Conditions Summary Flashcards by Jay Slater

20yo female
unilateral headache with nausea, aura and photophobia
once per month
lasts 4-72 hours

migraine

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migraine management (acute and prophylaxis)

acute - NSAIDs, triptans

prophylaxis - reduce triggers, propanolol, topiramide, gabapentin

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bilateral headache
no nausea/vomiting/visual loss/photophobia
mild/moderate
feels like a band squeezing round head

tension headache (completely normal)

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tension headache treatment (3)

relaxation
beta blockers
antidepressants

theyre fine so nothing major, just symptomatic

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young male
unilateral headache
eye lid oedema
ptosis 
lasts 45-90mins, 1-8 times per day

cluster headache (type of trigeminal autonomic cephalgia)

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cluster headaches (acute and prophylaxis)

acute - oxygen and SC sumastriptan

prophylaxis - verapamil

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60yo women 
unilateral headache 
miosis 
tearing
nasal stuffiness 
lasts 10-30mins, 1-40 times per day

paroxysmal hemicrania (type of trigeminal autonomic cephalgia)

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paroxysmal hemicrania (type of trigeminal autonomic cephalgia)

indomethicin

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obese female
vision loss
headache worse in morning
nausea and vomiting

idiopathic intracranial hypertension

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idiopathic intracranial hypertension treatment (3)

weight loss
acetazolamide
diuretics

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elderly women
severe unilateral stabbing pain in face
<90secs, 1-100 times per day
triggers - chewing, touch face

trigeminal neuralgia

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trigeminal neuralgia treatment

drugs (eg carbamazepine)
ablation
surgical decompression

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raccoon/panda eyes after head trauma

anterior cranial fossa fracture

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battle sign over mastoid process after head trauma

middle cranial fossa fracture

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haemorrhagic stroke treatment

acute - surgery

long term - nothing, treat hypertension (if cause)

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cardioembolic infarct stroke treatment

acute - thrombolysis and aspirin ASAP

long term - rivaroxaban (NOACs to decrease fibrin clot risk)

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atheroembolic/small vessel disease stroke treatment

acute - thrombolysis and aspirin ASAP

long term - clopidogrel (anti platelet to decrease platelet clot formation)

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sporting injury causing head trauma
middle meningeal artery haemorrhaged
CT - convex lens shapes bleed

extradural hameorrhage

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extradural haemorrhage treatment

surgery - to remove blood

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elderly/alcoholic falls over
slow onset confusion
cerebral bridging veins rupture
CT - crescent shaped bleed

subdural haemorrhage

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subdural hemorrhage treatment

surgery - to remove blood

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1 hour thunderclap headache 
neck stiffness 
vomiting 
photophobia 
lumbar puncture - with yellow CSF

subarachnoid haemorrhage (with meningitis symptoms)

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subarachnoid haemorrhage treatment

symptomatic
surgery - coil/clip
don’t need to remove blood bc will get reabsorbed into CSF

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20yo seizure after night out
tongue biting
urinary incontinence

primary generalized epilepsy

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65yo loss of auditory sensation last secs-mins

focal sensory seizures

treatment of primary generalized seizure

sodium valproate - teratogenic lamotrigine NOT carbamazepine

treatment of focal seizures/secondary generalized epilepsy

carbamazepine lamotrigine sodium valproate

acute treatment of epileptic seizure (status epilepticus)

benzodiazepines (anticonvulsants) 4mg IV lorazepam 10ml x 2 buccal midalozam 10mg PR diazepam

seizure with normal EEG

non epileptic attack disorder

treatment of non epileptic attack disorder

NOT anti convulsant (benzodiazepines) | treat cause - CBT, counselling

``` broad based gait nystagmus slurred speech weight loss headache worse on coughing ```

cerebellar tumour

``` seizure memory problems headaches with vomiting problems understanding questions weight loss ```

temporal lobe tumour

brain tumour treatment

surgery +/- radio +/- chemo (temozolomide (TMZ))

personality changes hemiparesis problems saying sentences coherently

frontal lobe tumour

``` headache worse with coughing hemisensory loss problems with maths R/L confusion dysgraphia ```

parietal lobe tumour gertmanns syndrome - problems with maths, problems with writing (dysgraphia), R/L confusion

visual hallucinations weight loss headache with vomiting

occipital lobe tumour

headache worse with coughing

raised ICP potentially tumour, haemorrhage etc

child tiptoeing gait headache with vomiting

astrocytoma in kid

