Neuro

Question 1

What is the most common complication following meningitis?

Answer 1

Sensorineural hearing loss

Question 2

What medications should people be sent home on after an ischaemic stroke?

Answer 2

Clopidogrel 75mg (plus statin if cholesterol is high)

Aspirin 300mg for first 14 days and then switch to clopidogrel

Question 3

What is prophylaxis for cluster headaches

Answer 3

Verapamil

Question 4

How long do cluster headaches last for

Answer 4

15 mins - 2 hours

Question 5

What is the treatment of bells palsy

Answer 5

1. Prednisolone within 72 hours of onset

2. Eye care (prescription artificial tears and eye lubricants)

Question 6

What is the best assessment tool for differentiating between stroke and stroke mimics?

Answer 6

ROSIER

Question 7

How does 3rd nerve palsy present?

Answer 7

ptosis, down & out deviation of the eye, and a dilated pupil known as mydriasis

Question 8

What should you do if Bells palsy hasnt cleared after 3 weeks of treatment

Answer 8

Urgent referral to ENT

Question 9

What is the most common form of MND?

Answer 9

Amyotrophic lateral sclerosis

Question 10

What is the most likely operation to be done in subdural bleeds?

Answer 10

Burr hole evacuation

Question 11

What are 1st line for spasticity in MS?

Answer 11

Baclofen and gabapentin

Question 12

What is Lambert-Eaton Syndrome?

Answer 12

A paraneoplastic myasthenia syndrome most commonly associated with small cell lung cancer

Question 13

What are the features of Lambert-Eaton syndrome

Answer 13

PMH of lung cancer (small cell)
Autonomic symptoms 
Waddling gait
Hyporeflexia
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Question 14

When is carotid endartectomy considered?

Answer 14

Patient who has had a TIA with CA stenosis of 70%+

Question 15

Following a single TIA or stroke, what is the advice on driving?

Answer 15

They can start driving if symptom free for 1 month - no need to tell the DVLA

Question 16

For patients after their first seizure, what is the advice on driving?

Answer 16

Must inform the dvla AND not drive for 6 months if brain scan/EEG is normal. If abnormal, 12 months.

Question 17

What is the advice on driving if somebody has had multiple TIAs over a short time period?

Answer 17

Must inform the DVLA and take 3 months off driving

Question 18

What is the advice on driving with patients with established epilepsy?

Answer 18

Must inform DVLA - may qualify for driving license if seizure free for 12 months.

If withdrawing fro medication, should not drive during or 6 months after the last dose.

Question 19

Why should you always replace vitamin B12 before folate?

Answer 19

It can cause subacute combined degeneration of the cord

Question 20

What is 1st line in patients with newly diagnosed Parkinson’s who have motor symptoms affecting their quality of life?

Answer 20

Levodopa

Question 21

What is the cushings reflex?

Answer 21

A physiological nervous system response to raised ICP that is a triad of:
Bradycardia
Hypertension
Wide pulse pressure

Question 22

What is the imaging of choice to confirm MS diagnosis?

Answer 22

MRI with contrast

Question 23

What is usually spared in MND?

Answer 23

Eye movements

Question 24

What is 1st line secondary prevention in ischaemic stroke and TIA?

Answer 24

Clopidogrel

Question 25

For seizures in the community, what should be given?

Answer 25

10-20mg rectal diazepam

Question 26

How is carotid artery stenosis diagnosed?

Answer 26

Duplex ultrasound

Question 27

What medication is most likely to cause personality changes in Parkinson's?

Answer 27

Dopamine receptor agonists e.g. Ropinirole

Question 28

What are the most common triggers of autonomic dysreflexia?

Answer 28

Faecal impaction/Urinary retention

Question 29

What is the management of Ischaemic stroke?

Answer 29

Thrombolysis within 4.5hrs and thrombectomy within 6 hrs

Question 30

In trauma, how do you test if the fluid draining from the nose or ear is CSF?

Answer 30

Check for glucose as it is not present in mucus

Question 31

What is the mechanism of pyridostigmine?

Answer 31

Long acting acetylcholinesterase inhibitor

Question 32

What is the gold standard test for degenerative cervical myelopathy?

Answer 32

MRI cervical spine

Question 33

How does an extradural haemorrhage appear on imaging?

Answer 33

Biconvex

Question 34

What are the risk factors for cluster headaches?

Answer 34

Being male (3x) Smoking Alcohol Nocturnal sleep

Question 35

What should a GP do if they see somebody within 7 days of TIA?

Answer 35

300mg aspirin and specialist review within 24hrs

Question 36

Which lobe is wernicke's area in?

Answer 36

Temporal lobe (near the ear)

Question 37

What lobe is Broca's area in?

Answer 37

Frontal lobe (near the mouth)

Question 38

What is Stevens-Johnson syndrome?

Answer 38

A severe systemic reaction affecting the skin and mucosa - drug reaction

Question 39

How do you treat Stevens-johnson syndrome?

Answer 39

Hospital admission for supportive treatment and stop causative drug

Question 40

What is used to treat neuroleptic malignant syndrome?

Answer 40

Bromocriptine

Question 41

What is the treatment for myasthenia crisis?

Answer 41

Plasmapheresis and Iv IgG

Question 42

What is 1st line in treating essential tremor?

Answer 42

Propanolol

Question 43

What innervates the palmar lateral 3 fingers?

Answer 43

Median nerve

Question 44

What innervates the palmar ring and little finger

Answer 44

ulnar nerve

Question 45

What would you expect to see in CSF in MS?

Answer 45

Oligoclonal bands

Question 45

What would you expect to see in CSF in MS?

Answer 45

Oligoclonal bands

Question 46

What is used to treat cerebral oedema in patients with brain tumours?

Answer 46

Dexamathasone

Question 47

What antibodies are seen in Lambert-Eaton syndrome?

Answer 47

Antibodies to voltage-gated calcium channels

Question 48

What are 1st line treatments for neuropathic pain?

Answer 48

Gabapentin, Pregabalin, Amitriptyline and Duloxetine

Question 49

What kind of bleed is more likely in a trauma young patient?

Answer 49

Extradural haemorrhage - biconvex haemotoma

Question 50

What does gradual onset headache with decreasing cognition in an older patient suggest?

Answer 50

Subdural haemotoma

Question 51

What nerve is likely to be injured on a mid humeral fracture?

Answer 51

Radial nerve (wrist drop)

Question 52

What is the most common cause of encephalitis?

Answer 52

Herpes simplex virus

Question 53

What is Todd's paresis?

Answer 53

Weakness following a seizure that wears off within 24 hours

Question 54

In suspected myasthenia gravis, if serum ACh receptor antibodies are negative/normal, what else should be measured?

Answer 54

Anti-muscle-specific tyrosine kinase

Question 55

What does movement disorder + atrophy of the caudate nucleus and putamen and generalised atrophy suggest?

Answer 55

Huntingtons disease