Neurology/surgery Flashcards
suspected SAH but CT is normal, do what?
LP 12 hours following onset of symptoms
signs of SAH on LP?
Xanthochromia (red cell breakdown)
Raised opening pressure
how are most aneurysmal SAH treated?
Aneurysm coiling
ptosis and/or fixed, dilated pupil may result from a lesion in what cranial nerve?
CN III
acute management of migraine?
Oral triptan (5ht Agonists) and NSAID
OR
Oral triptan and paracetamol
prophylaxis of migraine?
2 or more attacks per month
Topiramate (teratogenic) or Propranolol
first line drug for generalised seizures?
sodium valproate
- teratogenic
- P450 enzyme inhibitor (WATCH warfarin, antidepressants, statins)
first line focal/partial seizures?
carbamazepine
how long must you be seizure free to drive?
How long should established epilitptics be seizure free?
6 months
12 months
key feature of extrudural bleed?
lucid interval
Dermatomes? Index/thumb Nipples Umbilicus Inguinal Ligament Knee Big toes Small toe (lateral foot)
C6 (bring index to thumb to make a 6) T4 T10 L1gament L4 (down on all fours) L5 S1
subacute combined degenration of the spinal cord cause + presentation?
Vit B12 deficiency
Bilateral spastic paresis, loss of proprioception and vibration sensation, limb ataxia
parkinson drug which has reduced effectiveness over time?
Levodopa (honeymoon)
management of myaesthenia gravis?
long acting cholinesterase inhibitors e.g. PYRIDOSTIGMINE
Immunosuppression e.g. PREDNISOLONE
Recommended STRoke secondary prevention?
Clopidogrel (2nd line aspirin)
cluster headache presentation and common trigger?
Red eye, pain behind eye, lacrimation or nasal
Alcohol
Palsy affecting brachial trunk C5-6?
affecting C8-T1?
Erb’s Palsy
Klumpke’s palsy (involvement of T1 may cause Horner’s syndrome)
Reflexes nerves:
Ankle
Knee
Biceps
Triceps
S1-S2
L3-L4
C5-C6
C7-C8
acute treatment for Wernicke’s encepaholpathy and features
Thiamine (pabrinex)
Confusion, Ataxia, Nystagmus, Peripheral Neuropathy
jacksonian movement indicates what type of seizure?
Frontal Lobe seizure
GCS Motor?
6 obeys commands 5 localise to pain 4 withdraws from pain 3 flexion to pain 2 extending to pain 1 none
GCS Verbal?
5 orientated 4 confused 3 words 2 sounds 1 none
GCS Eyes?
4 spontaneous
3 to speech
2 to pain
1 none
when should stroke thrombolysis be considered?
<4.5 hours
