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Disease Table Flashcards

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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
Symptoms of Trigeminal autonomic cephalgias
``` Unilateral head pain Predominantly V1 Cranial autonomic symptoms: Lacrimation Runny nose Blocked nose Eyelid oedema Ptosis ```
26
Durations of attacks in SUNCT/SUNA
2-240 seconds
27
Duration of attacks in paroxysmal hemicrania
2-30 mins
28
What does Trigeminal Neuralgia affect
The trigeminal nerve
29
Which n. branches are more affected in trigeminal neuralgia
V2/V3>V1
30
Which N. branch is more affected in trigeminal cephalgias
V1
31
What is giant cell arteritis
Temporal arteritis | Inflammation of the temporal artery
32
Signs of giant cell arteritis
New onset headache | Prominent beaded or enlarged temporal arteries
33
Symptoms of giant cell arteritis
New onset headache Jaw claudication Visual disturbances Scalp tenderness
34
Blood Ix for giant cell arteritis
ESR elevated CRP Platelet count
35
Diagnostic Ix for giant cell arteritis
Temporal artery biopsy
36
Rx giant cell arteritis
High dose prednisolone
37
Prophylactic Rx SUNCT/SUNA
Carbamezepine
38
Rx for trigeminal neuralgia
Anti-convulsant: | Carbamezepine
39
Cutaneous triggers for trigeminal neuralgia
Wind Cold Touch Chewing
40
Is MS disease of old or young?
Young
41
What is MS
Autoimmune inflammatory myelination condition of the CNS
42
Diagnosis requirement for MS
Episodes of demyelination disseminated in space and time
43
Symptoms of optic neuritis relapse
Pain when moving eye Subacute visual loss Diploplia
44
Sensory symptoms MS relapse
Pins and needles Decreased vibration sense Dysaeathesia
45
Motor symptoms MS relapse
Limb weakness | Myelitis
46
Brainstem symptoms MS relapse
Trunk and limb ataxia Gait abnormality Nystagmus CN involvement
47
GI symptoms MS relapse
Swallowing disorders | Constipaiton
48
Sexual/GU symptoms MS relapse
Impotence Urinary incontinence Urinary retention
49
Ix MS
MRI | LP
50
Describe oligoclonal bands use in MS diagnosis
Oligoclonal bands present in CSF but not serum suggest Purely CNS inflammation
51
Disease modifying drugs in MS
Ocrelizumab Dimethyl Fumarate Beta-interferons Natalizumab
52
Treating relapse RX MS
Methylprednisolone
53
Rx for spasticity in MS
Muscle relaxants
54
Rx for Dysaethesia in MS
Amitriptyline
55
Rx for bladder in MS
Catheterisation
56
Rx for Constipation in MS
Laxatives
57
Describe Relapsing Remitting MS
Clearly defined as attacks followed by periods of partial or complete recovery/remission
58
Describe primary progressive MS
Worsening neurological function from onset without relapses or remission
59
Describe secondary progressive MS
Follows initial relapsing remitting course | Transition to progressive MS without remission
60
Describe Sensory MS
Those who have only ever had mild sensory episodes
61
Describe Benign MS
Have attacks but function always returns to normal
62
How does MS change with pregnancy
Fewer relapses during pregnancy | Increased risk of relapses for first 3 months post-partum
63
Describe malignant MS
Severe disability in small period of time Very aggressive demyelination attacks Rapid decline in function
64
What are the grades of Astrocytoma
I-IV
65
Risk factors for brain tumours
Often unknown FH Ionizing radiation Environmental hazard
66
Signs of brain tumour
Raised ICP
67
Symptoms of brain occupying lesions
``` New onset of change pattern of headache Nausea Vomiting Worse headaches in morning Seizures Neurological deficit depending on position ```
68
Brain tumour diagnosis IX
CT | MRI
69
Brain tumour staging Ix
CT chest/abdo/pelvis Biopsy any skin lesions Xray
70
Are brain mets or primary brain tumours more common
Brain mets
71
Common primary sites for brain mets
``` Lung Breast Renal GI Melanoma ```
72
Rx for brain tumours
Complete excision Chemo Radiotherapy
73
What is a glioblastoma?
Grade IV brain tumour
74
What can glioblastoma cross
Corpus callosum
75
Shape of glioblastoma
Butterfly shape
76
What do meningiomas arise from ?
