NEURO Flashcards by jane smith

acoustic neuroma features?

DVT plus absent corneal reflex

vertigo, hearing loss, tinnitus and an absent corneal reflex.

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woman has a TIA: unilateral weakness or sensory loss,
tx?

how does this differ in crescendo TIA- 2 TIAs in 7 days?

give aspirin 300 mg immediately, unless
1. the patient has a bleeding disorder or is taking an anticoagulant (needs immediate admission for imaging to exclude a haemorrhage)
2. the patient is already taking low-dose aspirin regularly: continue the current dose of aspirin until reviewed by a specialist
3. Aspirin is contraindicated: discuss management urgently with the specialist team

Specilaist revie

clopidogrel is recommended first-line (as for patients who’ve had a stroke)
aspirin + dipyridamole should be given to patients who cannot tolerate clopidogrel

how does this differ in crescendo TIA- 2 TIAs in 7 days?
CT head and aspirin

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when to think idiopathic intracranial hypertension?

Obese, young female with headaches / blurred vision

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typical symptoms seen in Parkinson’s disease?

Resting tremor + bradykinesia + rigidity

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cluster head ache description?
tx?

Episodic, intense, unilateral eye pain, lacrimation, restless
Tx is oxygen, then subcutaneous triptan

Prophylaxis: verapamil

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side effect of excess vitamin B6 (pyridoxine) ingestion?

peripheral neuropathy

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horizontal diplopia
nerve damage?

cranial nerve 6 abducens

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GCS points?

Motor (6 points) Verbal (5 points) Eye opening (4 points). Can remember as ‘654…MoVE’

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root?

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had shingles and now has post-herpetic neuralgia.
tx?

amitriptyline, duloxetine, gabapentin or pregabalin first-line.

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sensory loss to the little finger and wasting of the hypothenar eminence.

nerve damage?

ulnar nerve

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contraindication to triptan use in migraine?

cardiovasular diease

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sudden and transient loss of muscular tone caused by strong emotion (e.g. laughter, being frightened).

cataplexy

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Common peroneal nerve lesion

weakness of foot dorsiflexion
weakness of foot eversion
weakness of extensor hallucis longus
sensory loss over the dorsum of the foot and the lower lateral part of the leg
wasting of the anterior tibial and peroneal muscles

side note: L5 damage only causes foot drop but no effect on eversion

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in a young person… features should prompt investigation for a secondary cause of headaches?

headache triggered by coughing

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migraine
tx?
prophylaxis?

acute: triptan + NSAID or triptan + paracetamol
prophylaxis: topiramate or propranolol

side note: Propranolol is preferable to topiramate in women of childbearing age (i.e. the majority of women with migraine)

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long term mx of stroke?

Aspirin 300 mg daily for 2 weeks then clopidogrel 75 mg daily long-term

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Huntington’s disease is due to a defect in the huntingtin gene on chromosome…?..

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Guillain-Barre syndrome
presentation?

ascending paralysis

c.jejuni

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Phenytoin s/e
montioring?

megaloblastic anaemia (secondary to altered folate metabolism)
peripheral neuropathy

Phenytoin levels do not need to be monitored routinely but trough levels, immediately before dose should be checked if:
adjustment of phenytoin dose
suspected toxicity
detection of non-adherence to the prescribed medication

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Fasciculations’ - think …..?

MND

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where is the lesion- macular sparing?

Occipital cortex

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A 54-year-old man complains of sweating, headaches and ‘tunnel vision’.

lesion eye?

optic chiasm

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early blindness, now tunnel vision

where is the lesion?

retina

common presentation of retinitis pigmentosa.

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tuberous sclerosis adenoma sebaceum

Which of the following complications is classically associated with parotid gland surgery?

Parotid pathology can cause a lower motor neurone facial palsy

Which one of the following features of migraine is more common in children?

Gastrointestinal disturbance

Generalised tonic-clonic seizures tx in females vs males?

focal seizure tx

absense seizure tx

myocloninc seizure tx?

tonic or atonic seizure tx?

most appropriate for secondary prevention of stroke- already taken high dose aspirin for 14 days?

Clopidogrel is the preferred antiplatelet for secondary prevention following stroke

what dermatome supplies thumb, index finger, middle finger, palm, ring finger

CT head showing temporal lobe changes

think herpes simplex encephalitis

Primary open angle glaucoma in right eye damage visual field tract?

Unilateral peripheral visual field loss

20-year-old man presents with recent episodes of severe, stabbing pain in the right eye. has clear nasal discharge during the episodes. dx? trigger? tx? prophylaxis?

Alcohol is a common trigger for cluster headaches

ischemic stroke identified in 3 hrs mx?

A combination of thrombolysis AND thrombectomy is recommend for patients with an acute ischaemic stroke who present within 4.5 hours side note: BP MUST BE CONTOLLED- CAN GIVE B BLOCKER

man right sided numbness, poorly controlled htn, diabetes. ct shows no haemorrhage. dx?

lacunar infarct A patient having a lacunar stroke would present with either a purely motor, a purely sensory or a mixed motor and sensory deficit

typical aura in migraine?

