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Year 4 Finals > Neurology > Flashcards

Neurology Flashcards

1
Q

What is the acute management of cluster headaches?

A

100% oxygen + subcutaneous triptan

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2
Q

What medication is used in the prophylaxis of cluster headaches?

A

Verapamil

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3
Q

NICE recommend what for prophylaxis of tension headaches?

A

Acupuncture

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4
Q

Acute management of tension headaches is achieved via what medications?

A

Paracetamol, NSAIDs

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5
Q

In a patient with suspected temporal arteritis, what treatment should be given with:
1. No visual loss
2. Evolving visual loss

A
  1. High dose prednisolone
  2. IV methylprednisolone
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6
Q

Gastrointestinal upset is a common feature of what type of headache in children?

A

Migraine

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7
Q

What is the first line treatment for acute migraines?

A

Oral triptan + NSAID or paracetamol

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8
Q

Name the 3 medications used in prophylaxis of migraines

A

Propranolol, topiramate, amitriptyline

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9
Q

What should be used as prophylaxis in predictable menstrual migraine?

A

Triptans

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10
Q

Why is the oral contraceptive pill contraindicated in migraine with aura?

A

Increased risk of ischaemic stroke

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11
Q

Fundoscopy will show what in temporal arteritis?

A

Swollen pale disc with blurred margins

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12
Q

Through what mechanism does temporal arteritis cause vision loss?

A

Anterior ischaemic optic neuropathy

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13
Q

Acetazolamide is implicated in the management of what?

A

Idiopathic intracranial hypertension

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14
Q

Carboxyhaemoglobin percentage of over what is suggestive of carbon monoxide poisoning in:
1. Non smokers
2. Smokers

A
  1. Over 3%
  2. Over 10%
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15
Q

What is the target for oxygen saturations in carbon monoxide poisoning patients?

A

100%

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16
Q

In raised intracranial pressure, elevation of the head to how many degrees can be carried out?

A

30

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17
Q

Raised intracranial pressure can be temporarily controlled via what respiratory mechanism?

A

Hyperventilation to blow off CO2
Note - causes vasoconstriction of cerebral blood vessels, hence lowering ICP

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18
Q

A headache which is worse on standing up and better on lying down suggests what?

A

Low pressure headache

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19
Q

What type of headache may follow a lumbar puncture?

A

Low pressure

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20
Q

In what type of headache is a lumbar puncture contraindicated?

A

High pressure

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21
Q

Extradural haemorrhage most commonly involves what vessel?

A

Middle meningeal artery

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22
Q

Which type of intracranial bleed is limited by the suture lines of the skull, and which is not?

A
  1. Limited - extradural
  2. Not limited - subdural
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23
Q

What is the definitive treatment for an extradural haemorrhage?

A

Craniotomy + evacuation of haemorrhage

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24
Q

A unilateral dilated pupil indicates compression of which cranial nerve?