Meninges
77
Most common type of adult brain tumour
glioblastoma
78
Describe meningioma
Slow growing tumour Arise from arachnoidal cap cells from arachnoid membrane Usually benign Usually non-invasive
79
What is the prognosis for meningioma
Good prognosis
80
Most common pituitary tumour
Pituitary adenoma
81
What visual defect can pituitary adenoma cause
Bi-temporal hemianopia
82
Signs of pituitary adenoma
Hormone imbalance | Compression of optic chiasm leading to visual disturbances
83
Treatment for pituitary adenoma
Endocrine replacement Transsphenoidal surgery Corticosteroids
84
Definition of parkinsons
Clinical syndrome of 2 or more Bradykinesia Tremor Rigidity
85
Pathology of parkinsons
In the substantia nigra leads to dopamine loss Lewy bodies present
86
Describe parkinsons tremore
Resting tremor Pin rolling Most noticeable in hands
87
Describe Gait in parkinsons
Slow shuffling Lack of arm swing Unable to turn around quickly Slow to initiate movement
88
Describe rigidity in parkinsons
Cog wheel rigidity | Hypertonia
89
Other symptoms in parkinsons
Low mood Soft voice Anxiety
90
1st line Rx for Parkinsons
Levodopa
91
Action of levodopa
Can cross BBB and be converted to dopamina
92
Other RX for parkinsons
Dopamine agonist: Ropinorole COMT inhibitors MAO-B inhibitors
93
How do COMT inhibitors work
Stops COMT | Which is an enzyme that degrades dopamine
94
How do MAO-B inhibitors work
MAO-B is in enzyme which breaks down dopamine | Stops MAO-B
95
Differential diagnosis for parkinsons
Lewy body dementia | Normal pressure hydrocephalus
96
Does alcohol affect tremor in parkinsons?
No
97
What is dementia?
Syndrome consisting of progressive impairment of multiple domains of cognitive function in alert patients
98
Who does dementia generally affect?
Elderly
99
Most common cause dementia
Alzheimer's Disease
100
Causes of dementia
``` Alzheimer's Vascular Lewy body Frontotemporal Tempero-parietal Normal pressure hydrocephalus CJD ```
101
Pathology vascular dementia
Series fo minor strokes in brain | Mixed picture depending on where the strokes have occured
102
Progression in vascular dementia
Step wise
103
Progression lewy body dementia
Rapid progression
104
Pathology of lewy body dementia
Lewy bodies in brainstem and neocortex
105
Common finding in lewy body dementia
Parkinsonism
106
Describe frontotemporal dementia
``` Early behaviour change Drastic personality change Early aphasia Loss of neurons and connection in fronto/temporal lobe Emotional unconcern Change in eating/hygeine habits ```
107
Describe tempero-parietal dementia
Early memory disturbance Language and visuospatial problems Personality preserved until later
108
triad of normal pressure hydrocephalus
Wet Wobbly Wacky
109
What is CJD cause by?
Infiltration of prions in the brain
110
General symptoms of dementia
``` Worsening memory Change in personality Aphasias Aggression Hallucinations ```
111
Which type of dementia is hallucinations common
Lewy body
112
Which history is needed in dementia diagnosis
Witness
113
What investigations can rule out underlying causes of dementia
``` MRI Vit B12 Folic acid TSH C-reactive protein ```
114
Rx alzheimers +/- lewy body dementia
Cholinisterase inhibitors Antiglutamatergic treatment Antipsychotics
115
RX frontotemporal dementia
None
116
Example of cholinisterase inhibitors
Donezepril
117
Example of antiglutamatergic Rx
Mematine
118
Rx depression in dementia
Serotonin Reuptake inhibitors | E.g Citalopram
119
Non-pharmacological therapy for dementia
Cognitive behavioural therapy Aromatherapy Multi-sensory stimulation
120
Pathology in alzheimers
Loss of neurones and synapses in cerebral cortex
121
Risk factors for alzheimers
Age FH Downs syndrome Smoking
122
Progression of alzheimers
Short term memory loss Generally mild to begin with Gets worse over time
123
Signs alzheimer's
``` Progressively worse memory Confusion Disorientation Speech or language problems Personality change ```
124
What is hydrocephalus
Condition whereby there is excess CSF within intracranial space
125
Describe communicating hydrocephalus
CSF can flow freely | Normally production>absorption
126
Describe NCH
Involves obstruction | Blockage of outflow from ventricles
127
Most important sign of hydrocephalus
Raised ICP
128
Symptoms/signs of hydrocephalus in infants
``` Cranial enlargement Splaying sutures Fontanells full and bulging Eyes fixed downwards CN VI palsy ```
129
Symptoms/signs of hydrocephalus adults
``` Increased ICP Morning headaches Or worse during valsalva manoeuvre Papilloedema Gait abdnormality CN VI palsy ```
130
IX for hydrocephalus
CT | MRI
131
Acute Rx hydrocephalus
External ventricular drain
132
Surgical RX hydrocephalus
VP shunt
133
Potential RX for NCH
ETV Endoscopic 3rd ventriculostomy Hole in floor of 3rd ventricle
134
What is normal pressure hydrocephalus a potential reversible diagnosis of/
Dementia
135
Classic triad in NPHC
Dementia Gait disturbance Urinary incontinence
136
RX NPHC
VP shunt
137
IX for NPHC
CT MRI LP
138
Pathology of cauda equina syndrome
compresison cauda equina
139
Common causes for cauda equina syndrom
Prolapsed dise | Tumour pressing on spinal cord
140
PR findings cauda equina s.
