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Neurology System > Disease Table > Flashcards

Disease Table Flashcards

1
Q

Symptoms TTH

A

Unilateral pain

Tightening band round the head

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2
Q

Rx TTH

A

NSAIDS
Aspirin
Paracetamol

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3
Q

Describe infrequent TTH

A

<1day/mnth

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4
Q

Describe Frequent TTH

A

1-14days/month

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5
Q

Describe CTTH

A

> 14days/month

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6
Q

Is TTH disabling

A

no

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7
Q

Most frequent disabling headache?

A

Migraine

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8
Q

Triggers for migraine

A 
Stress
Hunger
Sleep disturbance 
Dehydration 
Diet 
Changes in oestrogen levels
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9
Q

Symptoms of migraine attack

A 
Nausea 
Vomiting 
Photophobia 
Phonophobia
Unilateral sometimes bilateral head pain
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10
Q

Prodrome symptoms migraine

A

Mood alterations
Food cravings
Muscle pain

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11
Q

Aura symptoms migraine

A

Visual disturbances
Temporary loss of sight
Numbness
Transient weakness

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12
Q

Ix for migraine

A

Clinical diagnosis

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13
Q

Rx for migraine

A

Triptans
Paracetomol
NSAIDS

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14
Q

Prophylactic RX migraine

A

Amitryptiline

Propanolol

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15
Q

What is CI in migraine

A

Combine OCP pill

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16
Q

Describe chronic mirgraine

A

Chronic headache >15 days/month
>8 days have to be migraine
Last >3 months

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17
Q

Symptoms of cluster headache

A 
Rapid onset of excruciating unilateral pain 
Suicide headache 
Lacrimation 
Runny nose 
Blocked nose 
Ptosis
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18
Q

What are cluster headaches all about?

A

Timing

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19
Q

How long do cluster headaches last?

A

15-180 mins

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20
Q

RX during cluster headache attack

A

Oxygen

Triptan

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21
Q

Preventative RX for cluster

A

Avoid alcohol
Corticosteroid
Verapamil

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22
Q

Describe timing in cluster headache

A

Episodes of attacks

Then period of remission

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23
Q

3 types of trigeminal autonomic cephalgias

A

Paroxysmal Hemicrania
SUNCT
SUNA

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24
Q

Difference between paroxysmal hemicrania and SUNCT/SUNA

A

Absolute response to prophylactic Indomethacin

In paroxysmal hemicrania

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25
Q

Symptoms of Trigeminal autonomic cephalgias

A 
Unilateral head pain 
Predominantly V1
Cranial autonomic symptoms:
Lacrimation 
Runny nose
Blocked nose 
Eyelid oedema 
Ptosis
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26
Q

Durations of attacks in SUNCT/SUNA

A

2-240 seconds

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27
Q

Duration of attacks in paroxysmal hemicrania

A

2-30 mins

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28
Q

What does Trigeminal Neuralgia affect

A

The trigeminal nerve

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29
Q

Which n. branches are more affected in trigeminal neuralgia

A

V2/V3>V1

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30
Q

Which N. branch is more affected in trigeminal cephalgias

A

V1

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31
Q

What is giant cell arteritis

A

Temporal arteritis

Inflammation of the temporal artery

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32
Q

Signs of giant cell arteritis

A

New onset headache

Prominent beaded or enlarged temporal arteries

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33
Q

Symptoms of giant cell arteritis

A

New onset headache
Jaw claudication
Visual disturbances
Scalp tenderness

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34
Q

Blood Ix for giant cell arteritis

A

ESR elevated
CRP
Platelet count

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35
Q

Diagnostic Ix for giant cell arteritis

A

Temporal artery biopsy

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36
Q

Rx giant cell arteritis

A

High dose prednisolone

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37
Q

Prophylactic Rx SUNCT/SUNA

A

Carbamezepine

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38
Q

Rx for trigeminal neuralgia

A

Anti-convulsant:

Carbamezepine

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39
Q

Cutaneous triggers for trigeminal neuralgia

A

Wind
Cold
Touch
Chewing

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40
Q

Is MS disease of old or young?

