Neuro

Question 1

venous sinus thrombosis gold standard test?

Answer 1

MRI venogram

Question 2

status epilepticus
in prehospital

Answer 2

PR diazepam

BUCCAL midazolam

Question 3

how should demyelinating lesions be seen?

Answer 3

MRI with contrast

Question 4

optic neuritis?

Answer 4

inflammation of optic nerve

colour blind (red)
sudden vision loss

Question 5

what does damage to the medial longitudinal fasciculus present with?

Answer 5

internuclear opthalmoplegia

impaired lateral gaze

Question 6

bacterial meningitis presents with?

Answer 6

high WCC
high protein

LOW glucose

Question 7

normal pressure hydrocephalus

presenstw ith

Answer 7

urinary incontinence, ataxic gait, cognitive impairment

Question 8

Normal pressure hydrocephalus neuroimaging findings:

Answer 8

ventriculomegaly in the absence of, or out of proportion to, sulcal enlargement

Question 9

Amaurosis fugax is a form of stroke affecting the _____ artery?

Answer 9

retinal / opthalmic artery

Question 10

imaging in suspected TIA?

Answer 10

MRI brain with diffusion weighted imaging

Question 11

bulbar onset amyotrophic lateral sclerosis
features

Answer 11

diff swallowing liquids
facial weakness

reduced jaw jerk reflex

Question 12

Steppage gait

Answer 12

occurs in sensory neuropathy

foot drop / loss of ability to dorsiflex

Question 13

autonomic dysreflexia

causes?

Answer 13

unbalanced sympathetic reflex
= HTN
sweaty
agitated

can be caused by a stimulus below the spinal cord injury level

Question 14

Mx of autonomic dysreflexia?

Answer 14

removal / control of the stimulus
treatment of any life threatening HTN / bradycardia

Question 15

Broca area is where?

Answer 15

inferior frontal gyrus

speech production

expressive aphaisa

Question 16

Wernickes is found?

Answer 16

superior temporal gyrus
>language comprehension

receptive aphasia

Question 17

arcuate fasiculus

Answer 17

conduction aphasia

Question 18

tonic seizures mx?>
women 26

Answer 18

lamotrigine first line

Question 19

rare but recognised S/E of lamotrigine?

Answer 19

stevens johnson syndrome

Question 20

acute ischaemic stroke mx

when do you control bp before thrombolysis?

Answer 20

> 185/110

labetalol IV bolus

Question 21

NICE guidelines bells palsy

no improvement follwoing 3 weeks

Answer 21

refer urgent to ENT
neuroimaging indicated

Question 22

mid shaft humeral fractures are associated with?

Answer 22

radial nerve injury

Question 23

Radial nerve

Answer 23

wrist extension

‘wrist drop’ =palsy

Question 24

antiepileptic associated with weight gain?

Answer 24

sodium valproate

Question 25

NMS management?

Answer 25

dopamine agonist bromocriptine

Question 26

postural hypotension 2 types?

Answer 26

compensatory tachycardia autonomic dysfunction

Question 27

4Ds of postural hypotension

Answer 27

deconditioning dysfunctional heart dehydration drugs >tamsulosin, antidepressants, anti angina

Question 28

uvula deviation

Answer 28

vagus nerve

Question 29

Trochlear nerve clinical

Answer 29

eyemovement > vertical diplopia >defective downwaed gaze

Question 30

horizontal diplopia

Answer 30

abducens

Question 31

vagus nerve

Answer 31

phonation swallowing uvula gag efferent

Question 32

Acoustic neuromas are?

Answer 32

schwann cell tumours of cochlear nerve

Question 33

status epilepticus management

Answer 33

ABC check blood glucose 1st line drugs benzodiazepine PR diazepam buccal midazolam IV lorazepam 5-10 minutes x2

Question 34

ongoing / established status epilepticus?

Answer 34

2nd line agent levetiracetam phenytoin sodium valproate

Question 35

CT head showing temporal lobe changes with meningism?

Answer 35

herpes simplex encephalitis

Question 36

DVLA and epilepsy confirmed

Answer 36

12 month seizure free 5 years no seizures

Question 37

stroke /TIA

Answer 37

1 month off driving

Question 38

raised ICP can cause what eye defect?

Answer 38

eye deviation down and out

Question 39

hypopigmented macule

Answer 39

tuberous sclerosis ash leaf spot

Question 40

what is tuberous sclerosis?

Answer 40

growth of benign tumours in different parts of the body including brain kidney heart

Question 41

cafe au lait spots

Answer 41

HYPERpigmented

Question 42

tunnel vision

Answer 42

macula spared

Question 43

absence seizures first line antiepileptic

Answer 43

ethosuximide

Question 44

otosclerosis causes?

Answer 44

conductive hearing loss

Question 45

which scale is effective in differentiating acute stroke from stroke mimics?

Answer 45

ROSIER scale > recognition of stroke in the emergency room

Question 46

what is friedrich ataxia?

Answer 46

hereditary deteriorates spastic paraparesis impaired vibration sense proprioception

Question 47

syringomyelia

Answer 47

compression of spinal cord 'SYRINX' upper limb affected more

Question 48

left 6th nerve palsy affects?

Answer 48

inability to abduct eye abducens nerve innervates the lateral rectus muscle

Question 49

baclofen is a?

Answer 49

GABA-B receptor agonist muscle relaxant

Question 50

what is degenerative cervical myelopathy? gold standard test?

Answer 50

high axial loading can cause disc degeneration and ligament hypertrophy MRI of cervical spine

Question 51

Hoffman's sign

Answer 51

cervical meylopathy gently flick one finger on a patients hand reflex twitch of other fingers

Question 52

most effective treatment of cervical myelopathy?

Answer 52

decompressive surgery

Question 53

Acute angle closure glaucoma

Answer 53

sudden blockage of aqueous drainage from the eye = rapid intraocular pressure increase sudden visual loss DM PAINFUL

Question 54

Acute open-angle glaucoma

Answer 54

cornea may be bulging dilated pupil / unresponsive to light

Question 55

Vitreous haemorrhage

Answer 55

painless blur / haziness of vision floaters 'cobwebs' transient bleeding into vitreous humour

Question 56

mx of acute relapse in MS?

Answer 56

methylprednisolone

Question 57

syringomyelia has a ___ sensory loss

Answer 57

spinothalamic

Question 58

spinothalamic is affecting?

Answer 58

pain and temperature

Question 59

dorsal column?

Answer 59

proprioception vibration

Question 60

root which supplies loss of sensation of medial epicondyle and intrinsic hand muscle weakness?

Answer 60

T1 via ulnar ner klumpke paralysis

Question 61

Erb-Duchenne paralysis

Answer 61

c5/c6 winged scapula breech presentation

Question 62

what is the role of controlled hyperventilation in patients with raised ICP?

Answer 62

hyperventilation = reduce CO2 vasoconstriction occurs = recude ICP

Question 63

what is cushing triad in HTN?

Answer 63

widening pulse pressure bradycardia irregular breathing