Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

2A - Stuff i just cannot remember > Neuro 2 > Flashcards

Neuro 2 Flashcards

(79 cards)

Start Studying
1
Q

65-M presents with 12hr Hx sudden headache + difficulty walking (balance problem). He feels nauseous and has vomited. His speech is slurred.

Likely diagnosis? Cardinal symptoms?

A

Cerebellar stroke

Cardinal symptoms:

  • ataxia
  • headache
  • vertigo
  • vomiting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pt presents with complete paralysis of facial muscles on one side.

Mouth droop, flattened nasolabial fold, cannot close eye, smoothened brow.

Likely diagnosis?

A

CNVII Palsy

  • ipsilateral side
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pt presents with dizziness, and feel faint when they get up from standing. They are on medication for their recently diagnosed BPH.

Likely diagnosis and cause?

A

Postural Hypotension 2o to Tamsulosin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

65-M presents complaining of a Hx sudden headache + difficulty walking (balance problem). He felt nauseous and has vomited. He noticed his speech was slurred. This resolved within 1 hour.

Likely diagnosis? Cardinal symptoms?

A

TIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Presentations of Subarachnoid haemorrhage

A

Sudden thunderclap headache, 10/10 severity

Neck stiffness, meningism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pt presents with stroke symptoms. Full acute management plan?

A

ABCDE

Within 4.5hr window:

  1. CT Head (within time-frame)

If confirmed Ischaemic stroke:

  1. IV Alteplase (within time-frame)
  2. Thrombectomy
    • w/in 6hr anterior circulation
    • w/in 12hrs posterior circulation
  3. a) 2wks Aspirin 300mg
    b) Long-term Clopidogrel
  4. Carotid US, CT Angiography, Echo.

CI to Alteplase: head trauma, GI/brain bleed, recent surgery, normal BP, plt count, INR

If confirmed Haemorrhagic stroke (ICH, SAH):

  1. SAH - Nimodipine, IV fluid
  2. Endovascular coiling, stent, Decompressive hemicraniectomy
  3. Serum toxicology screen (cocaine)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Chronic stroke management

A

HALTSS

Hypertension*, 2-wks after

Antiplatelet - Clopidogrel. If Ischaemic, 2o to AF then Warfarin/ Rivaroxaban

Lipid-lowering - Atorvastatin

Tobacco - stop smoking
Sugar - Diabetes screening
Surgery - if ipsilateral carotid stenosis >50% > carotid endarterectomy

*No benefit in lowering acutely :: reduces brain perfusion UNLESS malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Focal seizure of the frontal lobe presentations

A

MOTOR features

  • posturing
  • pedalling of legs
  • Jacksonian march
  • behavioural change
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Myoclonic seizure

A

Sudden jerk of limb, face, trunk; violent, disobedient limb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Tonic seizure

A

Sudden limb stiffness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Jason is a 34yr old builder. He developed sudden intense back pain at work + weakness and sensory loss in both limbs

Likely diagnosis? Possible underlying causes?

A

Spinal Cord compression
- BILATERAL sensory loss

Possible causes:

  • disc herniation
  • congenital stenosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Subarachnoid haemorrhage mx

A

IV Fluid + Nimodipine (Ca2B - reduces vasospasms - reduces cerebral ischaemia)

Endovascular coiling, intravascular stent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Subdural haemorrhage mx

A

ABCDE + IV Mannitol

Burr-twist irrigation/ craniotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Extradural haemorrhage mx

A

ABCDE + IV Mannitol

Clot evac/ ligation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Drug used to lower intracranial pressure

A

Mannitol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which artery is commonly affected in an extradural (epidural) haemorrhage?

A

Middle meningeal artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Main types of seizures, presentations and their proportions

A

Primary generalised (40%)

  • LOC
  • BILATERAL, SYMMETRICAL

Partial/focal (60%)
- depends on lobe location

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Epilepsy causes

Epilepsy RF

A

Epilepsy causes:
2/3 IDIOPATHIC.
Tumour, stroke, cortical scarring.

Epilepsy RF:
FHx, abnormal cerebral perfusion, cocaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Epilepsy management

  • uncomplicated
  • F child-bearing age
A

1L Valproate

If F child-bearing age - LAMOTRIGINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Simple vs Complex partial seizure

A

Complex affects awareness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Temporal partial/focal seizure px

A

Lip smacking, chewing, fiddling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Frontal partial/focal seizure px

A

Motor: Jacksonian, peddling,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Parkinson’s RF

Parkinson’s associations

A

55 - 65 M, pesticide exposure

Associated with LEWY-BODY dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Parkinson’s diagnosis

