and they usually subside within a week.

What does she have?

A

Multiple Sclerosis

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4
Q

How do you manage MS relapses?

A

Methylprednisolone

Reduces duration but does not change prognosis

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5
Q

What is used to treat muscle spasms (usually in MS)?

A

Baclofen

*Note: can also be used for hiccups

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6
Q

What is Charcot-Marie-Tooth disease?

A

A collection of peripheral neuropathies.
Progressive.
Px: muscle weakness (1st in ankles and feet), curled toes, foot drop, parasthesia in hands and feet.

May also have cold hands and feet due to poor circulation

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7
Q

What investigation findings would indicate a diagnosis of Myasthenia Gravis?

A

Anti-AchR Ab +ve
MUSK Ab +ve
Single fibre EMG showing a “jitter” and “blocking” pattern

*NOTE: Also do a contrast CT to exclude a Thymoma

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8
Q

How do you differentiate between Multiple Sclerosis and Motor Neurone Disease?

A

MND = sphincter disturbances, but no sensory loss

MS = sensory loss but no sphincter disturbances

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9
Q

What Anti-Epileptic Drug (AED) should be avoided in pregnancy?

A

Sodium Valporate

Teratogenic

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10
Q

A pt has a seizure lasting longer than 5 mins and has already been given IV Lorazepam, what do you do next?

A

Give another dose of IV Lorazepam.

If this is unsuccessful, give IV Phenytoin

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11
Q

What is a typical history of Myasthenia Gravis?

A

Weakness of extra-ocular region —> bulbar —> face —> neck—> limb—> trunk

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12
Q

How do you manage Myasthenia Gravis?

A

Pyridostigmine (Ach inhibitor) + immunosuppression

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13
Q

What is the drug Riluzole used for?

A

Motor Neurone Disease

It is a neuro-protective drug called an anti-glutamate

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14
Q

What is Horner’s Syndrome the triad of?

A

Anhydrosis (dry eyes)
Ptosis (droopy eyes)
Myosis (constricted pupils)

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15
Q

How do you manage temporal arteritis?

A

High dose oral prednisolone

If no dramatic response, consider another diagnosis

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16
Q

What condition is temporal arteritis associated with?

A

Polymyalgia Rheumatica

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17
Q

What is the common Px of temporal arteritis?

A 
Headache
Jaw claudication
Fatigue
Over 60
Morning stiffness
Visual disturbances

Skip lesions found on histology/biopsy

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18
Q

How do you manage an acute migraine?

A

Oral triptan (e.g. Sumatriptan) + NSAID or paracetamol

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19
Q

Migraine prophylaxis?

A

Topiramate or Propranolol

NOTE: topiramate is teratogenic, so give Propranolol to women of child-bearing age

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20
Q

Cluster headache prophylaxis

A

Verapamil

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21
Q

How do you manage acute cluster headaches?

A

100% oxygen via non-rebreather

Can also give subcut/nasal Triptan

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22
Q

Management of acute tension headaches

A

Aspirin, NSAIDs or paracetamol

23
Q

Trigeminal Neuralgia Px

A

Brief electric shock-like pains, abrupt onset and termination, limited to 1/2 divisions of the trigeminal.
Pain evoked by light touch and actions eg brushing teeth
Nasolabial fold is v susceptible

24
Q

How do you manage trigeminal neuralgia?

A

Carbamazepine

25
Q

What is a thunderclap headache indicative of?

A

Subarachnoid haemorrhage

26
Q

What kind of haemorrhage can be caused by beri aneurysms?

A

Subarachnoid

27
Q

If pt presents with subarachnoid haemorrhage symptoms (worst headache ever had, nausea, vomiting, seizures) but CT is -ve, what do you do?

A

Lumbar puncture - look for blood in CSF

28
Q

What are chronic subdural haematomas/ haemorrhages caused by?

A

Rupture of the small bridging veins; slow bleeding

29
Q

In what type of haemorrhage do you get a lucid interval?

