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clinical 7 Flashcards

(69 cards)

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1
Q

when do you give thrombolylis in stroke

A

within 4.5 hours of onset of symptoms

once haemorrhage stroke has been ruled out

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2
Q

preventative drug given after an ischaemic stroke

A

clopidogrel

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3
Q

what do you give after an ischaemic stroke if clopidogrel is CI

A

aspirin plus modified release (MR) dipyridamole

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4
Q

facial nerve innervates what 4 areas

A

face - facial expression
ear - nerve to stapedius
taste - anterior 2/3rds
tear - lacrimal gland

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5
Q

Causes of bilateral facial nerve palsy (4)

A

sarcoidosis
Guillain-Barre syndrome
polio
Lyme disease

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6
Q

cholesterol level that requires statin after an ischaemic stroke

A

if more than 3.5

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7
Q

anti epileptic most associated with weight gain

A

sodium valproate

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8
Q

how does sodium valproate work

A

increases GABA activity

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9
Q

first line treatment for generalised seizures

A

sodium valproate

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10
Q

first line treatment for partial seizures

A

carbamazepine

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11
Q

second lin treatment for generalised if sodium valproate is not working

A

lamotrigine

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12
Q

carbamazepine may actually exacerbate ______ seizure

A

absent

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13
Q

frequency of migraine that requires prophylaxis

A

more than 2 a month

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14
Q

migraine prophylaxis in woman of child bearing age

A

propanolol

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15
Q

migraine prophylaxis in the with asthma

A

topiramate

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16
Q

drug that can be given as migraine prophylaxis

A

topiramate or propanolol

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17
Q

when do you give phenytoin

A

in status epileptics is continuing 10 mins after receiving diazepam or lorazepam

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18
Q

what can happen following a sub arachnoid haemorrhage

A

cerebral vasospasm

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19
Q

what do you give following a subarachnoid haemorrhage to prevent cerebral vasospasm

A

calcium channel blocker (ends in -pine)

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20
Q

if stroke due to a-fib, when do you start anticoagulation therapy (warfarin)

A

15 days after onset of symptoms

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21
Q

first line for spasticity in MS

A

baclofen or gabapentin

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22
Q

whig parkinson drugs make you lose impulse control

A

dopamine agonists

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23
Q

what is ‘anticipation’ in huntingtons

A

earlier onset in successive generations

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24
Q

drug that can cause parkinsinism

A

haloperidol (antipsychotic: decrease amount of dopamine, low dopamine associated with parkinson)

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25
first line treatment for neuropathic pain
amitriptyline, duloxetine, gabapentin or pregabalin
26
first line treatment for trigeminal neuralgia
carmabazepine
27
bells palsy, what nerve
facial LMN
28
what is radiculopathy
nerve impingement/lesion at level of spine
29
'triptan sensation'
tingling, heat, tightness (e.g. throat and chest), heaviness, pressure
30
moraine treatment in pregnancy
1st line: paracetamol | 2nd: aspirin or ibuprofen is in 1st or 2nd trimester
31
who don't you give neuroleptics (i.e. haloperidol) to and why
lewy body because it can cause non reversible parkinsonism
32
how can you differentiate parkinson from drug induced parkisonism
do not get rigidity and resting tremor in drug induced
33
acute migraine treatment
oral triptan + NSAID or titan + paracetamol
34
what makes essential tremor better
alcohol and propanolol
35
treatment for essential tremor
propanolol
36
anti body present 25% of people with Guillain-Barre syndrome
anti-ganglioside antibody (e.g. anti-GM1)
37
bilateral acoustic neuromas - what condition
neurofibromatosis type 2
38
neurofibromatosis type 2 inheritance and chromosome
autosomal dominant and is an inherited defect in chromosome 22.
39
Neurofibromatosis type 1 is due to a mutation in chromosome ___
17
40
tuberous sclerosis is often associated with a mutation in chromosome ___
16
41
what will indicated neurofibromatosis 1 rather than 2
Café-au-lait spots (>= 6, 15 mm in diameter) | Axillary/groin freckles
42
what will indicated neurofibromatosis 2 rather than 1
bilateral acoustic neuromas
43
dopamine agonists end in
-ine(Bromocriptine, cabergoline, apomorphine)
44
what is dystonia
sustained, abnormal posture cased by persistent contraction of large trunk or limb muscles
45
what is blepharospasm
twitch or spasm of eye
46
what is hemiballismus
uncontrolled flailing of limbs - lesion or dysfunction of subthalmic nucleus
47
nerve root level if weakness in knee extension and ankle dorsiflexion
L4
48
parts of peripheral nervous system that carries parasympathetic nerve fibres
craniosacral out flow: cranial nerves III, VII, IX, X and anterior rami of sacral spinal nerves which enter PELVIC splanchnic nerves
49
roots carry what fibres
just motor or just sensory
50
what carries both sensory and motor fibres
rami
51
wha makes up brachial plexus
anterior rami of C5 - T1
52
calcimine sulcus located where
occipital lobe (part of visual pathway)
53
what is galantamine
cholinesterase inhibitor
54
oliclonal bands are seen in what condition
MS - seen in gel of CSF (also get high lymphocytes)
55
receptive aphasia
wernicke's (temporo-parietal area)
56
expressive aphasia
brocas (frontal lobe)
57
what is nominal aphasia
not being able to name familiar objects
58
middle cerebral artery supplies where
lateral aspect of parietal lobe
59
lateral aspect of parietal lobe is supplied by which artery
middle communicating
60
anterior cerebral artery supplies where
anterior corpus collosum and superior frontal gyrus
61
posterior cerebral artery supplies where
poseroventral nucleus of thalamus and inferior temporal gyrus
62
in brown squared syndrome at what level with pain and temp be lost
3 levels below the spinal lesion
63
part of brain responsible for memory, emotional reaction and decision making
amygdala
64
what ligament does an epidural needle pass through
filamentum flavum
65
level of epidural
L3/L4
66
what level does the spinal cord end
L2
67
subarachnoid space ends at what level
S2
68
dura that covers cerebellum
tentorium cerebelli
69
what causes a 'blow pupil'
compression of oculomotor nerve by an uncal herniation

Neuro (20 decks)

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