Neuro Core Conditions Flashcards

Question

Risk factors for SAH?

Answer 1

``` Large aneurysms Smoking HTN Alcohol Genetics 10% of AD PCK patients have berry aneurysms ```

Answer 2

``` Sudden thunderclap headache Vomiting Sentinel bleeds Expansion of aneurysm Dizzy Orbital pain Diplopia Visual loss Sensory/motor disturbances Seizures Ptosis Bruits Dysphasia Neck stiffness Focal neuro signs Complete/partial CNIII palsy (due to PCmmA rupture) ```

Answer 3

``` Meningitis Trauma Cluster headahce Encephalitis First seizure in adulthood IC haemorrhage Ischaemic stroke TIA ```

Answer 4

ABG ECG CTH and CT angio -ve CTH = LP (use spectrophotometry to detect xanthochromia)

Answer 5

``` Prevent further bleeding Nimodipine Ca antagonists (reduce vascular spasm) Phenytoin (prevent seizure spread) Nitroprusside (vasodilator) Labetolol Clip aneurysm Endovascular embolisation Secondary prevention advice ```

Answer 6

Older patients

Answer 7

``` DM B12/folate def Chemo Antiretrovirals Metrodinazole Thalidomide Phenytoin Insecticides Solvents Cancer Alcohol CKD Guillan-Barre syndrome Trauma and nerve compression Shingles HIV Lyme RhA Sjorgens SLE Sarcoidosis Coeliac Charcot Marie Tooth syndrome Freidriech ataxia Idiopathic ```

Answer 8

``` Alcohol DM Kidney/liver/thyroid disease Repetitive physical stress Age FHx HTN Peripheral vascular disease Smoking ```

Answer 9

``` Tingling, numbness Loss of coordination Burning/shooting pains (worse at night) Dificulty walking/picking stuff up Affects hands/feet first Muscle weakness Falling Difficulties with small movements (buttoning shirts) Swallowing problems Cachexia Muscle twitching/cramps/paralysis Dizzy/fainting Reduced sweating Heat intolerance Urinary incontinence Bloating Constipation/diarrhoea Impotence ```

Answer 10

``` Acromegaly Acute inflam demyelinating polyadiculoneuropathy Alcohol related neuropath CMT disease Coagulopathies Drug induced paraneoplastic syndromes Heavy metal toxicity Herpes Labert-Eaton myasthenic syndrome MG Nerve compression Post-surgical vagotomy Vit B6 intox ```

Answer 11

``` BM, vit B12, foalte, U+E creatinine Nerve conduction studies Electromyography Nerve/skin biopsy ```

Answer 12

``` Underlying cause Physio Surgery Anticonvulsants (gabapentin, carbamazepine) Elastic stockings Fludrocortisone Eating small frequent meals Sleeping with head raised Walking aids Occupational therapy ```

Answer 13

Children or >60 Learning difficulties 30% have a 1st degree relative affected

Answer 14

``` Primarily idiopathic Ischaemia Venous thrombosis Head injury Meningitis/encephalitis Provoked seizures Autoimmune Brain tumour Isoniazid Alcohol (withdrawal) Hypoglycaemia Imbalanced Na or Ca ```

Answer 15

``` Age M>F FHx Head trauma Stroke Brain infections Prolonged febrile seizures of childhood Congen abnormalities of brain structure Lack of O2 to brain CP Illicit drugs ```

Answer 16

``` Amnesia Falls Tonic-clonic Blank spells Incontinence Confusion/impaired awareness Visual/auditory/gustatory/olfactory hallucinations ```

Answer 17

``` Syncope Arrhythmias TIA Migraine BPPV Hypoglycaemia Acute encephalopathy Narcolepsy Sleep apnoea Panic attacks ```

Answer 18

``` EEG MRI/CTH BM, U+E, Ca, LFTs, FBC 12 lead ECG Neurophysiological assessment ```

Answer 19

Phenytoin Carbamazepine Na valproate Broad spectrum AEDs may work for treatment resistant epilepsy Drug treatment should be monitored and weaned off Relaxation and CBT may help

Answer 20

Babies Young children Elderly Can be anyone

Answer 21

``` Group B strep Listeria monocytogenes E coli H Flu B N Meningitis Strep pneumoniae ```

Answer 22

``` S pneumoniae H flu type B N meningitidis Gram -ve bacilla Staph Strep L Monocytogenese ```

Answer 23

S Pneumoniae L monocytogenes TB Gram -ve

Answer 24

``` CSF shunts Dural defects Spinal procedures Bacterial endocarditis DM Alcohol Prem birth PROM IVDU Malignancy Thalassaemia, sickle cell, splenectomy CF ```

Answer 25

``` Meningitism Fever Headache Altered mental state Shock Septicaemia Kernig's sign Brudzinski's sign PAresis Focal neuro def Seizures Viral may be more mild ```

Answer 26

``` Non-specific Resp distress Fever Apnoea Bradycardia Hypotension Difficulty feeding Irritable ```

Answer 27

``` Other causes of infection/pyrexia IC abscess Encephalitis SAH Tumours Delirium tremens HSV Paediatric febrile seizures ```

Answer 28

LP (unless at risk of herniation - then CTH) Gram stain, Ziehl-Neelson, cytology, virology, glucose, protein, culture, rapid antigen testing, PCR, Indian ink (cryptococci) Blood cultures, FBC, BM, coag, U+E Urine dip/culture MRI

Answer 29

Fluids Antipyrexics Antiemetics

Answer 30

Analgesia Aciclovir if due to herpes Ganciclovir if due to CMV (only if congenital or AIDS related as ganciclovir is v toxic)

Answer 31

Benzylpenicillin STAT if suspicion of meningococcal + non-blanching rash Blind therapy initially (3rd gen ceph or amoxicillin if listeriosis is suspected) Meningococcal - benzylpenicillin or cefotaxime for at least 7 days, rifampicin for 2 days to eliminate nasal carraige Pneumococci - Cefotaxime for 10-14 days H flu type B - Cefotaxime (10 days) + rif 4 days prior to discharge Group B strep - Benzylpenicillin + gentamicin or cefotaxime alone for 14 days Listeriosis - Amoxicillin and gentamicin for 10-24 days