Neurology

Question 1

Name some features of parietal lobe lesions

Answer 1

sensory inattention
apraxias
astereognosis (tactile agnosia)
inferior homonymous quadrantanopia
Gerstmann’s syndrome (lesion of dominant parietal): alexia, acalculia, finger agnosia and right-left disorientation

Question 2

Name some features of occipital lobe lesions

Answer 2

homonymous hemianopia (with macula sparing)
cortical blindness
visual agnosia

Question 3

Name some features of temporal lobe lesions

Answer 3

Wernicke’s aphasia: this area ‘forms’ the speech before ‘sending it’ to Brocas area. Lesions result in word substituion, neologisms but speech remains fluent
superior homonymous quadrantanopia
auditory agnosia
prosopagnosia (difficulty recognising faces)

Question 4

Name some features of frontal lobe lesions

Answer 4

expressive (Broca’s) aphasia: located on the posterior aspect of the frontal lobe, in the inferior frontal gyrus. Speech is non-fluent, laboured, and halting
disinhibition
perseveration
anosmia
inability to generate a list

Question 5

What is Friederich’s ataxia caused by?

Answer 5

Friedreich’s ataxia is the most common of the early-onset hereditary ataxias. It is an autosomal recessive, trinucleotide repeat disorder characterised by a GAA repeat in the X25 gene on chromosome 9 (frataxin).

Question 6

Name some neurological features of FA

Answer 6

absent ankle jerks/extensor plantars
cerebellar ataxia
optic atrophy
spinocerebellar tract degeneration

Question 7

Name some other features of FA

Answer 7

hypertrophic obstructive cardiomyopathy (90%, most common cause of death)
diabetes mellitus (10-20%)
high-arched palate

Question 8

Name some features of Horner’s syndrome

Answer 8

Miosis
Anhidrosis
Ptosis
Enophthalmos

Question 9

Name some central causes of Horner’s

Answer 9

MS
Syringomyelia
Stroke
Encephalitis
Tumour

Question 10

Name some preganglionic causes of Horner’s

Answer 10

Pancoast’s tumour
Thyroidectomy
Trauma
Cervical rib

Question 11

Name some postganglionic causes of Horner’s

Answer 11

Carotid artery dissection
Carotid aneurysm
Cavernous sinus thrombosis
Cluster headache

Question 12

What is Froin’s syndrome?

Answer 12

describes an increase in CSF protein below a spinal canal blockage (e.g. tumour, disc, infection)

Question 13

How many days after acute stroke should anticoagulation be commenced?

Answer 13

14 days

Question 14

Name some features of CJD

Answer 14

dementia (rapid onset)
myoclonus