Loss of anal tone
141
Red flags for cauda equina syndrome
Bilateral sciatica Saddle anaesthesia Urinary/bowel dysfunction
142
Ix cauda equina syndrome
Urgent MRI
143
RX cauda equina syndrome
Lumbar discetomy
144
What is sciatica
Pain from lower back down to legs
145
What is saddle anaesthesia
Loss of sensation of buttocks peritoneum and inner thighs
146
Risk factors for epidural abscess
IV drug abuse DM Chronic renal failure Alcholism
147
What is epidural abscess
Inflammation that involved collection of pus in epidural space
148
Common organism for epidural abscess
Staph aureus
149
Symptoms for epidural abscess
``` Back pain Spinal tendernes Pyrexia Fever Focal neurology Urinary problems ```
150
IX for epidural abscess
Blood cultures Urgent MRI WCC ESR
151
RX epidural abscess
Drainage | Long term IV antibiotics
152
Describe cervical spondylosis
Degenerative change in cervical spine | Leading to spine and nerve root compression
153
Risk factors for cervical spondylosis
Age Previous neck injury Arthritis
154
Symptoms of cervical spondylosis
Limited movement Painful neck LHermitte's sign
155
What is lHermitte's sign
Shock like sensation travelling down spine upon flection of the neck
156
Features of root compression in cervical sponylosis
``` Tingling pain in arm/fingers at affected level LMN signs: Hyporeflexia Muscle wasting ```
157
Treatment for moderate to severe myelopathy
Decompressive surgery
158
Features of myelopathy in cervical spondylosis
UMN signs legs LMN signs arms Bowel and bladder incontinence
159
What do UMN signs below the level of the affected root suggest?
Cord compression
160
Which tumours commonly metastasis to spinal cord
Brest Prostate Lung
161
Symptoms of spinal cord metastases
Back pain Weakness Incontinence Saddle anaesthesia
162
If a person has a known cancer and is experiencing back pain with urinary incontinence what is the Ix
Urgent MRI
163
RX for spinal cord metastases
Surgical | Radiotherpay
164
Types of generalised seizures
Tonic clonic Myoclonic Atonic seizure Absence seizure
165
Types of focal seizures
With retained awareness | With loss of awareness
166
IX for seizures
``` BG ECG EEG Consideration of alcohol and drugs CT head ```
167
When is epilepsy diagnoses
>2 unprovoked attacks
168
Causes of blackouts
``` Vasovagal syncope Concussive seizures Cardiac arrhthymias First seizure Hypoxic seizure Hypoglycemia Anxiety ```
169
Rx generalised tonic clonic seizures or atonic seizures
Sodium Valporate | Lamotrignine
170
Rx 2nd line generalised tonic clonic
Levetiracetam | Topiramate
171
RX for focal seizures
Carbamazepine | Lamotrigine
172
2nd line for focal seizures
Topiramate | Sodium valproate
173
Rx absence seizures
Ethosuximide
174
Rx myoclonic seizures
Sodium valproate
175
1st RX for status epilepticus
Lorazepam | Midazolam
176
2nd Rx status epilepticus
Slow infustion phenytoin
177
3rd Rx status epilepticus
Seek ICU help | Anaethesia
178
Bacterial causes meningitis
Meningococcus | Penumococcus
179
Signs meningitis
``` Fever Neck stiffness Photophobia Phonophobia Nausea Vomitng GCS<14 Seizures Petechial rash Cold Hands and feet ```
180
What is petechial rash in meningitis hallmark sign of
meningococcal meningitis
181
Classic triad meningitis
Feve Neck stiffness Headache
182
Ix meningitis
Blood cultures LP CSF culture/microscopy
183
Rx meningitis
IV ceftriaxone/AB Fluid resus Correct BG Dexamethasone
184
CI to LP
Raised ICP Spinal cord injury Infection over LP site GCS<10
185
LP signs of meningitis
Increase opening pressure Low glucose High mainly neutrophil cell count High protein levels
186
Is there need for imaging in meningitis?
