Neurology

Question 1

first line mild/mod Alzhemier’s

Answer 1

AChE inhibitors eg Rivastigmine or Donezepil (memantine second line)

Question 2

difference between essential and PD tremors

Answer 2

essential more in motion and PD more at rest

Question 3

cushings triad

Answer 3

increased ICP: braducardia, irregular resps and widened pulse pressure (also weakness, lethargy, headaches, vomiting, blurred vision and changes in behaviour)

Question 4

patchy reduced attentuation in brain

Answer 4

vascular dementia (short term memory loss, counting money issues and word finding difficulties)

Question 5

fever, headache and focal neuro deficit

Answer 5

brain abscess

Question 6

temporal lobe changes bilaterally

Answer 6

herpes simplex encephalitis

Question 7

difference between PD dementia and lewy body

Answer 7

PD is after PD diagnosis for 1y and LB is dementia then motor symptoms

Question 8

hyperthermia, muscle rigidity, autonomic instability and altered mental state

Answer 8

neuroleptic malignant syndrome

Question 9

migraine young woman prophylaxis

Answer 9

propranolol

Question 10

isolated raised protein on LP

Answer 10

GBS

Question 11

anterior stroke

Answer 11

lower>upper loss

Question 12

middle stroke

Answer 12

upper>lower loss

Question 13

IIH management

Answer 13

acetazolamide

Question 14

prevent vasospasm of aneurysm in SAH

Answer 14

nimodipine

Question 15

diffuse axonal injury imaging

Answer 15

MRI

Question 16

hypoglossal nerve injury

Answer 16

tongue deviates towards the lesion

Question 17

what do you prescribe with methotrexate

Answer 17

folic acid

Question 18

first line for trigeminal neuraglia

Answer 18

carbamazepine

Question 19

scary headache symptom

Answer 19

abrupt onset

Question 20

ankle reflex

Answer 20

S1-2

Question 21

knee reflex

Answer 21

L3-4

Question 22

biceps reflex

Answer 22

C5-6

Question 23

spinal level hip adduction affected

Answer 23

L3

Question 24

spinal level knee extension affected

Answer 24

L4

Question 25

ankle dorsiflexion affected spinal level

Answer 25

L5

Question 26

feet plantar flexion affected spinal level

Answer 26

S1

Question 27

dermatomes

Question 28

if SAH and CT nothing what do you do next?

Answer 28

LP 12 hours after symptom onset

Question 29

peak incidences of meningitis bugs

Answer 29

0-3m: GBS Children: S. pneumoniae Teens/young adults: N. meningiditis Older adults: S. pneumoniae

Question 30

bacterial men CSF

Answer 30

high pressure low glucose cloudy high protein polymorphs

Question 31

viral CSF

Answer 31

clear/cloudy 60-80% of plasma glucose normal/raised protein lymphocytes

Question 32

raised ICP and third nerve palsy

Answer 32

transtentorial or uncal herniation

Question 33

sodium valproate and warfarin

Answer 33

sodium valproate is enzyme INhibitor so it INcreases warfarin levels

Question 34

reverse dystonia from haloperidol

Answer 34

procyclidine

Question 35

lateral medullary syndrome features PICA lesion

Answer 35

ipsilateral dysphagia, facial numbness and Horner's contralateral limb sensory loss

Question 36

prophylaxis of meningococcal meningitis for contacts

Answer 36

oral ciprofloxacin

Question 37

community emergency meningitis management

Answer 37

IM or IV benzylpenicillin stat

Question 38

hospital management of meningitis

Answer 38

under 3m is Cefotaxime plus amox (for listeria cover) above 3m is Ceftriaxone add dexamethasone if bacterial

Question 39

HLA-DR2

Answer 39

MS marker

Question 40

carbamazepine side effect

Answer 40

siADH

Question 41

urinary incontinence + gait abnormality + dementia

Answer 41

normal pressure hydrocephalus

Question 42

MG association

Answer 42

thymoma

Question 43

acute cluster headache

Answer 43

high flow oxygen and subcut sumatriptan

Question 44

cluster headache prophylaxis

Answer 44

verapamil

Question 45

confusion, visual hallucinations, tachycardia and pyrexia with heavy alcohol use

Answer 45

delirium tremens

Question 46

papilloedema and 6th nerve palsy

Answer 46

idiopathic intracranial hypertension signs

Question 47

inflammatory myopathy with poor steroid response

Answer 47

inclusion body myositis

Question 48

weakness, frontal balding, cataracts and ptosis

Answer 48

myotonic dystrophy