Neuro

Question 1

Hemianopia and stroke

Answer 1

MCA : homonymous hemianopsia controlateral (look towards the side of lesion
PCA: contra lateral with macular sparing

Question 2

Contraindications of tissue plasminogens activator

Answer 2

1-stroke or head trauma within 3 months
2- haemorrhage within 21 days
3- surgery 21 days
4- histories of cranial haemorrhage
5- Bp > 180/110

Question 3

Aphasia types

Answer 3

1 broca: follow commands but unable to verbalize or write
2 - wenrnikie : the inverse of broca
3 - conduction aphasia : affects th

Question 4

Lacunar stroke

Answer 4

Subcortical necrosis ( small penetrating arteries)
- basal ganglia- pons

Question 5

Pure motor hemiparesis without sensory deficits or higher cortical function

Answer 5

Stroke of the posterior limb of the internal capsule

Question 6

Thalamic pain syndrome

Answer 6

Severe paroxysmal burning pain over the affected area which is exacerbated by light touch (allodynia)

Question 7

CN III ipsilateral + hemiplegia

Answer 7

Weber

Question 8

CN III ipsilateral + ataxia

Answer 8

Benedikt

Question 9

Facial sensory loss + body sensory loss

Answer 9

Wallenberg

Question 10

Quadriplegia + preserved consciousness + communicate through blinking

Answer 10

Looked in syndrome

Question 11

Cause of death in subarachnoid hemorrhage

Answer 11

1 - rebleeding within the first 24 hours
2- vasospasm 3-10 days : arterial narrowing due to degradation of the blood and its metabolites

Question 12

Upper motor neurons lesion

Answer 12

1 - spastic paralysis
2- hyperreflexia
3- no muscle wasting if present ( due to disuse atrophy
4- absent fasciculation
5- babinski sign ( fanning or the other toes)

Question 13

Lower motor neurons lesion

Answer 13

1- flaccid paralysis
2- hypo or areflexia
3- early and marked muscle wasting
4- twitches of group of muscles
5- normal plantar response
6- always ipsilateral and at the level of the lesion

Question 14

Pronator drift
Relatively sensitive and specific for upper motor neuron or pyramidal

Answer 14

Weakness in the supination compared to the pronator muscles of thr upper limb
The result: the affected arm drifts downward and the palm turns towards the floor

Question 15

Spinal discord

Answer 15

1 - anterior spinal artery infarction
2- subacute combined degeneration
3- tabes dorsalis
4- brown sequard syndrome
5- syringomyelia

Question 16

Romberg sign

Answer 16

Sways with eyes closed: sensory ataxia
Sways with closed eyes: cerebellar ataxia

Question 17

Argyll Robertson pupil

Answer 17

Accommodate to the near object but not to the light

Question 18

Loss of pain and temperature bilaterally across the upper back and both arms
Bubble in the cord

Answer 18

Syringomyelia
Key : frequent burns in both of her hands while cooking or packing

Question 19

Amyotrophic lateral sclerosis (lou gehrigs disease

Answer 19

Pure motor disease upper and lower Motor neurons lesion while at the same time preserving bowel bladder sensory

Question 20

Bradykinesia ( slow movement)
Rigidity ( cogwheel rigidity) : slowing of movement on passive flexion of an extremity
Instability tendency to fall
Tremor at rest

Answer 20

Parkinson

Question 21

Parkinson trt

Answer 21

Mild : age > 60 amantadine ( release the dopamine
Age <60 anticholinergic
Sever disease:
Initial: carbidopa/levodopa
Side effects early:hallucinations
Late : dyskinesia (abnormal movements) akathisia (restlessness) off on phenomena trt; adding maob or comt or dopamine agonists

Question 22

Multiple system atrophy shy drager syndrome

Answer 22

• Parkinson
• autonomic dysfunction
• widespread neurological signs
  Trt : volume expansion( fludrocortisone salt supplements