No if there are no CI to LP
187
What is encephalitis
Infection of brain substances
188
LP findings encephalitis
High lymphocytes Normal/high opening pressure Normal BG Protein slightly increased
189
Symptoms of encephalitis
Progressive headache Meningism Seizures Progressive cerebral dysfunction
190
Ix encephalitis
``` Blood cultures Imaging CT+/- MRI LP EEG Viral PCR ```
191
Difference between encephalitis and meningitis
Encephalitis | Brain is much more affected
192
Signs of encephalitis
``` Confusion Abnormal behaviour Memory disturbance Seizures Focal symptoms ```
193
Rx encephalitis
IV aciclovir
194
Common viruses causing encephalitiis
``` HSV Arbovirus Enterovirus Rabies HIV ```
195
2 types of autoimmune encephalitis
Anti-VGKC | Anti-NMDA receptor
196
What is a cerebral abscess
Localised area of pus within in the brain
197
Signs f of cerebral abcess
Seizures Fever Increased ICP signs
198
Ix cerebral abscess
``` CT MRI WCC Blood cultures ESR ```
199
Common organisms cerebral abscess
Step milleri
200
Rx cerebral abscess
Surgical drianage if possible | Penicillin or ceftriazone
201
Which organisms causes syphilis
Treponema Pallidum
202
What does tertiary syphilis present as
Neurosyphilis
203
Ix neuorsyphilus
Serology | VDRL antibodies
204
RX neurosyphilus
High dose penicillin
205
Types of CJD
Sporadic New variant Familial Acquired
206
What is CJD caused by?
Protein - prion
207
What was GH from human pituitaries sometimes containing
CJD
208
Rx CJD
Non proven
209
Prognosis for CJD
Death often within 6 months
210
Signs CJD
``` Rapidly progressive dementia Memory loss Hallucinations Focal CNS symptoms Myclonus ```
211
Iatrogenic causes of CJD
Contaminated surgical instruments GH from human pituitary glands dura matter graft
212
What type of virus is poliovirus
Enteroviruses
213
Route of infection for polio
Faecal-oral
214
Where is infected in polio
Anterior horn cells
215
Rx polio
Preventative in form of vaccine
216
Signs of polio
LMN signs Bulbar signs No sensory features
217
Ix polio
Viral culture of stools Pharyngeal swabs Bloods
218
What is rabies
Acute infection of CNS
219
How is rabies transmitted
Bite or salivary contamination | CNS tissue
220
Post Exposure Rx:
Wash wound Active rabies immunisation Human rabies immunoglobulin
221
Who should rabies vaccines be given to
Bat handlers Regular handlers of imported animals Selected travellers
222
Infective bacterium in tetanus
Clostridium tetani
223
Pathology Clostridium tetani
Toxin acts at neuromuscular junction | Blocks inhibitors of motor neurones
224
Signs tetanus
Severe rigidity and spasm
225
Rx of spasms in tetanus
Lorazepam
226
Infective organism in botulism
Clostridium botulinum
227
Pathology of botulism
Binds irreversibly to the pre-synaptic membranes of peripheral neuromuscular junction and autonomic nerve junction Blocks Ach release
228
Signs botulism
Flaccid paralysis | Progressive paralysis
229
Ix botulism
Clinical diagnosis do not delay treatment
230
Rx botulism
Admit to ICU | Botulinum anti-toxin
231
What can polio cause?
Irreversible paralysis
232
IX for poliomyelitis
Viral culture of stool Pharyngeal swabs Bloods
233
What is myopia?
Short sightedness
234
What is the commonest cause of myopia?
Eyeball too long | Imagines form infront of the retina
235
Symptoms fo myopia?
``` Objects close up are clear Distant are hazy Headaches Divergent squint Eyestrain ```
236
Rx myopia
Glasses | Contact lenses Laser eye surgery
237
Lense type for myopia
Concave
238
Lense type for hyperopia
Convex lenses
239
What is hyperopia
Far sightedness
240
Causes of hyperopia
Eyeballs too short | Image forms behind the retina
241
Symptoms of hyperopia
Convergent squint children | Eye strain after reading, computer ect...
