Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Alice's finals cards > Neurology > Flashcards

Neurology Flashcards

1
Q

What is crescendo TIA?

A

2+ TIAs in a week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the clinical scoring tool for stroke?

A

ROSIER. Anything above 0= likely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What dose is the stat dose of aspirin in stroke?

A

300mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the treatment window for thrombolysis in stroke?

A

4.5 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the secondary prevention of stroke?

A

Clopidogrel 75mg OD and Atorvastatin 80mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is GCS calculated

A

E4V5M6

Eyes:
Spontaneous=4
Speech=3
Pain=2
None=1

Verbal:
Orientated=5
Confused=4
Inappropriate words=3
Incomprehensible=2
None=1

Motor:
Obeys commands=6
Localises pain=5
Withdraws from pain=4
Abnormal flexion=3
Extends=2
None=1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the lowest possible GCS?

A

3/15

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the features of a subdural haemorrhage?

A

Caused by bridging veins
CT scan shows crescent shape
Not limited by cranial sutures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the features of a extradural haemorrhage?

A

Usually caused by rupture of the middle meningeal artery
Bi-convex shape
Limited by cranial sutures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What causes are subarachnoid haemorrhages particularly associated with?

A

Cocaine and sickle cell anaemia

(also strenuous activity such as weight lifting and sex)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What causes MS?

A

Inflammatory process activating the immune cells against myelin - results in demylination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which cells are attacked in MS?

A

Oligodendrocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the diganostic criteria for MS

A

Disseminated in SPACE and TIME

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the most common presentation of MS?

A

Optic neuritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the features of a 6th cranial nerve palsy?

A

Palsy results in defective abduction → horizontal diplopia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is Lhermitte’s sign?

A

Electric shock sensation that travels down the spine and into limbs when flexing the neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the two types of ataxia which can be seen in MS?

A

Sensory and cerebellar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the 3 patterns of progression in MS?

A

Relapsing-Remitting
Primary Progressive
Secondary progressive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How is MS diagnosed?

A

MRI
Lumbar puncture- oligoclonal bands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the key features of optic neuritis

A

Central scotoma (central blind spot)
Pain
Impaired colour vision
Relative afferent pupillary defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How can MS be managed?

A

DMARDs and biologic therapy (natalizumab or ocrelizumab)

Methylprednisolone for relapses (500mg orally daily)

Symptomatic treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is progressive bulbar palsy?

A

Second most common form of motor neurone disease which affects the muscles of talking and swallowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is affected in MND?

A

There is progressive upper and lower motor neurone degeneration. Sensory neurones are spared

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the signs of lower motor neurone disease?

A

Muscle wasting
Reduced tone
Fasciculations
Reduced reflexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the signs of upper motor neurone disease?

A

Increased tone or spasticity
Brisk reflexes
Upgoing plantar responses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the management of MND?

A

Riluzole can slow the progression (prevents stimulation of glutamate receptors)
Non-invasive ventilation
End of life care planning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the triad of parkinson’s disease?

A

Resting tremor
Rigidity
Bradykinesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What type of tremor is found in parkinson’s?

A

“pill-rolling tremor”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Name 4 parkinson’s plus syndromes?

A

multisystem atrophy
Dementia with Lewy Bodies
Progressive supranuclear palsy
Corticobasal degeneration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the management of parkinsons?

A

Levodopa +carbidopa (can be given as combination drugs co-benyldopa/ co-careldopa)

COMT inhibitors (entacapone)

Dopamine agonists (Cabergoline/Ropinirole)

MAO-B inhibitors (selegiline)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the main side effect of levodopa?

A

Dyskinesias (excessive motor activity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is a notable side effect of dopamine agonists? give an example of this drug.

A

Cabergoline

Pulmonary fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the pathopysiology of Parkinson’s

A

Reduced dopamine in the basal ganglia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the features of a benign tremor?

A

Fine
Symmetrical
More prominent on voluntary movement
Worse when tired, stress, caffeine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the management of benign tremor?

A

Propanolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What investigations should be done in epilepsy?

A

EEG
MRI brain
ECG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Whats the first line and second line management of tonic-clonic seizures?

A

1st= sodium valporate
2nd lamotrigine or cabamazipine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Where do focal seizures start?

A

temporal lobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Whats the first line and second line management of focal seizures?

A

1st= cabamazipine or lamotrigine
2nd= sodium valporate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Whats the management of juvenile myoclonic epilepsy?

