Neurology

Question 1

Subungual fibromas are seen in what neurocutaneous disorder?

Answer 1

Tuberous Sclerosis

Question 1

Edrophonium is used to diagnose what neurological disorder?

Answer 1

Myasthenia gravis
(the drug is an acetylcholinesterase inhibitor)

Question 2

What is the MOA of Sumitriptan?

Answer 2

5-HT1B and 1D agonist

Question 3

A craniopharyngioma causes an upper or lower bitemporal hemianopia?

Answer 3

Lower Bitemporal hemianopia
(pit adenoma -> Upper)

Question 4

Symptoms of Freidrich’s ataxia?

Answer 4

• Bilateral spastic paresis
• Loss of proprioception and vibration
  (Same as SCD of cord)
• Ataxia - intention tremor

Question 5

Wernicke’s aphasia is a disease of what lobe?

Answer 5

Temporal

Question 6

Auditory agnosia, prospagnosia (inability to recognise faces) can be result of a lesion to what lobe?

Answer 6

Temporal

Question 7

Sensory inattention, apraxias (inability to perform a task when asked), astereognosis (tactile agnosia) and Gerstmann’s syndrome are caused by lesions to what lobe?

Answer 7

Parietal

Question 8

Describe Gerstmann’s syndrome

Answer 8

Lesion of dominant Parietal
- Alexia (comprehension of language)
- Aculculia (maths inability)
- FInger agnosia
- R-L disorientation

Question 9

How is Freidrich’s ataxia inherited?

Answer 9

AR

Question 10

What neurocutaneous disorder may feature pheochromocytoma?

Answer 10

Neurofibromatosis

Question 11

What drugs are 1st line for focal seizures?

Answer 11

• Lamotrigine and levitiracetam

Question 12

What drugs are 1st line for myoclonic seizures?

Answer 12

• Men: Sodium Valproate
• Women: Levitiracetam

Question 13

Sagittal sinus thrombosis has what sign on imaging?

Answer 13

Empty delta sign

Question 14

What venous sinus thrombosis has an association with 6th and 7th cranial nerves?

Answer 14

Lateral sinus thrombosis

Question 15

What sinus thrombosis is associated with trauma, infection and 3456 (eyes and trigeminal) CNs?

Answer 15

Cavernous sinus thrombosis

Question 16

Treatment of ring-enhancing lesion

Answer 16

• Ceftriaxone
• Metronidazole

Question 17

What drugs increase idiopathic intracranial hypertension?

Answer 17

• COCP
• Tetracyclines
• Steroids
• Retinoids
• Lithium

Question 18

What nerve abducts the thumb?

Answer 18

Median

Question 19

What are the features of Wernicke’s encephalopathy?

Answer 19

• Oculomotor dysfunction (nystagmus and/or Opthalmoplegia)
  (LR palsy, conjugate gaze oalsy)
• Gait ataxia
• Encephalopathy (confusion, disorientation, indifference, inattentiveness)
• Peripheral sensory neuropathy

Question 20

What are the features that would give Korsakoff syndrome?

Answer 20

• Amnesia (mem loss)
• Confabulation

Question 21

Muscle spasticity in MS is treated with what?

Answer 21

• Baclofen (muscle relaxant)
• Gabapentin

Question 22

A lesion in the left trochlear nerve would cause a head tilt toward what side?

Answer 22

Right side

Question 23

Post stroke meds

Answer 23

• Clopidogrel
• Statin

If clopidogrel contra-indicated:
- Aspirin + MR dipyridamole

Question 24

Ischaemic stoke management

Answer 24

- Aspirin 300mg - Thrombolysis (within 4.5 hrs) - Thromobectomy (within 6 hrs or 24 hrs)

Question 25

What autoimmune disease may cause bilateral facial nerve palsy and bilateral parotid gland enlargement?

Answer 25

Sarcoidosis

Question 26

Foul smelling discharge from ear can indicate what?

Answer 26

Cholsteatoma

Question 27

What subtype of GBS has descending wekaness, areflexia, opthalmoplegia and ataxia?

Answer 27

Miller-Fisher syndrome

Question 28

A subdural and epidural bleed may require what surgery?

Answer 28

Burr hole evacuation

Question 29

How is MG diagnosed?

Answer 29

Antibody screen

Question 30

Diplopia and vertical gaze palsy is a feature of what Parkinson's plus syndrome?

Answer 30

PSP

Question 31

Diabetes insipidus (cranial) may cause what visual disturbance?

Answer 31

Bitemporal hemianopia (lower)

Question 32

What drugs (or class of drugs) may help in rigidity in Parkinson's?

Answer 32

Antimuscarnics - Procyclidine

Question 33

What Parkinoson's drugs have the highest side-effect profile?

Answer 33

Dopamine agonists (e.g bromocriptine)

Question 34

Give an example of a MAO-B (Monoamine Oxidase-B) inhibitor - used in Parkinson's

Answer 34

Selegiline (inhibits breakdown of dopamine secreted by dopaminergic neurons)

Question 35

Give an example of COMT (Catechol-O-Methyl Transferase) inhibitors (enzyme involved in breakdown of dopamine) can be used as adjunct to levodopa?

Answer 35

Entacapone, Tolcapone

Question 36

Treatment of DCM?

Answer 36

Decompressive surgery

Question 37

MG treatments? (management + crisis) (5)

Answer 37

- Pyridostigmine (long-acting acetylcholin - Immunosuppression - ?Thymectomy Crisis: - Plasmapheresis - IVIG

Question 38

What nerve extends the wrist?

Answer 38

Radial

Question 39

What brainstem stroke affects CN V (ipsilateral)?

Answer 39

PICA

Question 40

What brainstem stroke affects CN VII VIII (ipsilateral)?

Answer 40

AICA - lateral pontine

Question 41

MOA of ondansetron

Answer 41

5-HT3 antagonist

Question 42

What diet is good for epilepsy

Answer 42

Ketogenic

Question 43

What antiemetic is contraindicated in long QT

Answer 43

Ondansetron

Question 44

Thickened skin (shagreen patches are a feature of what neurocutaneous disorder)

Answer 44

Tuberous sclerosis

Question 45

A surgical neck of humerus fracture is likely to cause a lesion in wjat nerve?

Answer 45

Axillary

Question 46

What brainstem stroke can cause an ipsilateral Horner's ?

Answer 46

PICA

Question 47

Withdrawing from pain indicates an M of what on GCS?

Answer 47

4

Question 48

Hand above clavicle indicates an M of what on GCS?

Answer 48

5

Question 49

Intubate at what GCS?

Answer 49

8

Question 50

Blood resuts show what on Neuroleptic Malignant Syndrome

Answer 50

- Increased WCC (also pyrexia) - Increased CK

Question 51

A positive Rombergs indicates an issue where?

Answer 51

Dorsal columns

Question 52

Immediate management of pituitary apoplexy

Answer 52

IV Hydrocortisone

Question 53

What is the timings for stopping anti-epileptics

Answer 53

- Seizure free for > 2 years - AEDs being stopped over 2-3 months

Question 54

Adenoma sebaceum is a feature of what neurocutaneous disorder?

Answer 54

Tuberous Sclerosis

Question 55

What response may be preserved in an optice nerve lesion?

Answer 55

Consensual response

Question 56

A total vs a partial anterior circulation infarct can be decided based on the patient have either 2 or 3 symptoms. What are these 3 symptoms?

Answer 56

1 Unilateral hemiparesis and/or hemisensory loss of face/arm/leg 2. Homonymous hemianopia 3. Higher cognitive dysfunction (e.g. dysphagia)

Question 57

What is L'hermitte sign?

Answer 57

Electrical shock sensation on flexion of neck - Seen in MS, DCM, cervical spondy

Question 58

McArdles sign is what?

Answer 58

Impaired gait and muscle weakness with neck flexion - Seen in MS

Question 59

What muscles are spared in MND?

Answer 59

Ocular

Question 60

What is the most common form of hereditary peripheral neuropathy?

Answer 60

CMT

Question 61

What is the predominant management of CMT?

Answer 61

PT and OT

Question 62

What nerve has sensation of palmar aspect of thumb?

Answer 62

Median

Question 63

Axillary freckles are a feature of what neurocutaneous disorder?

Answer 63

NF1

Question 63

What nerve root is affected: - Finger abduction weakness - Medial aspect of elbow numb

Answer 63

T1

Question 64

The adductor pollicis (thumb adduction) is controled by what nerve?

Answer 64

Ulnar

Question 65

Is ICP headache worse when lying flat or upright?

Answer 65

Lying flat worse - Also remember it worsens with Valsalva

Question 66

What index measures Disability post-stroke?

Answer 66

Barthel index

Question 67

Paroxysmal Hemicrania (unilateral headache occuring multiple times a day) is treated with what?

Answer 67

Indomethacin

Question 68

Name a commonly prescribed mab for MS?

Answer 68

Natalizumab

Question 69

Name a commonly prescribed drug for ALS?

Answer 69

Riluzole

Question 70

Types of MND

Answer 70

- ALS (LMN signs in arms, UMN in legs) - Primary Lateral sclerosis (UMN signs only) - Progressive muscular atrophy (LMN signs) - Progressive Bulbar palsy (tongue, chewing, swallow)

Question 71

What type of MND has the best prognosis?

Answer 71

Progressive Muscular Atrophy

Question 72

What type of MND has the worst prognosis?

Answer 72

Progressive Bulbar palsy

Question 73

What anti-epeliptic causes bleeding gums and lymphadenopathy?

Answer 73

Phenytoin

Question 74

Topiramate causes what in a child (teratogenic effect)

Answer 74

Cleft lip and palate

Question 75

How is stroke assessed in ED (scoring system)

Answer 75

ROSIER

Question 76

Syringomelia has what 2 main signs?

Answer 76

- Loss of pain and temp sensation in cape-like distribution - Wasting of small hand muscles

Question 77

What drug is prescribed to prevent vasospasm in SAH?

Answer 77

Nimodipine

Question 78

What is the condition similar and often associated with syringomyelia but in the medulla and affecting the face and tongue / swallowning?

Answer 78

Syringobulbia