242
Rx for hyperopia
Convex lenses Contact lenses Laser eye surgery
243
What is presbyopia
Long sightedness of old age
244
When does presbyopia usually start
5th decade of life
245
Pathology of presbyopia
Decrease in elasticity in the lens | So when ciliary muscle contracts not as capable of changing shape
246
Cause of astigmatism
Surface of lens has different curvatures in different medians Meaning light never falls on the same place
247
Lenses for astigmatism
Cylindrical lenses | Toric contact lenses
248
Symptoms astigmatism
Close and distant objects appear hazy
249
2 types of glacoma
Open angle | Angle closure
250
Triad signs of glaucoma
Raised IOP Visual field defects Optic disc change
251
Type of visual defect in glaucoma
Tunnel vision | Loss of peripheral vision
252
Cause of open angle glaucomea
Drainage through trabecular meshwork is blocked Reduced flow though TM Loss of AH reabsorption Leads to increased IOP
253
Cause of angle closure glaucoma
Peripheral iris blocks the angle Caused by contact between the iris and TM AH cannot drain
254
How dos IOP increased in OAG and ACG differed?
Angle closure - sudden increase | Open angle - gradual increase
255
IX glaucoma
Opthalmoscopy | IOP measured
256
Open angle glaucoma symptoms
Develops over time Progressive visual loss No pain associated
257
Angle closure glaucoma symptoms
``` Sudden onset Red eye Vision loss Headaches Nausea/Vomiting ```
258
Open glaucoma signs
No pain Progressive peripheral visual loss Optic nerve changes
259
Angle closure signs
Red eye Cornea often opaque due to raised IOP IOP severely raised Fixed dilated pupil
260
Rx open angle glaucoma
Eye drops to decrease IOP Prostaglandin analogues BB Carbonic anhydrase inhibitors
261
Rx closed angle glaucoma
``` IV infusion carbonic anhydrase inhibitor Analgesics Antiemetic's Dexamethasone eye drop Surgery ```
262
Who should be informed if glaucoma is present in both eyes
DVLA
263
What is uveitis
Inflammation of the uvea
264
Where does anterior uveitis affect?
Inflammation that affects anterior part of uveal tract | Iris and ciliary body
265
Where does intermediate uveitis affects
Localised to vitreous and peipheral retina
266
Where does posterior uveitis affect?
Retina Choroid Optic nerve head
267
Triad of uveitis
Pain Photophobia Redness of eye
268
Symptoms of uveitis
Pain Photophobia Redness eye
269
In which types of uveitis do floaters and blurred vision often occur?
Intermediate and posterior
270
Rx anterior uveitis
Topical steroids: Prednisolone Dexamethasone
271
Rx intermediate uveitis
Corticosteroid injections
272
Rx posterior uveitis
Corticosteroid injections | Sometimes oral
273
Wat is conjunctivitis
Bacterial or viral infection that causes inflammation of the conjuntiva
274
What is pink eye often a name used for?
Conjunctivitis
275
Is there loss of vision in conjunctivitis
no
276
Symptoms conjuncitivitis
``` Red watery eyes Itchy/burning eye Discharge Excessive lacrimation Swollen eye lids Gritty feeling in eye ```
277
Rx conjunctivitis
Bacterial: AB eye drops Viral: often self-limiting Antihistamine eye drops Warm or cold compresses to eye
278
What should be avoided when having conjuncitivits
Contact lenses
279
Risk factors for age related macular degenration
Age Smoking Poor diet
280
2 types of age related macular degenration
Dry type: most common | Wet type
281
Visual loss of age related macular degeneration
Progressive loss of central vision | Over the macula
282
What is cavernous sinus trombosis
Blood clot in cavernous sinus
283
Common infection sites for cavernous sinus thrombosis
Nasal furuncle Dental infections Sphenoidal or ethmoidal sinuses
284
Common organisms cavernous sinus thrombosis
Staph. Aureus | Streptococcus
285
Signs cavernous sinus thrombosis
Red swollen eye Exophthalmos Ptosis CN palsies
286
Symptoms cavernous sinus thrombosis
Headache around eye Double vision Blurred vision Red swollen eye
287
Ix cavernous sinus thrombosis
Ophthalmoscopy | CT
288
Rx cavernous isnus thrombosis
Broad spectrum IV AB
289
Difference between orbital and preseptal cellulitis
Orbital; infection of soft tissue posterior to orbital septum Preseptal: Infection anterior to the septum
290
Who is orbital cellulitis most commonly seen in ?
