Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 4 - NSS > Neurology > Flashcards

Neurology Flashcards

1
Q

Space occupying lesions
- Symptoms

A

SOL - Symptoms

  1. Seizures
    - Aura
    - Smells/tastes in temporal lobe
  2. Focal neurology and gait disturbance
  3. Neuropsychiatric
    - Personality (frontal)
    - Mental state
    - Memory/cognition
  4. Endocrine
  5. ICP
    - Headaches
    - Vomiting
    - Papilloedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Neuro SoL
- Imaging

A

Neuro SoL - Imaging

  1. CT +/- contrast
    - Contrast for vessels and tumours
  2. MRI
  3. Diffusion weighted MRI
  4. Multimodal MRI
    - MR spectoscopy (metabolism)
    - MR perfusion (vascularity)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Imaging
- Describing SoLs

A

Imaging
- Describing SoLs

  1. Patient
  2. Imaging technique
  3. Intra-extra axial (paranchyma or outside)
    - nb pituitary is extra-axial
  4. Shape/location
    eg. Irregular, circular, frontal-temporal
  5. Density/intensity
    - Hypo/hyper dense on CT
    - Hypo/hyper intense on MRI
  6. Border
    - Defined
    - Oedema
  7. Contrast
    - Homogenous/heterogenous
    - Rim enhancement eg. abscesses
  8. Mass effect
    - Effacement of sulci
    - Midline shift
    - Ventricle compression
    - Basal cisterns: obliterated/patent
  9. Hydrocephalus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Spinal cord compression
- Aetiologies

A

SCC
- Aetiologies

  1. Trauma
  2. Prolapsed IVD
  3. Atlantoaxial subluxation
    - RA
  4. Infection
    - Pott’s disease/discitis
    - IVDUs
  5. Bony metastasis
  6. Others
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Tetraplegia vs paraplegia

A

Tetraplegia
1. Four limbs
2. Above T1

Paraplegia
1. Lower limbs
2. T1 or below

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

CES
- Symptoms
- Spinal level

A

CES

  1. Level of L4/L5 or L5/S1
  2. Symptoms
    - Weakness
    - Paraesthesia
    - Ataxia
    - LMN signs
    - Urinary retention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Spinal metastasis
- 5 primaries

A

Spinal metastasis Bs

  1. Prostate
  2. Breast
  3. Lung
  4. Kidney

5 . Thyroid

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

CES-I vs CES-R

A

CES-I
- Incomplete cauda equina
1. Urinary disturbance

CES-R
- Complete cauda equina

  1. Retention
  2. Overflow incontinence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

CES Syndrome

  • MN signs?
  • Presentation
A

CES Syndrome

  1. MN signs
    - LOWER signs
  2. Presentation
  • 50% atypical presentation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

CES

  1. Decompression Timeline
    - Recommendation
  2. Non-surgical treatments
A

CES

  • Decompression Timeline
    1. 48 hours
    2. BASS (british association of spinal surgeons)
  • Non-surgical treatments
  1. Radiotherapy
  2. Anti-inflammatories
  3. Antibiotics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Status Epilepticus
- A-E

A

Status Epilepticus
- A-E

  • Airway
    1. Tongue
    2. Bleeding
  • Breathing
    1. Challenging
    2. ABG
  • Circulation
    1. Access
  • Disability
    1. Glucose
  • Else
    1. Medications
    2. Trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Status Epilepticus
- Algorithm

A

Status Epilepticus
- Algorithm

  1. CBG check
    - Glucose
  2. A-E
  3. Lorazepam 4mg IV
    - Repeat after 10-15 minutes
    - IM Midazolam 10mg
    - PR Diazepam 10mg
  4. Phenytoin 20mg/kg
    - Max 50mg/min
    - Contact ITU
  5. ITU
    - Rapid sequence
    -Thiopental etc.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Status epilepticus
- Definition

A

Status epilepticus
- Definition

  1. > 5 mins continuous
  2. > 2mins
    - Without full recovery within 5 mins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Status epilepticus
- ABG findings

A

Status epilepticus
- ABG findings

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

Status epilepticus
- Blood Ix

A

Status epilepticus
- Blood Ix

  1. FBC
  2. U&E/LFT/Bone profile
  3. CRP/Cultures
  4. Glucose
  5. Clotting screen
  6. Toxicology
    - If on AEMs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Delirium
- vs dementia

