Q2 Flashcards
ant cerebral artery leads to what
frontal lobe
contralateral loss in foot and leg
paresis of arm and foot, relative sparing of thigh and face
middle cerebral artery
hemiparesis, hemisensory loss, aphasia/dysphasia, apraxia
ABCD2 score
- Age >=60 (1)
- BP >=140/90 (1)
- Clinical features unilateral weakness (2), speech disturbance without any weakness (1)
- Duration of symptoms >=60mins (2) 10-59 mins (1)
- hx of DM (1)
4 or above 300mg aspirin daily
GCS
motor:
- obeys commands (6)
- localises to pain (5)
- withdraws from pain (4)
- abnormal flexion to pain (3)
- extending to pain (2)
- none (1)
verbal response:
- orientated (5)
- confused (4)
- words (3)
- sounds (2)
- none (1)
Eye opening:
- spontaneous (4)
- to speech (3)
- to pain (2)
- none (1)
extradural haemoatoma
injury
subdural haemoatoma
old age
alcohol
anti coag
SAH
aneurysm
acute cluster
prophylaxis
100% o2, subcut/nasal triptan
verapamil, pred
new seizures
established seizure
stroke/TIA
multiple TIAs over a short period of time
6m no driving after assessment
1 yr seizure free
1m
3m
TACl
unilateral hemiparesis and/or hemisensory loss of the face, arm, leg
HH
higher cognitive impairment
middle and anterior cerebral arteries
PACl
2 of:
unilateral hemiparesis and/or hemisensory loss of the face, arm, leg
HH
higher cognitive impairment
lacunar LACl
unilateral weakness and/- sensory loss
pure sensory stroke
ataxic hemiparesis
POCl
cerebellar or brainstem syndrome
loss of consciousness
isolated HH
Lambart eaton synd ABs against what
symp
assoc with what
ABs again pre synap calcium gated channels in NMJ
prox arms and legs weakness temporarily relieved after exertion or physical exercise
small proportion associated with small cell lung cancer
contra indications to triptans
history or significant risk factors for ischaemic heart disease or cerebra vascular disease
anterior cerebral artery
contra lateral hemiparesis and sensory loss
lower extremity >lower extremity
middle cerebellar artery
contra lateral hemiparesis and sensory loss
upper extremity >lower
contra lateral HH
aphasia
posteriori cerebellar artery
contralateral HH with macula sparing
visual agnosia
high stepping gait
foot drop
vit B12 defic
sensory loss
LMN facial
UMN facial
all facial muscles
spares forehead
ischaemic stroke secondary care
clopidegrol and statin
aspirin and dipyridamole if clopidegrol contra indicated or not well tolerated
sodium valproate SE
weight gain nausea alopecia - hair grows back curly ataxia tremor hep pancreatitis thrombocytopenia teratogenic hyponatraemia
prophylaxis of migraines
propanolol or topirmate
3rd line gabapentin
menstrual migraines proph
frovatriptan 2.5mg twice daily
zolmitriptan 2.5 mg three times or twice daily
migraines during pregnancy
1g paracetomaol first line
2nd line in first and second trim -aspirin 300mg or iboburfen 400mg can be used
adverse effects of levodopa
dyskinesia on off effect [pstural hypotension cardiac arrhythmias N+V psychosis reddish discolouration of urine on standing
AML
LMN in arms and UMN in legs
primary lateral sclerosis
UMN signs only
progressive muscular atrophy
LMN signs only
affects distal muscles before prox
best prognosis
progressive bulbar palsy
palsy of tongue, muscles of chewing/swallowing and facial muscles due to loss of function of brainstem motor uncle
worst prognosis
children and migraines
shorter
bilateral
GI disturbance more predom
intracranial idiopathic hypertension
blurry vision
female
obese
headache
most common type of MS
relapsing remitting
cylizine and prochlorperazine
exacerbate parkinsons disease
neuropathic pain
1 - amitryptalline, duloxetina, gabapentin, pregablin
2 - tramadol (exacerbations of neuropathic pain), topical capsain (localised neuro pain)
trigmenal neuralgia
carbamazapine
osteomyelitis ix
MRI
tuberous sclerosis
shagreen patch - roughened skin
epilepsy common
balls pals rx
pred for 10d
eye care - lubricants, artificial tears
SAH LP
post 12 hours
SE of triptans
tingling, heat, tightness (chest and throat), heaviness and pressure
px with LBD are extremely sensitive to
neuroepileptic patients
most common cause of head tremor
ET
GBC commonly linked to
campylobacter jejuni
treatment prakisnos tremor
procydlidine
SORL1 protein
sporadic form of dementia
alzheimers
mutations in amyloid precursor protein leading to A beta
wilson ix
24 h urine collection
subdural haematoma
elderly and on anti coag
fall, urinary incontinance
balls palsy
loss of lacrimation
TIA
should resolve within 24 h
usually resolves within 1h
all patients with stroke should have
CT/MRI preferably within 24 hours
ECG
<60 and ischaemic stroke
thrombophilia screen and autoantibodies and anti cardiolupin
Erbs palsy
commonly cause by shoulder dystocia
C5-C6
familial hemiplegic migraine
assoc with transient motor deficit
wernickes encephalopathy
defic of B1
sarcoid
ACE
calcium high
phenytoin toxicity
present as cerebellar syndrome
sodium valproate SE
nausea, drowsiness and tremor at toxic levels
carbamazepine
aplastic anaemia and agranulocytosis - rare
resting pin rolling tremor
parkinsons
normal BG is
5.5
extradural haeatoma
deterioration in approx 4-6 hours
bulbar palsy
lmn
psueodobulbar palsy
umn