A

Third

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25
What is the surgical management involved in subdural haemorrhage?
Burr holes
26
Which renal disease is associated with subarachnoid haemorrhage?
Adult polycystic kidney disease
27
Lumbar puncture should be conducted at least how long after symptom onset in SAH?
12 hours
28
Lumbar puncture should be conducted at least how long after symptom onset in SAH?
12 hours
29
Nimodipine has what effect on cerebral vessels? In what situation may it be used?
Prevents vasospasm - used in subarachnoid
30
Subdural haemorrhage is most commonly due to shearing of bridging veins between what?
Cortex and venous sinus
31
Fluctuating consciousness suggests what type of intracranial bleed?
Subdural
32
A lucid interval indicates what type of intracranial bleed?
Extradural
33
Which type of intracranial bleed is associated with shaken baby syndrome?
Subdural
34
Which electrolyte abnormality is a common complication of SAH?
Hyponaetraemia via syndrome of inappropriate antidiuretic hormone secretion
35
Ring enhancing lesion on CT head is suggestive of what?
Brain abscess
36
Lymphocytosis and raised protein on LP is suggestive of what?
Encephalitis
37
Which bacteria classically causes Guillain Barre syndrome?
Campylobacter jejuni
38
What is the difference between Miller-Fisher syndrome and classic GBS?
Miller Fisher is a descending paralysis, GBS is ascending
39
Herpes simplex encephalitis most commonly affects which brain lobe? What symptom can this commonly produce?
Temporal lobes - aphasia
40
What is the most common organism implicated in meningitis in: 1. Neonates 2. Adults 3. Immunosuppressed
1. Group B strep 2. Neisseria 3. Listeria
41
Polymorph dominant cerebrospinal fluid on lumbar puncture suggests what?
Bacterial cause of meningitis
42
A fibrin web in cerebrospinal fluid is suggestive of what?
Tuberculous meningitis
43
What antibiotics should be used for initial empirical therapy of meningitis in: 1. Aged under 3 months or over 50 years 2. Between 3 months - 50 years
1. Ceftriaxone + amoxicillin 2. Ceftriaxone
44
Listeria meningitis should be managed with which 2 antibiotics?
Amox + gentamicin
45
Meningococcal meningitis is primarily managed with which antibiotic?
Benzylpenicillin
46
Isolated rise in protein in cerebrospinal fluid is indicative of what?
Guillain barre syndrome
47
What medication should be co-prescribed with antibiotics in bacterial meningitis?
Dexamethasone No longer than 12 hours after antibiotic administration
48
What is the most common complication of non-meningococcal meningitis?
Sensorineural hearing loss
49
What is the most common complication of meningococcal meningitis?
Waterhouse-Fridirechsen syndrome
50
Prophylaxis for contacts of bacterial meningitis is achieved via what 2 medications?
Single dose ciprofloxacin or rifampicin
51
What is the most common organism implicated in viral meningitis?
Coxsackie virus
52
Which 2 antibiotics are used together for brain abscess treatment?
Ceftriaxone + metronidazole
53
What type of bacteria is neisseria meningiditis?
Gram negative diplococci
54
Whilst awaiting transfer in primary care, what medication can be given in suspected meningitis?
IM benzylpenicillin
55
Which parameter may be used to monitor respiratory function in Guillain Barre syndrome?
Forced vital capacity (FVC)
56
Oligoclonal bands in CSF is suggestive of what?
Multiple sclerosis
57
What is given for acute relapses of MS?
High dose steroids
58
What is the first line disease modifying drug in MS?
Natalizumab
59
What medication can be used for fatigue in MS, once other possible causes have been excluded?
Amantadine
60
Thymoma is associated with which neurological disorder?
Myasthenia gravis
61
Which antibodies may be present in myasthenia gravis?
Acetylcholine receptor antibodies
62
What is the first line treatment for myasthenia gravis?
Pyridostigmine
63
What 2 treatments are indicated in myasthenic crisis?
Plasmapheresis and IVIG
64
Which imaging modality is used to diagnose MS?
MRI with contrast
65
Paraesthesia in the limbs on neck flexion is described as what sign?
Lhermitte’s
66
Describe Uhthoff’s phenomenon. Which neurological disorder is this seen in?
Worsening in vision following rise in body temperature Seen in MS
67
What 2 medications can be used for spasticity in multiple sclerosis?
Baclofen or gabapentin
68
Myasthenia symptoms which improve after repeated muscle contraction indicates what?
Lambert Eaton syndrome
69
Lambert Eaton syndrome is associated with what malignancy?
Small cell lung cancer
70
Myasthenia gravis patients are often resistant to which anaesthetic agent?
Suxamethonium
71
Which optic manifestation of alcohol excess is most common?
Lateral gaze palsy
72
Blood pressure should be lowered to a minimum of what for thrombolysis treatment?
185/110
73
Carotid endarterectomy is considered in patients with carotid stenosis above what percentage?
50%
74
Which sign differentiates between organic and functional lower limb weakness?
Hoovers sign

Year 4 Finals (15 decks)

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