A

Delirium
- vs dementia

1 Abrupt & fluctuating
2 Impaired intention & orientation

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

Delirium
- Mx of behaviour

A

Delirium
- Mx of behaviour

  1. Environment
    - Orientation
    - 1-1 nursing
  2. Quetiapine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Delirium
- WHIPMS causes

A

Delirium
- WHIPMS acronym causes

W - Wernicke’s
H - Hypoglycaemia
I - Infections/intracranial
M - Meningitis/encephalitis
P - Poisoning
S - Status epilepticus

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

Meningitis
- Common causes
1. Bacterial
2. Viral

A

Meningitis
- Common causes

  1. Bacterial
    - S pneumoniae
    - N menigitides
    - Hib
  2. Viral
    - Herpes simplex
    - Mumps virus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Meningitis
- Specific Signs

A

Meningitis
- Specific signs

  1. Jolt acceleration of headache 100%
  2. Kernig’s sign 9%
    - pain on hip flexion
  3. Brudzinski’s sign 1%
    - lift head
    - knees will bend
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Meningitis
- Empirical ABx

A

Meningitis
- Empirical ABx

  1. Local guidelines
  2. Vancomycin
    + cef
    +cefo
    +mero
    +chloramphenicol
  3. Ampicillin
    - 50+yo
    - immunocomprimise
  4. Nonate
    - Cefo + ampicillin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Meningitis
- CNS abscess mx

A

Meningitis
- CNS abscess mx

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

Meningitis
- Chemo-prophylaxis

A

Meningitis
- Chemo-prophylaxis

  1. Rifampicin
    - 2 doses
  2. Ciprofloxacin
    - 1 dose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Sub-arachnoid haemorrhage
- Presentation

A

Sub-arachnoid haemorrhage
- Presentation

  1. Thunderclap headache
  2. Meningism
  3. Decreased consciousness
  4. Focal neurology
    - Hemiparesis
    - CN III palsy
  5. Ophthalmopathy
    - Papilloedema
    - Retinal haemorrhage
  6. Seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Sub-arachnoid haemorrhage
- Head CT findings

A

Sub-arachnoid haemorrhage
- Head CT

  1. White areas
    - extravasation of blood
  2. Detect early hydrocephalus
  3. 10% may be negative
    - 6h from headache: 100%
    - 48hr from headache: only 89%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Sub-arachnoid haemorrhage
- LP/CSF

A

Sub-arachnoid haemorrhage
- LP/CSF

  1. Must wait 12 hours post-headache
  2. Xanthochromia
    - Spectophometry for bilirubin
    - 100% sensitive for 1 week
  3. Constituents
    - Blood stained
    - Elevated opening pressure
    - Lymphocytic reaction
    - Elevated protein
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Sub-arachnoid haemorrhage
- MRI

A

Sub-arachnoid haemorrhage
- MRI

  1. T2-FLAIR sequence
  2. Echo-gradient sequences
    - Haemosiderin
    - Susceptibility artefact
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Sub-arachnoid haemorrhage
- Angiography

  1. Non-invasive
  2. Invasive
A

Sub-arachnoid angiography

  • Non-invasive
    1. CTA
    2. MRA
  • Invasive
    1. DSA
  • Digital subtraction angiography
  • Endo-vascular coiling at same time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Sub-arachnoid haemorrhage
- Mx

A

Sub-arachnoid haemorrhage
- Mx

  1. Secure aneurysm
    - Endo-vascular coiling
    - Surgical clipping
  2. Prevent vasospasm (d4-d14)
    - Nimodipine
    - HTN therapy
  3. Treat
    - Hydrocephalus
    - Ventricular drain/shunt
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Neurology history
- Formulation

A

Neurology history
- Formulation

  1. A/S/L
  2. Onset
    - Timing
    - Mode
  3. Symptoms
    - Nature
    - Distribution
    - Progression
  4. Severity
  5. Salient information
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Neurology
- Anatomical DDx

A

Neurology
- Anatomical DDx

  1. Brain
  2. Brainstem
  3. Cerebellum
  4. Spinal cord
  5. Motor pathway
  6. Nerve roots
  7. Plexuses
  8. Peripheral nerves
  9. NMJ
  10. Muscle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Neuro ddx
- Brainstem Pathology presentations