A

Sodium valporate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is West syndrome?

A

Infantile spasms. Starts at around 6 months and is characterised by full body spasms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

How is West syndrome managed?

A

Prednisolone

43
Q

What are the notable side effects of sodium valporate?

A

Teratogenic
Liver damage
Hair loss
Tremor

44
Q

What are the notable side effects of carbamazapine?

A

Agranulocytosis
Aplastic anaemia

45
Q

What are the notable side effects of phenytoin?

A

Folate and vitamin D deficiency
Megablastic anaemia
Osteomalacia
gum bleeding

46
Q

What are the notable side effects of lamotrigine?

A

Stevens- johnson syndrome
Leukopenia

47
Q

How is status epilepticus defined?

A

seizures lasting more than 5 mins or more than 3 seizures in an hour

48
Q

How should status epilepticus be managed?

A

ABCDE

After 10 mins, 4mg IV lorazepam, 10mg diazepam PR

IV phenytoin 20mg/kg if not working after 2 repeats

49
Q

What are the 4 first line treatments for neuropathic pain?

A

Amitriptyline
Duloxetine (SNRI)
Gabapentin
Pregabalin (both anticonvulsants)

50
Q

What are the features of complex regional pain syndrome?

A

Neuropathic pain
Skin flushing
Colour change
Temperature change
Abnormal sweating
Abnormal hair growth
Swelling

51
Q

How does facial nerve palsy usually present?

A

Unilateral facial weakness

52
Q

What is the cause of an upper motor neurone facial palsy?

A

Stroke or tumour

53
Q

How do you differentiate between an upper and lower motor neurone facial nerve palsy?

A

Upper= can move forehead. It is spared
Lower= cannot move forehead, cant blink

54
Q

How long can recovery from Bell’s palsy take?

A

12 months

55
Q

How is bell’s palsy managed?

A

Prednisolone (50mg for 10 days, 60mg for 5 days, 5 days of reducing)

Lubricating eyedrops

56
Q

Which virus causes Ramsey Hunt sydrome, and what is it?

A

Varicella zoster virus - causes facial nerve palsy

57
Q

How does Ramsey Hunt syndrome present?

A

Unilater lower motor neurone facial palsy with painful vesicles behind the ear

58
Q

What is the key finding on fundoscopy in brain tumours?

A

Papilloedema

59
Q

What are headache red flags?

A

Constant
Nocturnal
Worse on wakening
Worse on coughing, straining or bending forward
Vomiting

60
Q

Name 4 cancers which commonly metastasise to the brain

A

Lung
Breast
Renal cell carcinoma
Melanoma

61
Q

What visual field defect do pituitary tumours cause and why?

A

Bitemporal hemianopia because they press on the optic chiasm

62
Q

Where do acoustic neuromas usually occur?

A

Cerebellopontine angle

63
Q

Which condition are bilateral acoustic neuromas associated with?

A

Neurofibromatosis type 2

64
Q

Which drug can be used to block prolactin secreting tumors?

A

Bromocriptine (dopamine agonist)

65
Q

What is the genetic mutations which causes huntington’s chorea?

A

Tricnucleotide repeat (repeated expansion of CAG) in the HTT gene on chromosome 4

66
Q

What is genetic anticipation?

A

This is diplayed in Huntington’s. Successive generations have more repeats in the gene which results in earlier age of onset and increased severity of disease

67
Q

What are the features of Huntington’s?

A

Chorea (sudden, unintended jerky movements)
Eye movement disorders
Intellectual impairment
Dysarthria
Dysphagia

68
Q

Which medications can be used to suppress the disordered movement in Huntington’s?

A

Anti-psychotics
Benzodiazepines
Dopamine-depleting agents (tetrabenazine)

69
Q

Which condition has a strong link to myasthenia gravis?

A

Thymoma

70
Q

Which antibodies cause the problem in myasthenia gravis?

A

Acetylcholine receptor antibodies

71
Q

How does myasthenia gravis present?

A

Weakness gets worse with use and better with rest

Most affects the proximal muscles - face, neck and shoulders

Dipolopia
Ptosis
Dysphagia
fatigue in jaw when chewing

72
Q

How can the fatiguability of muscles be assessed in myasthenia gravis?

A

Repeated blinking will exacerbate ptosis

Prolonged upward gazing will exacerbate diplopia

Repeated abduction of one arm 20 times will cause profound unilateral weakness

73
Q

What investigations should be done for myasthenia gravis?

