Neuro

Question 1

unilateral facial weakness/drop, forehead not spared,

Answer 1

Bells palsy

Question 2

recurrent severe headaches, unilat, esp around eyes, long pain free periods between sets

Answer 2

cluster headache

Question 3

insidious amnesia, language impairment, poor day to day memory,

Answer 3

Alzheimers

Question 4

Sudden onset dementia with stepwise derivation

Answer 4

vascular dementia

Question 5

personality change, disinhibition, well preserved memory

Answer 5

temporal dementia

Question 6

visual hallucinations, fluctuating cognition, asso with Parkinson’s

Answer 6

levy body dementia

Question 7

seizure - motor convulsions, jacksonian march, todds paralysis

Answer 7

frontal lobe focal motor siezure

Question 8

seizure with aura and halluciantions

Answer 8

temporal lobe focal

Question 9

irritability then generalised muscle spasm then repetitive synchronous jerks, tongue biting

Answer 9

tonic clonic siezure

Question 10

loss of consciousness with maintained posture

Answer 10

absence siezure

Question 11

head trauma, lucid interval then increasingly severe headache and dec GCS

Answer 11

extradural haemorrhage

Question 12

progressive, ascending symmetrical limb weakness and paraesthesia following recent inf

Answer 12

guillan barre syndrome

Question 13

ptosis, meiosis, anhydrosis

Answer 13

horners

Question 14

progressive chorea and dementia

clumsiness, involves movements, anxiety, strong FHx,

Answer 14

Huntingtons

Question 15

severe headache, photophobia, neck + backache, kernigs sign

Answer 15

meningitis

Question 16

severe episodic pulsatile headache that is associated with systemic disturbance and disrupts normal activities

Answer 16

migraine

Question 17

weakness in skeletal muscles that worsens with repetitive use, facial weakness

Answer 17

myasthenia gravis

Question 18

multiple cafe-au lait spots, learning difficulties, headaches, precious puberty

Answer 18

T1 neurofibromatosis

Question 19

bradykinsia, rigidity, resting asymmetrical pill rolling tremor, postural instability, stooped gait, shuffling, depression and dementia

Answer 19

parkinsons

Question 20

back pain, hyporeflexia, disturbance of bowel/bladder function, low BP, sensory loss

Answer 20

spinal cord compression

Question 21

facial droop, arm weakness, speech difficulty, sudden onset

Answer 21

stroke

Question 22

behavioural changes and centralat hemiparesis (leg>arm)

Answer 22

ACA stroke

Question 23

contralat hemiparesis (arm/face> leg) hemisensory loss, aphasia

Answer 23

MCA stroke

Question 24

contralat homonous hemianopia, visual agnosia, slurred speech,

Answer 24

PCA stroke

Question 25

sudden onset worst headache ever

Answer 25

subarachnoid haemorrhage

Question 26

trauma, ipsilat fixed, dilated puil, dec GCS, worsening headache

Answer 26

subdural haemorrhage

Question 27

new onset unilateral headache in pt >50, jaw claudation, scalp tenderness, shoulder pain

Answer 27

temporal arteritis

Question 28

unilateral stabbing/shooting facial pain lasting for a few seconds

Answer 28

Trigeminal neuralgia

Question 29

ataxia, confusion, ophlamoplegia, diplopia

Answer 29

wernickes encephalopathy

Question 30

ataxia, confubulation, amnesia, alert

Answer 30

korsakoff's psychosis

Question 31

brisk reflexes, babinski sign, fasciculations, tongue wasting, stiffness and weakness

Answer 31

Motor neurone disease

Question 32

what's the most important risk factor for stroke

Answer 32

HTN

Question 33

what often precedes bells palsy

Answer 33

upper RT inf

Question 34

management of bells palsy

Answer 34

protection of cornea (glasses/patch) | high dose corticosteroid if acute

Question 35

what is the aetiology of alzheimers

Answer 35

normal - a and y secretase -> normal degradation product alz - y and b secretase -> amyloid B (resistant to deg) - accumulator and forms amyloid plaques -> interfere with com -> dementia hypoerphosphorylated tau -> neurofibrillary tangles -> neuronal and synaptic loss

Question 36

Inv for alzheimers

Answer 36

CSF - inc tau and B amyloid

Question 37

focal epilepsy management

Answer 37

lamotrigine/carbamazepine

Question 38

generalised epilepsy management

Answer 38

sodium valproate

Question 39

treatment for status elipticus

Answer 39

1 - ABCDE and check glucose (correct if low) 2 - IV lorazepam/IV diazepam - repeat in 10 mins if doesn't stop 3- if 2 doses don't stop seizure - IV phenytoin

Question 40

common cause of status elitpicus

Answer 40

non compliance with anti-epileptic meds

Question 41

CT of extradural haemorrhage

Answer 41

lemon shape

Question 42

neonates - inc head circumference and downward facing eyes

Answer 42

obstructive hydrocephalus

Question 43

when would a lumbar puncture be contraindicated

Answer 43

inc ICP

Question 44

Dementia, gait disturbance, urinary incontinence

Answer 44

communicating hydrocephalus

Question 45

cause of huntingtons

Answer 45

CAG repeats

Question 46

huntingtons CT/MRI

Answer 46

symmetrical atrophy of striatum in brain

Question 47

where does meningitis cause inflam

Answer 47

pia + arachnoid mater

Question 48

management of meningitis

Answer 48

cephelosporin IV dexamethasone inform public health

Question 49

UMN signs

Answer 49

hyperreflexi, spastic weakness, extensor palmar response

Question 50

LMN signs

Answer 50

muscle wasting, hyporeflexia, flaccid weakness, fasciculations

Question 51

optic symptom of MS

Answer 51

optic neuritis - unilateral deterioration of visual acuity and colour perception, pain on eye movement

Question 52

Uhthoffs sign

Answer 52

MS - worsening of symptoms as body heats up

Question 53

Inv for myasthenia gravis

Answer 53

tension test - give short acting anti cholinesterase - rapid and transit improvement ice pack on eye for 2 mins -> dec ptosis nerve conduction study

Question 54

what cells does Parkinson's affect

Answer 54

dopaminergic neurones of substantiated nigra | pt only symptomatic after 70% loss

Question 55

Inv for parkinsons

Answer 55

levodopa trial - timed walking and then again after administration of levodopa bloods - serum caeruloplasmin to rule out wilsons Brain CT and MRI

Question 56

management of parkinsons

Answer 56

levodopa

Question 57

LMN symptoms in single/few muscles and pain in dermatomal pattern

Answer 57

radiculopathy

Question 58

management for ischaemic stroke

Answer 58

if <3hrs since onset - IV alteplase then aspirin if >3 - 300mg aspirin stroke unit follow up

Question 59

secondary prevention of stroke

Answer 59

AF + - warfarin prophylaxis | AF- - aspirin for 2 weeks then lifelong clopidogrel

Question 60

treatment for temporal arterisis

Answer 60

high dose oral prednisolone

Question 61

triggers for trigeminal neuralgia

Answer 61

vibration, brushing teeth, skin contact, wind