``` couple months ago was fine elderly person dementia shuffling gait urinary incontinence ```

normal pressure hydrocephalus

normal pressure hydrocephalus treatment

ventriculoperitoneal shunt - will defos improve gait, poss improve dementia

young obese women headaches worse in morning and when sneezing presents like a tumour but nothing on MRI

idiopathic benign intracranial hypertension

idiopathic benign intracranial hypertension treatment

lose weight! acetazolamide diuretics shunt

``` loss of temperature and arm pain sensation back stiffness horners syndrome hyperhidrosis headache ``` recent spine trauma

syringomyelia

syringomyelia treatment

surgical decompression

child with large head shiny forehead with visible veins sunsetting of eyes failure to thrive

aqueductal stenosis (or other congenital cause of hydrocephalus)

aqueductal stenosis

shunt (as it causes hydrocephalus)

``` non blanching rash photophobia neck stiffness headache fever seizure cochlear implant fast onset ``` with purple dots in pairs on histology

strep pneumonia causing meningitis

``` 65yo non blanching rash photophobia neck stiffness headache fever seizure fast onset ``` with purple rods on histology

listeria monocytogenes causing meningitis

``` non blanching rash photophobia neck stiffness headache fever seizure child fast onset ``` with GM-ve rods on histology

haem influenzae causing meningitis

``` non blanching rash photophobia neck stiffness headache fever seizure student fast onset ``` with pink intracellular whisps on histology

Neisseria meningococcus causing meningitis

``` slow onset photophobia neck stiffness headache fever seizure recent foreign travel ```

aseptic (non bacterial) meningitis

meningitis treatment

ABCDE ceftriaxone and dexamethasone ASAP change antibiotics when cultures back amoxicillin for listeria (immunocompromised) acyclovir for viral prophylaxis treatment for contacts - ciprofloxacin

encephalitis treatment

acyclovir

brain abscess treatment

ceftriaxone IV and metronidazole IV

``` women in 30s unilateral optic neuritis fatigue sensory loss moor weakness and spasticity urinary tract dysfunction worse in heat ```

multiple sclerosis Uhthoff phenomenon = worse in heat eg shower, exercise

multiple sclerosis acute exacerbation treatment

PO steroids

multiple sclerosis disease modifying drugs

interferon beta monoclonal antibody mitoxantrane

forgetfulness behavior change nucleus basalis atrophy occurs first

alzheimers dementia

alzheimers dementia treatment

rivastigmine

``` smoker 65yo PMH stroke sudden onset memory loss depression ```

vascular dementia

vascular dementia treatment

treat CVD risk - antihypertensives NOT rivastigmine

80yo 1 year memory loss recurrent hallucinations of children now shuffling gait and falls

lewy body dementia NOTE not parkinsons dementia bc dementia was present first)

lewy body dementia investigation and treatment

investigation - DaT scan to differentiate form parkinsons | treatment - levodopa

55yo with MND personality change memory loss compulsive behavior

frontotemporal lobe dementia

treatment of frontotemporal lobe dementia

nothing | symptomatic

``` 80yo resting tremor shuffling gait cogwheel rigidity depression no memory loss ```

parkinsons (with no lewy body dementia)

parkinsons treatment

levodopa

``` 40yo autosomal dominant emotional disturbance - depression motor disturbance - chorea cognitive disturbance ```

huntingtons disease

huntingtons treatment

nothing | symptomatic

babinskis sign increased tone and muscle wasting (lol) no sensory loss no eye involvement

motor neurone disease bc UMn and LMN signs = amyotrophic lateral sclerosis babinskis sign = UMN lesion

treatment of motor neurone disease (MND)

nothing | symptomatic

post spine trauma ipsilateral fine touch and paralysis contralateral pain and temp loss

brown sequards syndrome

``` post syringomyelia cape distribution pain and temp loss upper limb weakness no fine touch loss no lower limbs problems ```

central cord syndrome

diarrhea pain progressive paraplegia (lower limb paralysis)

guilliane barre syndrome post infectious (hence diarrhea) demyelination

``` 30yo female (or 70yo male) autoimmune PMH diplopia ptosis bilateral facial weakness proximal muscle weakness worse as day goes on anti-ACh antibodies ``` what cancer is associated with this

myasthenia gravis thymoma

muscle weakness better after exercise autoimmune PMH, no anti-ACh antibodies what cancer is associated with this

lambert eaton lung small cell carcinoma

post food poisoning toxin inhibiting ACh release | causes paralysis

botulism (from botulinum toxin)

young boy stands up by pushing on knees (what is this called) woody calves

duhcenne muscular dystrophy gowers sign

young boy woody calves, can stand up fine will live til 40

beckers muscular dystrophy

young boy muscle weakness hatchet like face

myotonic dystrophy