A

Epidural haemorrhage

30
Q

What type of haemorrhage is associated with elderly + alcoholics?

A

Subdural

31
Q

What is the triad of meningism?

A

Nuchal rigidity, photophobia and headache

32
Q

What are the early features of meningitis?

A

Headache and leg pains
Fever with cold hands and feet
Abnormal skin colour

33
Q

What type of rash indicates meningitis?

A

Non-blanching petechial rash

Especially in meningiococcal septicaemia

34
Q

What bacteria cause meningitis is 0-3 month olds?

A

Group B Streptococcus (most common in neonates)
E.Coli
Listeria Monocytogenes

35
Q

What bacteria cause meningitis in any patients over 3 months old?

A

Neisseria Meningitidis
Streptococcus Pneumoniae

Note* H. Influenzae causes meningitis in the old (over 60) and the young (3 months - 6yrs)

36
Q

What is the bacterial cause of meningitis in immunocompromised pts?

A

Listeria Monocytogenes

37
Q

What is the management of meningitis?

A

Ceftriaxone
Add Amoxicillin if >60yrs or immunocompromised

If signs if meningism - give Dexamethasone (but DO NOT GIVE if meningococcal septicaemia)

38
Q

What do you give as prophylaxis to close contacts of pts with meningococcal meningitis?

A

Ciprofloxacin or Rifampicin

Also offer vaccines

NOTE* do not give prophylaxis to close contacts of pts with pneumococcal meningitis

39
Q

What is ‘status epileptics’?

A

Status epilepticus is defined as:
a single seizure lasting >5 minutes, or
>= 2 seizures within a 5-minute period without the person returning to normal between them

This is a medical emergency. The priority is the termination of seizure activity, which if prolonged will lead to irreversible brain damage.

40
Q

3rd nerve palsy Px?

A
  • Eye deviated “down and out”
  • Ptosis
  • Pupil may be dilated (sometimes called surgical 3rd nerve palsy)
41
Q

What are the causes of 3rd nerve palsy?

A
  • Diabetes
  • Vasculitis Eg temporal arteritis, SLE
  • False localising sign due to uncal herniation through tentorium if raised ICP
  • Posterior communicating artery aneurysm
  • Cavernous sinus thrombosis
  • Weber’s syndrome: ipsilateral 3rd nerve palsy with contralateral hemiplegia - caused by midbrain strokes
  • Amyloidosis
  • MS
42
Q

Where does C6 innervate?

A

Thumb + index finger

Make a 6 with thumb +index finger - C6

43
Q

Where does T4 innervate?

A

T4 at the Teat Pore = Nipples

44
Q

Where does T10 innervate?

A

Umbilicus - BellybuT-TEN

45
Q

Where does L1 innervate?

A

Inguinal ligament - L for ligament, 1 for 1inguinal

46
Q

Where does L4 innervate?

A

Knee caps - Down on aLL fours (L4)

47
Q

L5 Innervation?

A

Big toe, dorm of foot (except lateral aspect)

L5 = Largest of the 5 toes

48
Q

S1 Innervation?

A

Lateral foot, small toe

S1 = the smallest one

49
Q

Lacunar stroke Px?

A
  • Unilateral motor disturbance affecting the face, arm or leg or all 3.
  • Complete one sided sensory loss.
  • Ataxia hemiparesis
50
Q

Which abx increase risk of intracranial HTN?

A

Tetracyclines Eg Doxycycline

51
Q

What are the features of idiopathic intracranial HTN?

A 
Headache
Blurred vision
Papilloedema (usually)
Enlarged blind spot
6th nerve palsy may be present
52
Q

Rx of idiopathic intracranial HTN?

A

Weight loss
Diuretics eg acetazolamide
Topiramate can be used
Repeated LP

53
Q

What are the main migraine triggers?

A 
CHOCOLATE:
C - chocolate
H - hangovers
O - orgasms
C - cheese + caffeine 
O - oral contraceptive pill
L - lie-ins
A - alcohol
T - travel
E - exercise

Medicine (16 decks)

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