Question 23

Optic neuritis
Transverse myelitis
Inter nuclear ophthalmollegia

Answer 23

Multiple sclerosis

Question 24

Charcot Marie tooth disease

Answer 24

Mutation of myelins synthesis ( peroneal and tibial nerves)
Weakness + wasting muscle ( inverted champagne bottle)
Foot drop
Tremors

Question 25

Fluctuating fatigable muscles worsens with repetitive motions ( extra ocular ptosis + diplopia + bulbar ( chewing nasal speech Tenslion test

Answer 25

Myasthenia

Question 26

Pseudo tumor cerebrei

Answer 26

Young obese female with headache and normal image and elevated CSF pressure *impaired absorption of CSF by the arachnoid villi * provoking agents corticosteroids and vitamin A

Question 27

Hearing loss + tinnitus + vertigo

Answer 27

Meniere disease

Question 28

Indications for treatment Seizures

Answer 28

1 - abnormal neurological exam 2-presented with status epileptic 3- strong family history of seizures 4- abnormal EEG

Question 29

Todd paralysis

Answer 29

Self limited focal weakness that occurs after a focal or generalised seizure Trt : supportive resolves within 36 hours Exhaustion and inhibition in the neurons

Question 30

Causes of dementia

Answer 30

1- alzheimer disease 2- Frontotemporal dementia ( pick’s disease) 3- dementia with Lewy body 4- Creutzfeldt Jakob disease 5- vascular dementia 6- normal pressure hydrocephalus

Question 31

Vascular dementia caused by subcortical type ischemia

Answer 31

- focal motor deficit - abnormal gait - urinary symptoms - psychiatric symptoms - gradual declining course

Question 32

Wacky ( dementia) Wet ( urinary incontinence ) Apraxic gait wobbly Ventriculomegaly

Answer 32

Normal pressure hydrocephalus Normal opening pressure and transient clinical improvement following high volume CSF

Question 33

Wernicke encephalopathy Chronic form : korsakoff syndrome

Answer 33

Confusion Ataxia Ophthalmoplegia

Question 34

Kosakoff syndrome

Answer 34

- anterograde and retre amnesia - confabulation ( fill the memory by fabricated story - apathy - lack of insight

Question 35

Ataxia + teleangiectasias + IgA deficiency

Answer 35

B and T cells disorder

Question 36

Eczema + thrombocytopenia + recurrent infections

Answer 36

Wiskott-Aldrich syndrome

Question 37

Huntington disease

Answer 37

CAG trinucleotide expansion results in the formation of an abnormal Huntington protein that is toxic to caudate and striatum which are responsible for producing GABA

Question 38

Huntington disease

Answer 38

CAG trinucleotide expansion results in the formation of an abnormal Huntington protein that is toxic to caudate and striatum which are responsible for producing GABA

Question 39

Miller fisher syndrome a variant of guillan barre syndrome

Answer 39

Cerebellar like ataxia and areflexia and rapid onset ophthalmoplegia

Question 40

Neurocutanous disease

Answer 40

1- tuberous sclerosis 2- neurofibromatosis type 1 3- Sturge Weber syndrome

Question 41

Tuberous sclerosis

Answer 41

Mutation suppressor genes TSC1 which code for the protein hamartin and tuberin - cortical tubers and subependymal hamartomas in the brain ( seizure and mental retardation - leaf shaped patches of skin lacking pigment ( ash leaf patches) - renal angio myo lipoma

Question 42

Neurofibromatosis type 1

Answer 42

Mutation gene suppressor NF1 - neurofibromas : sessile or pedunculated - skin cafe au lait spots - eye : optic nerve gliomas and visual loss and lisch nodules are pigmented hamartomas

Question 43

Sturge Weber

Answer 43

S : sporadic T : Tram track calcification U : unilateral R : retardation G : glaucoma E : epilepsy

Question 44

Cluster headache

Answer 44

Begin during sleep , peak rapidly, last approximately 90 minutes with men 8 times daily for 6-8 weeks followed by a remission lasting up to a year