A

Young

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41
Q

What is MS

A

Autoimmune inflammatory myelination condition of the CNS

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42
Q

Diagnosis requirement for MS

A

Episodes of demyelination disseminated in space and time

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43
Q

Symptoms of optic neuritis relapse

A

Pain when moving eye
Subacute visual loss
Diploplia

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44
Q

Sensory symptoms MS relapse

A

Pins and needles
Decreased vibration sense
Dysaeathesia

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45
Q

Motor symptoms MS relapse

A

Limb weakness

Myelitis

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46
Q

Brainstem symptoms MS relapse

A

Trunk and limb ataxia
Gait abnormality
Nystagmus
CN involvement

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47
Q

GI symptoms MS relapse

A

Swallowing disorders

Constipaiton

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48
Q

Sexual/GU symptoms MS relapse

A

Impotence
Urinary incontinence
Urinary retention

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49
Q

Ix MS

A

MRI

LP

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50
Q

Describe oligoclonal bands use in MS diagnosis

A

Oligoclonal bands present in CSF but not serum suggest Purely CNS inflammation

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51
Q

Disease modifying drugs in MS

A

Ocrelizumab
Dimethyl Fumarate
Beta-interferons
Natalizumab

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52
Q

Treating relapse RX MS

A

Methylprednisolone

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53
Q

Rx for spasticity in MS

A

Muscle relaxants

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54
Q

Rx for Dysaethesia in MS

A

Amitriptyline

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55
Q

Rx for bladder in MS

A

Catheterisation

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56
Q

Rx for Constipation in MS

A

Laxatives

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57
Q

Describe Relapsing Remitting MS

A

Clearly defined as attacks followed by periods of partial or complete recovery/remission

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58
Q

Describe primary progressive MS

A

Worsening neurological function from onset without relapses or remission

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59
Q

Describe secondary progressive MS

A

Follows initial relapsing remitting course

Transition to progressive MS without remission

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60
Q

Describe Sensory MS

A

Those who have only ever had mild sensory episodes

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61
Q

Describe Benign MS

A

Have attacks but function always returns to normal

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62
Q

How does MS change with pregnancy

A

Fewer relapses during pregnancy

Increased risk of relapses for first 3 months post-partum

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63
Q

Describe malignant MS

A

Severe disability in small period of time
Very aggressive demyelination attacks
Rapid decline in function

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64
Q

What are the grades of Astrocytoma

A

I-IV

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65
Q

Risk factors for brain tumours

A

Often unknown
FH
Ionizing radiation
Environmental hazard

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66
Q

Signs of brain tumour

A

Raised ICP

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67
Q

Symptoms of brain occupying lesions

A 
New onset of change pattern of headache 
Nausea 
Vomiting 
Worse headaches in morning 
Seizures
Neurological deficit depending on position
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68
Q

Brain tumour diagnosis IX

A

CT

MRI

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69
Q

Brain tumour staging Ix

A

CT chest/abdo/pelvis
Biopsy any skin lesions
Xray

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70
Q

Are brain mets or primary brain tumours more common

A

Brain mets

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71
Q

Common primary sites for brain mets

A 
Lung 
Breast
Renal  
GI 
Melanoma
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72
Q

Rx for brain tumours

A

Complete excision
Chemo
Radiotherapy

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73
Q

What is a glioblastoma?

A

Grade IV brain tumour

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74
Q

What can glioblastoma cross

A

Corpus callosum

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75
Q

Shape of glioblastoma

A

Butterfly shape

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76
Q

What do meningiomas arise from ?

A

Meninges

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77
Q

Most common type of adult brain tumour

A

glioblastoma

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78
Q

Describe meningioma

A

Slow growing tumour
Arise from arachnoidal cap cells from arachnoid membrane
Usually benign
Usually non-invasive

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79
Q

What is the prognosis for meningioma

A

Good prognosis

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80
Q

Most common pituitary tumour

A

Pituitary adenoma

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81
Q

What visual defect can pituitary adenoma cause

A

Bi-temporal hemianopia

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82
Q

Signs of pituitary adenoma

A

Hormone imbalance

Compression of optic chiasm leading to visual disturbances

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83
Q

Treatment for pituitary adenoma

A

Endocrine replacement
Transsphenoidal surgery
Corticosteroids

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84
Q

Definition of parkinsons

A

Clinical syndrome of 2 or more
Bradykinesia
Tremor
Rigidity

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85
Q

Pathology of parkinsons

A

In the substantia nigra
leads to dopamine loss
Lewy bodies present

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86
Q

Describe parkinsons tremore

A

Resting tremor
Pin rolling
Most noticeable in hands

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87
Q

Describe Gait in parkinsons

A

Slow shuffling
Lack of arm swing
Unable to turn around quickly
Slow to initiate movement

