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Year 6 - MBBS COPY > Passmed: Neuro > Flashcards

Passmed: Neuro Flashcards

(58 cards)

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1
Q

What are the classic pt demographics w bells palsy? (3)

A

20-40yo
Female
Pregnant

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2
Q

Is the forehead affected in bells palsy?

A

Yes it’s only unaffected in UMN

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3
Q

What others sx could a pt w bells experience? (4)

A

Dry eyes, altered taste, hyperacusis, post auricular pain

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4
Q

Tx of Bells Palsy

A

Pred 1mg/kg for 10d + consider artificial tears and eye taping at night

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5
Q

What are the tx targets for ischaemic stroke after you’ve excluded haemorrhagic?

A

Thrombolysis w alteplase within 4.5hrs of onset + thrombectomy within 6hrs

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6
Q

What is the most common comp of meningitis?

A

Sensorineural hearing loss

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7
Q

Why would a laminectomy be performed?

A

To relieve pressure on the spinal cord

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8
Q

What is microvascular decompression classically the surg option for?

A

Disabling trigeminal neuralgia if medical mx fails

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9
Q

What are other features of Parkinson’s aside from the triad of bradykinesia, tremor, rigidity? (6)

A

Mask-like facies, quiet monotonous speech, flexed posture, micrographia, postural hypotension, psych

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10
Q

How does Parkinson’s lead to postural hypotension w/o compensatory tachycardia upon standing up?

A

It’s due to autonomic failure

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11
Q

What are the causes of postural hypotension w compensatory tachycardia? (4)

A

The 4D’s: deconditioning, dysfunctional heart, dehydration, drugs

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12
Q

When does NICE suggest starting AEDs after the first seizures? (3)

A

The pt considers the risk unacceptable or has a neuro deficit, brain imaging shows structural abnormality, EEG shows unequivocal epileptic activity

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13
Q

Which seizures can carbamazepine exacerbate? (2)

A

Absence + Myoclonic

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14
Q

When can you consider stopping AEDs and for over how long?

A

Seizure free for >5yrs and stopped over 2-3mnths

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15
Q

Def of TIA

A

A transient episode of neuro dysfunction caused by focal brain, spinal cord or retinal ischaemia w/o acute infarction

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16
Q

What are the metabolic consequences of refeeding syndrome?

A

Hypokalaemia
Hypomagnesaemia
Hypophosphataemia
Abnormal Fluid Balance

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17
Q

What do you prescribe for pts at risk of refeeding syndrome?

A

Start at up to 10kcal/kg/day and inc to full needs over 4-7days

PLUS vit B co strong, 2-4K, 0.2-0.4Mg, 0.3-0.6PO4 all in mmol/kg/day

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18
Q

How is hypophosphataemia classified?

A

Mild 0.64-0.80
Mod 0.32-0.64
Severe <0.32

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19
Q

How is hypophosphataemia tx?

A

Mild-Mod: phosphate sandoz effervescent tabs w each tab containing 20.4Na, 3.1K, 16.1PO4

Severe: IV phosphate polyfusor w each 500ml containing 81Na, 9.5K, 50PO4

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20
Q

What is Hoffman’s sign?

A

A reflex test to assess for cervical myelopathy by gently flicking one finger and looking for twitching of the others

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21
Q

What is the gold standard test for DCM?

A

MRI

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22
Q

Tx of DCM

A

Decompressive surgery +/- physio and analgesia

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23
Q

What type of tremor is the essential tremor?

A

Postural that can be exacerbated by outstretching the arms

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24
Q

How does internuclear ophthalmoplegia px?

Study These Flashcards
A

The lateral gaze w abnormality shows:

Ipsilateral - impairment of aDduction

Contralateral - can aBduct but w nystagmus

25
Where is the lesion in INO?
The medial longitudinal fasciculus located in the paramedian area of midbrain and pons that interconnects the 3/4/6 CNs
26
What doesn’t MND typically affect?
Extraocular Muscles + Cerebellum
27
What are cutaneous features of tuberous sclerosis? (5)
Ash leaf spots, Shagreen patches, angiofibromas, subungual fibromata +/- cafe-au-lait spots
28
What are neuro features of tuberous sclerosis? (2)
Developmental Delay + Epilepsy
29
Ocular Hamartomas: NF vs TS
NF: iris ie Lisch nodules vs TS: retinal
30
Autonomic Dysreflexia
Spinal cord injury @ >= T6 characterised by HTN + bradycardia
31
Where does the autonomic nervous system leave the CNS?
Sympathetic: thoracolumbar Parasympathetic: medulla + sacral
32
Cushing’s Triad
HTN, Bradycardia, Irr Breathing
33
What are the red flags for trigeminal neuralgia?
Onset <40yo, fhx of MS, optic neuritis, pain only in ophthalmic division, sensory changes, deafness, hx of skin or oral lesions that could spread perineurally
34
What is the first line tx for trigeminal neuralgia?
Carbamazepine
35
Where is the lesion in Broca’s expressive aphasia?
Inf Frontal Gyrus supplied by superior division of left MCA
36
Where is the lesion in Wernicke’s receptive aphasia?
Sup Temporal Gyrus supplied by inferior division of left MCA
38
Ddx of non fluent speech
Comprehension relatively intact - broca’s Comprehension impaired - global
39
Ddx of fluent speech
Comprehension relatively intact - conduction Comprehension impaired - wernicke’s
40
Bitemporal Hemianopia Ddx
Optic chiasm lesion or compression: inferior comp is upper quadrant defect from pituitary macroadenoma + superior comp is lower quadrant defect from craniopharyngioma
41
Ischaemic Stroke + AF
Aspirin 300mg OD 2wks before any anticoags
42
Triptan CI
IHD
43
What are indications for urgent CT head in pts w headache? (5)
Vomiting >1 w no other cause, new neuro deficit, red GCS, valsalva or positional headaches, progressive headache w fever
44
What is the ROSIER score?
After excluding hypoglycaemia: -1 for LOC or seizure +1 for asymmetric weakness in face, arm, leg, speech disturbance, visual field defect If total score >0 a stroke is likely
45
What should you exclude in an older pt w headache + sev unilateral eye pain?
Glaucoma
46
Which cranial nerves are affected in vestibular schwannomas?
V VII VIII
47
What is the class hx of vestibular schwannoma?
Vertigo Tinnitus Hearing Loss Absent Corneal Reflex
49
Where is the lesion in conduction aphasia?
Arcuate Fasiculus b/w Broca’s + Wernicke’s
50
What is given during an acute relapse of MS?
5d methylpred
51
Which nerve supplies the nail bed of the index finger?
Median
52
Which nerve supplies the medial aspect of the dorsum?
Ulnar
53
Aside from the extensors what else does the posterior interosseous branch innervate?
Supinator + Abductor Pollicis Longus
54
What are the most common antiepileptics?
Gen: Na Valproate - P450 inhibitor Focal: Carbamazepine - P450 inducer 2nd Line: Lamotrigine - SJS
55
Which comp of bacterial meningitis is routinely tested for?
Sensorineural Hearing Loss
56
What is classified as a MOH?
Using triptans/opioids on 10d or more per mnth for 3m AND sx resolve within 2m of stopping
57
Acute mx of cluster headache
100% O2 + S/C Triptan
58
Prophylactic mx of cluster headache
Verapamil
59
Which haematoma is limited to the suture lines?
Epidural
60
Mx of Raised ICP
Ix and tx underlying cause, head elevation to 30°, IV mannitol, controlled hyperventilation, CSF removal

Year 6 - MBBS COPY (35 decks)

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