Neurological Flashcards

1
Q

What fraction of Strokes/TIAs occur in over 65 yr olds?

A

2/3

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2
Q

What are the two main types of stroke and which is most common?

A

Ischaemic (most common - 87%)

Haemorrhagic

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3
Q

What can cause a ischaemic stroke?

A

Thrombosis, Embolism, Shock

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4
Q

What can cause a haemorrhagic stroke?

A

Intracerbral bleed, Subarchnoid bleed

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5
Q

Definition of TIA

A

Symptoms appear and last less than 24 hours

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6
Q

Stroke/TIA Risk Factors

A

High BP, Smoking, Obesity, Cholesterol, Diabetes, AF

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7
Q

Stroke/TIA Presentation

A

Hemiplegia, Apraxia, Altered smell/taste/vision, Spasticity, Hyperreflexia, Aphasia

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8
Q

What symptoms are more common in haemorrhagic stroke?

A

Loss of consciousness, Thunderclap headache, Vomiting, Neck stiffness, Seizure

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9
Q

Stroke/TIA Investigations

A

CT/MRI, ECG, Bloods, USS, Angiogram

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10
Q

Stroke/TIA Treatment

A

Aspirin, Statins, Thrombolysis, Surgery

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11
Q

Who is subarachnoid haemorrhage more common in?

A

Elderly Females

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12
Q

What is usually the cause of a spontaneous subarachnoid haemorrhage?

A

Ruptured aneurysm in Circle of Willis

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13
Q

Subarachnoid haemorrhage Risk Factors

A

High BP, Smoking, Family Hx, Alcohol/Cocaine, Blood thinners

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14
Q

What does a lumbar puncture show in subarachnoid haemorrhage?

A

Elevated RBCs

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15
Q

Subarachnoid haemorrhage Treatment

A

Surgery, Labetolol, CCBs (prevent vasospasm), Benzodiazepines, Antiemetics

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16
Q

Most common cause of Peripheral Neuropathy?

A

Diabetes

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17
Q

Causes of Peripheral Neuropathy?

A

Systemic disease, Vitamin deficiency, Medication, Trauma, Genetic, Idiopathic

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18
Q

What medication can cause Peripheral Neuropathy?

A

Chemotherapy, Metronidazole, Fluoroquinolones

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19
Q

Peripheral Neuropathy Presentation

A

Motor = Balance, Weakness

Sensory = Numbness, Tingling

Autonomic = Poor bladder control, Sweating

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20
Q

Peripheral Neuropathy Investigations

A

EMG, Bloods (FBC, B12, TSH, Metabolic panel)

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21
Q

Peripheral Neuropathy Treatment

A

Cause, TCAs, SSRIs, Antiepileptics, Topical capsaicin

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22
Q

How many cases of Epilepsy occur in the developing world?

A

80%

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23
Q

What is Epileptogenesis?

A

When epilepsy occurs due to brain injury (stroke/infection etc.)

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24
Q

Epilepsy Risk Factors

A

Family Hx, Toxins (lithium), Metabolic disturbance, Infection, Degenerative disorders

25
What are the two main categories of seizure?
Focal and Generalised
26
What are the types of Generalised Seizure?
Tonic-Clonic, Tonic, Clonic, Myoclonic, Atonic, Absense
27
What are the types of Focal seizure?
Simple, Complex, Secondary Generalised
28
Epilepsy Presentation
Aura, Jerking, Muscle contraction, Loss of consciousness, Loss of bladder control
29
Epilepsy Investigations
EEG, CT/MRI, Blood prolactin
30
Epilepsy Treatment
Acute = IV lorazepam and then Phenytoin Chronic = Phenytoin, Carbamazepine, Sodium Valproate, Ketogenic diet
31
What Bacteria most commonly cause Meningitis in different age groups?
Babies = Group B Strep Children = Neisseria meningitis, Strep pneumoniae, Haemophilus Influenzae) Adults = Neisseria meningitis, Strep pneumoniae
32
What viruses can cause Meningitis?
Enterovirus, HSV (type 2), VZV, Mumps, HIV, LCMV
33
Most common fungal cause of Meningitis?
Cryptococcus neoformans
34
Meningitis Presentation
Headache, Fever, Stiff neck, Vomiting, Photophobia, Confusion, Non-blanching rash
35
Meningitis Investigations
Bloods (CRP, FBC, Cultures), Lumbar puncture, CT/MRI
36
Meningitis Treatment
Immediate empiric antibiotics (usually cephalosporin) IV fluids, Ventilation, Anticonvulsants (Viral = supportive / Fungal = Antifungals)
37
What is the most common type of Headache?
Tension Headache
38
Migraine Risk Factors
Food, Drink, Exercise, Medication, Stress, Bright lights, Hunger
39
Tension Headache Risk Factors
Stress, Sleep deprivation, Hunger, Eyestrain
40
Migraine Presentation
One half of head, Pulsating, Nausea/Vomiting, Sensitivity to light/sound/smell
41
4 Stages of a Migraine
Prodrome, Aura, Pain, Postdrome
42
Tension Headache Presentation
Constant pressure pain, Both sides of head
43
Migraine Treatment
Analgesics, Triptans/Ergotamines Prevention = Metoprolol, Valproate, Topiramate
44
Tension Headache Treatment
Water, OTCs, Amitriptyline
45
Who is most likely to get Parkinson's?
Males, Over 60yrs
46
Cause of Parkinson's?
Cell death in Basal ganglia and presence of Lewy Bodies in remaining neurons
47
Parkinson's Risk Factors
Pesticides, Trauma, Never smoked/Drank caffeine, Low urate
48
Parkinson's Presentation
Motor = Tremor, Bradykinesia, Rigidity, Postural instability Many Non-motor
49
What Imaging is not used in Parkinson's?
CT
50
Parkinson's Investigations
Neurological exam, MRI, PET/SPECT
51
Parkinson's Treatment
Levodopa, COMT inhibitors, Dopamine agonists, MAO-B inhibitors, Surgery, Rehabilitation
52
Proximal Myopathy Presentation
Symmetrical weakness of Upper and/or Lower Limbs
53
Proximal Myopathy Causes
Drugs, Alcohol, Thyroid disease, Osteomalacia, Myopathies, Malignancy, Infection, Sarcoidosis
54
Proximal Myopathy Investigations
Ca/K/Mg, ESR, Creatinine, TFTs, Vitamin D, Muscle imaging and biopsy
55
What is Multiple Sclerosis?
Demyelinating disease = disrupts communication in the nervous system
56
Who is most likely to get Multiple Sclerosis?
Women, 20-50yrs
57
Multiple Sclerosis Presentation
Double vision, Muscle weakness, Trouble with Sensation and Coordination
58
Multiple Sclerosis Investigations
Neuro-imaging, Lumbar puncture, Biopsy
59
Multiple Sclerosis Treatment
Acute = IV Corticosteroids Long term = Rituximab