Neurology Flashcards
What are the symptoms and signs of a vestibular schwannoma?
Tinnitus, progressive hearing loss, weak and pain on one side, tenderness, mild facial weakness on that side
CN 5, 7, 8 - tumour
What does damage to the ulnar nerve cause?
Weakness of hand, sensory loss to little finger, wasting of hypothenar component, no thumb adduction
What does viral meningitis show on LP?
Mononuclear cells, increased CSF glucose, decreased protein
What does bacterial meningitis show on LP?
Polymorphs, decreased CSF glucose, increased protein
What is the presentation of meningitis?
Fever, non-blanching petechial rash, neck stiffness, photophobia, headache, confusion
What are the RFs for haemorrhagic stroke?
Age, berry aneurysms, trauma, alcohol, anti-coagulants, cerebral neoplasm, HTN/cerebral amyloid angiopathy
What are the signs and treatment of middle cerebral artery?
Contralateral sudden onset weakness of arm and leg, slurred speech, facial asymmetry
Treatment - thrombolysis with rTPA, e.g. Alteplase, Tenecteplase
What does a tonic-clonic seizure look like and what is the treatment?
Limb stiffening and jerking, LOC, post-ictal confusion
Treatment: sodium valproate, Lamotrigine
What does an epileptic seizure look like?
Blackout, post-ictal phase, tongue biting, urinary incontinence
What does MS LP look like?
less WCC, less RCC, normal glucose, raised protein, oligoclonal bands on Western Blot in CSF, not plasma
What are the signs of cerebellar dysfunction?
DANISH
Dysdiadochokinesia, ataxia, nystagmus, intention tremor, slurred speech, hypotonia
What is BPPV and what is the treatment?
Debris in semi-circular canals of ears - vertigo
Treatment - employ manoeuvre
What cancer is associated with myasthenia gravis?
Thymoma
What medication is given for myasthenia graves?
Pyrostigmine and prednisolone
What is giant cell arteritis, how does it present and what is the treatment?
Inflammation of artery, tender and palpable over scalp, e.g. while combing hair/eating
Unwell, headache, visual loss, fever, tenderness to scalp palpitation, raised ESR, temporal artery biopsy - inflammation and immune cells
Treatment - high dose Prednisolone
What does an epileptic myoclonic seizure look like?
Sudden jerking of limb, trunk, face, no LOC, violent and unpredictable
What does glossopharyngeal nerve palsy look like?
Uvula away, difficulty swallowing, dry mouth
What are the signs of Parkinson’s and the treatment?
TRAP - tremor, rigidity, akinesia, postural instability (shuffling gait)
Treatment - Levodopa
What is the presentation of Meniere’s disease? What are the DDx for vertigo?
Vertigo, sensorineural hearing loss, tinnitus, aural fullness
Needs antihistamines and bed rest
Ddx: BPPV, acute labyrinthitis (no deafness, tinnitus, viral illness), acoustic neuroma
What makes myasthenia gravis worse?
B-blocker, Abx, anti-malarial, lithium and other psych drugs
What are the signs of common peroneal nerve palsy?
Foot drop, weakness in dorsiflexion, foot inversion is normal, lateral calf = sensory loss
L5 radiculopathy - cannot invert foot
What triad is seen in increased ICP?
Cushing’s triad - HTN, bradycardia, labile breathing
What is the treatment for seizures if pt is pregnant?
Lamotrigine
What is the presentation of hydrocephalus and the management?
Urinary incontinence, gait dysfunction, dementia
LP - then ventriculoperitoneal shunting
What is a long-term SE of levodopa?
Dyskinesia - writhing and unco-ordinated movements
What are the signs of an extradural haematoma and what is the treatment?
Raised ICP, head trauma, headache, vomiting, dilated fixed pupil
Drug = mannitol - osmotic diuretic that decreases ICP
What are the signs of myasthenia gravis?
Diplopia, speech disturbance, fatiguable weakness at rest
What is Cushing’s triad?
Increased ICP, leads to decreased GCSE. Brainstem compression leads to Cushing’s triad - bradycardia, HTN, abnormal breathing
What are the signs of a temporal lobe seizure?
Abdominal symptoms, staring, disorientation, lip smacking
What is the treatment for seizures?
Lorazepam, Diazepam, Midazolam
What is the sign of a hypoglossal nerve lesion?
Tongue deviation