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88
Q

Describe rigidity in parkinsons

A

Cog wheel rigidity

Hypertonia

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89
Q

Other symptoms in parkinsons

A

Low mood
Soft voice
Anxiety

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90
Q

1st line Rx for Parkinsons

A

Levodopa

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91
Q

Action of levodopa

A

Can cross BBB and be converted to dopamina

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92
Q

Other RX for parkinsons

A

Dopamine agonist:
Ropinorole

COMT inhibitors
MAO-B inhibitors

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93
Q

How do COMT inhibitors work

A

Stops COMT

Which is an enzyme that degrades dopamine

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94
Q

How do MAO-B inhibitors work

A

MAO-B is in enzyme which breaks down dopamine

Stops MAO-B

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95
Q

Differential diagnosis for parkinsons

A

Lewy body dementia

Normal pressure hydrocephalus

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96
Q

Does alcohol affect tremor in parkinsons?

A

No

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97
Q

What is dementia?

A

Syndrome consisting of progressive impairment of multiple domains of cognitive function in alert patients

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98
Q

Who does dementia generally affect?

A

Elderly

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99
Q

Most common cause dementia

A

Alzheimer’s Disease

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100
Q

Causes of dementia

A 
Alzheimer's 
Vascular 
Lewy body
Frontotemporal 
Tempero-parietal 
Normal pressure hydrocephalus 
CJD
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101
Q

Pathology vascular dementia

A

Series fo minor strokes in brain

Mixed picture depending on where the strokes have occured

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102
Q

Progression in vascular dementia

A

Step wise

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103
Q

Progression lewy body dementia

A

Rapid progression

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104
Q

Pathology of lewy body dementia

A

Lewy bodies in brainstem and neocortex

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105
Q

Common finding in lewy body dementia

A

Parkinsonism

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106
Q

Describe frontotemporal dementia

A 
Early behaviour change 
Drastic personality change 
Early aphasia 
Loss of neurons and connection in fronto/temporal lobe
Emotional unconcern 
Change in eating/hygeine habits
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107
Q

Describe tempero-parietal dementia

A

Early memory disturbance
Language and visuospatial problems
Personality preserved until later

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108
Q

triad of normal pressure hydrocephalus

A

Wet
Wobbly
Wacky

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109
Q

What is CJD cause by?

A

Infiltration of prions in the brain

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110
Q

General symptoms of dementia

A 
Worsening memory 
Change in personality 
Aphasias 
Aggression 
Hallucinations
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111
Q

Which type of dementia is hallucinations common

A

Lewy body

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112
Q

Which history is needed in dementia diagnosis

A

Witness

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113
Q

What investigations can rule out underlying causes of dementia

A 
MRI 
Vit B12
Folic acid 
TSH 
C-reactive protein
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114
Q

Rx alzheimers +/- lewy body dementia

A

Cholinisterase inhibitors
Antiglutamatergic treatment
Antipsychotics

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115
Q

RX frontotemporal dementia

A

None

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116
Q

Example of cholinisterase inhibitors

A

Donezepril

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117
Q

Example of antiglutamatergic Rx

A

Mematine

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118
Q

Rx depression in dementia

A

Serotonin Reuptake inhibitors

E.g Citalopram

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119
Q

Non-pharmacological therapy for dementia

A

Cognitive behavioural therapy
Aromatherapy
Multi-sensory stimulation

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120
Q

Pathology in alzheimers

A

Loss of neurones and synapses in cerebral cortex

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121
Q

Risk factors for alzheimers

A

Age
FH
Downs syndrome
Smoking

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122
Q

Progression of alzheimers

A

Short term memory loss
Generally mild to begin with
Gets worse over time

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123
Q

Signs alzheimer’s

A 
Progressively worse memory 
Confusion 
Disorientation 
Speech or language problems 
Personality change
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124
Q

What is hydrocephalus

A

Condition whereby there is excess CSF within intracranial space

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125
Q

Describe communicating hydrocephalus

A

CSF can flow freely

Normally production>absorption

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126
Q

Describe NCH

A

Involves obstruction

Blockage of outflow from ventricles

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127
Q

Most important sign of hydrocephalus

A

Raised ICP

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128
Q

Symptoms/signs of hydrocephalus in infants

A 
Cranial enlargement 
Splaying sutures
Fontanells full and bulging 
Eyes fixed downwards
CN VI palsy
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129
Q

