2009

Question 1

anti hu

Answer 1

paraneoplastic - limbic encephalopathy

Question 2

limbic encephalopathy

Answer 2

paraneoplastic - LUNG SCC
amnestic, hallucinations, sleep disturbance, seizures
anti hu

cerebellar, pyramidal, bulbar, and peripheral nerve disturbances may also occur.

EEG - Diffuse slowing
MRI - temporal lobes
CSF - protein and mononuclear cell pleocytosis,

Question 3

ergotamine
indication
MOA
C/I

Answer 3

migrane
serotonine agonist
C/I - atherosclerosis, coronary artery disease, hepatic disease, pregnancy, Raynaud’s syndrome, and renal disease

Question 4

SVT
symptoms
treatment
causes

Answer 4

90% headache - acute or developing over sevral days
SOMETIMES - stroke like
40% seizures

1 Pregnancy and puerperium (the period after giving birth)
2 OCP, thrombophilia, polycytemia vera…
3 meningitis and head infections

ANTICOAGULATIONS

Question 5

dermatomyositis vs polymyositis

Answer 5

1) weakness & wasting - proximal limb and girdle muscles.
2) association with various autoimmune disorders
3) high CK, needs biopsy
4) EMG - myopathic or neuropathic
5) females
6) rapid onset
7) predniosn, IVIG,
dermatomyositis - eyelids rash or on joints.
25% associated with malignancy

Question 6

inclusion body myositis

Answer 6

1) weakness & wasting - LEGS THEN ARMS - QUAD!! forearm muscles. imparied KNEE REFLEX
then PROXIMAL
2) association with various autoimmune disorders
3) NORMAL OR HIGH  CK, needs biopsy
4) EMG - myopathic or neuropathic
5) MALES
6) slowly progressive
7) predniosn, IVIG - NOT VERY HELPFUL!
8) familial, starts at childhood

Question 7

Myotonic dystrophy type 1

Answer 7

34+ CTG reapetitions
weakness and wasting of the facial,sternomastoid,
and distal limb muscles

cataracts, 
frontal baldness, 
testicular atrophy, 
diabetes mellitus, 
cardiac abnormalities, 
intellectual changes,

Question 8

Myotonic dystrophy type 2 diffrences from type 1

Answer 8

PROXIMAL WEAKNESS (not distal)
less severe
CCTG repeatitions

Question 9

dopicar

Answer 9

sinement

nausea, dizziness, headache, insomnia, abnormal dreams, dry mouth, dyskinesia, anxiety, constipation, vomiting, and orthostatic hypotension

Question 10

risperidone

Answer 10

antipsychotic

movement problems, sleepiness, trouble seeing, constipation, and increased weight.

tardive dyskinesia, neuroleptic malignant syndrome

Question 11

epidural hemoatoma

Answer 11

head trauma - raptured MMA
may lose consciousness initially.
after few hours - COMA!
meanwhile - headache, vomiting, seizures...
DIAGNOSIS - CT or MRI
SURGICAL TREATMENT

Question 12

chorea treatment

Answer 12

tetrabenazine

Question 13

cerebro pontine angle tumors

Answer 13

unilateral sensorineural hearing loss, unilateral tinnitus, or disequilibrium (vertigo is rare, on account of the slow growth of neuromas).

With brainstem extension, midfacial and corneal hypesthesia, hydrocephalus, and other cranial neuropathies become more prevalent.

Patients with larger tumours can develop Bruns nystagmus (‘dancing eyes’) due to compression of the flocculi

Question 14

syringomyelia

symptoms

Answer 14

# pinprick and temperature appreciation are impaired, but light touch sensation is preserved.
# wounds due to the sensory loss!!!
#A pyramidal deficit and sphincter disturbances sometimes occur below the level of the lesion.
# SCOLIOSIS
# Communicating - associated with Arnold-Chiari 
#non communicating - months after trauma

Question 15

triphasic eeg diseases

Answer 15

hepatic encephalopathy
uremia
CJD