Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

ACEM > Neurology > Flashcards

Neurology Flashcards

(53 cards)

Start Studying
1
Q

Name 5 peripheral causes of vertigo

A

BPPV
Menierres disease
Acute Vestibular Neuritis
Viral or suppurative Labyrinthitis
Acoustic Neuroma
Aminoglyocside ototoxicity

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

Name 5 central causes of vertigo

A

Cerebellar CVA
Cerebellar tumour
Vertebro-basillar insufficiency
Brain stem (any posterior circulation) CVA
Multiple Sclerosis
Drug toxicity- anti epileptics, anti depressants, antimalarials

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

Name 5 cerebellar signs on physical examination

A

broad based ataxia
nystagmus
intention tremor
abnormal finger nose test (past pointing)
abnormal heel- shin test (dysmetria)
abnormal heel-toe test (fall to side of lesion)

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

Complete table re clinical features of vertigo

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

Classic symptoms of Meniere disease

A

Tinnitus, vertigo, sensorineural hearing loss
Usually episodic in middle aged men
Associated with vomiting, nausea and sweating

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

Treatment of Meniere Disease

A

salt restriction
HCT 25mg daily
avoid caffeine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Classic BPPV presenting symptoms

A

acute onset, often after waking
worse with movement of head
improves when head still
nystagmus on provocative testing- Hall pike
F>M
50-60

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

BPPV treatment

A

Prochlorperazine 12.5mg IV
Promethazine 10mg TDS
Epleys Maneuvere

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Classic Acute Vestibular Neuritis presenting symptoms

A

Classically follows viral illness
Onset over few hours
Persistent vertigo when head is still and eyes closed
Associated with vomiting
Nystagmus at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Treatment of Acute Vestibular Neuritis

A

Prednisolone 125mg daily, decrease by 25mg every 3 days
Prochlorperazine 25mg IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Peripheral vertigo clinical signs

A

able to sit or stand without assistance
no cranial nerve or cerebellar signs
unidirectional fatiguable nystagmus
unilateral abnormal head impulse test
no skew

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Central vertigo clinical signs

A

unable to sit or mobilise without assistance
cerebellar signs
other cranial nerve signs
negative head impulse test (eyes fixed on nose)
nystagmus- vertical, torsional, non fatiguable and no latency with head movement
skew present -usually vertical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Best Imaging for vertigo

A

MRI
CT often not helpful- will miss small cerebellar strokes

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

Stroke Mimics- name 10

A

hypoglycaemia/ hyponatraemia
Hemiplegic Migraine
Post ictal Todds paresis
Brain tumour
Brain abscess
Meningoencephalitis
Head injury- subdural haematoma
Multiple Sclerosis
Wernickes- Korsakoffs syndrome
Drug toxicity
Bells Palsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Name 3 non cardiac thromboembolic causes of ischaemic stroke

A

Carotid artery atheroma
vertebral artery atheroma
Small vessel disease- lacunar infarct

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

Name 5 cardiac thromboembolic causes of ischaemic stroke

A

AF
Atrial myxoma
Valve disease
Mural thrombosis
PFO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Name 6 non cardioembolic causes of ischaemic stroke

A

Cerebral vasospasm post SAH
Aortic or vertebral artery dissection
Cerebral vasospasm- pre eclampsia
Moyamoya syndome
AFE
Gas embolism
Arteritis
Cardiac arrest- low flow state

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

Name 5 causes of Haemorrhagic stroke

A

HTN ++++++
liphylanosis
AVM
Aneurysm
Bleeding diathesis- oral anticoagulation or inherited
Secondary haemorrhage into infarction or tumour
Amyloid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Indications for thrombolysis in stroke

A

Onset of symptoms within 4.5 hours
Significant persistent neurological deficit
CT scan which does not show SAH or bleeding risk
Does not have any absolute contraindications
No other terminal disease or severe comorbidities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the Absolute contraindications for thrombolysis in CVA

A

-Onset of symptoms > 4.5 hours
-INR >1.7
-oral anticoagulation taken in the last 12 hours
-BP > 185 systolic or 110 diastolic
-Platelets < 100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the relative contraindications for thrombolysis in CVA

Study These Flashcards
A

-Pregnancy
-Known MI in the past 30 days
-known IC bleeding past 30 days
-surgery/biopsy or trauma of internal organs past 30 days
-severe comorbidities
-advanced dementia
-CPR or arterial puncture past 30 days

23
Q

Name 2 thrombolysis drugs and doses

Study These Flashcards
A

-altelpase- 0.9mg/kg max 90 mg. Give first 10% as a push and the other 90% over 60 minutes
-tenecteplase- 0.25mg/kg. Max 25 mg given as a single push
-need to be given through dedicated IV line

24
Q

What are the main complications of thrombolysis treatment

Study These Flashcards
A

-ICH
-internal bleeding-retroperitoneal, GI/GU, solid organ
-external bleeding- massive epistaxis
-angioedema (give icatabant 30 msg s/cut- don’t want to cause HTN)
-anaphylaxis