Symptoms/signs of hydrocephalus adults

A 
Increased ICP 
Morning headaches 
Or worse during valsalva manoeuvre
Papilloedema 
Gait abdnormality 
CN VI palsy
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130
Q

IX for hydrocephalus

A

CT

MRI

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131
Q

Acute Rx hydrocephalus

A

External ventricular drain

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132
Q

Surgical RX hydrocephalus

A

VP shunt

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133
Q

Potential RX for NCH

A

ETV
Endoscopic 3rd ventriculostomy
Hole in floor of 3rd ventricle

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134
Q

What is normal pressure hydrocephalus a potential reversible diagnosis of/

A

Dementia

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135
Q

Classic triad in NPHC

A

Dementia
Gait disturbance
Urinary incontinence

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136
Q

RX NPHC

A

VP shunt

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137
Q

IX for NPHC

A

CT
MRI
LP

138
Q

Pathology of cauda equina syndrome

A

compresison cauda equina

139
Q

Common causes for cauda equina syndrom

A

Prolapsed dise

Tumour pressing on spinal cord

140
Q

PR findings cauda equina s.

A

Loss of anal tone

141
Q

Red flags for cauda equina syndrome

A

Bilateral sciatica
Saddle anaesthesia
Urinary/bowel dysfunction

142
Q

Ix cauda equina syndrome

A

Urgent MRI

143
Q

RX cauda equina syndrome

A

Lumbar discetomy

144
Q

What is sciatica

A

Pain from lower back down to legs

145
Q

What is saddle anaesthesia

A

Loss of sensation of buttocks peritoneum and inner thighs

146
Q

Risk factors for epidural abscess

A

IV drug abuse
DM
Chronic renal failure
Alcholism

147
Q

What is epidural abscess

A

Inflammation that involved collection of pus in epidural space

148
Q

Common organism for epidural abscess

A

Staph aureus

149
Q

Symptoms for epidural abscess

A 
Back pain 
Spinal tendernes 
Pyrexia 
Fever 
Focal neurology 
Urinary problems
150
Q

IX for epidural abscess

A

Blood cultures
Urgent MRI
WCC
ESR

151
Q

RX epidural abscess

A

Drainage

Long term IV antibiotics

152
Q

Describe cervical spondylosis

A

Degenerative change in cervical spine

Leading to spine and nerve root compression

153
Q

Risk factors for cervical spondylosis

A

Age
Previous neck injury
Arthritis

154
Q

Symptoms of cervical spondylosis

A

Limited movement
Painful neck
LHermitte’s sign

155
Q

What is lHermitte’s sign

A

Shock like sensation travelling down spine upon flection of the neck

156
Q

Features of root compression in cervical sponylosis

A 
Tingling pain in arm/fingers
at affected level 
LMN signs:
Hyporeflexia 
Muscle wasting
157
Q

Treatment for moderate to severe myelopathy

A

Decompressive surgery

158
Q

Features of myelopathy in cervical spondylosis

A

UMN signs legs
LMN signs arms
Bowel and bladder incontinence

159
Q

What do UMN signs below the level of the affected root suggest?

A

Cord compression

160
Q

Which tumours commonly metastasis to spinal cord

A

Brest
Prostate
Lung

161
Q

Symptoms of spinal cord metastases

A

Back pain
Weakness
Incontinence
Saddle anaesthesia

162
Q

If a person has a known cancer and is experiencing back pain with urinary incontinence what is the Ix

A

Urgent MRI

163
Q

RX for spinal cord metastases

A

Surgical

Radiotherpay

164
Q

Types of generalised seizures

A

Tonic clonic
Myoclonic
Atonic seizure
Absence seizure

165
Q

Types of focal seizures

A

With retained awareness

With loss of awareness

166
Q

IX for seizures

A 
BG 
ECG 
EEG 
Consideration of alcohol and drugs 
CT head
167
Q

When is epilepsy diagnoses

A

> 2 unprovoked attacks

168
Q

Causes of blackouts

A 
Vasovagal syncope 
Concussive seizures 
Cardiac arrhthymias
First seizure 
Hypoxic seizure 
Hypoglycemia 
Anxiety
169
Q

Rx generalised tonic clonic seizures or atonic seizures

A

Sodium Valporate

Lamotrignine

170
Q

Rx 2nd line generalised tonic clonic

A

Levetiracetam

Topiramate

171
Q

RX for focal seizures

A

Carbamazepine

Lamotrigine

172
Q

2nd line for focal seizures

A

Topiramate

Sodium valproate

173
Q

Rx absence seizures

A

Ethosuximide

174
Q

Rx myoclonic seizures

A

Sodium valproate

175
Q

1st RX for status epilepticus

A

Lorazepam

Midazolam

176
Q

2nd Rx status epilepticus

A

Slow infustion phenytoin

177
Q

3rd Rx status epilepticus

A

Seek ICU help

Anaethesia

178
Q

Bacterial causes meningitis

A

Meningococcus

Penumococcus

179
Q

Signs meningitis

A 
Fever
Neck stiffness 
Photophobia 
Phonophobia 
Nausea 
Vomitng 
GCS<14
Seizures 
Petechial rash 
Cold Hands and feet
180
Q

What is petechial rash in meningitis hallmark sign of

A

meningococcal meningitis

181
Q

Classic triad meningitis

A

Feve
Neck stiffness
Headache

182
Q

Ix meningitis

A

Blood cultures
LP
CSF culture/microscopy

183
Q

Rx meningitis

A

IV ceftriaxone/AB
Fluid resus
Correct BG
Dexamethasone

184
Q

CI to LP

A

Raised ICP
Spinal cord injury
Infection over LP site
GCS<10

185
Q

LP signs of meningitis

A

Increase opening pressure
Low glucose
High mainly neutrophil cell count
High protein levels

186
Q

Is there need for imaging in meningitis?

A

No if there are no CI to LP

187
Q

What is encephalitis

A

Infection of brain substances

188
Q

LP findings encephalitis

A

High lymphocytes
Normal/high opening pressure
Normal BG
Protein slightly increased

189
Q

Symptoms of encephalitis

A

Progressive headache
Meningism
Seizures
Progressive cerebral dysfunction

190
Q

Ix encephalitis

A 
Blood cultures
Imaging CT+/- MRI 
LP 
EEG 
Viral PCR
191
Q

Difference between encephalitis and meningitis

A

Encephalitis

Brain is much more affected

192
Q

Signs of encephalitis

A 
Confusion 
Abnormal behaviour 
Memory disturbance 
Seizures 
Focal symptoms
193
Q

Rx encephalitis

A

IV aciclovir

194
Q

Common viruses causing encephalitiis

A 
HSV 
Arbovirus 
Enterovirus 
Rabies 
HIV
195
Q

2 types of autoimmune encephalitis

A

Anti-VGKC

Anti-NMDA receptor

196
Q

What is a cerebral abscess

A

Localised area of pus within in the brain

197
Q

Signs f of cerebral abcess

A

Seizures
Fever
Increased ICP signs

198
Q

Ix cerebral abscess

A 
CT 
MRI 
WCC 
Blood cultures 
ESR
199
Q

Common organisms cerebral abscess

A

Step milleri

200
Q

Rx cerebral abscess

A

Surgical drianage if possible

Penicillin or ceftriazone

201
Q

Which organisms causes syphilis

A

Treponema Pallidum

202
Q

What does tertiary syphilis present as

A

Neurosyphilis

203
Q

Ix neuorsyphilus

A

Serology

VDRL antibodies

204
Q

RX neurosyphilus

A

High dose penicillin

205
Q

Types of CJD

A

Sporadic
New variant
Familial
Acquired

206
Q

What is CJD caused by?

A

Protein - prion

207
Q

What was GH from human pituitaries sometimes containing

A

CJD

208
Q

Rx CJD

A

Non proven

209
Q

Prognosis for CJD

A

Death often within 6 months

210
Q

Signs CJD

A 
Rapidly progressive dementia 
Memory loss 
Hallucinations 
Focal CNS symptoms 
Myclonus
211
Q

Iatrogenic causes of CJD

A

Contaminated surgical instruments
GH from human pituitary glands
dura matter graft

212
Q

What type of virus is poliovirus

A

Enteroviruses

213
Q

Route of infection for polio

A

Faecal-oral

214
Q

Where is infected in polio

A

Anterior horn cells

215
Q

Rx polio

A

Preventative in form of vaccine

216
Q

Signs of polio

A

LMN signs
Bulbar signs
No sensory features

217
Q

Ix polio

A

Viral culture of stools
Pharyngeal swabs
Bloods

218
Q

What is rabies

A

Acute infection of CNS

219
Q

How is rabies transmitted

A

Bite or salivary contamination

CNS tissue

220
Q

Post Exposure Rx:

A

Wash wound
Active rabies immunisation
Human rabies immunoglobulin

221
Q

Who should rabies vaccines be given to

A

Bat handlers
Regular handlers of imported animals
Selected travellers

222
Q

Infective bacterium in tetanus

A

Clostridium tetani

223
Q

Pathology Clostridium tetani

A

Toxin acts at neuromuscular junction

Blocks inhibitors of motor neurones

224
Q

Signs tetanus

A

Severe rigidity and spasm

225
Q

Rx of spasms in tetanus

A

Lorazepam

226
Q

Infective organism in botulism

A

Clostridium botulinum

227
Q

Pathology of botulism

A

Binds irreversibly to the pre-synaptic membranes of peripheral neuromuscular junction and autonomic nerve junction
Blocks Ach release

228
Q

Signs botulism

A

Flaccid paralysis

Progressive paralysis

229
Q

Ix botulism

A

Clinical diagnosis do not delay treatment

230
Q

Rx botulism

A

Admit to ICU

Botulinum anti-toxin

231
Q

What can polio cause?

A

Irreversible paralysis

232
Q

IX for poliomyelitis

A

Viral culture of stool
Pharyngeal swabs
Bloods

233
Q

What is myopia?

A

Short sightedness

234
Q

What is the commonest cause of myopia?

A

Eyeball too long

Imagines form infront of the retina

235
Q

Symptoms fo myopia?

A 
Objects close up are clear 
Distant are hazy
Headaches
Divergent squint 
Eyestrain
236
Q

Rx myopia

A

Glasses

Contact lenses Laser eye surgery

237
Q

Lense type for myopia

A

Concave

238
Q

Lense type for hyperopia

A

Convex lenses

239
Q

What is hyperopia

A

Far sightedness

240
Q

Causes of hyperopia

A

Eyeballs too short

Image forms behind the retina

241
Q

Symptoms of hyperopia

A

Convergent squint children

Eye strain after reading, computer ect…

242
Q

Rx for hyperopia

A

Convex lenses
Contact lenses
Laser eye surgery

243
Q

What is presbyopia

A

Long sightedness of old age

244
Q

When does presbyopia usually start

A

5th decade of life

245
Q

Pathology of presbyopia

A

Decrease in elasticity in the lens

So when ciliary muscle contracts not as capable of changing shape

246
Q

Cause of astigmatism

A

Surface of lens has different curvatures in different medians
Meaning light never falls on the same place

247
Q

Lenses for astigmatism

A

Cylindrical lenses

Toric contact lenses

248
Q

Symptoms astigmatism

A

Close and distant objects appear hazy

249
Q

2 types of glacoma

A

Open angle

Angle closure

250
Q

Triad signs of glaucoma

A

Raised IOP
Visual field defects
Optic disc change

251
Q

Type of visual defect in glaucoma

A

Tunnel vision

Loss of peripheral vision

252
Q

Cause of open angle glaucomea

A

Drainage through trabecular meshwork is blocked
Reduced flow though TM
Loss of AH reabsorption
Leads to increased IOP

253
Q

Cause of angle closure glaucoma

A

Peripheral iris blocks the angle
Caused by contact between the iris and TM
AH cannot drain

254
Q

How dos IOP increased in OAG and ACG differed?

A

Angle closure - sudden increase

Open angle - gradual increase

255
Q

IX glaucoma

A

Opthalmoscopy

IOP measured

256
Q

Open angle glaucoma symptoms

A

Develops over time
Progressive visual loss
No pain associated

257
Q

Angle closure glaucoma symptoms

A 
Sudden onset 
Red eye 
Vision loss 
Headaches 
Nausea/Vomiting
258
Q

Open glaucoma signs

A

No pain
Progressive peripheral visual loss
Optic nerve changes

259
Q

Angle closure signs

A

Red eye
Cornea often opaque due to raised IOP
IOP severely raised
Fixed dilated pupil

260
Q

Rx open angle glaucoma

A

Eye drops to decrease IOP
Prostaglandin analogues
BB
Carbonic anhydrase inhibitors

261
Q

Rx closed angle glaucoma

A 
IV infusion carbonic anhydrase inhibitor 
Analgesics 
Antiemetic's 
Dexamethasone eye drop 
Surgery
262
Q

Who should be informed if glaucoma is present in both eyes

A

DVLA

263
Q

What is uveitis

A

Inflammation of the uvea

264
Q

Where does anterior uveitis affect?

