Neurology Flashcards Preview

RCSI Medicine > Neurology > Flashcards

Flashcards in Neurology Deck (107)
Loading flashcards...
1

BENZO S/e

sedation
resp depression
Agitation
ataxia
sudden w/d - seizure
tolerance

2

phenytoin s/e

HYPERPLASIA GIGIVAL
Hirtuism
decrease BMD
decrease folic acid
drownsiness
rash
nystagmus

3

Primidone

biotransformation into metabolites phenobarbitone and phenylethylmalonamide → anticonvulsant activity
Use: GP FEM generalised seizures, psychomotor (temporal lobe) epilepsy, focal seizures, myoclonic jerks
Adverse effects: Decreased bone mineral density, ataxia, drowsiness, fatigue, hyperirritability, suicidal ideation, vertigo, rash, GI upset, impotence, haematological, nystagmus, diplopia
Comments: May reduce effectiveness of hormonal contraception

4

s/e CARBAMAZEPINE

hyponatraemia, rash, pruritus, fluid retention, aplastic anaemia, hepatotoxicity, GI effects, sedation, ataxia, nystagmus, depression, dizziness, diplopia, lethargy, headache, idiosyncratic

May make primary generalised epilepsy worse.

5

Valproate moa and s/e

inhibits na channel
S/e
- NTD
- PCOS
= hypothyroidism
= insulin resistent DM

6

ETHOSUXAMIDE moa and s/e

nausea, vomiting, sleep disturbance, drowsiness, and hyperactivity
Comments: Rarely lupus-like reactions, SLE

MOA: iBlocks T-type calcium channels in thalamic neurons

7

lamotrigine s/e moa

Rash (Stevens-Johnson), tremor, headache, GI, insomnia, somnolence

moa blocks Na and decrease electrical emission

8

how is VIGABATRIN secreted

really

9

VIGABATRIN s/e

Sedation, fatigue, depression, psychosis,, headache, dizziness, weight gain

10

TOPIRAMATE s/e

Sedation, cognitive slowing, renal stones, weight loss, glaucoma, paresthesias, headache, fatigue, dizziness, depression, mood problems, metabolic acidosis

11

gabapentine moa and s/e

increase GABA in the brain binds to voltage dependent calcium channel
edation, dizziness, ataxia, GI upset, weight gain.

12

TIAGABINE moa and s/e

GABA uptake inhibitor

potential pro-convulsive effect
Dizziness, tiredness, mood changes, lack of energy, somnolence, nausea, nervousness, TREMOR , DIFFICULT CONCENTRATION , abdominal pain

13

ZONISAMIDE moa and s/e

blocks voltage-dependent sodium and T-type calcium channels

Somnolence, ataxia, cognitive slowing, weight loss, rash, ataxia, anorexia, confusion, abnormal thinking, nervousness, fatigue, and dizziness, nephrolithiasis (low risk)

14

what two anticonvulsants cause nephrolithiasis

ZONISAMIDE
TOPIRAMATE

15

LEVETIRACETAM moa s/e

Unclear, binds to a synaptic vesicle protein, may modulate synaptic transmission through alteration of vesicle fusion, may indirectly modulate GABA

Usually well tolerated
Sedation, mood disturbance, behavioural disturbance, fatigue, somnolence, dizziness, and infection (upper respiratory

16

what anticonvulsants mess the OCP effectiveness up

phenytoin

Primidone
Carbamazepine
lamotrigine

17

what three anticonvulsants are excreted renally vs. hepatic

1. VIBigatrin
2. Zonisamine
3. Gabapentine
4/ levetiracetam

18

Ulnar nerve Supplies and defect if damage

C8 , T1
supplies
All small muscles of hands except LOAF
Wasting of small muscles of hand
Claw hand
Sensory loss over medial one and half fingers
Froment’s sign

19


Radial nerve Supplies and defect if damage

C5-C8
Supplies
Triceps
Brachioradialis
Extensors of hand
Wrist drop
Sensory loss over anatomical snuffbox

20

Median nerve

C6-T1
Supplies
Muscles of forearm (except FCU, FDP)
LOAF
Sensory loss over palmar aspect of thumb and lateral two fingers
Ochsner’s clasping test
Tinel’s test
Phalen’s test

21

Sciatic nerve

Supplies
Hamstrings
All muscles below knee
Footdrop
Weak knee flexion
Normal knee jerk, absent/weak ankle jerk
Sensory loss posterior thigh, lateral and posterior calf and foot

22

Common peritoneal nerve

L4-S1
Terminal branch of sciatic nerbe
Supplies
Anterior and lateral leg compartments
Weak dorsiflexion/eversion
Normal reflexes
Sensory loss lateral dorsum of foot

23

Brown Squard Syndrome

IPSILATERAL - UMN sign below lesion, LMN at level of lesion and VIBRATION AND propioperception

CONTROLATERAL temp and pain

24

SACD spinal cord

Symmetrical UMN signs in lower limbs
Exaggerated knee jerks
Absent ankle jerks
Symmetrical proprioception/vibration loss
Peripheral neuropathy
Optic atrophy

25

CAUSE OF SACD SPINAL CORD

B 12

26

SYRINGOMYELIA

A fluid-filled, gliosis-lined cavity within the spinal cord
Pain/temperature loss over neck/shoulders/arm (cape)
Arm atrophy
UMN lesions in LL

Causes
Congenital malformations (e.g. Chiari malformation Type 1)
Postinfectious
Postinflammatory (e.g. transverse myelitis, MS)
Posttraumatic

27

CONUS MEDULARIS

Lesions at vertebral level L2
flaccid paralysis of the bladder and rectum
impotence
saddle (S3-S5) anaesthesia, usually more localised to perianal area.

Causes
disc herniation
spinal fracture
Space occupying lesion

28

seizure

sudden change in behaviour or function due to neurological dysfunction

epilepsy - recurrent seizures (at least 2) due to excessive electrical activity in the brain

29

Complication of epilepsy

AAA CDD T
AED S/e
anorexia
Acidosis
Cognitive impairment
Depression
death
Trauma / personal injury

30

Risk of epilepsy recurrence

- structural brain disease
- cognitive impairment
- multiple seizure type
- age onset in 1st decade ( 10 years)
- family history

- not responding to treatment
- combo treatment needed

- abnormal neuro exam
- epileptiform foci on EEG
- Abnormal MRI