Neurology

Question 1

Define syncope

Answer 1

Fainting - term used to describe the event of temporarily losing consciousness due to a disruption of blood flow to the brain, often leading to a fall.

Question 2

Signs of syncope

Answer 2

Prodrome - hot clammy, sweaty, Heavy, dizzy or lightheaded, vision going blurry or black, headache

Sudden loss of conciousness and falling tot he ground
Unconscious for a few seconds
May be some twitching shaking or convusion activity
Slightly groggy but no true post ictal period
May lose continence

Question 3

Causes of syncope

Answer 3

Dehydration
Missed meals
Extended standing
Vasovagal response
Secondary
Hypoglycaemia
Dehydration
Anaemia
Infection
Anaphylaxis
Arrhythmias
Valvular heart disease
Hypertrophic obstructive cardiomyopathy

Question 4

Investigations in syncope

Answer 4

ECG - 24 hours
Echo
Bloods - glucose

Question 5

Management of syncope

Answer 5

Reassurance and advice
Avoid triggering factors - dehydration, meals,

Question 6

Define epilepsy

Answer 6

Umbrella term for a condition where there is a tendency to have seizures - transient episodes of abnormal electrical activity in the brain

Question 7

Management of generalised tonic clonic seizures

Answer 7

Sodium valproate
2 - lamotrigine or carbamazepine

Question 8

Management of focal seizures

Answer 8

Carbamazepine or lamotrigine
2 - sodium valproate or levetiracetam

Question 9

Management of absence seizures

Answer 9

Sodium valproate or ethosuximide

Question 10

Management of atonic seizures

Answer 10

Sodium valproate
Lamotrigine

Question 11

Management of myoclonic seizures

Answer 11

Sodium valproate
Lamotrigine
Levetiracetam
Topiramate

Question 12

Define febrile convulsions

Answer 12

Type of seizure that occurs in children with high fever
Not caused by epilepsy or ounderlying condition
Must be between 6 months and 5 years

Question 13

Presentation of febrile convusions

Answer 13

18 months old with 2-5 minute seizure during high fever - often due to underlying viral illness

Question 14

Management of febrile convulsions

Answer 14

Reassurane and education

Question 15

Causes of head aches

Answer 15

Tension headaches
Migraines
ENT infection
Analgesic headache
Problems with vision
Raised intracranial pressure
Tumour
Meningitis
Encephalitis
Carbon monoxide poisoning

Question 16

Define cerebral palsy

Answer 16

Permanent neurological problems resulting from brain damage around time of birth -

Question 17

Causes of cerebral palsy

Answer 17

Antenatal - maternal infection, trauma in pregnancy
Perinatal - birth asphyxia, pre-term
Post natal - meningitis, severe neonatal jaundice, head injury

Question 18

Types of cerebral palsy

Answer 18

Spastic - hypertonia, upper motor neurone damage
Dyskinetic - muscle tone, athetoid movemets oro-motor problems, basal ganglia damage
Ataxic - coordination, cerebellar damage
Mixed

Question 19

Patterns of spastic cerebral palsy

Answer 19

Monoplegia
Hemiplegia
Diplegia
Quadriplegia

Question 20

Classic presentation of cerebral palsy

Answer 20

Failure to meet milestones
Increased or decreased tone
Hand preference below 18 months
Problems with coordination speech or walking
Feeding or swallowing problems
Learning difficulties

Question 21

Clinical signs of upper motor neurone lesion

Answer 21

Normal muscle bulk
Hypertonia
Normal power
Brisk reflexes

Question 22

Clinical signs of lower motor neurone lesion

Answer 22

Reduced muscle bulk
Hypotonia
Reduced power
Reduced reflexes
Fasciculations

Question 23

Complications of cerebral palsy

Answer 23

Learning diability
Epilepsy
Kyphoscoliosis
Muscle contractures
Hearing and visual impairment
GORD

Question 24

Management of cerebral palsy

Answer 24

Supportive management from a multidisciplinary team
Muscle relaxants
Anti-epileptics
Glycopyrronium bromide

Question 25

Define strabismus

Answer 25

Squint - refers to the misalignment of the eyes

Question 26

Define amblyopia

Answer 26

Affected eye becomes passive and has reduced function compared to dominant eye

Question 27

Define esotropia

Answer 27

Inward positioned squint - towards the nose

Question 28

Define exotropia

Answer 28

Outward positioned squint - towards the ears

Question 29

Define hypertropia

Answer 29

Upward positioned squint

Question 30

Define hypotropia

Answer 30

Downward positioned squint

Question 31

Causes of strabismus

Answer 31

Idiopathic Hydrocephalus Cerebral palsy Space occupying lesions - retinoblastoma Trauma

Question 32

Management of strabismus

Answer 32

Occlusive eye patch Atropine drops in goof eye

Question 33

Define hydrocephalus

Answer 33

Describes cerebrospinal fluid building up abnormally within the brain and spinal cord. Results from either over production or issues draining CSF

Question 34

Causes of hydrocephalus

Answer 34

Arachnoid cysts Arnold-Chiari malformation - cerebellum herniates through the foramen magnum blocking outflow of CSF Chromosomal - malformation

Question 35

Presentation of hydrocephalus

Answer 35

Enlarged and increasing head Bulging fontanelle Poor feeding and vomiting Poor tone Sleepiness

Question 36

Management of hydrocephalus

Answer 36

Vetriculoperitoneal shunt - infections, blockages, too much drainage, intraventricular haemorrhage

Question 37

Define craniosynostosis

Answer 37

Premature closure of skill sutures - results in abnormal head shapes and growth restriction

Question 38

Define muscular dystrophy

Answer 38

Umbrella term for genetic conditions that cause gradual weakening and wasting of muscles

Question 39

Types of muscular dystrophy

Answer 39

Duchennes ! Beckers Myotonic Fascioscapulohemeral Oculopharyngeal Limb-girdle Emery-Dreifuss

Question 40

Clinical signs of muscular dystrophy

Answer 40

Gower's Signs - uses hand to push self p legs

Question 41

Define duchennes muscular dystrophy

Answer 41

Defective gene for dystrophin - on X chromosome X linked recessive

Question 42

Define myotonic dystrophy

Answer 42

Prolonged muscle contractions - unable to let go after shaking hand Progressive muscle weakness Cataracts Cardiac arrhythmias