neuro Flashcards
(65 cards)
ipsilateral hemiplegia
same said loss of proprioception and vibration
contralateral loss of pain and temp
brown sequard
causes of brown sequard
cord trauma neoplams disc herniation demyelination epidual haemtoma
how does ipsilateral UMN weakness present in an exam of limbs?
tone
power
reflex
increased tone
hyperreflexia
leg lift
what are causes of bulbar palsy?
categorise them
absent jaw jerk
absent gag reflex
fasciculating tongue
infection: GBS,
inflammation: MG, MND
malignancy : neoplasm of brainstem
ischaemic: brainstem stroke
cerebeller syndrome signs?
DANISH
dysdiadochokinesia ataxia nystagmus intention tremor slurred speech hypotonia
what causes cerebeller syndrome?
vitamin C
vascular: stroke; posteriro circulation
infection: lyme disease
inflammation: Multiple sclerosis
trauma
metabolic: alcohol
iotrogenic: carbamazepine
neoplastic: tumour , acoustic neuroma
hereditary: friedrichs
cerebeller syndrome causes simple
infection: Lyme
Inflammation: MS
Malignancy: acoustic neuroma, 2O mets from breast cancer, lung
cag trinucleotide affected - repeats choero dementia dystonia saccadic eye movements
striatal colume loss and increased size of frontal horns of lateral ventricles
what is this?
Mx?
huntingtons
chorea - tetrabenzine
SSRI-
psychosis : olanzapine
diplopia causes
categorises
infection: sixth nerve palsy
inflammation: Graves, MG
malignancy: neoplasm of cranial nerves
which drug commonly causes dystonia?
metocllopramide
mx of encephalitis
what does it present with?
IV acyclovir and broad spectrum abx IV ceftriaxone 2g BD IV
seizures alongside characteristic infection signs ; neck stiffness, fever
altered mental state
management of epilepsy
lamotrigine - not teratogenic
levetiracetam
valproate- teratogenic
carbamazepine and gabapentin: focal , may worsen myoclonic seizures
ethosuximide good for absence
gabapentin
what is it used for?
SE?
focal seizures
anxiety, confusion, constipation
lamotrigine SE
what is it used for?
focal seizures blurred vision: diplopia arthralgia ataxia dizziness headache rash tremor
valproate
SE
anaemia confusion convulsions deafness extrapyramidal disorders
phenytoin
se
acne anorexia constipation dizziness gingival hypertrophy
levetiracetam
headaches
feeling sleepy
blocked nose
itchy throat
what is the most common source of bleeding in a head trauma pt
pt had lucid period followed by deterioting consciousness and a headache
what would you see on a CT?
how do you differentiate between subdural
what constitues an emergency?
management?
this is an extradural bleed
middle meningeal artery
bi convex shape - blood is fresh so appears white as it is least dense
blood is clotted and old so appears darker, also banana shaped
midline shift on ct
burr hole
how can you medically manage subdural bleeds?
transexamic acid
foot drop
causes?
what level lesion?
L5 root lesion: radiculopathy - disc herniation
GBS
treatment
what infection most commonbly associated?
what are you worried about?
monitor ventilation- abg, serial spirometry
VTE- LMWH
medically: IV immunoglobulin, plasmapheresis
campylobacter, mycoplasma and EBV: so GI upset in a question could indicate
respiratory arrest- forced vital capacity
criteria for CT headl
More than 30 minutes retrograde amnesia.
Focal neurological deficit or seizure.
GCS <13 at any time (or <15 2 hours after injury).
More than 1 episodes of vomiting.
Loss of consciousness and any amnesia in patients who:
Are >65 years
Suffered a dangerous mechanism of injury (great height, road traffic accident)
Have evidence of coagulopathy (including anticoagulation with warfarin).
clinical evidence of skull fracture
horners syndrome
causes?
pancoast tumour
stroke
carotid artery dissection - NECK pain
stroke management
4.5 hours of presenting
alteplase - inr normal , acceptable bp
mechanical thrombectomy
aspirin 300mg 2 weeks
carotid ultrasound, CT/MR angiography
