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Neurology Flashcards

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1
Q

What should a GP initiate if they suspect a TIA?

A

300mg Aspirin STAT and referral to specialist within 24 hours

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2
Q

What is the triad of symptoms in Wernickes encephalopathy?

A

Opthalmoplegia/ confusion/ gait ataxia/ nystagmus - (acute presentation)

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3
Q

Following a TIA, what are the driving rules?

A

If symptom free at 1 month can start driving again as long as symptom free. no need to inform dvla

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4
Q

Cluster headache - what is the prophylaxis?

A

Veramapil

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5
Q

How does Ramsay Hunt syndrome present?

A

Facial nerve palsy/ vesicles in mouth or ear, ear pain.

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6
Q

Treatment of Ramsay Hunt syndrome?

A

Treatment= Oral aciclovir and oral prednisolone

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7
Q

How does spinal stenosis present?

A

Bilateral leg pain on walking/ relieved on crouching forward. Weakness

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8
Q

What is the management of trigeminal neuralgia?

A

Carbamazapine

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9
Q

What would be seen on a CT of herpes simplex encephalitis?

A

Temporal lobe changes (hypo densities)

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10
Q

Who does herpes simplex encephalitis affect?

A

ImmunoCOMPENENT individuals. Presents with confusion, irritability.

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11
Q

How to remember GCS?

A

654, MoVE

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12
Q

What is the time frame for providing thrombectomy within?

A

6 hours!

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13
Q

If symptoms of a stroke are presented within 4.5 hours what should be provided?

A

Thrombectomy AND thrombolysis

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14
Q

What is the first line treatment for motor symptoms in Parkinson’s?

A

Levodopa.

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15
Q

What is the management of TIA in GP setting if symptoms have resolved?

A

300mg Aspirin and referral to TIA clinic within 24 hours

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16
Q

What is Cataplexy?

A

Cataplexy- eg bouts of laughter produce muscle weakness

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17
Q

What is the ‘thrombolysis’ window?

A

4.5 hours!

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18
Q

What is the presentation of Wilsons disease?

A

Neurological symptoms (bradykinesa/ speech/ ataxia)/ Kayser-Fleischer rings, family history

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19
Q

What is the prophylaxis for preventing migranes?

A

Propanaolol
Topiramate- avoid in women of childbearing age

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20
Q

Post stroke what is the combination of antiplatlets?

A

Clopidogrel monotherapy

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21
Q

What drug choice for generalised tonic clonic seizures?

A

Males-Sodium valporate
Females- Lamotrigine

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22
Q

What is the drug choice for absent seizures?

A

Ethosuxamide

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23
Q

Focal seizures drug management 1st line

A

Lamotrigine

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24
Q

Cabergoline- what type of drug and what is the side effect?