Children
291
Common causes pre-septal cellulitis
Lid cyst | Insect bite
292
Common cause orbital cellulitis
Sinusitis | Dental infections
293
Symptoms preseptal cellulitis
Pain Erythema Systematically well Vision intact
294
Symptoms orbital cellulitis
``` Pain Erythema Lid swelling Systematically unwell Double vision Conjunctivitis Expohthalmos Clurred vision ```
295
Rx pre septal callulitis
Oral co-amoxiclav
296
Rx orbital cellulitis
IV AB
297
Sign of CN III palsy
Ptosis | Eye position Inferior and lateral
298
What is a symptoms of CN IV palsy
Diploplia which is maximal when looking down
299
Signs of CNVI palsy
Esotropia | Diploplia
300
What is SAH
Spontaneous bleeding into subarachnoid space
301
What is the main concern with thunderclap headache
SAH
302
Risk factos SAH
``` Hypertension Alcohol Smoking FH Previous SAH ```
303
Main Cause of SAH
Berry aneurysm
304
Signs ofSAH
Signs of increased ICP Decreased conscious level Seizure Neck stiffness
305
Describe thunderclap headache
High intensity headache reaching maximum intensity in <1min Majority peak instantly Start at back of head and progresses round
306
IX SAH
CT | LP >12hrs
307
RX SAH
Early clipping/coiling | Nimodepine
308
Why should LP for SAH be >12 hrs
To allow breakdowns of rBC | Determine old blood from bloody tp
309
Complications of SAH
Re-bleeding | Cerebral ischaemia
310
What is subdural haematoma
Blood gathers in subdural space
311
What is SDH usually associated with
Traumatic brain injury
312
What is the origin of bleeding in SDH
Venous origin
313
Risk factors SDH
Brin injury Elderly Anti-coagulation
314
What type of bleed may be seen in shaken babies
SDH
315
Why are SDH usually slower onset compared to EDH
Because pressure veins bleed slower than arteries
316
Signs of SDH
Increased ICP
317
Symptoms SDH
``` History recent injury Loss of consciousness Fluctuating consciousness Seizures Headache Pain Dizziness ```
318
IX SDH
CT | MRI
319
Signs on CT of SDH
Classic crescentic shape | Concave curve away from skull
320
Rx SDH
Craniotomy | Burr hole
321
What is epidural haematoma
Bleeding between dura and skull
322
What is the usual origin of EDH
Bleeding from middle meningeal artery
323
Ix for EDH
CT
324
CT signs EDH
Biconvex lens shape | ura matter tightly attached to the skull
325
Symptoms of EDH
``` Lucid period Decreased GCS Increased ICP Severe headache Vomiting Confusion Seizures ```
326
2 types of strokes
Ischaemic | Haemorrhagic
327
Wha t is TIA
Mini stroke | Symptoms relieve <24 hrs
328
How long does it take for most TIAs to resolve
1-60mins
329
PACS criteria
``` 2/3 1. Higher Dysfunction Aphasia Decreased conscious level Visuospatial disturbance 2. Homonymous Hemianopia 3. Hemiparesis 2 of Face/ Arm/ Leg ```
330
TACS criteria
``` 3/3 1. Higher Dysfunction Aphasia Decreased conscious level Visuospatial disturbance 2. Homonymous Hemianopia 3. Hemiparesis 2 of Face/ Arm/ Leg ```
331
Where is the occlusion in TACS
Middle cerebral artery
332
Type of lacunar stroke
``` 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
Symptoms of POCS stroke
``` Ataxia Vertigo Nystagmus CN palsies Loss of heel-shin test Visual field defects ```
334
Signs stroke
``` Aphasia Weakness Gait disturbance Visual defects Loss of co-ordination ```
335
FAST symptoms
Facial weakness/asymmetry Arm weakness Problems with speech Time to call 999
336
Ix stroke
CT ECG Carotid dopple US
337
Risk factors for stroke
``` Hypertension AF Smoking DM Hyperlipidaemia Obesity Combined OCP ```
338
Secondary preventative Rx stroke
``` Anti-hypertensives Anti-platelets Warfarin Statins Carotid endarectomy ```
339
General lifestyle modifications to prevent stroke
Smoking cessation DM control Lipid level control Good BP control
340
Which type of stroke has the worst prognosis
TACS

Neurology System (35 decks)

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