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Take 2: Electric Boogaloo > Revision notes > Flashcards

Revision notes Flashcards

1
Q

Causes of hyPERcalcaemia

A
  • Primary hyperparathyroidism
  • Malignancy
    • SQUAMOUS CELL LUNG CANCER
      • releases Parathyroid Hormone-related Protein (PTH-rP) - paraneoplastic syndrome
    • MYELOMA (releases cytokines -> increased osteoclastic resorption)
    • Bone METASTESES
  • SARCOIDOSIS (granulomatous disease)
  • Addison’s disease
  • Thiazides
  • THYROTOXICOSIS
  • Vitamin D intoxication
  • Acromegaly
  • DEHYDRATION
  • Milk-alkali syndrome
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2
Q

Px of subdural haemorrhage

A
  • Acute = Sx within 48 hours of injury - rapid neurological deterioration
  • Subacute = over days / weeks
  • Chronic = over weeks to months (esp in elderly - may not remember specific trauma)

Typical Hx:

  • Head trauma
  • Lucid interval
  • Gradual decline in consciousness / cognition (esp in chronic SDH)

Oft also, unilateral headache, confusion + lethargy

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3
Q

Which groups of people are particularly at risk of subdural haematomas

A

Elderly and Alcoholic
- they have brain atrophy -> more fragile / taut bridging veins

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4
Q

Acute vs chronic subdural haematomas on CT

A
  • Acute = hyperdense
  • Chronic = hypOdense
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5
Q

Parietal lobe lesion Px

A
  • Sensory inattention
  • Apraxia
  • Astereognosis (tactile agnosia)
  • Inferior homonymous quadrantinopia (if optic radiations affected)
  • Grestmann’s syndrome (if dominant parietal lobe affected):
    • Alexia (can’t comprehend written language)
    • Acalculia
    • Finger agnosia
    • Right-left disorientation
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6
Q

Occipital lobe lesion Px

A
  • Cortical blindness
  • Visual agnosia
  • Homonymous hemianopia (oft with macula sparing)
    • spacifically from posterior cerebral artery strokes
    • The macula is usually spared because the occipital pole (which is where the info from macula is processed) is usually supplied by the middle cerebral artery (tho not always)
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7
Q

Temporal lobe lesion Px

A
  • Wernike’s aphasia
  • Superior homonymous hemianopia (if optic radiations affected)
  • Auditory agnosia
  • Prosopagnosia (difficulty recognising faces)
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8
Q

Frontal lobe lesion Px

A
  • Expressive dysphasia (Broca’s)
  • Disinhibition
  • Perseveration
  • Anosmia
  • Inability to generate lists
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9
Q

Which area of the brain in particular is associated with Wernicke Korsakoff

A

Medial thalamus + mammillary bodies (in hypothalamus)

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10
Q

Posterior cerebral artery stroke Px

A
  • Contralateral homonymous hemianopia with macular sparing
  • Visual agnosia

(baso just the occipital cortex)

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11
Q

Middle cerebral artery stroke Px

A
  • Contralateral hemiparesis and sensory loss, upper extremity > lower
  • Contralateral homonymous hemianopia
  • Aphasia
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12
Q

Anterior cerebral artery stroke

A

Contralateral hemiparesis and sensory loss, lower extremity > upper

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13
Q

Ipsilateral CN III palsy + Contralateral weakness of upper and lower extremity

A

Weber’s syndrome (branches of the posterior cerebral artery that supply the midbrain)

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14
Q

Posterior inferior cerebellar artery stroke

A
  • Ipsilateral: facial pain and temperature loss
  • Contralateral: limb/torso pain and temperature loss
  • Ataxia,
  • nystagmus
  • Sudden onset vertigo + vomiting
  • Dysphagia

(AKA lateral medullary syndrome + Wallenberg syndrome)

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15
Q

Anterior inferior cerebellar artery

A
  • Ipsilateral: facial paralysis and deafness
    +/- Contralateral: limb/torso pain and temperature loss
  • Ataxia, nystagmus
    • oft associated sudden onsent vertigo + vomiting

(AKA lateral pontine syndrome)

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16
Q

Common sites of lacunar strokes

A
  • Basal ganglia
  • Thalamus
  • Internal capsule
17
Q

What pathology is often associated with temporal lobe epilepsy

A

Sclerosis of hippocampus

18
Q

What is Jacksonian march

A

A type of focal epileptic seizure - typically related to lesions of the frontal lobe

Starts with tingling / twitching in small area (Finger, Big toe, Corner of mouth) then spreads (whole hand, foot, face etc)

Also oft associated with:

  • Automatisms (licking lips, rhythmic hand movements, touching clothes)
  • Head turning
  • Eye movement
  • MUSCLE CRAMPING
  • Numbness
  • HALLUCINATIONS
  • Drooling

Some link to MS

19
Q

The typical presentations of common MND types

A

Amyotrophic Lateral sclerosis (50% of pts)

  • typically more UMN signs in legs and more LMN signs in upper body

Primary lateral sclerosis = UMN signs only

Progressive muscular atrophy (has best prognosis)

  • LMN signs only
  • But characteristically affects DISTALLY before proximally (usually opposite in myopathies)

Progressive bulbar palsey (worst prognosis)

  • palsey of tongue, muscles of mastication + swallowing + facial muscles (from loss of function of BRAINSTEM NUCLEI)
  • oft presents as part of ALS
20
Q

ALS Px

A
21
Q

Thoracic outlet syndrome

A

A combination of 3 related syndromes caused by compression of any of the 3 key structures in the thoracic outlet (area between neck + shoulder):

  • Brachial plexus (most common)
  • Subclavian artery (least common - aneurysm)
  • Subclavian vein (blood clot risk)
22
Q

Causes of thoracic outlet syndrome

A
  • Trauma (e.g. car accident)
  • Repetitive injuries from sport / job
  • Pregnancy
  • Differences in anatomy (e.g. extra rib)
  • Poor posture
  • Idiopathic
23
Q

Thoracic outlet syndrome Px

A

Neurogenic:

  • Pain
  • Paresthesia
  • Arm fatiguing with activity
  • Weakening grip

Venous:

  • Change in colour (starts with extremities)
  • Hand/arm swelling + pain

Arterial:

  • Pulsating lump near collar bone
  • Cold arm (starting from extremities)
  • Hand / arm PAIN
  • Colour change
24
Q

RFx + Prevention of thoracic outlet syndrome

A

RFx = Female sex + age 20-50 (most common)

  • Avoid repetitive movements
  • Losing weight if overweight
  • Avoid carrying heavy weight (e.g. bags) over shoulder
  • Daily stretches / exercise
25
Q

What is the most common cause of intracerebral haemorrhage

A

Hypertension

26
Q

What is the most common site of microaneurysms in the brain and what are the aneurysms called

A
  • Leticulostriatal arteries (small penetrating blood vessels)
  • Chracot bouchard aneurysms
27
Q

Features of unsafe swallow + Mx

A

Any of the following upon drinking water in upright position:

  • Drooling
  • Dysphonia / ‘wet’ voice
  • > 2 seconds to initiate swallow
  • Coughing during / within 1 min of swallowing

Need to make NIL by mouth + need urgent SALT review

28
Q
A

Take 2: Electric Boogaloo (20 decks)

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