A

Brainstem
- Pathologies

  1. Multiple CN palsies
  2. Cerebellar and CN Sx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Neuro DDx
- Cerebellar lesions

A

Neuro DDx
- Cerebellar lesions

  1. DANISH
  2. Broad based ataxia
    - Heel-shin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Parkinson’s
- Examination

A

Parkinson’s
- Examination

  1. Gait
    - Forward flexed
    - Assymetric reduced arm swing
    - Cog wheel rigidity
    - Turning on block
    - Reduced facial expression
  2. Tremor
    - At rest
    - Relaxed arm
    - Frequency 3-6
    - Nature: pill-rolling
    - Admonished by movement
  3. Rigidity
    - Lead pipe at elbow
    - Cog wheel at wrist
  4. Bradykinesia
    - Cannot maintain amplitude or rhythm of repeated movement
    - Micrographia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Neuropathies
- Symmetry in degeneration and autoimmune disease

A

Neuropathies
- Symmetry in degeneration and autoimmune disease

  1. Asymmetric early on
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Neuro ddx
- Spinal features

A

Neuro ddx
- Spinal features

  1. Below a certain point
  2. Can involve spincters
  3. Motor and sensory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Neuro ddx
- Nerve root features

A

Neuro ddx
- Nerve root features

  1. Dermatomal distribution
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Neuro ddx
- Plexus features

A

Neuro ddx
- Plexus features

  1. Unusual Distribution
  2. Sensory and motor
39
Q

Neuro ddx
- NMJ presentation

A

Neuro ddx
- NMJ presentation

  1. Muscular only
  2. Distribution
  3. Fatigability
    - eg gaze
40
Q

Myasthenia gravis
- Pathology

A

Myasthenia gravis
- Pathology

  1. Anti-ACh IgG
  2. Thymus abnormalities
    - Hyperplasia
    - Tumors
41
Q

Myasthenia gravis
- Presentation

A

Myasthenia gravis
- Presentation

  1. Fatigability
  2. Extraocular muscles
  3. Ptosis
  4. No sensory or reflex loss
42
Q

NMJ
- Drug triggers

A

NMJ
- Drug impacts

  1. Aminoglycosides
  2. Beta blockers, CCBs
    … See MG website
43
Q

Myasthenic crisis
- Features

A

Myasthenic crisis

  1. Slack facial muscles
  2. Head falling
  3. Jaw slack
    - drooling
    - absent gag reflex
  4. Nasal voice
  5. Limp body
44
Q

Cholinergic crisis
- Features

A

Cholinergic crisis
- Features

  1. Miosis
  2. SLUDGE
  3. Flaccid muscle paralysis
    - Like myasthenic
45
Q

Myasthenia gravis
- Ix

A

Myasthenia gravis
- Ix

  1. AChR antibodies
  2. Tension test
    - Edrophonium
  3. EMG
    - Muscle fatigue
  4. CT thorax
  5. Ice test
    - Ptosis
46
Q

Myasthenia gravis
- early management

A

Myasthenia gravis
- early management

  1. Supportive
    - respiratory
    - aspiration
    - DVT
  2. Spirometry
    - FVC
    - ITU if <1l and ABG
47
Q

Myasthenia gravis
- Therapeutic management

A

Myasthenia gravis
- Therapeutic management

  1. Acetylcholinesterase inhibitors
    - Pyridostigmine
    30 mins before meals
    - Neostigmine (ITU)
  2. CSTs
  3. Azathioprine
  4. IVIG
  5. Aspiration and DVT
48
Q

Guillain barre syndrome
- 4 Subtypes

A

Guillain barre syndrome
- 4 Subtypes

  1. AIDP
  2. AMAN
  3. AMSAN
  4. Miller Fisher Syndrome
49
Q

Guillain Barre Syndrome
- Post infectious features

A

Guillain Barre Syndrome
- Post infectious

  1. Acute, rapidly progressing
    - 1-3 weeks after URI or GI
  2. Flaccid paralysis
    - both arms and legs
    - often backache
  3. Bi modal peek
    - commonest in elderly
50
Q

GBS
- Autonomic involvement

A

GBS
- Autonomic involvement

  1. Cardiac arrhythmia
  2. Ileus
51
Q

GBS Respiratory Failure
- Monitoring

A

GBS Respiratory Failure
- Monitoring

  1. Spirometry QDS
  2. 1/4 need NIV
52
Q

GBS
- Therapeutic Management

A

GBS
- Therapeutic Management

  1. IVIG
  2. Plasmapheresis
  3. Ventilation
53
Q

MS
- S&S

A

MS
- S&S

  1. Optic neuritis
    - blurred vision
    - ocular pain
    - disc swelling/normal (pale)
    - RAPD (slower response to swinging)
  2. Nystagmus
  3. Intra nuclear opthalmoplegia
    - 3rd nerve
    - no adduction
  4. Spinal cord lesion
    - Lhermitte’s shock pain
    - Upper limb UMN
  5. Other
    - Trigeminal neuralgia
    - Epilepsy
    - psychosis
    - dementia
54
Q

MS
- Pathophysiology

A

MS
- Pathophysiology

  1. Body attacks myelin
  2. Multiple plaques
  3. Brain and spinal cord
    - disseminated in space
    - disseminated in time
55
Q

MS
- Prevalence

A

MS
- Prevalence

  1. 7000 new per year
  2. > 130,000 UK
  3. 3:1 F:M
56
Q

Ms
- Ix

A

Ms
- Ix

  1. MRI brain
    - multiple plaques
  2. CSF
    - Oligoclonal bands
  3. Visual delay
57
Q

MS
- Criteria

A

MS
- Criteria

  1. McDonald Criteria
    - two lesions in time and space
    - MRI evidence
58
Q

MS
- Clinical courses

A

MS
- Clinical courses

  1. Clinically isolated
  2. RRMS
    - Relapsing remitting (+24hrs each)
    - Most common
    - Worsening
  3. SPMS
    - secondary progressive
    - gradual and worsening
  4. PPMS (15%)
    - primary progressive
59
Q

MS Mx

  1. Acute
  2. Chronic
A

MS Mx

  1. Acute
    - Rule out infection
    - Short course of steroids for inflammation
  2. Chronic
    - DM treatment
    - MDT
60
Q

MS
- Disease Modifying Treatment

  1. Factors to consider
  2. Drugs: Eg.
A

MS
- Disease Modifying Treatment

  1. Course of MS
  2. Activity of disease

Eg.
Interferon beta
Alemtuzumab
Cladribine

61
Q

MS
- Uhthoffs Sign

A

MS
- Uhthoffs Sign

  1. Worse in heat
62
Q

Epilepsy
- definition

A

Epilepsy
- definition

  1. ?
63
Q

Epilepsy
- types

A

Epilepsy
- types

  1. Focal onset
  2. Generalised onset
  3. Unknown onset
64
Q

Seizure
- Quality of movement

A

Seizure
- Quality of movement

  1. Clonic
    - Fast out
    - Slow in
65
Q

Seizure
- Stabilisation phase mx

A

Seizure
- Stabilisation phase mx

  1. A-E
  2. Time it
    - monitor vitals
  3. Oxygen
  4. ECG
  5. CBG
    - Thiamine
    - D50W (dextrose in water)
  6. IV access
66
Q

Seizure initial phase
- 5-20min mx

A

Seizure initial phase
- 5-20min mx

  1. IM midazolam
    - 10/5mg
  2. IV Lorazapam
    - 4mg max
    - 0.1mg/kg/dose
  3. IV diazepam
    - 10mg max
    - 0.15-0.2mg/kg/dose
67
Q

Seizure
- Second phase therapy (20-40 mins)

A

Seizure
- Second phase therapy (20-40 mins)

  1. Fosphenitoin
  2. Valproate
  3. Levetiracetam
68
Q

Generalised weakness
- Common Differentials

A

Generalised weakness
- Common Differentials

  1. Stroke/TIA
  2. MS
  3. Post ictal
  4. Hypo
  5. Nerve palsy
  6. Narcolepsy/cataplexy
69
Q

Generalised weakness
- uncommon differentials

A

Generalised weakness
- uncommon differentials

  1. Haemorrhage/Haematoma
  2. Spine trauma
  3. Encephalitis/brain abscess
  4. MG/GBS
  5. Drug induced
  6. Electrolyte abnormality
70
Q

