Pre-placement/Week one cases Flashcards Preview

Year 4: Neurology and special senses > Pre-placement/Week one cases > Flashcards

Flashcards in Pre-placement/Week one cases Deck (35):
1

What 10 factors would typically be considered in a neurological systems review? It may help to go top to bottom)

1) Headaches
2) Fits, faints and "funny turns"
3) Memory problems
4) Altered vision
5) Hearing difficulties
6) Speech swallowing difficulties
7) Weakness
8) Numbness/tingling
9) Balance or co-ordination difficulties
10) Incontinence or erectile dysfunction

2

What type of headache can be characterized as a tight band like sensation precipitated by stress?

Tension headache

3

What type of headache characteristically involves photophobia, neck stiffness and fever?

Meningitis headaches

4

What type of headache can be characterized by a brief stabbing pain when brushing teeth or chewing?

Trigeminal neuralgia

5

What type of headache can be characterized with a suddenly appearing excruciating headache?

headache resulting from a subarachnoid haemorrhage

6

What type of headache can be characterized by its associated facial tenderness and rhinorrhoea?

Sinusitis

7

What type of headache can be characterized by a unilateral pounding pain often preceded by an aura with multiple triggers that lasts for hours. Accompanied by an aversion to bright lights and loud noises

Migrane headache

8

What type of headache can be characterized by a 20 minute debilitating episode of retro-orbital pain with red, watering eyes?

cluster headaches

9

What type of headache can be characterized by a headache triggered by changes in position or by exertion where vision changes occur with leaning forward

Increased ICP

10

What type of headache can be characterized with pain around the eye, blurred vision with halos around lights?

Acute glaucoma

11

What type of headache can be characterized as unilateral with scalp tenderness and jaw claudication?

temporal arteritis

12

What cause of syncope is characteristically triggered by suddenly standing up

postural hypotension

13

What cause of syncope is characteristically triggered by fear, pain micturation or prolonged standing. Preceded by pallor, nausea or sweating. No associated confusion

vasovagal syncope

14

What type of syncope is associated with chest pain breathlessness and collapse on exertion

aortic stenosis

15

What cause of syncope is characteristically triggered by vigorous exercise in a young person

Hypertrophic cardiomyopathy/Cardiogenic syncope

16

What type of syncope is typically preceded by palpitations or chest pain beforehand and associated with a family history of sudden unexplained death

Arrhythmia/Cardiogenic syncope

17

What cause of syncope is characteristically triggered by shaving or turning of the head

Carotid sinus hypersensitivity

18

What type of seizure is typically characterised as being told off by teachers for day dreaming

Absence seizures

19

What type of seizure typically starts with crying out falling to the floor with a period of stiffness followed by rhythmic jerking that gradually decreases in amplitude and frequency , with a period of confusion that lasts for 30 minutes after

Generalised tonic-clonic seizure

20

What type of seizure is characterized by a patient being pale and sweaty beforehand, jerking of limbs eyes rolled back with a short duration and no confusion after

Vasovagal syncope

21

What type of seizure is characterized by violent shaking, head moving side to side, arching back, episodes of stillness before starting again. With forced eye closure

Psychogenic non epileptic attack

22

What type of seizure is characterized by early morning twitching

Early morning myoclonus

23

What is the most likely cause for a lower motor neuron facial weakness?

idopathic

24

What is Ramsay hunt syndrome? What does it need to be distinguished from?

A herpes zoster/shingles infection of the geniculate ganglion of the facial nerve that often causes painful vesicles affecting the external ear and occasionally the face. It needs to be distinguished from bells palsy

25

Define 0 on the MRC muscle scale

No movement

26

Define 1 on the MRC muscle scale

Flicker of movement

27

Define 2 on the MRC muscle scale

Movement with gravity eliminated

28

Define 3 on the MRC muscle scale

Movement against gravity but not against resistance

29

Define 4- on the MRC muscle scale

Slight movement against resistance

30

Define 4 on the MRC muscle scale

Moderate movement against resistance

31

Define 4+ on the MRC muscle scale

Submaximal movement against resistance

32

Define 5 on the MRC muscle scale

Normal power

33

What is the typical CSF/lumbar puncture reading for Guillain Barre syndrome?

Cytoalbuminologic dissociation i.e. normal cell count but elevated protein level

34

In the case of a patient with suspected Guillain Bare syndrome complaining of worsening SOB what emergencies need to be considered (what questions need to be asked) and what features indicate this is related to GBS and why?

Chest infection and PE need to be considered. You need to ask about fever, sweats & sputum production and leg pain, swelling and redness respectively. If the breathing is worsened by lying flat this occurs most often in neuromuscular ventilatory failure due to a weak diaphragm and is thus indicative of GBS

35

What signs on examination might indicate Neuromuscular ventilatory weakness?

Worsening neck weakness, reduced chest excursion on deep inspiration, CO2 retention flap