EXTRA

Question 1

Neurofibromatosis

Answer 1

Type 1:
cafe au lait spots
axillary/groin freckles

Type 2:
bilateral vestibular schwanomma

Question 2

Neuroleptic Malignant Syndrome

Answer 2

seen when starting an antipsychotic
stopping/reducing dose of a Parkinson’s drug

distress
pyrexia
muscle rigidity
tachycardia, hypertension

stop drug

Question 3

Neuropathic pain management

Answer 3

amitriptyline/duloxetine/gabapentin/pre-gablin

try one of the others

used as a monotherapy

tramadol for exacerbations

Question 4

Normal pressure hydrocephalus

Answer 4

reduced CSF at the arachnoid villi

signs:
urinary incontinence
dementia
gait abnormaliity

management:
shunting

Question 5

Pituitary apoplexy

Answer 5

enlargement of pituitary tumour secondary to infarction

signs;
sudden onset of intense headache
hypotension, hyponatraemia
bitemporal superior quadratic defect
extra ocular palsies

management:
steroids
supportive

Question 6

Restless Legs Syndrome

Answer 6

uncontrollable movement of legs, starts at night can progress to day

FH
iron deficiency anaemia

active stretching, exercise
manage anaemia
dopamine agonist

Question 7

Thoracic Outlet Syndrome

Answer 7

neuro/vascular damage to the brachial plexus

causes:
injury
presence of cervical rib

neuro:
wasting, numbness and tingling of muscles, especially in hands
autonomic - cold

vascular:
swelling, ulcer

management:
supportive measures
surgery if severe

Question 8

Tuberculosis Sclerosis

Answer 8

genetic disorder affecting kids

hypopigmentation 
ash leaves
leathery plaque
cafe au lait spots
angiofibroadenoma on face

development delay
epilepsy

supportive management

Question 9

Pontine Haemorrhage

Answer 9

complication of chronic hypertension

low GCS
quadripelgia
miosis
absent horizontal eye movements