Neurology

Question 1

Imaging in stroke?

Answer 1

Non-contrast CT head

Question 2

First line drug in myoclonic seizures (women)?

Answer 2

Leviteracitam

Question 3

What is a Jacksonian movement and the it is observed?

Answer 3

Clonic movement travelling proximally
Frontal lobe epilepsy

Question 3

Level at the spinal cord is affected in autonomic dysreflexia?

Answer 3

Above T6

Question 4

Areas affected in the brain in Alzheimer’s disease?

Answer 4

Widespread cerebral atrophy
Cortex and hippocampus

Question 5

Movements spared in MND?

Answer 5

Occular movement

Question 6

Which intracranial bleed can present several weeks after injury?

Answer 6

Subdural haematomas

Question 7

When should LP be performed in SAH?

Answer 7

12 hours post onset of headache

Question 8

Dermatome of sciatic nerve?

Answer 8

S1

Question 9

UMN tests?

Answer 9

UL: Hofman’s
LL: Babinski’s

Question 10

Signs of idiopathic intracranial hypertension?

Answer 10

Papilloedema
6th nerve palsy

Question 11

If suspected TIA and patient is on warfarin/DOAC?

Answer 11

ED for imaging to exclude haemorrhage

Question 12

Horner’s syndrome?

Answer 12

Ptosis and constricted pupil

Question 13

CN3 findings?

Answer 13

Down and out
Dilated pupil

Question 14

Weber’s syndrome?

Answer 14

Crossed findings due to brain stem infarcts
Ipsilateral CN3 palsy
Contralateral hemiplegia or hemiparesis

Question 15

Symptoms in subacute degeneration of the cord?

Answer 15

1. Loss of proprioception and vibration sense (dorsal columns)
2. Spasticity and brisk reflexes (lateral columns)

Question 16

Risk factor for pontine haemorrhage?

Answer 16

Chronic HTN

Question 17

Pontine haemorrhage symptoms and signs?

Answer 17

Reduced GCS
Quadraplegia
Miosis
Absent horizontal eye movement

Question 18

Symptoms in neurogenic thoracic outlet syndrome?

Answer 18

Muscle wasting in hands
Numbness and tingling
Autonomic symptoms

Question 19

Symptoms of autonomic dysreflexia?

Answer 19

Severe HTN
Sweating above level of the lesion
Agitation

Question 20

Complication of autonomic dysreflexia?

Answer 20

Haemorrhagic stroke

Question 21

After clinical diagnosis of spinal stenosis what is the next step?

Answer 21

MRI to confirm diagnosis and exclude other pathology

Question 22

Lateral medullary syndrome (Wallenberg’s syndrome) symptoms?

Answer 22

Ipsilateral: Ataxia, nystagmus, dysphagia, facial numbness, CN palsy
Contralateral: Limb sensory loss

Question 23

MND with worse prognosis?

Answer 23

Progressive bulbular palsy

Question 24

Most common earliest symptom in spinal cord compression?

Answer 24

Back pain

Question 25

What is angiomyolipoma associated with?

Answer 25

Tuberous sclerosis

Question 26

First line management in atonic or tonic seizure in females?

Answer 26

Lamotragine

Question 27

Which nerve does finger abduction?

Answer 27

Ulnar

Question 28

Which nerve does finger extension?

Answer 28

Radial

Question 29

Parsonage-Turner's syndrome?

Answer 29

Peripheral neuropathy, complication of viral illness, resolves spontaneously

Question 30

Type of scan required to view demyelinating lesions (as in MS)?

Answer 30

Contrast MRI

Question 31

Gold standard test for venous sinus thrombosis?

Answer 31

MR venogram

Question 32

Barthel index?

Answer 32

Scale that measures disability or dependence in activities of daily living in stroke patients

Question 33

Lesions at T1?

Answer 33

Cause finger abduction weakness

Question 34

Acute ischaemic stroke CT sign?

Answer 34

'hyperdense artery' sign (usually visible immediately in contrast to changes in the parenchyma)

Question 35

Management of SAH?

Answer 35

Coiling of aneurysm

Question 36

Isolated seizure and normal EEG affect on driving?

Answer 36

Patients cannot drive for 6 months following a first unprovoked or isolated seizure if brain imaging and EEG normal

Question 37

What artery supplies Broca's area?

Answer 37

Middle cerebral artery (on dominant side of brain)

Question 38

Relapsing remitting MS?

Answer 38

Acute attacks followed by periods of remission (85%)

Question 39

Secondary progressive MS?

Answer 39

Relapsing and remitting has deteriorated and patient has developed neuro signs and symptoms between relapses

Question 40

Primary progressive MS?

Answer 40

Progressive deterioration from onset (10%, more common if older)

Question 41

management if dent on head after injury?

Answer 41

Immediate CT ?depressed skull fracture

Question 42

When is thrombectomy indicated in stoke?

Answer 42

6-24 hour window if potential to salvage brain tissue (limited infarct core volume)

Question 43

Presentation of syringomyelia?

Answer 43

Cape-like loss of pain and temperature sensation duets compression of spinothalamic tract fibres Strong association with Chari malformation

Question 44

Acute intermittent porphyria presentation?

Answer 44

Abdominal, neurological and psych symptoms

Question 45

Management of acute porphyria?

Answer 45

IV haem arginate / haematin If not available give IV glucose

Question 46

Electrolyte abnormality in SAH?

Answer 46

Hyponatrameia

Question 47

Uhtoff’s phenomenon?

Answer 47

Neuro signs worse with increase in body temp (E.g worse vision when running)

Question 48

Brown- sequadrad syndrome?

Answer 48

Spinal cord hemisection Ipsilateral spastic paresis below lesion Ipsilateral loss of proprioception and vibration sense Contra lateral loss of pain and temp

Question 49

Which PD drugs are associated with the highest chance of inhibition disorders out of the antiparkinsonian medications?

Answer 49

Dopamine receptor agonists