Neurology - AS Flashcards
UMN signs
Increased tone, refexes and plantars go up
Less power
UMN signs
Increased tone, reflexes and plantars go up
Less power
Cerebellar signs
DANISH:
Ataxia Nystagmus Dysdiadochokinesia Intention tremor Speech slurred
Treatment of peripheral neuropathy
Duloxetine
Causes of peripheral neuropathy
Drugs HIV Diabetes Alcohol (raised GGT and MCV) Uremia (U and E) Amyloidosis - deposition of abnormal protein in organs (if there is a history of myeloma or chronic infection/inflammation)
Tumour causes of peripheral neuropathy ?? LOok back at the slide from 03.12.20
Paraeoplastic
Paranproteinaemia
spastic lesion means it’s in the ?
spinal cord
Another term for optic ner
Papilitis = head of optic nerve neuritis
Symptoms of paipilitis
Blurred vision
Blurred optic disc margins
Pain on eye movement
Spastic paraparesis can be caused by
Vascular - anterior spinal artery problem
Infection - TB
Inflammation - demyelination or transverse myelitis
Toxic/metabolic
Tumour/malignancy
Spastic paraparesis can be caused by
Vascular - anterior spinal artery problem
Infection - TB
Inflammation - demyelination or transverse myelitis
Toxic/metabolic - b12
Tumour/malignancy
NOTE SOMETHING MUST BE PRESSING ON THE CORD
Two lesions together - what do you think?
MS
Where do you check for sensation of radial nerve?
Base of thumb
Pain distribution in sciatica?
Pain in buttock radiation down to the leg belwo th eknee
Causes of sciatica
Disc herniation
Spinal canal stenosis
What do you call disease of nerve roots?
Radiculopathy
What is micrographia
Small writing
Parkinsons signs
Tremor
Rigidity
Bradykinesia
Lewy body dementia signs
Alzhiemers _ prarksinsons + hallucinations
Causes of confusion
Post ictal (after seizure)
Dysphasia (stroke/TIA)
Dementia (?????)
Depressive pseudodementia
Differentials for CONFUSION
HYPOGLYCEAMIA
Vascular - bleed
- they’d have headache and collapse
Subdural haematoma - post fall, fluctutating consciousness
Infection
Intracranial/extracranial
Inflammation
malignancy
metabolic/toxic
Drugs/UandE/LFT/vit D/endocrinopathiese
GCS
Eye (4) - open open at demand open at ? not at all
Verbal confused - 4 words 3 sounds 2 nothing 1
Motor
obeying commands - 6
First steps in GCS scoring
DOB Age Time Year Place REcall West streeet reocgnise doctor who's PM Second WW COunt backwards from 20
Eye - GCS scoring
Spontaenous - 4
opens in response to voice - 3
Opens in resopnse to pain - 2
does not open 1
Verbal function GCS scoring
orientated confused words sounds no words
Motor function - GCS scoring
obeys commands - 6 localises pain - 5 withdraws to painful stimuli - 4 Abnormal flexion - 3 extension - 3 no movement - 1
Meningitis signs
Fever
Neck
Stiffness
Kernig’s sign
Causes of headache
Meningitis SAH GCA Migraine Pituatry apoplexy
GCA management/investigations
ESR
Steroids
Bx
Stroke within 4.5 hrs management and investigation
CT would show no haemorrhage??
Thrombolysis
Stroke after 4.5 hrs management and investigation
CT head - exclude haemorrhage Aspirin - 300mg Maintain hydration Oxygenation Monitor glc?
TIA management and investigations
Aspirin Don't treat BP acutely unless over 220/120 ECG Echocardiogram Carotid doppler Risk factor modification
Lower limb weakness?
Guillain Barre
Lower limb weakness and back ache?
Guillain Barre