4 Motor neurone disease

A

4 Motor neurone disease

  1. ALS
  2. PMA
  3. PBP
    4.PLS
71
Q

PLS
- Features

A

Primary lateral sclerosis

  1. Prgressive tetraparesis
72
Q

MND
- Differentials

A

MND
- Differentials

  1. Cervical myelo-radiculopathy
  2. yringomyleia
  3. Syphilic pachymeningiti
  4. Motor neuropathy
73
Q

Motor neurone disease
- Investigations

A

Motor neurone disease
- Investigations

  1. MG
  2. NCS
74
Q

MND
- Management principles

A

MND Mx

  1. Communication
    - Ceiling of care
  2. MDT
    - Resp
    - Nutrition
    - Psych
  3. Riluzole
    - 6 Mo Life extension
75
Q

MND
- Supportive mx

A

MND
- Supportive mx

  1. PEG nutrition
  2. Ventilation
    - NIV
    - Intubation
    - Ceiling of care
76
Q

MND
- Complications

A

MND
- Complications

  1. Respiratory failure
    - Breathlessness on lying flat
  2. Aspiration pneumonia
77
Q

MND
- Presentation

A

MND Presentation

  1. Commonly 60s-70s
  2. UMN
    - Spasticitiy/Babinski
  3. LMN
    - Atrophy/Weakness
    - Fasciculations
  4. Bulbar
    - Jaw jerk
    - Swallowing
    - Pseudobulbar
78
Q

MND
- Presentation

A

MND Presentation

  1. Commonly 60s-70s
  2. UMN
    - Spasticitiy/Babinski
  3. LMN
    - Atrophy/Weakness
    - Fasciculations
  4. Bulbar
    - Jaw jerk
    - Swallowing
    - Pseudobulbar
79
Q

Migraines
- Associated symptoms

A

Migraines
- Associated symptoms

  1. Nausea/vomiting
  2. Auras
    - Visual (black/white/prism)
    - 1 hr before onset
80
Q

Cluster headache
- Associated symptoms

A

Cluster headache
- Associated symptoms

  1. Watery eye
  2. Runny nose
  3. Hyperhydrosis
81
Q

Tension headache
- Timing

A

Tension headache
- Timing

  1. Onset later in the day
  2. Up to 1 hour
82
Q

Cluster headaches
- Timing

A

Cluster headaches
- Timing

  1. Night-time
  2. 20mins - 1 hour
  3. Once or more per day
83
Q

Migraine
- Exacerbating and relieving

A

Migraine
- Exacerbating and relieving

  1. Relieved by dark room/nap
  2. Photo/phono-phobic
84
Q

Cluster headache
- Exacerbating relieving

A

Cluster headache
- Exacerbating relieving

  1. Too painful to sit still
85
Q

Tension headache
- Intensity

A

Tension headache
- Intensity

4-6

86
Q

Migraine headache
- Intensity

A

Migraine headache
- Intensity

6-8

87
Q

Cluster headache
- Intensity (1-10)

A

Cluster headache
- Severity

8-10

88
Q

Chronic migraines
- Timing

A

Chronic migraines
- Timing

15 days per month

89
Q

Headaches
- Family history

A

Headaches
- Family history

  1. Hemiplegic migraines
    - First-degree relative
90
Q

Tension headache
- Medical management

A

Tension headache
- Medical management

  1. Conservative
  2. TCA
    - Amitriptyline
91
Q

Migrane
- Medical management

A

Migrane
- Medical management

  1. Paracetamol
  2. Naproxen
  3. Metoclopromide
  4. Triptans
    - Sumatriptan
    - Limit to 2 days per week
92
Q

Migraines
- Medical prevention

A

Migraines
- Medical prevention

  1. Anti-HTN
    - Propanolol
    - Candesartan
  2. TCA
    - Amitriptyline
  3. Anti-histamine
    - Histofen
  4. AEDs
    - Lamotrigine
    - Valproate
93
Q

Cluster headache
- Medical management

A

Cluster headache
- Medical management

  1. Nasal/Sub-cut
    - Triptan
  2. High flow oxygen

Year 4 - NSS (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions