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4th Year Exam > Neurology ILOs > Flashcards

Neurology ILOs Flashcards

1
Q

Define seizure and outline the two types

A

Sustained and synchronised electrical discharge in brain causing signs and symptoms

  1. Generalised tonic clonic (increased tone then jerking)
  2. Partial (focal signs, brain defences restrict activity to one part of brain)
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2
Q

Define epilepsy

A

Tendency to have recurrent unprovoked seizures

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3
Q

What is localised onset epilepsy?

A

Abnormal area in otherwise normal brain

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4
Q

What is generalised onset epilepsy?

A

Genetically driven change in neurotransmission

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5
Q

Give 3 investigations for epilepsy

A
  • MRI
  • CT
  • EEG
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6
Q

Define status epilepticus

A

Prolonged seizure which is a medical emergency, treat with IV benzodiazepine all the way to ITU admission

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7
Q

Give one example of a drug for each localised and generalised epilepsy

A

L: Carbamazepine

G: Valproate

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8
Q

Define stroke and outline the 2 main types

A

Acute neurological deficit lasting more than 24 hours and caused by cerebrovascular aetiology

Ischaemic + haemorrhagic

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9
Q

What are the 2 main aetiologies of ischaemic stroke?

A

Embolic (e.g. carotid artery)

Thrombotic (e.g. atherosclerosis)

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10
Q

Give the 3 types of ischaemic stroke

A

Large vessel
Small vessel
Posterior circulation

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11
Q

Give 2 clinical features of a large vessel stroke

A

Gaze preference (towards size of damage)

Neglect

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12
Q

Give 2 clinical features of posterior circulation stroke

A

Crossed signs

Cranial nerve findings

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13
Q

Give 3 risks of ischaemic stroke

A

HTN
AF
Smoking

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14
Q

What imaging is used is suspected stroke?

A

Non-contrast CT head

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15
Q

Give 3 management options in ischaemic stroke

A
  • tPA within 4.5 hours
  • Dual antiplatelet
  • Mechanical thrombectomy
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16
Q

Give 3 causes of intracranial haemorrhage

A
  • Hypertension
  • Aneurysm
  • AV malformation
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17
Q

How will a patient act if they are suffering from a hypertensive intracranial haemorrhage?

A

Awake and stressed then sudden symptom onset with decompensation

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18
Q

Give 2 symptoms of cerebellar haemorrhage

A

Vomiting

Ataxia

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19
Q

Give 2 clinical features of pontine haemorrhage

A

Pin-point reactive pupils

Abrupt onset coma

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20
Q

Give 3 management options intracranial haemorrhage

A
  • Refer to neurosurgery
  • BP control
  • Anticoagulant reversal
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21
Q

Give 4 clinical features of a subarachnoid haemorrhage

A

Thunderclap headache
Seizure
Loss of consciousness
Visual problems

22
Q

Give 3 features which may be seen on examination in subarachnoid haemorrhage

A

Photophobia
Meningism
Pulmonary oedema

23
Q

What may be seen on LP in subarachnoid haemorrhage?

A

Xanthochromia: yellowing of CSF due to blood breakdown products)

24
Q

Give 2 management options in subarachnoid haemorrhage

A
  • Surgical clipping

- Endovascular e.g. coils

25
Q

Define TIA

A

Transient episode of neurological dysfunction without acute infarction with resolution of signs and symptoms within 24 hours

26
Q

Give 2 management options for TIA

A

Antiplatelet

Statin

27
Q

Define multiple sclerosis

A

Idiopathic inflammatory demyelinating disease of CNS with 2 or more episodes of demyelination disseminated in space and time

28
Q

Give 2 syndromes that can develop as a consequence of MS

A
  • Optic neuritis

- Transverse myelitis

29
Q

Give 3 symptoms of MS

A
  • leg weakness
  • visual loss
  • urinary incontinence
30
Q

Give 2 investigations for MS

A
  • MRI brain and cervical spine with contrast

- LP (oligoclonal bands seen in CSF but not blood)

31
Q

What is a pseudo-relapse of MS?

A

Re-emergence of previous symptoms related to old area of demyelination in context of heat or infection

Can be triggered by temperature rise above 37.5

32
Q

How are relapses of MS treated?

A

IV/oral methylprednisolone

33
Q

Give one cause of each of the following:

a) sudden onset headache
b) hours to days onset
c) 2-10 days onset
d) morning headache

A

a) Subarachnoid
b) Tension headache
c) Cluster headache
d) Intracranial mass

34
Q

Give 4 important things to examine in the investigation of a headache

A
  • BP
  • Palpation (skull, neck, temporal arteries)
  • Eyes (fundi, papilloedema)
  • Facial sensation
35
Q

Using the CSF acronym, who should be imaged when presenting with a headache?

A
  • Change in nature
  • Systemic symptoms or signs
  • Focal neurological deficit
36
Q

Define Parkinson’s disease and it’s pathology

A

Dopaminergic neurons in the substantia nigra of basal ganglia are lost, meaning dopamine cannot be transported for motor movement. Surviving motor neurons contain Lewy bodies (made of alpha synuclein and ubiquitin proteins)

37
Q

What are the 3 cardinal features of Parkinson’s?

A

Resting tremor
Bradykinesia
Rigidity

38
Q

Give 2 investigations of Parkinson’s

A
  • Dopaminergic agent trial

- DAT SPECT scan

39
Q

Give 4 pharmacological management options for Parkinson’s

A
  • L-DOPA + Carbidopa
  • Dopamine agonist
  • MAO-B inhibitor
  • COMT inhibitor
40
Q

Define cervical spondylosis

A

Arthritis of the neck occurring with age, causing discs to shrink and bony spurs to develop

41
Q

Give 3 management options for cervical spondylosis

A

Physiotherapy
Analgesia
Steroid injection

42
Q

Define Myasthenia Gravis

A

AI disease whereby antibodies block acetylcholine receptors at the post-synaptic neuromuscular junction

43
Q

Give 2 symptoms and 1 investigation for myasthenia gravis

A
  • Ptosis
  • Diplopia

Serum ACh Receptor Ab

44
Q

Give 3 management options for Myasthenia Gravis

A
  • Pyridostigmine
  • Immunosuppressant
  • Thymectomy
45
Q

Who is likely to suffer from myasthenia gravis?

A

Women in 20s

Men in 70s

46
Q

Give 2 features of polyneuropathy affecting motor nerves

A

Weakness

Muscle atrophy

47
Q

Give 2 features of polyneuropathy affecting sensory nerves

A

Sensory ataxia

Impaired pin prick

48
Q

Give 2 features of polyneuropathy affecting autonomic nerves

A

Postural hypotension

ED

49
Q

Define peripheral neuropathy

A

Mixed motor and sensory polyneuropathy, starts distally because those are the longest nerves in the body

50
Q

What is Guillain-Barre syndrome and how is it treated?

A

Post-infectious inflammatory demyelinating neuropathy which ascends over days

Tx: IV immunoglobulins

51
Q

Define motor neurone disease and give 2 symptoms

A

Rapidly progressive neurological disease attacking motor neurones

Muscle weakness + aphasia

52
Q

What imaging can be done in motor neurone disease?

A

Brain and spinal cord MRI

4th Year Exam (20 decks)

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