A

Inflammation that affects anterior part of uveal tract

Iris and ciliary body

265
Q

Where does intermediate uveitis affects

A

Localised to vitreous and peipheral retina

266
Q

Where does posterior uveitis affect?

A

Retina
Choroid
Optic nerve head

267
Q

Triad of uveitis

A

Pain
Photophobia
Redness of eye

268
Q

Symptoms of uveitis

A

Pain
Photophobia
Redness eye

269
Q

In which types of uveitis do floaters and blurred vision often occur?

A

Intermediate and posterior

270
Q

Rx anterior uveitis

A

Topical steroids:
Prednisolone
Dexamethasone

271
Q

Rx intermediate uveitis

A

Corticosteroid injections

272
Q

Rx posterior uveitis

A

Corticosteroid injections

Sometimes oral

273
Q

Wat is conjunctivitis

A

Bacterial or viral infection that causes inflammation of the conjuntiva

274
Q

What is pink eye often a name used for?

A

Conjunctivitis

275
Q

Is there loss of vision in conjunctivitis

A

no

276
Q

Symptoms conjuncitivitis

A 
Red watery eyes
Itchy/burning eye 
Discharge
Excessive lacrimation 
Swollen eye lids 
Gritty feeling in eye
277
Q

Rx conjunctivitis

A

Bacterial: AB eye drops
Viral: often self-limiting
Antihistamine eye drops
Warm or cold compresses to eye

278
Q

What should be avoided when having conjuncitivits

A

Contact lenses

279
Q

Risk factors for age related macular degenration

A

Age
Smoking
Poor diet

280
Q

2 types of age related macular degenration

A

Dry type: most common

Wet type

281
Q

Visual loss of age related macular degeneration

A

Progressive loss of central vision

Over the macula

282
Q

What is cavernous sinus trombosis

A

Blood clot in cavernous sinus

283
Q

Common infection sites for cavernous sinus thrombosis

A

Nasal furuncle
Dental infections
Sphenoidal or ethmoidal sinuses

284
Q

Common organisms cavernous sinus thrombosis

A

Staph. Aureus

Streptococcus

285
Q

Signs cavernous sinus thrombosis

A

Red swollen eye
Exophthalmos
Ptosis
CN palsies

286
Q

Symptoms cavernous sinus thrombosis

A

Headache around eye
Double vision
Blurred vision
Red swollen eye

287
Q

Ix cavernous sinus thrombosis

A

Ophthalmoscopy

CT

288
Q

Rx cavernous isnus thrombosis

A

Broad spectrum IV AB

289
Q

Difference between orbital and preseptal cellulitis

A

Orbital; infection of soft tissue posterior to orbital septum
Preseptal: Infection anterior to the septum

290
Q

Who is orbital cellulitis most commonly seen in ?

A

Children

291
Q

Common causes pre-septal cellulitis

A

Lid cyst

Insect bite

292
Q

Common cause orbital cellulitis

A

Sinusitis

Dental infections

293
Q

Symptoms preseptal cellulitis

A

Pain
Erythema
Systematically well
Vision intact

294
Q

Symptoms orbital cellulitis

A 
Pain 
Erythema
Lid swelling 
Systematically unwell 
Double vision 
Conjunctivitis 
Expohthalmos 
Clurred vision
295
Q

Rx pre septal callulitis

A

Oral co-amoxiclav

296
Q

Rx orbital cellulitis

A

IV AB

297
Q

Sign of CN III palsy

A

Ptosis

Eye position Inferior and lateral

298
Q

What is a symptoms of CN IV palsy

A

Diploplia which is maximal when looking down

299
Q

Signs of CNVI palsy

A

Esotropia

Diploplia

300
Q

What is SAH

A

Spontaneous bleeding into subarachnoid space

301
Q

What is the main concern with thunderclap headache

A

SAH

302
Q

Risk factos SAH

A 
Hypertension 
Alcohol 
Smoking 
FH 
Previous SAH
303
Q

Main Cause of SAH

A

Berry aneurysm

304
Q

Signs ofSAH

A

Signs of increased ICP
Decreased conscious level
Seizure
Neck stiffness

305
Q

Describe thunderclap headache

A

High intensity headache reaching maximum intensity in <1min
Majority peak instantly
Start at back of head and progresses round

306
Q

IX SAH

A

CT

LP >12hrs

307
Q

RX SAH

A

Early clipping/coiling

Nimodepine

308
Q

Why should LP for SAH be >12 hrs

A

To allow breakdowns of rBC

Determine old blood from bloody tp

309
Q

Complications of SAH

A

Re-bleeding

Cerebral ischaemia

310
Q

What is subdural haematoma

A

Blood gathers in subdural space

311
Q

What is SDH usually associated with

A

Traumatic brain injury

312
Q

What is the origin of bleeding in SDH

A

Venous origin

313
Q

Risk factors SDH

A

Brin injury
Elderly
Anti-coagulation

314
Q

What type of bleed may be seen in shaken babies

A

SDH

315
Q

Why are SDH usually slower onset compared to EDH

A

Because pressure veins bleed slower than arteries

316
Q

Signs of SDH

A

Increased ICP

317
Q

Symptoms SDH

A 
History recent injury 
Loss of consciousness 
Fluctuating consciousness
Seizures
Headache 
Pain 
Dizziness
318
Q

IX SDH

A

CT

MRI

319
Q

Signs on CT of SDH

A

Classic crescentic shape

Concave curve away from skull

320
Q

Rx SDH

A

Craniotomy

Burr hole

321
Q

What is epidural haematoma

A

Bleeding between dura and skull

322
Q

What is the usual origin of EDH

A

Bleeding from middle meningeal artery

323
Q

Ix for EDH

A

CT

324
Q

CT signs EDH

A

Biconvex lens shape

ura matter tightly attached to the skull

325
Q

Symptoms of EDH

A 
Lucid period 
Decreased GCS 
Increased ICP 
Severe headache 
Vomiting 
Confusion 
Seizures
326
Q

2 types of strokes

A

Ischaemic

Haemorrhagic

327
Q

Wha t is TIA

A

Mini stroke

Symptoms relieve <24 hrs

328
Q

How long does it take for most TIAs to resolve

A

1-60mins

329
Q

PACS criteria

A 
2/3
1.	Higher Dysfunction
Aphasia 
Decreased conscious level 
Visuospatial disturbance  
2.	Homonymous Hemianopia
3.	Hemiparesis 
2 of Face/ Arm/ Leg
330
Q

TACS criteria

A 
3/3
1. Higher Dysfunction
Aphasia 
Decreased conscious level 
Visuospatial disturbance  
2.	Homonymous Hemianopia
3.	Hemiparesis 
2 of Face/ Arm/ Leg
331
Q

Where is the occlusion in TACS

A

Middle cerebral artery

332
Q

Type of lacunar stroke

A 
1.	Pure sensory
2/3 of face / arms/ legs
2.	Pure motor 
2/3 of face/ arms/ legs
3.	Sensori-motor
2/3 of face/ arms/ legs
4.	Ataxic hemiparesis 
Devoid of cortical signs
333
Q

Symptoms of POCS stroke

A 
Ataxia
Vertigo
Nystagmus 
CN palsies 
Loss of heel-shin test 
Visual field defects
334
Q

Signs stroke

A 
Aphasia 
Weakness 
Gait disturbance 
Visual defects 
Loss of co-ordination
335
Q

FAST symptoms

A

Facial weakness/asymmetry
Arm weakness
Problems with speech
Time to call 999

336
Q

Ix stroke

A

CT
ECG
Carotid dopple US

337
Q

Risk factors for stroke

A 
Hypertension 
AF 
Smoking 
DM 
Hyperlipidaemia
Obesity 
Combined OCP
338
Q

Secondary preventative Rx stroke

A 
Anti-hypertensives
Anti-platelets
Warfarin 
Statins 
Carotid endarectomy
339
Q

General lifestyle modifications to prevent stroke

A

Smoking cessation
DM control
Lipid level control
Good BP control

340
Q

Which type of stroke has the worst prognosis

A

TACS

Neurology System (35 decks)

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