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Flashcards in Revision 2 Deck (198)
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151

what are the features of a stabbing/ icepick headache

more common in females
stabbing pain
severe
anywhere in head
lasts <30 secs
any prequency
autonomic features
no trigger
responds to indomethicin

152

summarise brown sequard syndrome

hemicord lesion

-lateral corticospinal tract damage = ipsilateral UMN weakness
-posterior column= ipsilateral vibration and proprioception loss
-anterolateral system= contralateral pain and temperature loss

153

describe the symptoms seen in central cord syndrome

centre part of spinal cord affected
in small lesions- spinothalamic tract fibres that cross the anterior white matter commisure are interrupted = bilateral pain and temp loss at affected levels, below this cord function intact = cape like distribution

large lesions- corticospinal, spinothalamic and dorsal column may be affected aswell= upper motor neurone pattern of deficit below the level of injury (interrupted corticospinal), with spastic paralysis and urinary retention, and a LMN deficit pattern at level of injury (damage to ant horn cells)
upper extremities more affected than lower as fibres more central

154

which nerve is at risk of injury:
colles fracture

median

155

which nerve is at risk of injury:
ant shoulder dislocation

axillary

156

which nerve is at risk of injury:
humeral shaft #

radial (in spiral groove)

157

which nerve is at risk of injury:
posterior dislocations of hip

sciatic

158

which nerve is at risk of injury:
supracondylar # of the elbow

median (anterior interosseous branch)

159

which nerve is at risk of injury:
bumper injury to the lateral knee

peroneal nerve (fibular)

160

what differentiates back ache from sciatica

back ache can radiate to buttock and thigh but not below the knee like sciatica can

161

what are the symptoms of an L3/4 prolapse

> L4 root entrapment > pain down to medial ankle (L4), loss of quadriceps power, reduced knee jerk

162

what are the symptoms of an L4/5 prolapse

L5 root entrapment > pain down dorsum of foot, reduced power Extensor Hallucis Longus and tibialis anterior

163

what are the symptoms of an L5/S1 prolapse

S1 root entrapment > pain to sole of foot, reduced power planarflexion, reduced ankle jerks

164

what is the role of broca and wernickes areas

brocas- speech production
wernickes- speech comprehension

165

what are the SEs of sodium valporate

increased appetite= massive weight gain
alopecia
teratogenic (neural tube defects, cleft lip and palate, cardiovascular abnormalities, genitourinary defects, developmental delay, endocrinological disorders, limb defects, and autism)

166

what is lamotrigine first line for

focal seizures (carbamazepine is 2nd line)
women with generalised seizures

167

what are the SEs of lamotrigine

rash
HA
dry mouth

168

what is levetiracetam

epilepsy management
2nd line in women of childbearing age
Good 3rd line alternative after sodium valproate and lamotrigine
Quite well tolerated – tiredness apathy weight gain

169

what are the key symptoms of MS

Optic neuritis, Sensory symptoms, Lr urinary tract dysfunction, Pyramidal dysfunction (Tone+, spastcicity, F of UL, E of LL)
At least 2 episodes suggestive of demyelination + Dissemination in time and place

170

what will be seen on blood tests for MS

nothing

171

what for acute Tx for MS flare

steroids

172

what are the treatment options for parkinsons

levodopa (with dopadecarboxylase inhibitor)
monoamine oxidase B inhibitor
dopamine agonist

can add on
catechol-o-methyl transferase inhibitor (prolongs actions of levodopa)

173

what are the symptoms of parkinsons

Gait - shuffling, slow turning with multiple steps, trouble with doorways, stooped over, reduced arm swinging, fenestration

Also non-motor features: EARLY - Hyposmia (reduced smell),
Constipation,
REM sleep disturbance (can act out dreams)
depression – V V common and pronounced generally

LATE - Dementia (it is Lewy body dementia if within the first 2 years, otherwise is parkinsons disease dementia)
Everyone gets some form of cognitive decline over time with parkinsons disease.

cog wheel rigidity
resting tremour)
positive froment's maneuver (rigidity increases in examined body segment by voluntary movement of other parts),
micrographia,
bradykinesia,
hypomimia (decreased facial expression),
hypophonia (quieter voice)

174

which generation of antipsychotic is clozapine

2nd - is an atypical

175

name extrapyramidal drugs

(dopamine antagonists)
all antipsychotics- typicals (haloperidol) worse than atypicals (clozapine)

metoclopramide
domperidone

176

what is the main down fall of atypical antipsychotics

weight gain and metabolic syndrome

177

what causes meningitis in neonates

listeria, group B streptococci, E. coli

178

what causes meningitis in children

H influenza

179

what causes meningitis in ages 10-21

meningococcal

180

what causes meningitis in >21s

pneumococcal > meningococcal