neuro psmd

Question 1

what does ptosis + dilated pupil indicate?

Answer 1

third nerve palsy

also associated with eyes down and out

Question 2

what does ptosis + constricted pupil indicate?

Answer 2

Horner’s syndrome (miosis + ptosis)

Question 3

what does pain + CN3 palsy indicate?

Answer 3

posterior communicating artery aneurysm (petrous part of temporal bone presumably idk?)

Question 4

what is hyperacusis associated with?

Answer 4

Bell’s palsy

Question 5

what would a vesicular rash + bell’s palsy indicate?

Answer 5

ramsay hunt

is not bell’s palsy.

Question 6

what is lhermitte’s sign?

Answer 6

flexion of neck causes tingling of hands

Question 7

what does lhermitte’s sign indicate?

Answer 7

indicates disease near the dorsal column nuclei of the cervical cord

Question 8

how does ulnar nerve lesion present?

Answer 8

wasting of hypothenar emininence
weakness of finger abduction
weak thumb adduction
claw hand
wasting and paralysis of intrinsic hand muscles
sensory loss to medial 1.5 fingers

Question 9

how does essential tremor present?

Answer 9

worse when arms outstretched

Question 10

how is essential tremor treated?

Answer 10

propanolol

alcohol makes it better

Question 11

what should be given to a patient with ischaemic stroke to prevent another ischaemic stroke?

Answer 11

clopidogrel and statin

dipyridamole if clopidogrel contraindicated

Question 12

how do you treat acute cluster headache?

Answer 12

high flow O2 + nasal,SC sumatriptan

Question 13

what is used for treatment of trigem neuralgia?

Answer 13

carbamezapine

Question 14

what should a person with a single provoked seizure do?

Answer 14

inform the DVLA and await guidance on driving

Question 15

what is a lateral medullary stroke?

Answer 15

acute ischaemic infarct of medulla oblongata

Question 16

what type of bitemp hemianopia is seen in pituitary gland tumour?

Answer 16

upper quadrant defect!

Question 17

how does primary open angle glaucoma present?

Answer 17

unilateral PERIPHERAL visual field loss

Question 18

how would a patient who had an extensive stroke (right sided hemiplegia)

Answer 18

right homonymous hemianopia

homonymous hemianopia is always on the same side as the paresis

Question 19

how would a patient who had an extensive stroke (right sided hemiplegia)

Answer 19

right homonymous hemianopia

homonymous hemianopia is always on the same side as the paresis

Question 20

what is an acoustic neuroma?

Answer 20

vestibular schwannoma

Question 21

how does vestibular schwannoma present?

Answer 21

vertigo
hearing loss
tinnitus
absent corneal reflex

Question 22

what is friedrich-waterhouse syndrome?

Answer 22

Rare complication of meningococcal sepsis involving bilateral adrenal haemorrhage. This would be a patient who is extremely unwell, or who has been recently treated for meningitis and presents with collapse and salt-wasting.

Question 23

what is multisystem atrophy?

Answer 23

parkinsonism and autonomic disfunction such as atonic bladder, postural hypotension

Question 24

which nerve is most likely to be injured in a Colles fracture?

Answer 24

median nerve - no thumb abduction

colles fracture affects wrist

Question 25

what is a side effect of carbamezapine?

Answer 25

Stevens-Johnson syndrome