Neuro and eyes

Question 1

Menstrual migraine prophylaxis medication

Answer 1

Zoltriptan or frovatriptan
(unlicensed taken around time of menstruation)

Question 2

Dementia screen bloods

Answer 2

FBC, u&e, LFT, TFT, calcium, glucose, folate, b12

Question 3

steroid dose in children

Answer 3

The recommended dosage of prednisone for asthma exacerbation is 10 mg of prednisolone for children under two years of age, a dose of

2-5 is 20 mg for children aged

> 5 of 30–40 mg for children

Question 4

psedomonus sputum treatment

Answer 4

cipro 7-14 days

Question 5

Acute severe asthma episode is

Answer 5

Peak expiratory flow (PEF) 33–50% best or predicted

respiratory rate ≥ 25 breaths per minute

heart rate ≥ 110 beats per minute

inability to complete sentences in one breath

Question 6

A 60 year-old retired man who has a sudden onset of slurring of speech and unilateral weakness. He has a complete recovery within 24 hours, and there are no neurological abnormalities at this time. He has not had any similar episodes in the past. DVLA guidance TIA

Answer 6

Cannot drive until 1month
TIA

The DVLA only need be informed if there are neurological abnormalities present four weeks after the episode.

Group 2 driver 1 year

Question 7

Werneckes triad

Answer 7

Ataxia, confusion and ophthalmoplegia

Question 8

Korsacoff psychosis

Answer 8

Amnesia, confabulation and disorientation of time

Question 9

Delirium tremens

Answer 9

Present uptp 7 days of alcohol withdrawal
Autonomic dysfunction- sweating, htn and tachycardia with confusion

Question 10

Motor neurone disease good presdictive factor

Answer 10

Onset at young age(i.e. 20s or 30s)
female sex
relapsing-remitting disease
sensory symptoms only
long interval between first two relapses
complete recovery between relapses

Question 11

Horners syndrome

Answer 11

Ptosis, mitosis (constricted pupils), anhidrosis

Question 12

herpes zoster ophthalmicus tx

Answer 12

Oral acovlovir

Question 13

acute angle closure glaucoma risk factors

Answer 13

hypermetropia (long-sightedness)
pupillary dilatation
lens growth associated with age
medications - amitriptyline, topiramate, mirtazapine, ssri

Question 14

Holmes-Adie pupil

Answer 14

dilated pupils
slowly reactive to accommodation
associated with absent knee and ankle reflexes

Question 15

Stye - infection of the glands on eye lids tx

Answer 15

warm compress for 5-10mins 3-4 times a day

Question 16

Acute angle closure management if delay in hospital admission

Answer 16

Lie facing front without pillow
Pilocarpine 2% in blue eyes, 4% in green eyes
acetazolamide 500 mg

Question 17

prostaglandin analogues e.g lantoprost side effects

Answer 17

Brown pigmentation around eyes
Thickened eye lash

Question 18

Pilocarpine side effects

Answer 18

Small pupils, headaches and blurred vision

Question 19

Anticholinergic medication licensed for dementia in Parkinson’s disease

Answer 19

Rivadigistimine

Question 20

Ergotic Dopamine receptor agonists
e.g. bromocriptine cabergoline, side effects

Answer 20

impulsiveness
cardiac/ pulmonary fibrosis

Question 21

the only anti-emetic that should be used in patients with Parkinson’s disease

Answer 21

Domperidone

Question 22

Levodopa side effects

Answer 22

Dyskinesia
Motor fluctuations
Hypotension
anorexia
dry mouth
lethargy/drowsiness
psychosis

Question 23

drugs that can cause peripheral neuropathy

Answer 23

nitrofurantoin
metronidazole
phenytoin

Question 24

Parkinsons first line medications

Answer 24

1. levodopa
2. non ergonotic dopamine agonists e.g ropinirolone, apomorphine, pamprixiole
3. MAOI

Question 25

Which migraine prophylaxis medication can precipitate acute angle closure glaucoma

Answer 25

topiramate

Question 26

Drugs that precipitate acute angle closure glaucoma

Answer 26

antihistamines, antiparkinsonian medications, antipsychotics, benzos, botox, cocaine, H2RAs, mefenamic acid, SSRIs, topiramate, tricyclics

Question 27

Motor neurone disease facts

Answer 27

Mixed upper and lower motor neurone signs fasciculations sensation not affected don't affect eye muscles

Question 28

Risk factors for dementia

Answer 28

Parkinsons downs' syndrome cvd risk factors - htn, cholesterol, smoking FH severe psychiatric disease low IQ head injury low physical activity

Question 29

Dementia MMSE scoring >26 21- 26 10-20 <10

Answer 29

Normal mild Moderate Severe

Question 30

Three Dementia acetylcholnisterase inhibitors

Answer 30

donepezil, galantamine and rivastigmine

Question 31

Huntingtons disease

Answer 31

Autominal dominant disease anticipation chorea, dystonia, saccadic eye movements, personality changes

Question 32

After having a seizure, what is the risk of having another seizure in the next 1 year

Answer 32

30%

Question 33

If patient has been seizure free for how long can we consider stopping/ reducing their seizure medications?

Answer 33

2yrs

Question 34

NICE states that the lifetime risk of SUDEP (sudden unexplained death I epilepsy in a patient with epilepsy is how much?

Answer 34

7-12 %

Question 35

Cause of secondary glaucoma

Answer 35

Uveitis, eye trauma, cataracts, medications especially steroid

Question 36

Bell’s palsy poor prognosis

Answer 36

Complete palsy Severe pain No recovery by 6 weeks Age >60

Question 37

Glaucoma vs anterior uveitis

Answer 37

Glaucoma causes visual loss Anterior uveitis don’t. Includes iritis - redness around the sclera

Question 38

1.Migraine prophylaxis in children >12 2. Under 12

Answer 38

1. Propanol 2. Pizotifen

Question 39

Tension headaches prophylaxis

Answer 39

Acupuncture, CBT, amitriptyline