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65 Cards in this Set
- Front
- Back
Frontal lobe responsible for? (3)
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Executive Function, Movement, Broca's Speech
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Parietal Lobe (3)
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Sensory, Numeracy, Spacial awareness
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Temporal lobe (5)
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Auditory, Olfactory, Memory, Emotions, Wernicke's
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Occipital (1)
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Visual
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Two named signs of Meningitis
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Kernig's
Brudzinski's |
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What is Kernig's sign?
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Flex hip and knee. Extend knee.
Pain and resistance |
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What is Brudzinski's sign?
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Flex neck cause flex hips and knees
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Name 4 types of headache
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Cluster
Tension-type Temporal Arteritis Migraine |
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What are the features of a cluster headache?
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30-90mins
5M:F 30-50yrs At a particular time of day |
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Tension type headache features
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Dull/Tight/Pressure
Radiates to occipitut Poor response to analgesia |
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Features of Temporal Arteritis (3)
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Scalp tenderness, tender non-pulsatile temporal arteries
Systemic anorexia, wt loss, depression, fever Diploplia, central scotoma, TIA |
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Definition of a stroke
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Focal neurological deficit lasting longer than 24hrs as a result of a vascular lesion
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Causes of stroke (3)
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Ischaemic (80)
Haemorrhagic (15) Subarachnoid (5) |
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Pathological evolution of stroke (5)
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Oxygen deprivation.
Energy dependent membrane ionic pumps fail Cytotoxic oedema + depolarisation Ca entry, glutamate release Organelle damage, apoptosis |
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What are the homeostatic responses to falling O2 perfusion of the brain (3)
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Initial vasodilation
Increase in Oxygen extraction Infarction |
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Ix in Stroke (3++)
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Simple : BP, BM, pulse (AF), ECG
Bloods : FBC, U&E, Lipids, Glucose, TFT, Syphilis, SLE autoantibodies, protein Sand C, antithrombin III, sickle cell, Clotting, Cardiac doppler Special : CT (may take 12hrs to show) |
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3 components of GCS
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Eyes
Verbal Motor |
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Eyes score
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Max 4
None Pain Speech Spontaneous |
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Verbal Score
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Max 5
None Incomprehensible Inappropriate Disorientated Orientated |
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Motor Score
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Max 6
None Pain extension Pain flexion Pain withdrawl Pain localised Obeys verbal |
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What is it called when patients have a "curtain coming down" over one eye
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Amaurosis fugax - carotids?
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TACS requires (3)
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hemiplegia
higher cortical dysfunction hemianopia |
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PACS requires
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2 of TACS
or lone higher cortical dysfunction |
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Pure motor dysfunction with no eye or higher cortical signs is a
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Lacunar
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Common causes of SAH(3)
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Berry (80%)
AV malformation (10%) Other |
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Mx of SAH (5)
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Nimodipine (Ca antag) prevent spasm?
ECG Analgesia Fluids CT for neurosurg/radio |
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Organisms in neonatal meningitis
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Listeria
Strep Group B Proteus E Coli |
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Causes of encephalitis (4)
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HSV (infancy - generalised; adult - trigeminal reactivation)
HZV - painful vesicular rash Mumps, CoxSachie, CMV, EBV, Rabies |
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Specific antivirals in encephalitis (2)
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HSV - Acyclovir IV
CMV - Ganciclovir IV |
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Define epilepsy
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A tendancy to have seizures
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Classify seizures into two subgroups
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Generalised
Partial (focal) |
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What subtypes come into Generalised seizures (5)
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Petit mal
Grand mal Myoclonic Tonic Atonic |
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Subclassify Partial (focal) seizures
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Simple and Complex
Simple - have no altered consciousness, alert - Jacksonian/Todd's Complex - Altered consciousness but no LOC - automations, hallucinations |
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Four stages of Grand Mal Seizure
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Prodromal partial seizure - simple or complex
Tonic Phase - rigid, collapse, apnoeic Clonic - tongue biting, urinary continence Confused, disorientated, headache sleepy |
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Three common treatments for epilepsy, what would you use if your patient was on the COCP
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Sodium Valproate
Carbamezapine - enzyme inducer Phenytoin - EI |
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Define status epilepticus
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Tonic/Clonic phases >30mins
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Mx of status epilepticus
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Airway - on side/O2
IV access - fluids, anticonvulsant levels, drug, alcohol, glucose, Diazepam 10mg Rectal IV phenytoin General anaesthetic |
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4 types of syncope
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Vasovagal - <venous return
Cardiac - bradycardia Carotid Sinus - induce brady Effort - aortic stenosis, obstructive cardiomyopathy |
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Triad of Parkinson's Disease
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Bradykinesia
Inc Tone Resting Tremor |
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Male of Female prevelance
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Equal
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Tell me about the pathology of Parkinson's disease
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atrophy of dopaminergic neurons, fall in dopamine in striatum with hyaline Lewy bodies in the Sub Nigra
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Medication for a young parkinsonian in order as things progress (3+)
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Ropinirole (Dop agonist)
L-dopa (6-18month) Benserazide (dopa-decarboxylase inhibitor) Selegiline (MAO-B Inhib) Entacapone (COMT) |
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Define dementia
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global deterioration of higher cognitive function and personality without lowered consciousness
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Fx of Wernicke's Aphasia
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Fluent
Decreased comprehension |
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Fx of Broca's Aphasia
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Non-Fluent
Good comprehension |
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Fx of Lewy Body dementia
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Lewy (hyaline) bodies in cerebral cortex (like PD in BG). Hard to distinguish from Alzheimer's but with visual hallucinations
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What is Huntington's Chorea
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Rare autosomal dom degenerative frontal lobe and caudate nucleus. Face, hands, dysarthria, gait.
DNA marker of trinucleotide repeat |
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Age of presentation MS
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30-40's
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4 areas of demyelination in MS
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Periventricular (slurred speech)
Brainstem (Ataxia, nystagmus, urinary retention) Optic nerves (scotoma, diploplia) Cervical spinal cord (weakness, numbness, tingling) |
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Patterns of MS progression with percentages (3)
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Relapse/Remitting 80
Primary progressive 12 Fulminant 8 |
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Treatments for MS (3)
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Azothioprine
B interferon Short steroid bursts for relapses |
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Name 4 Muscular dystrophies
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Myotonic dystrophy
Duchenne Musc Dystrophy Polymyositis Inclusion Body myositis |
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Describe the course of Guillan Barre Syndrome
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Ascending weakness and numbness over 3/52. 20% affect facial/respiratory mm. 80% resolve fully. 15% deficit. 4% die.
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Cause of Guillan Barre
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autoallergic demyelinating postinfective (70%) monophasic illness (CMV/Camp Bacter)
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Right sided UMN signs and loss of pain and temperature perception. Left sided loss of vibration and proprioreception.
diagnosis? |
Brown Sequard Syndrome
L cervical spinal cord lesion Corticospinal (ipsilateral spastic paralysis) Spinothalamic tract (contralateral pain and temperature) Doral columns (ipsilateral fine touch, proprioreception and vibration) |
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myasthenia gravis is caused by what in 90%
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autoimmune against ACh receptors
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Presenting features of MG (5+)
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extraocular, bulbar, facial, neck, limb weakness
look specifically for ptosis, diploplia, NORMAL REFLEXES |
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Mx of MG (4)
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Anticholinesterase
Immune suppression (steroid/azothioprine) Thymectomy (pre-50) Plasmaphoresis |
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causes of unilateral CN VII palsy
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Bells palsy
CPA tumour Mononeuritis - sarcoid, diabetes, lyme Ramsay Hunt syndrome Parotid tumour Pontine lesion - vascular/demyelinating |
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good discriminating test between benign and parkinsonian tremor
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smell test
DAT scan for dopamine depletion |
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mx of tremor
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b blocker
gabapentin |
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ix for suspected SAH
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CT
AND LUMBAR PUNCTURE IF NEG |
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mx of migraine due to vigorous activity
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beta blocker
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Sx of cerebello-pontine angle lesion
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CN V, VI, low VII and VIII
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young female complains of difficulty swallowing with a sensation of lump in throat
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globus hystericus
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