Parkinson’s management

A

Clinical diagnosis - response to L-dopa

Mx: MDT care

  1. Levodopa + Co-Careldopa
  2. Cabergoline/Rantipole - DA agonist
  3. Selegline - MAO-B inhibitor
  4. Entacaopone - COMT i
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Parkinson's presentations Parkinson's pathophysiology
Resting tremor Bradykinesia Cogwheeling Rigidity, foot drop, insidious onset Pathophysiology: reduced DA in Substantia Nigra
26
Migraine management What should you avoid?
Prophylaxis: Propranolol, Topiramate, TCAs, Bockulinum toxin A Acute attack: NSAIDs, Paracetamol > Triptan. Metoclopramide (antiemetic) Avoid opiates and the pill
27
Cluster headache management
Prophylaxis: Verapamil Acute attack: High flow O2 > Nasal Triptan
28
Trigeminal neuralgia mx
Carbamazepine
29
Tension headache triggers
Stress, sleep deprivation, hunger, anxiety, eye strain NOT DEHYDRATION
30
Tension headache mx
Avoid triggers Aspirin Paracetamol, NSAIDs
31
Multiple Sclerosis pathophysiology
MS CD4-mediated demyelinating condition affecting oligodendrocytes > gliosis + neuronal damage
32
Multiple Sclerosis presentations + demographic
F 20-40, NORTHERN latitude (SWEDEN), HLA-DRB1 1) Optic neuritis - one blurry eye 2) Pyramidal weakness - upper limb extensors + leg flexors 3) Sensory phenomena Spastic paraparesis + numbness + declining cognition + UMN signs Lhermitte's sign Sensory WORSE in SHOWER
33
MS Investigations
MCDONALD CRITERIA CSF - oligoclonal bands/ IgG GOLD: MRI Brain + Spinal Cord - Demyelinating lesions (ventricles) Gadolinium-enhanced hyperintensity of ventricles
34
MS Management
Acute relapse: Methylprednisolone Chronic relapse-remitting: Interferon-B, Fingolimod, Natalizumab
35
MND Investigations + Diagnosis
El Escorial Criteria EMG nerve condition studies
36
Kerning's sign indicates
Meningitis - severe hamstring stiffness
37
Encephalitis presentations Encephalitis mx What can you prescribe for seizures?
Looks like meningitis + Stroke - meningism + fever + ALTERED MENTAL STATUS + seizure Mx: primary: IV Benzylpenicillin Hospital: IV Ceftriaxone + ACICLOVIR (HSV1) (2wks) Anticonvulsants: Phenytoin
38
Encephalitis common cause Encephalitis ix
HERPES SIMPLEX VIRUS 1 (HSV1) Bloods/ culture, CSF, Viral PCR, CT/MRI
39
SE Acyclovir
Fatigue, GI disturbance, photosensitivity, rash
40
Alzheimer's px Alzheimer's Ix
Memory loss, speech/ motor deficit, personality change, disorientation 1L: MMME + Blessed Dementia Scale GOLD: CT - cortical atrophy Mx: 1. Acetylcholinesterase inhibitor - Donezpil/ Rivastigmine 2. CSF amyloid-beta monitoring "see friends, play board-game"
41
Acetylcholinesterase inhibitor uses Examples
Myasthenia Gravis + Alzheimer's disease Donepezil, Rivastigmine
42
Alzheimer's complications
Aspiration pneumonia 2o to dysphasia, UTI
43
Alzheimer's pathophysiology
Beta-amyloid peptide accumulation > AMYLOID PLAQUES + NEUROFIBRILLARY/TAU TANGLES, lost ACh, Tau
44
Frontotemporal dementia (aka Pick's) px Associations?
Younger, semantic dementia (teacher can't spell) Personality change, episodic memory loss, lowered inhibitions Associated with MOTOR NEURONE DISEASE
45
Pick's disease diagnosis
Port-mortem - TAU proteins stain with silver Causes FRONTOTEMPORAL DEMENTIA
46
Vascular dementia px + aetiology
CVD/ stroke aetiology - HTN + Focal signs Px: Stepwise: 1. visual disturbance 2. UMN 3. Attention deficit 4. Depression 5. Emotional disturbance
47
Lewy Body Dementia px Association
Fluctuating, cognitive impairment, visual hallucinations + Parkinsonism PARKINSON'S DISEASE association
48
Lewy body dementia mx
Acetylcholinesterase inhibitors
49
Most common type of brain tumour
Glioma - #1 = Astrocytoma
50
Common sites which metastasis TO brain
Lung, breast, skin , kidney, GI
51
Brain tumour px Brain tumour Ix
Raised ICP - headache - drowsy - nausea Local effects Ix: Neuro exam GOLD: Brain CT/MRI
52
Most affected vessel in GCA?
Carotid artery
53
GCA Investigations
