1.2. Neurology Flashcards by Rodrigo Aralios

How to differentiate the types of dementias?

Vascular: step ladder. Alzheimer: disorientation.
Lewy: visual hallucination.
Picks: 50-60yo, behaviour, rigidity, apraxia.

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How to make the diagnosis of Lewy bodies dementia?

Dopamine transporter uptake scan (DatSCAN) / Single photon emission computed tomography (SPECT) of the basal ganglia

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What are the cognition assessment tools for A&E snd GPs?

6CIT: 6-item Cognitive Impairment Test
GPCOG: GP Assessment Cognition

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What are the cognition assessment tools for secondary care?

MMSE: Mini-Mental State Exam
MoCA: Montreal Cognitive Assessment (more sensitive, good for early stages)
ACE: Addenbrook’s Cognitive Exam (longest and most comprehensive, good for frontotemporal)

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What are the differences between Broca’s and Werneckie’s aphasia?

Broca: frontal lobe, aware of defficiency, non fluent.
Wernickie: temporal lobe, unaware of defficiency, fluent.

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What are the main symptoms of Lewy Body Dementia?

Fluctiation of cognition
DAT Scan (Dopamine Transporter Scan) reduced dopamine uptake

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What are the main symptoms of Picks Disease (FTD)?

Disinhibition, Executive disfunction, Anomia

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What are the main treatments of Picks Disease (FTD)?

IRSS, Antipsychotics, Anticholinesterasics

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What is a reflex anoxic seizure?

• 6m-2yo
• Trigger event > Anoxic + Vagal reflex > Asystoly > Syncope +Stiffness
• No tongue biting!

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What is the treatment for absence seizures?

Ethosuximide or Valproate.

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What is the treatment in a first episode of epilepsy?

Refere to first-fit-clinic.
Advise not to drive until seen.

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What is the first choice of antibiotics for Listeria meningitis?

Ampicilin 2g 4/4h + Gentamicin 5mg/kg 8/8h.

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When should be ordered a lumbar puncture for patients with headache?

When you suspect SAH or meningeal signs, after 12h of onset, if CT normal.
SAH: Nimodipine.

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What are the preventive medications for migraines?

Propranolol, Candesartan, Amitriptiline, Pregabalin, Topiramate (not for woman).

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How is the manegement of Psychosis in Parkinson?

1st: reduce drug (balance sane/stiff x mad/mobile). 2nd: clozapine or quetiapine.

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What are the diagnostic criteria for Multiple Sclerosis?

McDonald Criteria: Clinic + MRI + CSF (Oligoclonal bands)

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What are the main symptoms of Multiple Sclerosis?

Relapsing Remitting ME (85%)
Lhermittes phenomena
Any neurological symptom

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What are the McDonald Criteria?

History | =+ MRI gadolinium: Demyelination disseminated in time and space. | =+- CSF: Oligoclonal bands. |

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What are the pre motor symptoms of Parkinson Disease?

Anosmia, REM sleep disturbances

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What bacterial infections has higher risk of Guillain-Barré Syndrome?

Campulobacter jejuni, Mycoplasma.

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What is Lhermittes phenomena?

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Shocks in the limbs.

What is the acute treatment for MS flare?

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Methylprednisolone.

What is the Hoover Sign?

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Functional Limb Weakness.
Bad leg pushes down when raising good leg.

What are the main subjects in neurology?

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ABCDE: AVE, B, Cefaleias, Demencial, Epilepsy

What are the neurologic manifestations of Paraneoplastic Syndrome?

Autoimmune autonomic neuropathy: urinary retention, postural hypotension, diminished reflexes sluggish pupillary reaction.

What are the symptoms of syringomyelia?

Cape-like loss of pain & temperature Upper limb pain worse on coughing Muscle wasting from hands to shoulder Paraparesis

What explains an Autonomic Neuropathy in cancer patients?

Paraneoplastic Syndrome.

What is the treatment for Bell's palsy?

Prednisolone 40-60mg x10d Artificial tears Wear an eye patch at night Sun glasses to protect the eye

What is the treatment for metocloprimide neurologic reaction?

Procyclidine.

In intracerebral haemorrhage, when and how should blood pressure be controlled?

If systolic between 150-220: Labetalol.

What are the aims for secondary prevention after a TIA?

After 48h, BP<130x80. Atorvastatin, Non-HDL<-40%. If no AF: Clopidogrel 75mg (or AAS 75mg + Dipyridamole 200mg 2xd); If AF: DOAC (or Warfarin, INR 2-3). If stenosis male>=50% female>=70% endarterectomy.

What are the symptoms of Anterior Cerebral Artery occlusion?

Urinary incontinence Psychiatric symptoms Contralateral lower (+/-upper) limbs

What are the symptoms of Internal Carotid Artery occlusion?

≈MCA +Others

What are the symptoms of Middle Cerebral Artery occlusion ?

Contralateral limbs Contralateral hemologous hemianopsia Aphasia of expression (if left side)

What are the symptoms of Posterior Cerebral Artery occlusion?

Contralateral hemologous hemianopsia

What exam to request in suspected TIA?

Catotid Duplex, OR CT Angiogram of Supra Aortic Arteries (Not head CT!) If stenosis >50% men or 70% women, endarterectomy within 2 weeks from admission.

What exam to request in TIA?

CT angiography of the carotid vessels OR Carotid artery doppler ultrasound. (Do not request non-contrast head CT).

What is "word salad"?

Uncommon symptom of migraines, difficulty to choose right words in a sentence.

What is the current recommendation for secondary prevention after a ischemic stroke?

First 2 weeks: AAS 300mg. After 2 weeks: AAS 75mg OR clopidogrel 75mg.

What is the discharge medication for subarachnoidal haemorrhage?

Nimodipine 60mg 4xd x21d. CHECK SLIDES

When the DVLA needs to be notified after a TIA?

Group 2. Group 1 only if multiple TIAs.

Where is the damage in hemineglect syndrome?

Parietal lobe

How is the Bamford Stroke Classification?

CHECK SLIDES

What are the cerebellar signs?

(DANISH) Disdiadochokinesia, Ataxia, Nystagmus (ipsilateral), Intention tremor, Staccato speach, Hypotonia

What are the main treatments for Multiple Sclerosis?

Methylprednisolone

What is Hoovers sign?

Lift good leg, bad leg pushes the bed. Functional leg weakness.

What are the initial investigation in blackouts?

Lying and standing blood pressure ECG

What are the criteria for head CT in children head trauma?

MAJOR (If 1, CT) • Seizures or Focal signs • Fractures suspected • GCS<14 arrival or GCS<15 after 2h MINOR (if 2, CT) • 5 minutes loss of consciousness • 5 minutes amnesia • 3 episodes of vomiting • 3 meters high falls • 1 highroad accident • 1 dowsiness

What are the indications for CT after head trauma in the first 1 hour?

WITHIN 1 HOUR. (Look for evidence of fractures or intracranial hypertension/bleeding) GCS: <13 at 0h or <15 in 2h. Scalp: Depressive/open fracture. Nose: Leakage of CSF. Eye: Raccoon's. Pupils. Ear: Haemotympanus. Battle's. Mouth: Vomiting >1x. Spine: Seizures. Deficits.

What are the indications for CT after head trauma in the first 8 hours?

WITHIN 8 HOURS (ABCDEF): Retrograde Amnésia of >30' Bleeding disorder Conscience loss Drug for anticoagulation Elder >65yo Fall >1m or 5 stairs

What are the symptoms of post-traumatic organic brain injury?

Amnesia Agitation/Irritation Confusion

1.2. Neurology Flashcards

(51 cards)