A

Acetyl choline receptor antibodies

CT or MRI of thymus

Edrophonium test

74
Q

What is the edrophonium test?

A

Give an IV dose of edrophonium chloride (or neostigmine). This blocks the cholinesterase enzymes, increases the concentration of ACh and briefly relieves the symptoms of myasthenia gravis

75
Q

What is the management of myasthenia gravis?

A

Reversible acetylcholinesterase inhibitors (pyridostigmine or neostigmine)

Immunosupression

Thymectomy

Rituximab

76
Q

Whats is myasthenic crisis?

A

Acute worsening of symptoms, sometimes triggered by another illness such as URTI

77
Q

What is the management of myasthenic crisis?

A

BiPAP/ intubation

IV immunogloblins and plasma exchange

78
Q

Which condition is lambert-eaton myasthenic syndrome often associated with?

A

Small cell lung cancer

79
Q

What is the presentation of lambert-eaton?

A

Affects proximal muscles
slow onset
Diplopia
Ptosis
Dysphagia
Post-tetanic potentiation (tense muscles and reflexes are improved after)

80
Q

What is the management of lambert eaton?

A

Sort the small cell lung cancer

Amifampridine allows more acetylcholine to be released

81
Q

What is the inheritance pattern of charcot-marie-tooth disease?

A

Autosomal dominant
Affects the peripheral motor and sensory nerves

82
Q

When do symptoms of charcot-marie-tooth disease appear?

A

Either <10 years or after 40 years of age

83
Q

What are the features of charcot-marie-tooth?

A

High foot arches (pes cavus)
Distal muscle wasting causing inverted champagne bottle legs
Distal weakness in lower legs (particularly ankle dorsiflexion)
Weakness in hands

84
Q

What are the causes of peripheral neuropathy?

A

ABCDE
A-alcohol
B-B12 deficiency
C-Cancer and CKD
D-diabetes and drugs
E-Every vasculitis

85
Q

What is the management of charcot-marie-tooth disease?

A

Supportive

86
Q

What viruses is Guillain Barré associated with?

A

Campylobacter jejuni (commenest cause)
Cytomegalovirus
Epstein-Barr

87
Q

What is the presentation of Guillian Barre?

A

Symmetrical ascending weakness (glove and stocking)
Reduced reflexes
Peripheral loss of sensation or neuropathic pain

88
Q

When do symptoms of guillain barre occur after the preceding infections?

A

4 weeks after

89
Q

What are the diagnostic criteria for guillian barre?

A

the brighton criteria

90
Q

What investigations should be done for guillian barre syndrome?

A

Nerve conduction studies
Lumbar puncture (shows raised protein, normal WCC and glucose)

91
Q

What is the management of guillian barre?

A

IV immunoglobulins or plasma exchange
Supportive care
VTE prophylaxis

92
Q

What is neurofibromatosis?

A

Genetic condition that causes neuromas to develop throughout the nervous system

93
Q

Which is the more common type of neurofibromatosis?

A

Type 1

94
Q

What is the inheritance pattern of neurofibromatosis?

A

Autosomal dominant

95
Q

What are the diagnostic criteria for neurofibromatosis?

A

2 of the 7. Remember by the mnemonic CRABBING

C- cafe-au-lait spots (6 or more)
R-relative is affected
A-Axillary or inguinal freckles
BB- Bony dysplasia such as Bowing of a long bone
I- Iris haemotomas
N-Neurofibromas
G-Gliomas

96
Q

What are the investigations for neurofibromatosis?

A

Genetic testing
X-rays
CT and MRI

97
Q

What is the characteristic feature of Tuberous Sclerosis?

A

The development of hamartomas

98
Q

What are the skin signs of tuberous sclerosis?

A

Ash leaf spots
Shagreen patches
Angiofibromas
Subungal fibromatoma
Cafe-au-lait spots
Poliosis

99
Q

What are the neurological features of tuberous sclerosis?

A

Epilepsy
Learning difficulties

100
Q

Which type of migraine can mimic stroke?

A

Hemiplegic

101
Q

What are triptans?

A

5HT receptor agonists (serotonin receptor agonists)

102
Q

Which medications can be used as migraine prophylaxis?

A

Propanolol
Topiramate
Amitriptyline

103
Q

What is the acute management of a cluster headache?

A

Triptans
100% oxygen for 15-20 mins

104
Q

What is used for cluster headache prophylaxis

A

Verapamil

Alice's finals cards (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions