Bits from Formative

Question 1

Describe the medial lateral arrangent of the motor homunculus?

Answer 1

Medial to lateral
Foot -> Rest of leg
Shoulder -> Arm -> Hand
Neck -> Brow ->Eyes
Face -> Lips -> Jaw -> Tongue -> Mastication

Question 2

What is the most likely diagnosis for an 80 yr old man with gradual onset of walking difficulties, urinary incontinence and cognitive decline?

Answer 2

Normal pressure hydrocephalus
(Wet Wacky Wobbly)

MS would require episodes and not likely to cause cognitive decline
Vascular dementia progressives stepwise
Parkinson’s is possible but less likely to cause cognitive decline

Question 3

Which of the following cant be explained by anxiety?

• Brisk reflex + Flexor plantar response
• Excess sweat + Palpitations
• Fatigue + Something stuck in throat
• Numb legs + Extensor Plantar response
• Poor conc. + Forgetfullness

Answer 3

Numb legs & Babinski’s sign

Question 4

What is the most appropriate way to test the 2nd cranial nerve?

Answer 4

testing Pupillary response to light

Afferent II and efferent III

Question 5

What are the 3 spriochaetes we need to know?

Answer 5

• Borrellia Burgdorferi - Lyme’s
• Lepstospira Interrogans - Leptospirosis
• Treponema Pallidum - Syphilis

Question 6

Which of these is most likely a feature of an UMN lesion?

• Absent reflexes
• Dysdiadochokinesia
• Hypotonia
• Muscle Fasciculations
• Sustained Clonus

Answer 6

Sustained Clonus

All the rest are LMN except dysdiadochokinesia which is part of cerebellar ataxia

Question 7

What primary site most commonly metastasizes to the brain?

Answer 7

Breast

Question 8

What lab test would you expect in Giant Cell Arteritis?

• Elevated ESR
• Elevated Urate
• Elevated WBC
• Reduced Haemoglobin
• Reduced ESR

Answer 8

Elevated ESR, its an inflammatory condition after all

Question 9

GCS score for:

• Opens eyes to pain
• Says innapropriate words
• Localises to pain

Answer 9

Localises to pain - M5 / 6
Says innapropriate words - V3 / 5
Opens eyes to pain - E2 / 4

GCS = 10/15