GeriQBank · Topic
Cerebrovascular disease, seizures, headache, neuromuscular disease and neurological emergencies.
Set 3 or more times
Emerging Biomarkers in Cognition Fifteen–Twenty High-Yield Points Rationale Cognitive impairment in the elderly is usually the result of mixed pathology. More than 230 combinations of neuropathology have been described, and altered…
Set twice
Subdural Haematoma RECURS ×2 Definition and classification Subdural haematoma (SDH) is a collection of blood in the subdural space — the potential space between the dura mater and the arachnoid mater. The dura has two layers — an outer…
Management of Extracranial Carotid Artery Stenosis Pathogenesis and definitions Atherosclerosis is the commonest arterial disorder in developed countries and, when complicated by thrombosis and embolism, causes ischaemic stroke,…
Bedside Assessment of Swallow in a Patient with Recent Stroke Why it matters Dysphagia is present initially in 78% of patients who have had a stroke; although acute dysphagia improves in about 80% of survivors, its early consequences…
Motor Neuron Disease Fifteen–Twenty High-Yield Points Definition and classification Motor neuron diseases (MNDs) are a heterogeneous group characterised by degeneration or dysfunction of the upper motor neurons (UMNs) of the precentral…
Set once
Epilepsy in the Elderly — Definition, Pathophysiology, Clinical Features, Investigations and Treatment Definitions (ILAE / IBE) An epileptic seizure is a transient occurrence of signs and/or symptoms due to abnormal excessive or…
Coma in the Elderly Source note: Coma is addressed across chapters in the uploaded textbooks (Glasgow Coma Scale and prognosis in the subdural haematoma chapter, level-of-consciousness grading within the Confusion Assessment Method,…
Subacute Combined Degeneration of the Cord — Presentation and Treatment Definition and biochemistry Subacute combined degeneration (SACD) is progressive degeneration — demyelination followed by axonal loss — of the posterior (dorsal)…
Motor Neuron Disease — Presentation, Evaluation and Treatment Definition and classification Motor neuron diseases (MNDs) are a heterogeneous group characterised by degeneration or dysfunction of the upper motor neurons (UMN) of the…
Peripheral Neuropathy — Common Causes and Approach to the Patient Definition and classification Peripheral neuropathy is a disorder of peripheral nerves — motor, sensory and/or autonomic — producing weakness, sensory disturbance or…
Neuritic (Neuropathic) Pain Definition and classification Neuropathic pain is pain caused by a lesion or disease of the somatosensory nervous system, at either a peripheral or a central level. It is a clinical description, not a…
Confusion States in the Elderly — Investigation and Management Fifteen–Twenty High-Yield Points Definition and classification Confusion in an older patient is a presentation, not a diagnosis. Disorders causing confusion fall into three…
History of the 'Stroke Clinics' — Why They Were Set Up and What Issues They Addressed Fifteen–Twenty High-Yield Points The problem that had to be solved Before organised services, stroke patients were admitted to general medical wards…
Restless Legs Syndrome — Risk Factors, Diagnostic Criteria and Management Fifteen–Twenty High-Yield Points Definition and epidemiology Restless legs syndrome (RLS, Willis-Ekbom disease) is a sensorimotor disorder characterised by motor…
Myasthenia Gravis — Presentation, Laboratory Evaluation and Treatment Fifteen–Twenty High-Yield Points Definition and epidemiology Myasthenia gravis (MG) is an antibody-mediated disorder of neuromuscular transmission. The commonest…
Ring-Enhancing Shadow on CT Brain Coverage note: the uploaded geriatric textbooks do not cover ring-enhancing intracranial lesions as a discrete topic. This answer is therefore constructed from current neuroradiology and infectious…
Causes of Coma in the Elderly Fifteen–Twenty High-Yield Points Definition and anatomy Coma is a state of unarousable unresponsiveness — the deepest grade on the scale of consciousness used in delirium assessment: alert, vigilant,…
Normal Pressure Hydrocephalus Fifteen–Twenty High-Yield Points Definition and historical background NPH is an adult-onset chronic condition with enlarged cerebral ventricles on imaging plus the clinical Hakim and Adams triad — gait…
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Question 1. Epilepsy in Elderly People and its Management 20 MARKS Answer Textbook Core – 14 Points Definition and burden. The elderly have the highest incidence of new-onset epilepsy of any age group — over 100 per 1,00,000 per year…
Definition and current terminology. A seizure arising in one hemisphere with impairment of awareness or consciousness. The ILAE 2017 classification renamed “complex partial seizure” as focal seizure with impaired awareness (focal…
Definition and general advantages. The second- and third-generation antiseizure medications — lamotrigine, levetiracetam, topiramate, gabapentin, pregabalin, oxcarbazepine, zonisamide, lacosamide, brivaracetam, perampanel,…
Frame the problem. A generalised tonic-clonic seizure at 80 years is an acute symptomatic (provoked) seizure until proved otherwise, not idiopathic epilepsy. Two features dominate the differential: she is on antithrombotic therapy for…
Question 5. Transient Ischaemic Attack 7 MARKS • ASKED ×2 Answer Textbook Core – 6 Points Definition. A transient episode of neurological dysfunction caused by focal brain, spinal cord or retinal ischaemia, without acute infarction on…
Definition and pathology. A small subcortical infarct, less than 15–20 mm in diameter, resulting from occlusion of a single deep penetrating artery (lenticulostriate, thalamoperforating or pontine perforator). It accounts for about 25%…
Principle. “Time is brain” — reperfusion aims to salvage the ischaemic penumbra before infarction is complete. A non-contrast CT to exclude haemorrhage is mandatory before thrombolysis; the target door-to-needle time is 60 minutes or…
Definition. Wallenberg syndrome is the lateral medullary syndrome — infarction of the dorsolateral medulla, often with the inferior cerebellum. Despite the name “PICA syndrome”, the commonest vessel involved is the vertebral artery…
Definition and causes. Bleeding into the subarachnoid space. About 85% follow rupture of a saccular (berry) aneurysm — anterior communicating > posterior communicating > middle cerebral bifurcation; 10% are perimesencephalic…
Definitions. Symptomatic carotid stenosis = an ipsilateral stroke, TIA or amaurosis fugax within the preceding 6 months. Asymptomatic = stenosis detected on imaging or from a bruit, with no such event. Severity is quantified by the…
Definition and pathogenesis. A collection of blood in the subdural space caused by tearing of the bridging cortical veins. Cerebral atrophy in old age stretches these veins and widens the subdural space, so a trivial or entirely…
Post-stroke depression (PSD) — definition and burden. Depressive disorder occurring after stroke, affecting about one-third of survivors and peaking at 3–6 months. Predictors are stroke severity, physical disability, aphasia, cognitive…
Neurodegenerative, Movement and Balance Disorders Question 13. Normal Pressure Hydrocephalus 7 MARKS Answer Textbook Core – 6 Points Definition. NPH is a syndrome of gait disturbance, cognitive impairment and urinary incontinence…
Definition and classification. Progressive degeneration of upper and lower motor neurons. Variants: amyotrophic lateral sclerosis (commonest, UMN + LMN), progressive bulbar palsy, progressive muscular atrophy (pure LMN) and primary…
Definition and diagnostic criteria (IRLSSG — all five essential; mnemonic URGE). (i) Urge to move the legs, usually with unpleasant crawling or creeping sensations; (ii) begins or worsens at Rest; (iii) partially or completely Relieved…
Neuromuscular, Spinal Cord and Peripheral Nerve Disorders Question 18. Myasthenia Gravis in the Older Adult 7 MARKS Answer Textbook Core – 6 Points Definition. An antibody-mediated disorder of the neuromuscular junction in which…
Definition. A vitamin B12 (cobalamin) deficiency myelopathy causing symmetrical demyelination of the dorsal (posterior) columns and lateral corticospinal tracts, chiefly in the cervical and upper thoracic cord. It is frequently combined…
Definition and classification. A disorder of peripheral nerves, classified by fibre type (sensory, motor, autonomic, mixed), distribution (mononeuropathy, mononeuritis multiplex, polyneuropathy, radiculopathy, plexopathy), pathology…
Question 21. Temporal Arteritis and its Neurological Complications 7 MARKS Answer Textbook Core – 6 Points Definition. Temporal (giant cell) arteritis is a granulomatous large- and medium-vessel vasculitis affecting the extracranial…
Definition and classification (ICHD-3). Recurrent unilateral, brief, electric shock-like facial pain, abrupt in onset and termination, confined to one or more divisions of the trigeminal nerve and triggered by innocuous stimuli. Three…
Definition (ICHD-3). A trigeminal autonomic cephalalgia characterised by attacks of severe, strictly unilateral orbital, supraorbital and/or temporal pain lasting 15–180 minutes, occurring from once every other day to eight times a day,…
Definition (ICHD-3). The commonest primary headache disorder. Pain is bilateral, pressing or tightening (non-pulsating), of mild to moderate intensity, lasting 30 minutes to 7 days, and NOT aggravated by routine physical activity. There…
Neurological Emergencies, Encephalopathies and Toxidromes Question 25. Hypoxic-Ischaemic Encephalopathy — Causes, Clinical Manifestations, Diagnosis and Management 15 MARKS Answer Textbook Core – 10 Points Definition. Diffuse brain…
Scope and geriatric context. The post-acute phase begins once the patient is medically and neurosurgically stable, and covers rehabilitation, prevention of secondary complications, and management of long-term sequelae. In older adults,…
Definition. An acute, potentially reversible neuropsychiatric emergency caused by thiamine (vitamin B1) deficiency, with lesions in the mammillary bodies, medial thalami, periaqueductal grey matter and the floor of the fourth ventricle.…
Normal CSF and pre-requisites. Opening pressure 8–18 cm H O; clear and colourless; 0–5 lymphocytes/mm³; 2 protein 15–45 mg/dL; glucose 45–80 mg/dL, or at least 60% of a simultaneous blood glucose — always send a paired blood sugar, or…
Definition. A predictable, dose-related toxic state caused by excess serotonergic activity at central and peripheral 5-HT receptors, chiefly 5-HT . It is not idiosyncratic — it follows starting or increasing a serotonergic 2A drug, or…
Definition. A rare, life-threatening idiosyncratic reaction to dopamine (D ) receptor blockade, or to abrupt 2 withdrawal of dopaminergic therapy, characterised by hyperthermia, rigidity, autonomic instability and altered consciousness.…
Definition. A syndrome of skeletal muscle necrosis with release of intracellular contents — myoglobin, creatine kinase, potassium, phosphate and urate — into the circulation. It is diagnosed by a creatine kinase more than five times the…