Week 4 part 2 Flashcards Preview

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Flashcards in Week 4 part 2 Deck (60):
1

What is the commonest extra-axial tumour?

Meningioma

2

What presents with progressive neurological deficit, motor weakness, headache and seizures?

Brain tumour

3

What is a headache due to if its worse in the morning, wakes them up, increases with coughing/leaning forward and decreased with vomiting?

ICP

4

What can be secondary to diplopia (CN VI) and secondary to difficulty focusing?

Tumour headache

5

A tumour where affects perserveration?

Frontal lobe

6

A tumour where affects dyspraxia and neglect?

Parietal lobe

7

How do you investigate bran tumour?

CT, MRI LP

8

What two cells make up neuroepithelial tissue?

Astrocytes
Oligodendroglial cells

9

What do glial tumours arise from?

Astrocytes or oligodendrocytes

10

What grade of astrocytoma is truly benign, slow growing, children young adults, pilocytic astrocytomas and treatment of choice is surgery?

grade 1 astrocytomas

11

What do low grade astrocytomas present with?

Seizures

12

Where do low grade astrocytomas want to occur?

IN temporal lobe
Posterior frontal
anterior parietal

13

What grades are malignant astrocytomas?

Grades III - IV

14

How common is glioblastoma multiforme (malignant)?

Most common primary tumour - spreads white matter tracking

15

Tumours are solid, appear grey/whiteish and subarachnoid accumulations are grossly characterised by surgeons as having toothpaste morphology

oligodendroglial tumours

16

How do you treat oligodendroglial tumours?

Chemosensitive - procarbazinr, lomustine, vincristine

17

Arachnoid cap cells, extraaxial, 20% of intracranial neoplasms, majority asymptomatic ?

Meningiomas

18

What condition has vestibular schwannomas?

NF type II

19

hEARING Loss, tinnitus, dysequilibrium?

Acoustic neuromas

20

What are the red flag s for headaches?

1. New onset over 55 years
2. Known/previous malignancy
3. Immunosuppressed
4. Early morning headache
5. Exacerbation by valsalva

21

In the pathophysiology of a migraine what chemical irritates nerves and blood vessels causing pain?

Substance P

22

What do the dorsal raphe nucleus and the locus coeruleus make up?

Migraine center

23

What is more common - migraine with or without aura?

Without (flashibg kights, weakness, balance problems)

24

What abortive drugs can you give for migraines +/- an anti-emetic?

Aspirin
Naproxen
Ibuprofen

25

When should you give triptans fot a migraine?

At start of headaceh

26

What kind of relief does frovatriptan give for migraines>

SUSTAINED

27

When might you consider prophylactic migraine treatment?

If nmroe thanb three attacks per month or very severe consider prophylaxis

28

When beta blockers are given for migraines qwhat do you need to be careful for?

Avoid asthma, PVD (heart gfaiure)

29

A carbonic anhydrase inhibityor topiramate can be used for migraine - give some adverse effects?

1. Weight loss
2. Paraesthesia
3. Imparied concentration
4. Enzyme inducer

30

Amitriptyline can be given for migraines - give some adverse effects?

1. Dry mouth
2. Postural hypotension
3. Sedation

31

What are the trigeminal autonomic cephalgias (TACs)?

A group of primary heache disorders characterised by unilateral trigeminakl distribution pain that occurs in association with prominent ipsilateral cranial autonomic features

32

What are ptosis, miosis, nasal stuffiness, nausea, teareing and eye lid oedema?

Ipsilateral cranial autonomic features

33

What are cluster, paroxysmal hemicrania, hemicrania continua and SUNCT?

TCA types - trigeminal autonomic cephalgias

34

What kind of age group get cluster headaches?

30s and 40s

35

When do people get cluster headaches?

Striking circadian (around sleep) nd seasonal variation

36

Severe unilateral headache, duration 45-90 minutes, 1 to 8 a day and cluster bout may last from a few weeks to months?

Cluster headache

37

How is cluster headache treated?

1. High flow oxygen
2. Sub cut sumatriptan
3. Steroids
4. Verapamil for prohpylaxis

38

Who gets paroxysmal hemicrania?

Elderly 50s and 60s, women more than men

39

Severe unilateral headache, unilateral autonomic features, 10-30 minutes, 1 to 40 a day?

Paroxysmal hemicrania (shorter duration and more frequent than cluster)

40

How is paroxysmal hemicrania treated?

Absolute response to indomethicin

41

What is short lived, unilateral, neuralgiaform headache, conjunctival injetions and tearing?

SUNCT

42

How is SUNCT treated?

Lamotrigine
Gabapentin

43

What is done for patients with new onset unilateral cranial autonomic features?

MRI brain and MR angiogram

44

Who gets trigeminal neuralgia?

Elderly ikder than 60, women more than men

45

What headache s triggered by touch, usuall V2/3?

Ttrigeminal neuralgia

46

Severe stabbing unilateral pain, 1 second to 90 seconds, 10 to 100 a day, bouts of pain may last from few weeks to months before remission?

Trigeminal neuralgia

47

If a patinet has trigeminal neuralgia and signs of atypical features, poor response to treatment what might yoyu do?

MRI

48

How is trigeminal neuralgia trated?

Carbamazepine
Gabapentin
Phenytoin
Baclofen

49

Name a trigger for cluster headache?

Alcohol (more common in males)

50

Are the majority of adult brain tumours supratentorial or infratentorial?

Supratentorial - children infratentorial

51

What brain tumour: pleomorphic tumour cells border necrotic areas?

Gliolastoma multiforme - most common primary brain tumour

52

What brain tumour: spindle cells in concentric whorls and calcified psammoma bodies?

Meningioma

53

What schwannoma is seen in cerebellopontine angle?

Acoutic neuroma

54

What is the most common primary brain tumour in children?

Pilocytic astrocytoma

55

What brain tumour: rosenthal fibres (corkscrew eosinophilic bundle)?

Piloctic astrocytoma

56

What brain tumour: benign, slow growing common in frontal lobes, calcifications with fried egg appearance?

Oligodendroma

57

What are these all patterns of: amyotrophic lateral sclerosis, progressive muscular atrophy and bulbar palsy?

MND

58

wHAT IS associated with low levels of orexin (hypocretin), a protein responsivle for appetite and sleep patterns?

Narcolepsy

59

Typical onset teenage years, hypersomnolence, cataplexy (sudden loss of muscle tone triggered by emotion), sleep paralysis and vivid hallucinations on going to sleep or waking up?

Narcolepsy

60

How do you investigate narcolepsy?

Multiple sleep latency EEG