Year 5 > y4 opic > Flashcards

y4 opic Flashcards

(50 cards)

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1
Q

Risk factors for stroke

A

Htn
Diabetes
Obesity
Sedentary lifestyle
High LDL cholesterol
Dyslipidaemia
AF
Smoking
Alcohol
Illicit drug use
Poor diet
Kidney disease
Environmental factors (air pollution, low ambient temperatures, lead exposure)

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2
Q

Ddx for stroke

A

Hypoglycaemia
Migraine
Space occupying lesion
FND
Encephalitis
Wernicke’s

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3
Q

Ix for strokes

A

CT Head without contrast
CT angiography if considering thrombolysis or thrombectomy
CXR as high risk aspiration
ECG for potential AF
Swallow assessment
Bloods

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4
Q

Causes of stroke in u50s

A

Same as over 50s
Vasculitis (SLE, Takayasu, GCA, Bechet’s)
Sickle Cell disease
Cocp
Anyiphospholipid syndrome
Malignancy
Factor V Leiden

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5
Q

Wernicke’s encephalopathy symptoms

A

Triad of
Confusion
Ataxia
Nystagmus / opthalmoplegia

Other sx
Agitation, hallucinations, confabulation

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6
Q

oxford classification types of stroke

A

TACS
PACS
LACS
POCS

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7
Q

criteria for TACS

A

homonymous hemianopia
higher cortical dysfunction
hemiparesis or hemisensory loss

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8
Q

criteria for PACS

A

2/3 from
homonymous hemianopia
higher cortical dysfunction
hemiparesis or hemisensory loss

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9
Q

criteria for a LACS

A

pure sensory or pure motor or sensorimotor
ataxic hemiparesis

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10
Q

criteria for POCS

A

Cranial nerve palsy and a contralateral motor/sensory deficit
Bilateral motor/sensory deficit
Conjugate eye movement disorder (e.g. horizontal gaze palsy)
Cerebellar dysfunction (e.g. vertigo, nystagmus, ataxia homonymous hemianopia

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11
Q

what is lateral medullary syndrome

A

ipsilateral- ataxia, nystagmus, dysphagia, cranial nerve palsy, horner’s syndrome

contralateral- limb sensory loss

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12
Q

management of stroke

A

thrombolysis within 4.5 hours of sx onset

thrombectomy if appropriate within 24 hours of sx onset

aspirin- wait for 24 hours after thrombolysis

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13
Q

causes of stroke in under 50s

A

hyper coagulable states
vasculitis (GCA, takayasu, bechets)
SLE
antiphospholipid syndrome
Sickle cell
malignancy
factor V leiden
COCP

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14
Q

what gives you contralateral superior quadrantopia

A

MCA stroke which gets rid of superior optic raidations in temporal lobe

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15
Q

what gives you contralateral inferior quadrantopia

A

MCA stroke which gets rid of inferior optic raidations in parietal lobe

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16
Q

what give you homonymous hemianopia with macular sparing

A

PCA stroke in visual cortex in occipital lobe- dual blood supply from MCA

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17
Q

what give you homonymous hemianopia

A

TACS or PACS

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18
Q

what area does the ACA generally cover

A

lower limb, incontinence, behavioural abnormalities

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19
Q

what areas does the MCA generally cover

A

upper limb, vision, face

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20
Q

what areas does the PCA generally cover

A

vision, aphasia, hemiparesis, sensory loss

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21
Q

what are signs of a cerebellar stroke

Study These Flashcards
A

IPSILATERAL

DANISH
dysdiadokinesia
ataxia
nystagmus
Intention tremor
slurred speech
hypotonia

vertigo, n&v

22
Q

what are the features of Horner’s syndrome

Study These Flashcards
A

anisocoria
miosis
ptosisanhidrosis + vasodilation

23
Q

dorsal column tracts carry

Study These Flashcards
A

vibration, proprioception, fine touch

24
Q

spinothalamic tracts carry

Study These Flashcards
A

lateral- temperature, pain
anterior- crude touch, pressure,

25
where does spinothalamic tract decussate
at spinal level
26
where does dorsal column decussate
medulla
27
pathophysiology of Alzheimer's disease
amyloid plaques (extracellular) Tau protein tangles in neurones atrophy in hippocampus, parietal lobe, temporal lobe
28
pathophysiology of vascular demetia
multi-infarct- many small infarcts causing tissue loss small vessel disease of penetrating arteries
29
pathophysiology of frontotemporal dementia
tau proteins in frontal and temporal lobes causing pick bodies
30
pathophysiology of Lewy body dementia
Lewy bodies made of A-synuclein widely distributed
31
pathophysiology of Parkinson's disease
Lewy bodies made of A-synuclein in substantial nigra causing loss of neurone and reduction of dopamine
32
alzheimer's presentation
short term memory loss issues with planning, reasoning, orientation (getting lost)
33
vascular dementia
cognitive impairement after stroke or mood disorder
34
fronto-temporal dementia presentation
behavioural, semantic or non-fluent
35
behavioural fronto-temporal dementia presentation
less emotionally responsive, apathy, disinhibition, obsessions, rituals,
36
semantic fronto-temporal dementia presentation
input issue less understanding words difficulty in name retrieval inability to recognise names and faces (prosopagnosia)
37
non-fluent fronto-temporal dementia presentation
poor output of language impaired comprehension, poor articulation
38
Lewy body dementia presentation
parkinsonianoism cognitive decline visual hallucinations autonomic dysfunction AT SAME TIME
39
what are examples of autonomic dysfunction in dementia
orthostatic hypotension constipation incontinence
40
presentation of parkinson's
bradykinesia rigidity (cogwheel, lead pipe) tremor (rest, pill rolling) postural instability shuffling gate anosmia hypomimia (mask face)
41
what does levodopa do?
dopamine agonist parkinson's
42
what does carbidopa do
dopadecarboxylase inhibitor parkinson's
43
what to ropinerole and pramipexole do
dopamine agonist parkinson's
44
selegiline function
MAO B inhibitor parkinson's
45
amatade function
increase dopamine synthesis parkinson's
46
what do tolcapone and entacapone do
reduce breakdown of levodopa parkinson's
47
biggest cause of death in dementia pts
pneumonia
48
what does donepezil, galantamine do
cholinesterase inhibitors dementia
49
what does memantine do
NMDA inhibitors
50
how do you treat dementia
doepeziul / galantamine memantine reduce risk factors treat MH (anxiety, depression, psychosis) stable environment regular exercise
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