ques Flashcards
differnce in testing for myasthenia gravis and lambert eatonsydnrome
. It also only has a small response to edrophonium and shows areflexia. Myasthenia gravis on the other hand, has a good response to edrophonium, displays fatigability and there are normal reflexes
edrophonium moa
reversible acetylcholinesterase inhibitor, competitive muscarinic antagonist.
most common cuase of encephalitis
herpes simplex
aciclovir
ramsay hunt syndrome tx
Prednisolone and oral acyclovir
spinal ALS stand for
Spinal amyotrophic lateral sclerosis
MND
difference between ALS and MS
This patient has presented with symptoms purely affecting his motor function. Examination findings show a mixture of upper motor neuron signs (hyperreflexia and increased tone) and lower motor neuron signs (fasciculations and muscle atrophy). most common variant of motor neuron disease which presents with a mixture of upper and lower motor neuron signs.
MS is caused by demyelination of the CNS and would present with a mixture of motor and sensory deficits affecting upper motor neurons. As this patient has lower motor neuron signs and no sensory deficit, a diagnosis of multiple sclerosis is unlikely.
types of motor neurone disease
Spinal ALS (the classic MND syndrome)
Bulbar ALS (with early tongue and bulbar involvement)
Progressive muscular atrophy (with only lower motor neuron features)
Primary lateral sclerosis (with only upper motor neuron features).
What is the most appropriate first-line treatment for neuropathic pain?
Gabapentin
This is the correct answer. Gabapentin, Pregabalin, Amitriptyline and Duloxetine are commonly used to treat neuropathic pain
causes of sensory peripheral neuropathy
A helpful mnemonic that some use is ABCDE:
Alcohol
B12/Folate
Chronic Renal Failure
Diabetes Mellitus
Everything Else (!) - Vasculitis and Paraneoplastic
space ocupying lesion sx
Headache may be prominent, which is worse on waking, lying down or coughing/straining, and may be associated with vomiting.
CN palsy - 6 as goes through cavernou ssinus
drwosy seizure
need 2ww
what would herpes simplex virus show on MRI
HSV has a predilection for the temporal lobes and bilateral multifocal haemorrhage is typical.
what can anterior spinal artery infarct cause
As there is a single anterior spinal artery running down the midline of the spinal cord (in the anterior median fissure), blockage causes loss of pain, temperature, motor and autonomic function below that level.
Dorsal column function is preserved.
1st line cluster
High-flow Oxygen
propanolol CI for migraine what use
topiramate
Subacute combined degeneration of the cord caused by
B12 deficency
both the dorsal columns and corticospinal tracts (pain and temperature sensation are typically preserved).
SX of subacute degeneration of cord
Symmetrical distal sensory sx
Begin in feet and spread to hands
ataxia
loss of vibration and proprioception legs
Limb reflexes exaggerated/diminished/absent ( mixed Upper & Lower Motor Neuron signs- can be)
Autonomic bladder or bowel symptoms
presence/absence of haematological manifestations.
Hydroxocobalamin 1 mg IM on alternate days until there is no further improvement then administer hydroxocobalamin 1 mg intramuscularly every 2 months (NICE Guidelines)
prostate cance rand spinal problems what Ix
whole spine MRI
MS eye lesion where
optic nerve
does lambert eaton syndrome improve on repetition
yes
what do high CO2 levels do to the bood vessels
dilate - raised ICP - need to hyperventilate patient
raised ICP
hyperventilate
mannitol
got a haemorrhagic stroke on dabigatran what do you do
Give idarucizumab - reversal agent
most common visual defect in optic neuritis
Central scotoma
Thiamine deficiency most commonly occurs in alcohol abuse, but is also be seen in
malnutrition, bariatric surgery, and hyperemesis gravidarum
described raised ICP
This is not the correct answer. Headaches secondary to raised intracranial pressure would usually be persistent rather than episodic, worse in the mornings and alleviated by vomiting, and associated with neurological deficits depending on the site of the pathology
