Anatomy

Question 1

Brachial plexus

Answer 1

Supraspinitus
Infraspinnitus
Serratus anterior
Deltoid
Biceps brachii
Triceps branchii

Question 2

Brain abscess

Answer 2

Headache
Fever
Vomiting
Focal neurological deficits
LP contraindicated

Question 3

Central venous thrombosis

Answer 3

Sagittarius sinus thrombosis(most common)
Transverse sinus thrombosis
Carvenous sinus thrombosis
Straight sinus thrombosis
Cerebral vein thrombosis
Jugular vein thrombosis

Question 4

Cervical spondylitic myelopathy

Answer 4

Motor weakness,sensory loss,bladder n bowel dysfunction
Neck pain
UMN weakness in lower legs-upgoing planters,hyperreflexia,hypertonia
Wide based gait

Question 5

Charcot Marie tooth disease

Answer 5

Most common hereditary peripheral neuropathy
Motor loss
No cure
Foot drop high arched foot(pes cavus)
Hyporeflexia
Hammer toes
Distal muscle weakness
Stork leg deformity

Question 6

Chronic inflammatory demyelinating polyneuropathy

Answer 6

CD4 and CD8 T calls and autoantibodies to myelins proteins are mediators of attack to nerve tissue .
Breakdown of blood-brain barrier
Autoantibody binds to the nodes of ranvier

Question 7

Features of atypical CIDP

Answer 7

Predominantly distal weakness
Pure motor and sensory presentation
Lewis-summer syndrome(asymmetry)
Focal presentation(eg brachial or lumbrosacral plexus involvement or 1 or more upper extremity or lower extremity peripheral nerves)

Question 8

Diagnosis of CIDP

Answer 8

Sensory and motor nerve conduction studies
Lumbar puncture-protein and leukocyte count<10/mm3 supports diagnosis
MRI -gadolinium enhancement and/or hypertrophy of causal equine,branchial, LS or cervical nerve roots
Nerve biopsy

Question 9

Management of CIDP

Answer 9

Prednisone 60mg 6/52
Plasma exchange-quick relief
IVIG-2-6weeks symptom relief
Neuropathic analgesic

Question 10

Cluster headache

Answer 10

Oxygen
Verapamil
Tapering dose of prednisone

Question 11

Creutzfeldt Jakob disease

Answer 11

Rapidly progressive disease caused by prion proteins on chromosome 20
Formation of amyloid folds in tightly packed beta pleated sheets resistent to proteases .
Rapid onset dementia
Myoclonos
Biphasic high amplitude waves on EEG
MRI-hyperintense signals in the basal ganglia and thalamus

Question 13

Essential tremor

Answer 13

AD with incomplete penetrance
Organophosphate
Lead
Mercury
Beta Carboline alkaloids

Question 14

Essential tremor

Answer 14

Absent on rest
Exercebated with daily task
Bilateral
Involve head,voice,trunk,hands
Moderate to high frequency
Relieved by alcohol

Question 15

Friedreich’s ataxia

Answer 15

Early onset AR ataxia GAA on X25 gene on chr9
No anticipation
10-15yrs
Ataxia and kyphoscolosis

Question 16

Friedreich’s ataxia

Answer 16

Absent ankle jerks/extensor planters
Cerebellar ataxia
Optic atrophy
Spinocerebellar tract degeneration
HOCM
High arched palate
DM

Question 17

Frontotemporal lobar degeneration

Answer 17

MAPT resulting in tau inclusion bodies
PGRN resulting in TDP43 inclusion bodies
C9orf72 also found in ALS

Question 18

Frontotemporal(Nonfluent/agrammatic variant PPA)

Answer 18

Variable atrophy in posterior frontal lobe,insular cortex,temporal lobe including hippocampus.

Question 19

Semantic variant PPA

Answer 19

Left sided lobe and hippocampus atrophy
Frontal lobes are spared in early disease

Question 20

Behavioral variant Frontotemporal dementia

Answer 20

Most common form
Disinhibition,apathy,loss of empathy or compulsive behaviors.
Frontal and temporal lobe atrophy

Question 21

Note

Answer 21

Acetycholinesterase inhibitors or memantine hydrochloride not recommended in FTLD

Question 22

GBS

Answer 22

Anti-GM1 Autoimmune preceded by campylobacter,EBV,CMV
FVC
IVIG or plasma exchange
Cause urine retention,diarrhea,diplopia,papilloedema