American College of Rheum Classification GOLD: Temporal Artery Biopsy, ^ESR/CRP
54
GCA Management
High dose steroid, low dose aspirin, tocilizumab
55
SC Compression px
Contralateral UMN signs + Back pain Paresis + Sensory loss + Bladder/ bowel dysfunction if lumbar lesion
56
SC Compression Ix SC Compression Mx + Mx for underlying malignancy
Acute SCC emergency = Immediate WHOLE SPINE MRI Mx: Surgical decompression w/in 48hrs If Malignancy - IV Dexamethasone
57
Types of SC Compressions
Cauda Equina Syndrome Brown-Sequard Syndrome
58
Cauda Equina Syndrome Presentations
SADDLE PARASTHESIA, bladder/ bowel dysfunction Lower back pain, absent ankle reflex
59
Brown-Sequard Syndrome presentations
Isilateral: - hemiplegia - loss of proprioception + vibration Contralateral: Loss of pain + temperature
60
Common peroneal nerve palsy px L5 Radiculopathy px
Common peroneal nerve: Foot drop + affects ankle eversion L5 Radiculopathy: Foot drop + affects ankle inversion
61
Myasthenia Gravis investigations Mx
Clinical, TFT, crushed ice test (ptosis) ACh_R Ab + MuSK Tensilon Test Mx: - Acetylcholinesterase inhibitors - pyridostigmine CT Chest - Thymoma??
62
Causes of peripheral neuropathy
Diabetes Mellitus B12 deficiency Lead poisoning Trauma
63
Huntington's disease Pathophysiology Presentations Ix
Ppx: CAG repeats > TOO MUCH DA Px: Chorea, cognitive decline, hyperkinesia, incoordination, depression Ix: CAG Repeat Testing + MRI/CT - basal ganglia lesions Differential: - Wilson's (Copper - Liver biopsy, rings in eyes)
64
Wilson's presentations Ix
Rings in eyes Similar to Parkinsons/Huntingtons Ix: Liver Biopsy (copper)
65
Huntington's Disease Mx for: - Chorea - Psychosis - Jerk
Chorea: Tetrabenazine Psychosis: Haloperidol Jerk: Risperidone
66
Guillain-Barre Syndrome presentations Ix Mx (+ DVT prophylaxis)
Viral > Neuro - TOES to NOSE weakness distal > proximal Ix: Bloods, LP (protein), spirometry, ECH EMG - slow conduction Mx: Plasma exchange + IV Ig (AVOID corticosteroids). DVT prophylaxis: LMW Heparin
67
Lambert-Eaton Syndrome RF, Px, Ix, Mx
RF Malignancy, AI, smoking Px: GRADUAL proximal limb weakness, dry mouth, dysarthria Ix: Ab against Voltage-gated Ca Channel Mx: Plasma exchange, IV Ig, Amifampridine
68
Define amaurosis Fugax
Painless temporary vision loss
69
Charcot-Marie-Tooth Ix
Progressive peripheral neuropathy + PES CAVUS + FOOT DROP /slapping Ix: EMG - symmetrical change GOLD: CMT mut
70
Duchenne Muscular Dystrophy Ix
<3, delayed motor milestone, lower limb weakness, GOWER's sign Ix: Muscle biopsy - absent dystrophin
71
Wernicke's Encephalopathy Define Px
Thiamine (B1) deficiency due tp alcohol abuse/ GI surgery Px: Confusion, ataxia, ophthalmoplegia, asterixis Mx: Pabrinex - IV Thiamine + Mg Supplement
72
Depression screening tool
PHQ-9
73
ABCD2 score parameters
``` Age >60 BP >140/ >90 Clinical - speech, weak, sleep disturbance Duration <1hr (1), >2hr (2) DM ```
74
Signs of radial nerve damage
Can't open fist BEST muscles
75
Signs of Median nerve damage
Carpal Tunnel Precision grip muscles - LOAF
76
Signs of Ulnar nerve damage
Vulnerable to elbow trauma CLAW sign
77
Signs of axillary nerve damage
Weak shoulder abduction
78
Differentiate between Myasthenia Gravis and Lambert Eaton Syndrome
Myasthenia Gravis: - Muscle fatigue worsens with exercise - EMG - decremental (muscle response goes down) Lambert Eaton: - Muscle fatigue improves with exercise - EMG - Incremental (muscle response goes up) - Autonomic: incontinence, dry mouth, low libido
79
Antiphospholipid syndrome Px, Ix, Mx
ANTIPHOSPHOLIPID SYNDROME Px: thromboses, preg-related morbidity (miscarriage) Ix: Antiphospholipid Ab + (2, 12 wks apart) - Lupus anticoag - Anticardiolipin Ab - Anti-B2-Glycoprotein I Ab Mx: Dalteparin (UF/LMW Heparin) AND Warfarin AND Vit K Antagonist AND aspirin if prior thrombosis

2A - Stuff i just cannot remember (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions