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Finals Questions > Neuro > Flashcards

Neuro Flashcards

1
Q

TACS

A

Motor/sensory deficit in 2 or more face, arm, leg
Homonymous hemianopia
Higher cortical dysfunction

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2
Q

PACS

A

2 of TACS
higher corical dysfunction alone
Isolated motor deficit not meeting LACS

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3
Q

LACS

A

Motor and/or sensory deficit affecting 2 of face, arm ,leg
No higher cortical dysfunction/hemianopia
Thalamic stroke - cognition/consciousness affected

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4
Q

POCS

A

Any of:
Ipsilateral cranial nerve palsy + contralateral motor/sensory deficit
Bilareral motor/sensory deficit
Disordered conjugate eyemovement
Cerebellar dysfunction
Isolated hemainopia or cortical blindness

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5
Q

Wernicke’s

A

Receptive dysphasia

Work mouth, no sense

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6
Q

Broca’s

A

Expressive dysphasia
Cannot find words or work mouth
Frontal

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7
Q

Stroke scoring

A

Rosier

<0 = unlikely to be a stroke

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8
Q

Ischaemic stroke windows

A

<4.5hours
No bleeding on CT but clinical Sx - thrombolyse

> 4.5 hours
Start aspirin immediately
Carotid doppler - USS
70% occlusion = PCI

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9
Q

Haemorrhagic stroke

A

FFP or
PT complex
Vitamin K
Surgical review

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10
Q

Headache warning signs

A 
Systemic Sx
Neuro Sx
Onset - sudden
Older >40
Previous Hx - difference?
Triggered headache - valsalva/exertion
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11
Q

Mx stroke

A

300mg aspirin 2 weeks if non-haemorrhagic
Warfarin after 2 weeks if AF
Aim for glucose 4-11, sliding scale if DM

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12
Q

Mx TIA

A

ABCD2 score High
Start 300mg aspirin or BD dipyridamole MR
Or clopidogrel monotherapy
Carotid endarterectomy within 2 weeks if >70% carotid artery occlusion

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13
Q

TIA risk score

A

ABCD2
0-3 = low
4-5 = moderate
6-7 = high

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14
Q

Difference between brudzinski and kernig’s sign

A

Brudzinski - knees flex when neck is flexed

Kernig’s - pain on extending knee with hip fully flexed

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15
Q

Viruses commonly causing meningitis

A

Mumps
Coxsackie
Echovirus
HSV

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16
Q

Tests for CSF

A 
MC+S
Gram stain
Protein
Glucose
PCR
Lactate
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17
Q

Mx bacterial menigitis

A

2g IV ceftriaxone + specific bacterial sensitivies

Consider dexamethasone - avoid if shock

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18
Q

Mx contacts meningitis

A

Ciprofloxacin

19
Q

Mx Temporal arteritis

A

200mg IV hydrocortisone or 40mg prednisolone

Aspirin 75mg OD

20
Q

Mx venous sinus thrombosis

A

Anticoagulants
Surgery
Anticonvulsants if seizure

21
Q

Conservative Mx delirium

A 
Quiet side room, good lighting
Clock + calendar
Check sensory aids
Routine and mobilisation
Small no. of staff 
Family involvement
22
Q

Mx delirium

A

Haloperidol - non-seizure, 0.5mg-1mg QDS

Lorazepam - seizure/parkinson’s/alcohol 0.5-1mg PO/IM

23
Q

Post-seizure Ix

A

CT brain

Lumbar puncture

24
Q

Seizure - Glucose <4

A

50ml, 50% dextrose IV or 1mg IM glucagon

25
Q

Discharge in seizure

A 
Ix normal
Observed 4+ hours
Adequate follow-up
Causing - drive, machinery, swimming, bathing until review
1st fit clinic
26
Q

Mx SAH

A

Conservative - nurse flat
Analgesia
Metoclopramide
Nimodipine 60mg 4hoursly to prevent vasospasm
Keep systolic BP <130
Surgical - endovascular coiling/neurosurgical clipping

27
Q

Mx Subdural haematoma

A

Burr hole craniostomy

28
Q

Common blood vessel causing extradural haematoma

A

Middle meningeal artery and vein

29
Q

Sx extradural haematoma

A

Upper motor neuron lesions

30
Q

Uper motor neuron lesions signs

A

Brisk reflees

Up going planter

31
Q

What is Cushing’s reflex

A

Increased ICP
Increase BP
Irregular breathing
Reduced HR

32
Q

Ix MS

A

Nerve conduction tests
MRI
LP - CSF electrophoresis - oligoclonal bands of IgG

33
Q

Mx MS

A 
Vitamin D
Catheterisation - prevent retention
Methyprednisolone for 3/7 acute flares
B-interferon to reduce relapse
Baclofen - spasticity
34
Q

Charcot’s Neuro triad

A

Dysarthria
Nystagmus
Intention tremor

35
Q

Triad for Parkinson’s

A

Usually unilateral on presentation:
Resting Tremor around 5Hx
Rigidity/increased tone
Bradykinesia

36
Q

Mx Parkinson’s

A

Levodopa - wears off after 2-5 years
MAOi-B - selegiline - metabolises dopamine
Amantadine - dopamine agonist

37
Q

Drug withdrawal for epilepsy

A

2+years seizure free

withdraw over 2-3 months

38
Q

Mx Migraine

A 
Abortive:
NSAIDS and aspirin
Anti-emetic
5HT1 agonists - triptans
Ergotamine

Preventative
B-blockers - propanolol
Amitriptyline
Topiramate

39
Q

Cerebellar signs

A 
Dysdiadokinesis
Ataxia
Nystagmus
Intention tremor
Slurred speech
Hypotonia
40
Q

Drug to give in raised ICP SAH

A

Mannitol IV

41
Q

Sx myaesthenia Gravis

A

Progressive weakness throughout the day and with repetitive activity
Ptosis/diplopia
Normal tone,/no wasting
Normal reflexes

42
Q

Ix for myaesthenia gravis

A

Serum anti-ACh-R antibody

Edrophonium test

43
Q

Mx Myaesthenia gravis

A

Ach-inhibitors - pyridostigmine
Immunotherap
Thmectomy if thymoma

Finals Questions (8 decks)

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