Neurology

Question 1

GBS progression of symptoms & common causative

Answer 1

C. jejuni - gastroenteritis

back/leg pain

progressive, symmetrical weakness of all limbs, ASCENDING
reduced/absent reflexes

Question 2

GBS investigations

Answer 2

• LP: rise in protein w/ normal WBC
• nerve conduction studies: – velocity

Question 3

high-resolution CT finding pancreatic cancer

Answer 3

double duct sign

Question 4

measuring iron levels during infection

Answer 4

ferritin is an unreliable indicator
transferrin saturation should be used instead

Question 5

tremors

Answer 5

• parkinsons: asymmetrical, pill-rolling, improves w/ movement
• benign: improves with alcohol; worse with arms stretched out

Question 6

raised IC pressured headache vs IIH mx

Answer 6

• dexamethasone
• acetazolamide + weight loss

Question 7

should be used to view demyelinating lesions (MS)

Answer 7

MRI with contrast

Question 8

+ve Hoffmans sign

Answer 8

DCM

Question 9

following stroke
- difficulty understanding written and spoken language despite intact speech fluency
- partial or complete loss of language production (spoken or written) despite retention of language comprehension
- fluent speech despite significantly impaired repetition of words/phrases spoken by others

Answer 9

• Wernicke’s (superior temporal gyrus)
• Broca’s (inferior frontal gyrus)
• Conductive aphasia (supramarginal gyrus in the parietal lobe and receives blood supply from MCA)

Question 10

chocolate triggers of migraine

Answer 10

chocolate, hangovers, orgasms, cheese/caffeine, oral contraceptives, lie-ins, alcohol, travel, exercise

Question 11

stroke syndromes:
- cerebellar signs, contralateral sensory loss & ipsilateral Horner’s

Answer 11

• ## lateral medullary syndrome (PICA)

Question 12

LP results
- bilirubin + normal opening pressure
- Light chains and raised protein
- Oligoclonal bands
- Bence-Jones proteins

Answer 12

• subarach haem
• MS
• MS
• multiple myeloma

Question 13

most common form of MS

Answer 13

relapse remit

Question 14

this meningitis yield low CSF glucose and elevated opening pressure, common in immunosuppressed

Answer 14

Cryptococcal

Question 15

SIADH is a common consequence of …

Answer 15

subarachnoid haemorrhage
(increased attenuation of the tentorium, basal cisterns, and sylvian fissures)

Question 16

… is used to prevent vasospasm in aneurysmal subarachnoid haemorrhages

Answer 16

Nimodipine

Question 17

corrections complications:
Hyponatraemia correction -
Hypernatreamia correction -

Answer 17

osmotic demyelination syndrome

cerebral oedema