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Neurology > Neurology - head problems > Flashcards

Neurology - head problems Flashcards

1
Q

What are some symptoms of optic neuritis?

A

decreased acuity in few days pain, pain on moving eye, made worse by heat and exercise, afferent pupil reflex (RAPD), colour blindness

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2
Q

What are the signs of cerebellar disease?

A 
DANISH
Dysdiadodochokinesis
Ataxia
Nystagmus
Intention tremor
Speech
Hypotonia 
Reflexes (pendular)
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3
Q

What is hydrocephalus?

A

excess CSF in intracranial cavity - caused by bacterial meningitis, haemorrhage post fossa tumours, spina bifida

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4
Q

How do you treat hydrocephalus?

A

CT head - surgical drainage

if untreated there is likely to be irreversible brain damage

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5
Q

How do you diagnose giant cell arteritis?

A

temporal artery biopsy
PET scan
ESR/CRP

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6
Q

How do you treat giant cell arteritis?

A

steroids

immunosuppressants/biologicals

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7
Q

Name 3 signs of encephalitis

A 
fever, headache, lethargy
photophobia, neck stiffness
behaviour change 
seizure
decreased consciousness
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8
Q

What is the treatment of encephalitis?

A

30 minutes after arrival - acyclovir

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9
Q

How do you treat meningitis?

A

bacterial - cefotaxime, ceftriaxone

Viral - acicylovir

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10
Q

What tests would you do for meningitis?

A 
Blood culture - gram - diplococcus 
LP - between L3 and S1 
CT of head 
throat swap 
serum PCR - for viral, meningococcal, pneumococcal 
check retina for raised ICP
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11
Q

What is the treatment for a cluster headache?

A

100% O2, 7-15 L for 15 mins

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12
Q

What is a cluster headache?

A

5 attacks of facepain (15-180 mins), upsilateral cranial autonomic features, restlessness 1-8 day

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13
Q

Who is most at risk of a cluster headache?

A

Risk increases with smokers, more alcohol,

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14
Q

Prophylaxis for migraine

A

primary - beta blocker, e.g. propanolol
amytriptyline
topiramirate, sumatriptan

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15
Q

What symptoms indicate temporal arteritis?

A

Headache, scalp tenderness, jaw caludication, malaise, acute blindness (curtain coming down)

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16
Q

Name 3 symptoms of a brain tumour

A 
Signs of raised ICP - vomiting, headache 
progressive neurological deficit 
epilepsy 
tiredness 
papilloedema
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17
Q

What disease is associated with trigeminal neuralgia?

A

MS

18
Q

What are the diagnostic criteria for trigeminal neuralgia?

A

3 of - recurrent very short attacks, severe electric shock, shooting or stabbing triggered by normal stimuli

19
Q

How would you test for glucoma?

A

tonometry

20
Q

What is Uthoff’s phenomenon?

A

precipatation of symptoms of optic neuritis by heat

21
Q

What is prophylaxis for cluster headaches?

A

veramapril - calcium channel blocker

22
Q

How would you manage idiopathic intracranial hypertension?

A

weight loss, serial LPs
acetazolomide and furesomide to lower CSF production
surgical decompression but only if eyesight is affected

23
Q

What are the long term effects of bacterial meningits?

A

hearing loss

24
Q

How who are the ‘contacts’ of someone with meningitis and how do you treat them?

A

Contact = household or kissing partner

ciprofloxacin 500mg

25
Q

What are some causes of optic neuritis?

A

MS, GCA, diabetic papillopathy, autoimmune, post-infection, post-vaccination, TB, syphillis, B12 deficiency, ethamutol, viral

26
Q

How would you treat a migraine?

A 
Triptains e.g. sumatriptain 
NSAIDs/paracetamol 
antiemetics 
physiological and behavioural therapy 
lifestyle modification
27
Q

What are the 3 most common cancers to cause secondary brain tumours?

A

breast, lung, melanoma

28
Q

How would you treat a brain tumour?

A

radio

debulking surgery

29
Q

What is the prognosis of a brain tumour?

A

13.4 months

30
Q

What are the 3 most common types of headache?

A

cluster, tension, migraine

31
Q

What are the arteries affected in a TACS and what are the symptoms?

A

total anterior circulation stroke - ACA and MCA
need 3 of:
unilateral weakness +/- sensory deficit of face, arm and leg
homonymous hemianopia
high cerebral dysfunction

32
Q

What are the arteries affected in PACS and what are the symptoms?

A

partial anterior circulation stroke - ACA and MCA
need 2 of:
unilateral weakness +/- sensory deficit of face, arm and leg
homonymous hemianopia
high cerebral dysfunction

33
Q

What are the arteries affected in POCS and what are the symptoms?

A 
posterior circulation stroke
one of the following: 
cranial nerve palsy with contralateral motor sensory deficit
bilateral motor/sensory deficit 
conjugate eye movements 
cerebellar dysfunction 
isolated homonymous hemianopia
34
Q

What are the arteries affected in a LACS and what are the symptoms?

A 
lacunar circulation stroke 
no loss to higher cerebellar function 
one of the following: 
pure sensory 
pure motor
sensorimotor
ataxic hemiparesis
35
Q

What are some symptoms of low pressure headaches?

A

post LP

worse on standing, better in morning

36
Q

How would you treat low pressure headaches?

A

caffeine

blood patch

37
Q

What can cause some carotid artery dissection?

A

sudden jolts or head turning e.g. rollercoasters

associated with Horner’s syndrome

38
Q

What is the risk with carotid artery dissection and how do you treat it?

A

Big risk is a stroke as clot forms on flap of carotid artery
- give them anticoagulants

39
Q

What are the symptoms of venous sinus thrombosis?

A

sudden onset headache which gradually gets worse, a seizure can happen

40
Q

How does trigeminal autonomic cephalgia present?

A

similar to cluster headaches, F>M, more frequent episodes than cluster headaches

41
Q

How do you treat trigeminal autonomic cephalgia?

A

indomethacin (an NSAID) cures them

Neurology (10 decks)

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