Neurology

Question 1

What are the radiological (MRI) findings in MS?

Answer 1

MRI: disseminated demyelinating lesions in two of four key areas (periventricular, juxtacortical/cortical, infratentorial and spinal cord). Dissemintion = contrast enhancing of one lesion with others non-enhancing.

Question 2

What artery is responsible for cortical blindness

Answer 2

basilar artery (bilateral occipital lobeinfarcts)

Question 3

What antibiotic should be added in to ceftriaxone cover in people over 60 with suspected meningitis and why

Answer 3

amoxicillin - cover listeria

Question 4

in which disorder is accumulation of alpha synuclein seen

Answer 4

DLB

Question 5

What do lesions in the geniculate ganglion cause?

Answer 5

facial nerve palsy and hearing loss

Question 6

Which drug causes yellow field disturbance and what causes blue field disturbance

Answer 6

yellow - digoxin, blue - sildenafil

Question 7

What sign is pathognomonic in corticobasal degeneratin

Answer 7

phantom limb syndrome, also apraxia eg failing in task like brushing teeth

Question 8

What signs are often present with MSA

Answer 8

cerebellar sings also significant autonomic dysfunction

Question 9

What nerve supplies the quadriceps

Answer 9

femoral nerve

Question 10

Qhat is the half life of amiodarone

Answer 10

25 - 30 days

Question 11

What muscle serves abduction for first 30 degrees shoulder movement

Answer 11

supraspinatus, then deltoid

Question 12

What nerve is responsible for motor control of hip flexors

Answer 12

L1/L2 (also sensory to inner groin)

Question 13

WHat would a lesion in posterior cerebral artery result in

Answer 13

visual loss

Question 14

How does menieres disease present

Answer 14

paroxysmal vertigo, N+V, and sn deafness

Question 15

Give examples of dominant parietal lobe dysfunction

Answer 15

language disorders, agnosia, ideomotor apraxia, right left syndrome, acalcaluia, agraphia and finger agnosia

Question 16

What is the trigger for trigeminal neuralgia

Answer 16

carbamezapine - triggered by washing face

Question 17

What action is typically associated with exacerbation in sx of a cervical syrinx

Answer 17

coughing or laughing

Question 18

what sensory deficit is first to disappear with syrinx

Answer 18

loss of pain and temperature sensation. spastic paraparesesis with hyperreflexia is seen in upper limbs. LMN signs in upper limbs as syrinx disrupts upper horn cells

Question 19

which structure is damanged in hemiballism

Answer 19

subthalamic nucleus

Question 20

what is damage t the red nucleus associated with

Answer 20

tremor

Question 21

what nucleus is most likely damaged with ataxia

Answer 21

dentate nucleus

Question 22

can you get horner’s syndrome in a migraine

Answer 22

yes

Question 23

how does hsv present on MRI

Answer 23

hypodense areas in both temperal lobe. inflammatory markers often nomral

Question 24

what is the test for wilson’s disease

Answer 24

serum caeruloplasmin low, urine copper high. ATP7B gene

Question 25

what presents the greatest increase in stroke, AF with vheumatic heart disease or AF non rheumatic

Answer 25

AF rheumatic

Question 26

when is intermittent self catheterisation appropriate in MS

Answer 26

when residual volume is greater than 100mls. When residual volume is <100mls anticholinergics may be more appropriate

Question 27

are statins associated with peripheral neuropathy yes or no

Answer 27

yes

Question 28

is hungtington's disease sex linked

Answer 28

no

Question 29

what type of aneurysm is typically associated with a 3rd nerve palsy

Answer 29

PCA aneurysm

Question 30

what is lateral meduallary syndrome

Answer 30

occurs with brainstem strokes (thromboembolic disease of PI cerebellar artery of vertebral artery is most common cause). Crossed nature of signs eg rhs face lhs body

Question 31

what is the inheritence pattern of friedrich's ataxia

Answer 31

AR

Question 32

which crnail nerves are affected i pituitary apoplexy

Answer 32

III, IV and VI

Question 33

what nerve lesion causes weakness of the hand muscles

Answer 33

T1

Question 34

what nerve is responsible in global muscle wasting of hand

Answer 34

t1. both medial and ulnar invovlement

Question 35

what is difference between AC type 1 and 2 malformations

Answer 35

AC type 2 is present at birth with other signs spina bifida

Question 36

what is the MRI abnormality in SCDC? (b12 def)

Answer 36

increased T2 weighted lesions in posterior columns evolving spastic paresis, peripheral neuropathy (absent ankle jerks) nd posterior column sensory loss (vibration and joint sense

Question 37

What is typical about GBS CSF

Answer 37

high protein

Question 38

in a patient who has optic neuritis does the presence of 3 white matter lesions in mRI predict onset of MS in five years

Answer 38

yes - 50% likelyhood

Question 39

What lesion would left temporal lobe lesion cause

Answer 39

right superior homonymous quadrantopia (PITS PITS)

Question 40

How do macroadenomas get treated i pituitary

Answer 40

dopamine agonist then surgery

Question 41

Artery occluded in LATERAL MEDUALLARY SYNDROME

Answer 41

Po inferior cerebellar artery or vertebral artery

Question 42

Medication for stress incontinence

Answer 42

Duloxetine

Question 43

Common complication of SAH ?

Answer 43

Hydrocephalus

Question 44

Abuse of which drug exacerbates b12 def

Answer 44

Alcohol and noz

Question 45

What b vitamin is folate

Answer 45

B9

Question 46

What pump does dioxin inhibit

Answer 46

Na k atpase pump resulting in increase in intracellular sodium Act on phase 4 cardiac myocytes

Question 47

Difference between conus medullary and cauda equina

Answer 47

Conus medullaris sudden and bilateral with more severe radicular pain Cauda is unilateral

Question 48

What supplies the deltoid and regimental badge sensation

Answer 48

C5

Question 49

What nerve supplies biceps and wrist extensors

Answer 49

C6

Question 50

What supplies triceps wrist flexors and finger extentensors

Answer 50

C7

Question 51

What supplies finger flexors

Answer 51

C8

Question 52

what is pathophysiology of holmes adie pupil

Answer 52

damage to parasympathetic ciliary ganglion

Question 53

antiepeleptic in JME

Answer 53

sodium valproate (males) levetiracetam (females)

Question 54

antiepeleptic for focal seizures

Answer 54

carbamezapine