neurology Medicine Flashcards
What happened here?
What do the scan show
sudden onset, transient? (distinguish from stroke)
negative phenomena? (distinguish from Migraine)
- subdural haematoma
- space occupying lesion
What are important questions for TIA
sudden onset, transient? (distinguish from stroke)
negative phenomena? (distinguish from Migraine)
What are vascular risk factors can be modified for TIA?
smoking
hypertension
hyperlipaediamia
diabetes
carotid stenosis
weight
hypertension
What is the main investigation for a TIA
MRI
What are the causes of TIA?
How would your therapy change?
- Athrosclerosis (WHite clot) - treat with antiplatelet
- carotid artery stenosis - carotid endarterectomy
- check this with MRA and Doppler OR CTA of Neck
- Cardio embolic - red clot - anti coagulant
- AF - CHA2DS2- VASc- do an ECG
When would you do a carotidendarterectomy?
if you have stenosis is symptomatic and significant on that area
reduce the risk of future strokes
Summarise the management of TIA?
Patient with right homonymus hemianopia
Where is the lesion?
left occipital lobe problem
What are signs to lookout for with diplopia? when lookingat them
disalignment in their gaze
pupil asymerty, ptosis or nystagmus
fatiguability (during H test)
any other neurological finding
person with fully shut left eye and myosis
What is it?
Why explain
left surgical oculomotor nerve palsy
What is this condition
Horner syndrome
partial ptosis
mildy constricted pupil
anhydrosis
DIFFERENTIATE TO third nerve palsy
-> partial ptosis NOT FULL
fatiguable eyelid when getting her to keep looking up?
get diplopia everytime she she does something and rests and the diploplia goes away
At what level is the lesion
What other symptoms would they get
Neuromuscular junction
What are te tests that you do for myesthenia gravis
nerve condiction studies
Antibody testing antibody tsting (ACHR and Msk)
What is lambert eaton disease?
para neoplastic
better with movement
What are causes of facial weakness?
Varicella zoster