25
Blood pressure target in first 24 hours post thrombolysis
180 Systolic and 110 diastolic
26
What is the BP target in ischaemic stroke
-if receiving thrombolysis- 185/110 or less -if infarction not receiving thrombolysis 220 max- lower by no more than 20% in first 48 hours
27
What is the BP target in haemorrhagic stroke
140 systolic
28
Name 4 drugs and does for acute treatment of HTN in setting of stroke
-Labetalol IV- 10-20 mg bolus repeat every 10 minutes as required- can start infusion 3-8 mg/hr thereafter -Hydralazine 5mg bolus- repeat every 20 minutes -GTN 6mg in 100ml- start 2 ml/hr and increase every 5 minute -Sodium Nitroprusside 0.5mcg/kg/minute
29
Indications for clot retrieval
-Can be commenced 6 hours of onset of symptoms or up to 24 hours of onset if perfusion scan shows a favourable penumbra -Severe persistent neurological deficit -Anatomical location amenable to therapy- ICA, MCA, ACA, basilar, dominant vertebral artery -combination of age, premorbid function, time since last known to be well and penumbra imagine make it non futile
30
Exclusion criteria for clot retrieval
-> 24 hours since onset of symptoms -Anatomical location not amenable to therapy/ unfavourable penumbra on imaging -significant pre morbid comorbidities/lack of independence -suspicion for SAH or vasospasm on imaging -INR > 1.7 -known severe hypersensitivity to contrast
31
What are the clinical features of MCA stroke syndrome
-contralateral motor weakness- face>legs -contralateral sensory loss -face>legs -homonymous hemianopia -receptive and expressive aphasia if dominant hemisphere -visual neglect -gaze deviation to side of affected lesion
32
What are the clinical features of ACA stroke syndrome
-contralateral motor weakness- peripheral > proximal -contralateral sensory loss- peripheral > proximal -Urinary and faecal incontinence (paracentral lobule) -Abulia (prefrontal cortex and anterior cingulate gyrus) -Transcortical motor aphasia--> can repeat sentence but not come up with their own
33
What are the features of ICA stroke syndrome?
since it splits into ACA, MCA and ophthalmic--> all of ACA and MCA symptoms and sudden visual loss
34
What are the clinical features of PCA syndrome?
homonymous hemianopia quadrantanopia memory loss ipsilateral 3rd neve palsy
35
What are the clinical features of basilar stroke?
Locked in syndrome Ocular palsies
36
What are the clinical features of cerebellar stroke?
vertigo nausea and vomiting ataxia nystagmus dysmetria
37
CT Brain findings in CVA
-hyperdense MCA sign on CTA (if MCA) -loss of grey white matter differentiation -loss of insular ribbon sign -effacement of ventricles -effacement of cisternes -sulcal effacement -midline shift
38
Clinical features of temporal arteritis
-F>M ->50 yo -monocular visual loss -scalp tenderness -jaw claudication -has PMR
39
What investigations are useful in temporal arteritis?
Blood- ESR> 50 if over 100 virtually diagnostic CRP Temporal artery biopsy- start steroids before, can be skip lesions
40
What is the treatment of temporal arteritis?
If Visual Loss- IV methylprednisolone If no visual Loss- oral prednisolone
41
What are the common organisms for bacterial meningitis in adults
-streptococcus pnumoniae -neiserria meningitides -haemophilus inluenzae B
42
What are the common organisms for bacterial meningitis in kids? 1month-18 years
-streptococcus pnumoniae -neiserria meningitides -haemophilus inluenzae B
43
What are the common organisms for bacterial meningitis in neonates?
Listeria monocytogenes Group B streptococcus Ecoli
44
What are the clinical features of idiopathic intracranial hypertension?
-young, obese female -headaches -visual blurring -loss of peripheral vision -PE- diplopia and CN VI palsy -LP opening pressure > 25 cm H20 RX weight loss, acetazolamide
45
Clinical features of Cerebral venus sinus thrombosis
female OCP, pregnancy, post partum, malignancy headache, visual change, seizure, altered mental state PE- focal neurology, seizures, papilloedema MRI gold standard- CT V next best- empty delta sign
46
CT brain findings in Cerbral Venous sinus thrombosis
Empty delta sign
47
Clinical features of Guillain Barre?
-recent repsiratory or GI illness -symmetrical ascending paralysis -loss of deep tendon reflexes -glove and stocking distribution sensory deficit -dysautonomia
48
Investigation in Guillain Barre
-Largely clinical diagnosis -Bloods- IgG campylobacter, EBV, CMV, mycoplasma, TFTS, electrolytes -LP- high protein, normal gluconse and cell count -Peak flow and FVC testing
49
Treatment of Guillan Barre
FVC < 30% predicted--> indication for intubation CN involvement and neck weakness and dysautonomia predict need for intubation IVIG plasmapheresis supportive care- DVT prophylaxis, management of dysautonomia, nutrition, pressure care etc
50
Classical features of Miller fisher variant of GB syndrome
opthalmoplegia ataxia areflexia
51
What are possible complications of VP shunts?
infection- can happen anywhere blockage-from infection or migration of catheter tip in tissues- progressive raised ICP features and neruology fracture-mild ICP symptoms and discomfort around fracture site- most commonly near clavicle overdrainage- waxing and waning symptoms- slit like ventricles on CT pseudocyst formation- in abdominal site- causes blocakge
52
What are the clinical features of cluster headache
M>F episodes 15-180 minutes occur in cluster and then resolve severe periorbital and temporal pain associated with lacrimation, conjunctival injection and rhinorrhoea
53
Treatment of cluster headache
100 oxygen sumitriptan 6 mg s/cut prevention- verapamil

ACEM (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions