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JL Neurology > Week 4 part 2 > Flashcards

Week 4 part 2 Flashcards

1
Q

What is the commonest extra-axial tumour?

A

Meningioma

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2
Q

What presents with progressive neurological deficit, motor weakness, headache and seizures?

A

Brain tumour

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3
Q

What is a headache due to if its worse in the morning, wakes them up, increases with coughing/leaning forward and decreased with vomiting?

A

ICP

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4
Q

What can be secondary to diplopia (CN VI) and secondary to difficulty focusing?

A

Tumour headache

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5
Q

A tumour where affects perserveration?

A

Frontal lobe

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6
Q

A tumour where affects dyspraxia and neglect?

A

Parietal lobe

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7
Q

How do you investigate bran tumour?

A

CT, MRI LP

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8
Q

What two cells make up neuroepithelial tissue?

A

Astrocytes

Oligodendroglial cells

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9
Q

What do glial tumours arise from?

A

Astrocytes or oligodendrocytes

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10
Q

What grade of astrocytoma is truly benign, slow growing, children young adults, pilocytic astrocytomas and treatment of choice is surgery?

A

grade 1 astrocytomas

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11
Q

What do low grade astrocytomas present with?

A

Seizures

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12
Q

Where do low grade astrocytomas want to occur?

A

IN temporal lobe
Posterior frontal
anterior parietal

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13
Q

What grades are malignant astrocytomas?

A

Grades III - IV

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14
Q

How common is glioblastoma multiforme (malignant)?

A

Most common primary tumour - spreads white matter tracking

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15
Q

Tumours are solid, appear grey/whiteish and subarachnoid accumulations are grossly characterised by surgeons as having toothpaste morphology

A

oligodendroglial tumours

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16
Q

How do you treat oligodendroglial tumours?

A

Chemosensitive - procarbazinr, lomustine, vincristine

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17
Q

Arachnoid cap cells, extraaxial, 20% of intracranial neoplasms, majority asymptomatic ?

A

Meningiomas

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18
Q

What condition has vestibular schwannomas?

A

NF type II

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19
Q

hEARING Loss, tinnitus, dysequilibrium?

A

Acoustic neuromas

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20
Q

What are the red flag s for headaches?

A
  1. New onset over 55 years
  2. Known/previous malignancy
  3. Immunosuppressed
  4. Early morning headache
  5. Exacerbation by valsalva
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21
Q

In the pathophysiology of a migraine what chemical irritates nerves and blood vessels causing pain?

A

Substance P

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22
Q

What do the dorsal raphe nucleus and the locus coeruleus make up?

A

Migraine center

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23
Q

What is more common - migraine with or without aura?

A

Without (flashibg kights, weakness, balance problems)

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24
Q

What abortive drugs can you give for migraines +/- an anti-emetic?

A

Aspirin
Naproxen
Ibuprofen

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25
Q

When should you give triptans fot a migraine?

A

At start of headaceh

26
Q

What kind of relief does frovatriptan give for migraines>

A

SUSTAINED

27
Q

When might you consider prophylactic migraine treatment?

A

If nmroe thanb three attacks per month or very severe consider prophylaxis

28
Q

When beta blockers are given for migraines qwhat do you need to be careful for?

A

Avoid asthma, PVD (heart gfaiure)

29
Q

A carbonic anhydrase inhibityor topiramate can be used for migraine - give some adverse effects?

A
  1. Weight loss
  2. Paraesthesia
  3. Imparied concentration
  4. Enzyme inducer
30
Q

Amitriptyline can be given for migraines - give some adverse effects?

A
  1. Dry mouth
  2. Postural hypotension
  3. Sedation
31
Q

What are the trigeminal autonomic cephalgias (TACs)?

A

A group of primary heache disorders characterised by unilateral trigeminakl distribution pain that occurs in association with prominent ipsilateral cranial autonomic features

32
Q

What are ptosis, miosis, nasal stuffiness, nausea, teareing and eye lid oedema?

A

Ipsilateral cranial autonomic features

33
Q

What are cluster, paroxysmal hemicrania, hemicrania continua and SUNCT?

A

TCA types - trigeminal autonomic cephalgias

34
Q

What kind of age group get cluster headaches?

A

30s and 40s

35
Q

When do people get cluster headaches?

A

Striking circadian (around sleep) nd seasonal variation

36
Q

Severe unilateral headache, duration 45-90 minutes, 1 to 8 a day and cluster bout may last from a few weeks to months?

A

Cluster headache

37
Q

How is cluster headache treated?

A
  1. High flow oxygen
  2. Sub cut sumatriptan
  3. Steroids
  4. Verapamil for prohpylaxis
38
Q

Who gets paroxysmal hemicrania?

A

Elderly 50s and 60s, women more than men

39
Q

Severe unilateral headache, unilateral autonomic features, 10-30 minutes, 1 to 40 a day?

A

Paroxysmal hemicrania (shorter duration and more frequent than cluster)

40
Q

How is paroxysmal hemicrania treated?

A

Absolute response to indomethicin

41
Q

What is short lived, unilateral, neuralgiaform headache, conjunctival injetions and tearing?

A

SUNCT

42
Q

How is SUNCT treated?

A

Lamotrigine

Gabapentin

43
Q

What is done for patients with new onset unilateral cranial autonomic features?

A

MRI brain and MR angiogram

44
Q

Who gets trigeminal neuralgia?

A

Elderly ikder than 60, women more than men

45
Q

What headache s triggered by touch, usuall V2/3?

A

Ttrigeminal neuralgia

46
Q

Severe stabbing unilateral pain, 1 second to 90 seconds, 10 to 100 a day, bouts of pain may last from few weeks to months before remission?

A

Trigeminal neuralgia

47
Q

If a patinet has trigeminal neuralgia and signs of atypical features, poor response to treatment what might yoyu do?

A

MRI

48
Q

How is trigeminal neuralgia trated?

A

Carbamazepine
Gabapentin
Phenytoin
Baclofen

49
Q

Name a trigger for cluster headache?

A

Alcohol (more common in males)

50
Q

Are the majority of adult brain tumours supratentorial or infratentorial?

A

Supratentorial - children infratentorial

51
Q

What brain tumour: pleomorphic tumour cells border necrotic areas?

A

Gliolastoma multiforme - most common primary brain tumour

52
Q

What brain tumour: spindle cells in concentric whorls and calcified psammoma bodies?

A

Meningioma

53
Q

What schwannoma is seen in cerebellopontine angle?

A

Acoutic neuroma

54
Q

What is the most common primary brain tumour in children?

A

Pilocytic astrocytoma

55
Q

What brain tumour: rosenthal fibres (corkscrew eosinophilic bundle)?

A

Piloctic astrocytoma

56
Q

What brain tumour: benign, slow growing common in frontal lobes, calcifications with fried egg appearance?

A

Oligodendroma

57
Q

What are these all patterns of: amyotrophic lateral sclerosis, progressive muscular atrophy and bulbar palsy?

A

MND

58
Q

wHAT IS associated with low levels of orexin (hypocretin), a protein responsivle for appetite and sleep patterns?

A

Narcolepsy

59
Q

Typical onset teenage years, hypersomnolence, cataplexy (sudden loss of muscle tone triggered by emotion), sleep paralysis and vivid hallucinations on going to sleep or waking up?

A

Narcolepsy

60
Q

How do you investigate narcolepsy?

A

Multiple sleep latency EEG

JL Neurology (12 decks)

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