Typical aura include a spreading scintillating scotoma ('jagged crescent')

A maximum of ...?.... doses of IV benzodiazepines can be administered during convulsive status epilepticus

two!!

Peripheral neuropathy is a known adverse effect of WHICH ANTI EPILEPTIC DRUG?

PHENYTOIN

Parkinson's disease - most common psychiatric problem is

depression

Useful for managing tremor in drug-induced parkinsonism

Procyclidine

PARKINSONS Has been associated with pulmonary fibrosis

Cabergoline

PARKINSONS: which medication Often has a reduced effectiveness with time

Levodopa

Neuropathic pain responds poorly to opioids. if standard treatment failed which opioid is it most EFFECTIVE?

TRAMADOL

DVLA informing and TIA?

Can start driving if symptom free after 1 month - no need to inform the DVLA

test is used to determine whether your fingers or thumbs flex involuntarily in response to certain triggers. name of this sign?

hoffmans sign

neurodegenerative disorder involving death of neurones in the substantia nigra

parkinsons

Which vitamin, present in Pabrinex, can prevent progression of symptoms to Wernicke's encephalopathy?

B1 aka thiamine

Common sites of lacunar strokes are...

basal ganglia, thalamus and internal capsule

.....artery?.... is affected in 'locked-in' syndrome.

BASILAR ARTERY

confused 6 weeks post at RTA. what injury in brain?

subdural haematoma can present several weeks after the initial head injury

Patients cannot drive for ....?... following a first unprovoked or isolated seizure if brain imaging and EEG normal

6 months

amaurosis fugax. What part of the brain anatomy is affected with this type of stroke?

retinal/ophthalmic artery

Unilateral tinnitus associated with deafness is likely to be a feature of

The classical history of vestibular schwannoma includes a combination of vertigo, hearing loss, tinnitus and an absent corneal reflex

CT head of an elderly patient unilateral crescentic lesion in the right frontoparietal area. dx? artery?

Subdural haemorrhage results from bleeding of damaged bridging veins between the cortex and venous sinuses

Bilateral acoustic neuromas are associated with ----what genetic condition-----??

neurofibromatosis type 2

type of seizure? surroundings like a dream Lip smacking is an example of an automatism - an automatic, repetitive act

focal impaired awareness

presentation of myasthenia gravis? tx? associated with?

dysphagia, diplopia, ptosis long-acting acetylcholinesterase inhibitors pyridostigmine is first-line THYMOMA

most common symptom of posterior circulation stroke

dizziness think posterior--posture... dizzy

bleeding gums--- what antiepileptic med?

phenytoin

bleeding gums--- what antiepileptic med?

phenytoin

first-line for spasticity in multiple sclerosis

Baclofen and gabapentin

bells palsy craniel nerve?

7 LMN

...?..... help in the diagnosis of Guillain-Barre syndrome

Nerve conduction studies

appropriate anti-emetic in parkisnsons

domeridone side note: Cyclizine is an antihistamine which, like prochlorperazine, may exacerbate Parkinson's disease.

episodes of suddenly smelling burnt rubber-despite there being none in her presence. lasting 2 mins seizure type?

A woman suddenly has the sensation of smelling roses whilst at work. She is conscious throughout - focal aware seizure

essential tremor tx?

Essential tremor is an AD condition that is made worse when arms are outstretched, made better by alcohol and propranolol

ALS long term mx for food if they can swallow?

Percutaneous gastrostomy tube (PEG)

A POCI (posterior circulation infarct) involves ... what artery...?

vertebrobasilar arteries

multiple sclerosis complains of tingling in her hands which comes on when she flexes her neck. sign?

Lhermitte's sign

Hyperacusis - along with one sided lower facial parylsis, young person, what condition?

Hyperacusis is when everyday sounds seem much louder to you than they should. bells palsy

antiepileptic drugs is most associated with weight gain?

SODIUM VALPORATE

how to manage pain relief in neuropathic pain?

Drugs for neuropathic pain are typically used as monotherapy, i.e. if not working then drugs should be switched, not added

Parkinson's disease medications: higher risk of hallucinations?

Ropinirole

parkinsons 1st line tx?

if the motor symptoms are affecting the patient's quality of life: levodopa if the motor symptoms are not affecting the patient's quality of life: dopamine agonist (non-ergot derived), levodopa or monoamine oxidase B (MAO‑B) inhibitor

dose of rectal diazapem in adult?

a loss of dexterity in both hands. struggling to type at work and use her mobile phone. Her symptoms have been deteriorating gradually over the preceding months. dx?

Degenerative cervical myelopathy leads to loss of fine motor function in both upper limbs.

stroke definitive mx is thrombolysis and thrombectomy for acute ischaemic attack. what is the the time frame for each?

thrombectomy 6hrs thrmobolysis 4.5 hours

speech non-fluent, WHAT PART BRAIN DAMAGED?

FRONTAL LOBE brocas dysphasia

NEURO Flashcards

(82 cards)