Pass Med Q's Flashcards
what is neuroleptic malignant syndrome
rare but dangerous condition seen in patients taking antipsycotic medication
presentation of neuroleptic malignant syndrome
pyrexia muscle rigidity HTN, tachycardia, tachypnoea delirium / agitation / confusion - symptoms begin within hours to days of starting the medication
what is raised in neuroleptic malignant syndrome
CK + leucocytosis
what can occur as a consequence of neuroleptic malignant syndrome
AKI secondary to rhabdomyolysis
acute management of cluster headache
SC Sumatriptan + oxygen
prophylaxis for cluster headache
verapamil
which anti-epileptics can cause Steven Johnston syndrome
lamotrigine
carbamazepine
how long do you have to be seizure free to consider stopping anti-epileptic drugs?
seizure free for 2 years
- stop drugs over 2-3 month period
what can a tentorial / uncle herniated cause
CN III palsy
- fixed dilated pupil, eye is down + out
how long must you stop driving for following a TIA
1 month
how long must you stop driving for after 1st unprovoked seizure
6 months
bitemporal hemianopia with predominantly lower quadrants affected is caused by what?
craniopharyngioma
nerve roots for knee reflex
L3 - L4
nerve roots for ankle reflex
S1 - S2
nerve roots for biceps reflex
C5 - C6
nerve roots for triceps reflex
C7 - C8
5 headache red flags that warrant imaging
- vomiting more than once with no other cause
- new motor or sensory defecit
- decreased conscious level
- headache assoc. with caughing/ sneezing
- progressive headache + fever
what is Wernicke’s aphasia
receptive aphasia
- patients can produce fluent speech but sentences don’t make sense
- comprehension impaired
where is the lesion in Wernickes aphasia
superior temporal gyrus
what is Brocas aphasia
expressive aphasia
- speech is non-fluent, laboured, halted
- comprehension normal
where is the lesion in Brocas aphasia
inferior frontal gyrus
gold standard test for venous sinus thrombosis
MR venogram
what condition is suggested by a positive Hoffmans sign
degenerative cervical myelopathy
most common complication following meningitis
sensorineural hearing loss
what blood test can be used to differentiate between a seizure and pseudo seizure
prolactin
- prolactin with be raised following a seizure
what diagnosis should be suspected in patient with unilateral hearing loss, balance problems and reduced facial sensation
acoustic neuroma (vestibular shwannoma)
what reflex can be lost in an acoustic neuroma
corneal reflex
Investigation of acoustic neuroma
MRI + audiogram
medications post ishcaemic stroke
aspirin 300mg for 2 weeks then clopidogrel 75 mg daily long term
first line treatment of trigeminal neuralgia
carbamazepine
triad of symptoms wernicke’s encephalopathy
confusion, ataxia, opthalmoplegia
treatment of wernicke’s ecephalopathy
Pabrinex
hallucinations, lip smacking, plucking at clothes, deja vu are symptoms of a seizure in what part of the brain?
temporal lobe seizure
what are seizures in the parietal lobe associated with?
sensory abnormalities
dermatome corresponding to
- thumb
- middle finger
- little finger
thumb = C6
middle finger = C7
little finer = C8
what is a Arnold-Chiari malformation
downward displacement / herniation of cerebellar tonsils through foramen magnum
what condition can an Arnold-Chiari malformation cause?
how does this present?
syringomyelia
- cape like loss of pain + temperature sensation (spinothalamic tract)
tx of tremor in drug induced parkinsons
procyclidine
patient with left inferior homonymous hemianopia
where is the lesion?
right parietal lobe
isolated rise of protein in CSF on LP indicates what
Guillian Barre
what veins are damaged in a sub-dural haemorrhage
bridging veins between cortex and venous sinuses
most common psychiatric problem in parkinsons disease
depression
which nerve is affected in a RAPD
optic nerve
- affected eye will not constrict when light is shone directly in that eye
- affected eye will constrict when light is shown in the other eye (consensual response)
who typically gets idiopathic intracranial hypertension
young, overweight females
features of idiopathic intracranial hypertension
headaches
blurred vision
papillodema
high opening pressure on LP
what shoulder movement is most affected in adhesive capsulitis
external rotation
what is Kernig’s sign
painful knee extension from position of hip + knee flexion
- suggests meningeal irritation e.g. meningitis, SAH
occlusion of which artery causes complete aphasia
middle cerebral in the DOMINANT hemisphere
e.g left middle cerebral as most people are right side dominant
what condition needs to be excluded in a painful third nerve palsy
posterior communicating artery aneurysm
what can trigger cluster headaches
alcohol
