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medicine year 3 > neuro > Flashcards

neuro Flashcards

1
Q

low levels of which ion can cause seizures?

A

phosphate

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2
Q

how long does it take for delirium to resolve and its significance?

A

takes 4-6 weeks, sometimes up to 2-3 months. (means patient can’t be diagnosed w dementia unless symptoms longer than this)

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3
Q

when are headaches associated with raised ICP the worst?

A

in the mornings

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4
Q

what is a big risk after an SAH?

A

cerebral vasospasm

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5
Q

which prophylaxis do you give for cerebral vasospasm?

A

nimodipine -type of calcium blocker that decreases risk of vasospasm

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6
Q

what is roseola infantum caused by?

A

HHV-6

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7
Q

what is the presentation of roseola infantum?

A

viral illness-3-4 days of fever, 24 hours of maculopapular rash, self resolving

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8
Q

what is progressive supranuclear palsy?

A

degenerative condition of unknown aetiology that produces an akinetic-rigid form of parkinsonism characterised by early falls and abnormalities of extraocular movements

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9
Q

what are the typical signs of progressive supranuclear palsy?

A

backwards falls
hypometria
dysarthria
dysphagia
bradykinesia

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10
Q

what is hypometria?

A

when the eyes undershoot when trying to focus on an object

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11
Q

what visual field defect would a stroke affecting the optic radiation cause?

A

contralateral HH

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12
Q

what visual field defect would a stroke affecting the occipital lobe cause?

A

HH usually with macular sparing

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13
Q

what is brown-sequard syndrome?

A

result of hemisection of spinal cord-ipsilateral loss of fine touch, vibration, and proprioception, contralateral loss of pain and temp

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14
Q

what is the preferred imaging modality for TIA?

A

MRI brain with diffusion weighted imaging-to determine area of ischaemia

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15
Q

what is functional MRI used for?

A

assess regional blood flow in brain whilst patient performs tasks, may be used to study the effect of TIA once confirmed.

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16
Q

what drug is used as first line treatment of MS?

A

methylprednisolone

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17
Q

what is the recommended empirical therapy for adults >50 with suspected bacterial meningitis?

A

IV cefotaxime/ceftriaxone + amoxicillin/ampicillin

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18
Q

what is tardive dyskinesia?

A

disorder that result in involuntary repetitive body movements eg grimacing, sticking out tongue, smacking lips. most common=chewing, pouting jaw.

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19
Q

what medication is usually prescribed to relieve headache due to raised ICP?

A

dexamethasone

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20
Q

what is mannitol used for and why?

A

cerebral oedema, raised intra-ocular pressure, CF as add-on therapy (helps with pulmonary oedema)
is an osmotic diuretic

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21
Q

what is the nice treatment for neuropathic pain?

A

amitriptyline, duloxetine, gabapentin, or pregabalin
if one doesn’t work try one of the others-switch don’t add
tramadol can be used as ‘rescue therapy’
topical capsaicin can be used for localised neuropathic pain, eg post herpetic neuralgia
carbamazapine-1st line for trigeminal neuralgia

22
Q

what is the 1st line treatment for early status epilepticus?

A

IV lorazepam

23
Q

what do you do if it’s an ischaemic stroke but it’s been more than 4.5 hours?

A

give aspirin

24
Q

what are the rules on epilepsy and driving?

A

1st ever seizure with LOC: license gone for 6 months, then have to reapply if no seizures for 6 months
have had more than one seizure with LOC: license gone for a tear, can reapply
if seizure because of medication change: can reapply after 6 months if back on previous medication and no more seizures in that time

25
Q

what are the rules on stroke and driving?

A

driving may resume after 1 month if satisfactory clinical recovery-dvla doesn’t need to be notified unless residual neurological deficits

26
Q

name 3 risk factors for MS

A

female gender
age 20-40
vit D deficiency

27
Q

what is the investigation of choice for optic neuritis MS?

A

MRI with contrast-allows visualization of the demyelinating lesions

28
Q

what is the drug management of status epilepticus?

A

1st line: IV benzos like lorazepam, diazepam (generally IV lorazepam)
PR diazepam or buccal midazolam can be given too
2nd line: phenytoin or phenobarbital infusion
if no response within 45 minutes, induce general anaesthesia.

29
Q

when do you do thrombolysis AND thrombectomy to treat stroke?

A

confirmed occlusion of the proximal anterior circulation on imaging

30
Q

what artery is occluded if you have amaurosis fugax stroke?

A

retinal/opthalmic artery
on the side you’re experiencing symptoms

31
Q

what visual field defect would you get if you have an MCA stroke?

A

contralateral homonymous quandrontanopia/hemianopia

32
Q

what visual field defect would you get if you have an MCA stroke?

A

contralateral homonymous quandrontanopia/hemianopia

33
Q

what is hoover’s sign and its significance?

A

diagnostic test from neurological as opposed to psychological hemiplegia
positive hoover’s sign suggests it is psychogenic and not truly neurological

34
Q

what is conversion disorder?

A

symptom, usually neuro, presenting after period of stress.

35
Q

what is factitious disorder?

A

feigning of symptoms in order to receive compassion from healthcare professionals

36
Q

what is titubation?

A

(involuntary) nodding movement of head or body usually caused by neuro disorder

37
Q

what’s the firstline imaging for stroke?

A

NON CONTRAST CT head

38
Q

what is the correct first line imaging for SAH?

A

non contrast CT head

39
Q

when should you do a LP when suspecting SAH?

A

if the CT head had been performed after 6 hours from the onset of symptoms and came back normal. The timing of the LP should be 12h after the onset of symptoms to allow for the development of xanthochromia-not recommended to do any earlier.

40
Q

what is essential to rule out in someone presenting with vertigo?

A

posterior stroke

41
Q

what is a broad based ataxic gait associated with?

A

midline cerebellar pathology, eg a lesion in MS or degeneration of the cerebellar vermis due to chronic alcohol excess

42
Q

in unilateral cerebellar disease what does their gait look like?

A

ataxic (staggering, slow, unsteady) and patient veers towards side of lesion.

43
Q

what blood gas abnormality does meningitis show?

A

metabolic acidosis

44
Q

what are some examples of third gen cephalosporins?

A

ceftriaxone, cefotaxime

45
Q

what is the most common electrolyte abnormality complication of SAH?

A

hyponatraemia -usually due to SiADH

46
Q

which GCSs indicate when to do a CT head?

A

<13 at first presentation: CT head within an hour
<15 2h post injury: CT head within 8 hours

47
Q

what is the classic symptoms of normal pressure hydrocpehalus?

A

wet, wacky, and wobbly: urinary incontinence, gait ataxia, dementia

48
Q

what are the features of viral labyrinthitis?

A

recent viral infection
sudden onset
vertigo, N+V, can affect hearing

49
Q

what are the features of vestibular neuronitis?

A

recent viral URTI
recurrent vertigo attacks lasting hours/days
no hearing loss

50
Q

what are the features of vertebrobasilar ischaemia?

A

vertigo
dizziness on extension of neck
happens in older people

51
Q

what are the features of accoustic neuroma?

A

hearing loss, vertigo, tinnitus
absent corneal reflex
associated with neurofibromatosis type 2

52
Q

what can acute severe hyponatraemia cause?

A

cerebral oedema

medicine year 3 (21 decks)

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