A

Dopamine receptor agonist “dostinex”
Side effect: Pulmonary fibrosis

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25
After an ischaemic stroke what antiplatelet/ anti platelets should be given?
Monotherapy with clopidogrel
26
Presentation of bulbar-onset amyotrophic lateral sclerosis (ALS) (part of motor neurone disease)
Difficulty swallowing liquids, facial weakness, hypophonic speech, fasciculation's and eye movements spared
27
Bells palsy vs stroke
Bells palsy- complete facial nerve paralysis Stroke (spare the forehead).
28
Lewy body dementia presents how?
Fluctuating cognition, visual hallunications
29
How does an extradural haemorrage present?
LOC followed by lucid period and then LOC again
30
What is an example of Dopamine receptor agonists?
ropinirole, Rotigine
31
What is first line in the management of Parkinson's?
If motor symptoms then levodopa.
32
What does an Abducens nerve palsy present with?
Palsy results in defective abduction → horizontal diplopia Eye looks inwards Abducens is the 6th nerve
33
How does an oculomotor palsy present?
Eye is down and out Ptosis Dilated pupil
34
What is the most common cause of a Trochlear nerve lesion? and what would a palsy result in?
Head Trauma Palsy results in downward gaze but at resting the eye looks up
35
How does an ANTERIOR cerebral artery stroke present?
Contralateral hemiparesis and sensory loss
36
How does a POSTERIOR cerebral artery stroke present?
Contralateral homonymous hemianopia with macular sparing
37
How does a MIDDLE cerebral artery stroke present?
-Contralateral hemiparesis and sensory loss - Contralateral homonymous hemianopia -Aphasia
38
Presentation of Acoustic neuroma?
Unilateral hearing loss Affects cranial nerves so can get facial palsy, absent corneal reflex
39
How does Myasthenia Gravis present?
Females Autoimmune Extraocular muscle weakness, diplopia, Slurred speech, Dysphagia Ptosis
40
What are the classical features of Guillain Barre syndrome?
Ascending weakness Bilateral and symmetrical Reduced reflexes
41
Infantile spasm/ west syndrome- what is the presentation?
Spasms described as 'drawing legs up'. A/W birth asphyxia
42
Juvenille myoclonic epilepsy (Janz syndrome)
Most common Myoclonic Jerks in the morning
43
Subdural and extradural haemorrhage present how?
Subdural- elderly/ alcoholics. Bridging veins.Crescent shaped Extradural- Head injury/ middle meningeal/ LUCID period/ lens shaped.
44
What is the treatment of Guillian Bare?
IV Immunoglobulin
45
What are the three features of Wernickes encephalopathy?
ophthalmoplegia/nystagmus, ataxia and encephalopathy
46
What are the features of Multisystem atrophy?
Parkinsons symptoms (gait) Autonomic disturbance Cerebellar symptoms ORTHOSTATIC HYPOTENSION Dry mouth and dry skin
47
Carpal tunnel affects which nerve?
Median nerve of hand
48
Foot drop is caused by injury to which nerve?
Common peroneal
49
DVLA and stroke rules?
1 month off driving
50
How may Neurofibromatosis type 2 present?
Acoustic neuroma (SNHL) Meningioma
51
How does Charcot Marie Tooth Disease present?
Inverted Champagne bottle legs Pes cavus Foot drop 'Inherited peripheral neuropathy'
52
What are the treatment principles of myasthenia Gravis?
Anticholinesterases Thymectomy
53
First line for a focial seizure ?
Lamotrigine or Levetiracetam
54
Management of status epilepticus?
Pre hopsital: PR Diazepam/ Buccal Midazolam In Hopsital: IV Lorazepam
55
Malignant spinal cord compression vs. cauda equina?
Cauda equina- sensory loss over buttocks. (motor loss in toes) Spinal cord compression- depends where the lesion is.
56
What is Chiari malformation?
Cerebellum herniates through foramen magnum. Presents with headache which is worse on movement
57
Antiganglioside antibodies are seen in which condition?
Guiline Barre
58
First line for absent seizure?
Ethosuxamide
59
First line for each of these seizures: Absent Generalised tonic-clonic Focal
Absent - Ethosuxamide Generalised tonic-clonic- males sodium valproate females- lamotrigine/ levetriticam Focal seizures- lamotrigine or levetraticam
60
What are the drugs indicated for Alzheimer's dementia?
First line: Donepezil/ Galantamine/ Rivastigmine Second line : Memantine (NMDA Antagonist)
61
What would show on the CSF of a bacterial meningitis?
Polymorphic cells Protein + LOW GLUCOSE IN CSF when compared to serum.
62
What would show on the CSF of a VIRAL meningitis?
Monomorphic cells Normal or raised protein Normal glucose
63
What would show on the CSF of a FUNGAL meningitis?
Raised protein Low glucose
64
Adults- most common cause of bacteria meningitis?
Streptococcus pneumonia Neiserria meningitis (HIB)
65
How is Huntingtons disease inherited?
Autosomal dominant
66
What are the 2 diagnostic tests for Guilliane Barre?
Nerve conduction studies and Lumbar puncture
67
Cluster Headaches- acute and prophylaxis?
Acute- Triptans and O2 Prophylaxis- Vermapril (Prednisolone)
68
What are the indications for a CT head within an hour
GCS less 13 at time of injury GCS less than 15 at 2 hours Suspected basal fracture >1 episode of vomiting CT scan within 1 hour
69
What is the triad for normal pressure hydrocephalus?
gait abnormalities/ urinary incontinence and dementia
70
Myathenia gravis - presentation Investigations and management
Ptosis Fatigabilty of muscles Ix- acetylcholinesterase autoantibodies Repetitive nerve conduction studies Mx- Acetylcholinesterse inhibitors Thymectomy
71
Parkinsons drugs Co-careldopa and Co-beneldopa are a mix of which drugs?
Co-beneldopa: levodopa and benserazide Co-careldopa: levodopa and carbidopa
72
What is a Total Anterior Circulation Stroke (3 things)
Homogenous hemianopia and hemiparesis (on the same side, but contralateral to the lesion) Dysphagia
73
What is classified as a PACI?
2 Of the following: - homogenous hemiapnoa - hemiparesis -dysphagia
74
What is a lacunar infarct?
unilateral weakness (and/or sensory deficit) of face and arm, arm and leg or all three. pure sensory stroke. ataxic hemiparesis
75
How does a posterior stroke present?
- Isolated homogenous hemianopia - Cerebellar syndromes - Loss of consciousness

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