Epilepsy
FFFTs
I can't feel my feet
What's that mass?
GL HF
100
5 min or more of (i) continuous clinical and/or electrographic seizure activity or (ii) recurrent seizure activity without recovery (returning to baseline)
What is Status Epilepticus?
100
Centre responsible for consciousness/wakefulness.
Reticular activating system.
100
"Stocking and glove" progressive sensory loss; most common peripheral neuropathy.
What is Diabetic Peripheral Neuropathy?
100
Most common brain tumour in adults.
What is a Glioma?
100
3Hz spike-wave pattern
What are the EEG changes in absence seizure
200
Risk of another seizure after one unprovoked seizure.
What is 40% risk?
200
Initial management of unconscious patient, "Coma cocktail"
What is TONG? T = Thiamine O = Oxygenation N = Naloxone G = Glucose
200
Tests used to determine nature of peripheral neuropathy.
What are Nerve Conduction Studies and Electromyography?
200
Features of metastases to the brain as compared to primary tumours.
Multiple well circumscribed mass lesions, often localised around the grey white interface.
200
Location of lesion producing bipolar hemianopia. Possible cause of damage.
What is the optic chiasm? Aneurysm of ACA, Pituitary adenoma, meningioma.
300
First line therapy for focal seizures. And one concerning side effect.
What is Carbamazepine? What is Steven Johnson Syndrome?
300
Differential diagnosis of altered mental state.
What is AEIOUTIPS? A - alcohol/acidosis E - endocrine, electrolytes I - infection O - overdose U - uraemia T - trauma I - insulin P - psychosis S - seizure, syncope
300
Peripheral neuropathy presenting with weakness with little to no sensory disturbance. Proposed pathogenesis of disorder.
What is Guillian Barre Syndrome? What is molecular mimicry?
300
Frequently presents with seizures, 1p/19q co-deletion, "fried egg" appearance on histology.
What is Oligodendroglioma?
300
Henry Molaison suffered anterograde and retrograde amnesia with working memory and procedural memory preserved post resection of ... to correct ...
What is the medial temporal lobe?
400
Jacksonian March, Todd's paralysis.
What are common effects in focal motor seizures? Jacksonian March = progression of seizure activity from distal to proximal. Todd's paralysis = weakness of involved muscles post seizure, typically lasts minutes to hours post seizure.
400
Red flags of FFFT, indications.
What are: • Onset in older person • Neurological symptoms and signs • Headache • Tachycardia • Irregular pulse • Fever • Drugs: social or prescribed • Cognitive impairment • Confusion: gradual onset
400
Test of proprioception (incl. anatomical structure tested and significance of result)
What is Romberg's test? What is the dorsal column? NB. Romberg's test is positive with ataxia if the patient sways with eyes closed, indicating dorsal column pathology. If Romberg's test is negative with ataxia indicates cerebellar pathology.
400
Types of brain herniation, false localising signs which may be associated.
What are transtentorial, subfalcine and tonsillar herniations? What are fifth, sixth, seventh nerve palsies, third nerve palsy and Kernohan's notch?
400
UMN vs LMN
UMN deficit weakness, no atrophy, no fasciculations, incr reflexes, incr tone, pos Babinski, spastic paralysis, clasp knife spasticity. LMN deficit weakness, atrophy, fasciculations, decr reflexes, decr tone, neg Babinski, flaccid paralysis
500
Describe the three phases of a "grand mal" seizure.
Tonic Phase Clonic Phase Post-Ictal Phase
500
Confusion with severe acute alcohol withdrawal, may see withdrawal seizures in first 48 hours.
What is delirium tremens?
500
Hereditary motor and sensory peripheral neuropathy on chr17. Impaired balance, reduced pinprick and vibration sensation on lower extremities, pes cavus.
What is Charcot-Marie-Tooth?
500
metabolic encephalopathy, NBTE, [...] cerebellar degeneration, limbic encephalitis, encephalomyelitis, anti-NMDA receptor- associated encephalitis, opsoclonus/myoclonus, sensory neuronopathy, dermatomyositis, Lambert Eaton myasthenic syndrome.
What are non-metastatic neurological complications of malignancy?
500
History A 63-year-old woman is referred to a nephrologist for investigation of polyuria. About 4 weeks ago she developed abrupt-onset extreme thirst and polyuria. She is getting up to pass urine five times a night. Over the past 3 months she has felt generally unwell and noted pain in her back. She has lost 3 kg in weight over this time. She also has a persistent frontal headache associated with early morning nausea. The headache is worsened by coughing or lying down. Eight years previously she had a left mastectomy and radiotherapy for carcinoma of the breast. She is a retired civil servant who is a non-smoker and drinks 10 units of alcohol per week. She is on no medication. Examination She is thin and her muscles are wasted. Her pulse rate is 72/min, blood pressure 120/84 mmHg, jugular venous pressure is not raised, heart sounds are normal and she has no peripheral oedema. Examination of her respiratory, abdominal and neurological systems is normal. Her fundi show papilloedema.
What is neurogenic diabetes insipidus as a result of secondary metastases in her hypothalamus?
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