neurology

Question 1

rapid onset severe unilateral headache
blood shot eyes
facial flushing

Answer 1

cluster headache

Question 2

management of cluster headache

Answer 2

acute - sumatriptan
prophylaxis - verapamil

Question 3

tight band around head
bilateral headache
non throbbing

Answer 3

tension headache

Question 4

management of tension headache

Answer 4

analgesia
hot towel to local area

Question 5

prolonged headache
nausea
decreased ability to function
sensitivity to light
aura - visual changes

Answer 5

migraine

Question 6

management of migraine

Answer 6

NSAIDs
hydration
triptans

prophylaxis - propranolol, topiramate

Question 7

can girls with migraine be given OCP

Answer 7

no

Question 8

severe sudden onset thunderclap headache
decreased consciousness
vomiting
seizures

Answer 8

subarachnoid haemorrhage

Question 9

investigations for subarachnoid haemorrhage

Answer 9

non contrast CT - star shaped lesion
lumbar puncture

Question 10

trauma
headache
diminished eye response
confusion
LOC
personality change

Answer 10

subdural haematoma

Question 11

investigation for subdural haematoma

Answer 11

non contrast CT - crosses suture lines, crescentic shape

Question 12

head trauma
LOC but improves slowly
headache
lucid interval
comiting
bilateral limb weakness

Answer 12

extradural haemorrhage

Question 13

investigation for extradural haemorrhage

Answer 13

non contrast CT - biconvex

Question 14

facial pain, intense sharp unilateral
pain made worse by brushing teeth, eating cold and touch

Answer 14

trigeminal neuralgia

Question 15

investigation for trigeminal neuralgia

Answer 15

clinical

Question 16

management of trigeminal neuralgia

Answer 16

carbamezipine

Question 17

differentials for parkinsons

Answer 17

parkinsons
drug induced parkinsons
lewy body dementia

Question 18

if someone has reduced sensation and nerve problems what investigation can you do

Answer 18

nerve conduction studies

Question 19

MND upper motor neuron

Answer 19

increased tone
hyper-reflexia
upward plantar
slowed movement
weak extensors in arm

Question 20

MND lower motor neuron

Answer 20

muscle wasting
weakness
fasciculation
absent tendon reflex

Question 21

management of MND

Answer 21

riluzole

Question 22

women
loss of vision in one eye
sensory defects in limb, increase muscle tone
ataxia
nystagmus

Answer 22

multiple sclerosis

Question 23

investigation for multiple sclerosis

Answer 23

MRI
CSF - oligoclonal bands

Question 24

management of multiple sclerosis

Answer 24

acute - methylprednisolone
symptomatic:
physio
baclofen
gabapentin, amitriptyline

B- interferon (disease modifying)

Question 25

unilateral onset bradykinesia - slow movements resting tremor rigidity postural instability shuffling gait constipation

Answer 25

parkinsons

Question 26

investigation for parkinsons

Answer 26

clinical diagnosis

Question 27

management of parkinsons

Answer 27

levodopa

Question 28

symmetrical descending flaccid paralysis blurred vision diplopia

Answer 28

botulism - give antidote

Question 29

proximal muscle weakness gets better with movement, diplopia, ptosis, dry mouth

Answer 29

lambert eaton myasthenic syndrome

Question 30

investigations for lambert eaton

Answer 30

nerve conduction studies chest CT - small cell lung cancer

Question 31

management of lambert eaton

Answer 31

amifampiridine immunosuppressants

Question 32

muscle fatigability worse with movement, improves with rest facial weakness

Answer 32

myasthenia gravis

Question 33

investigations for myasthenia gravis

Answer 33

serum AChR antibodies pulmonary function test CT chest - thymoma

Question 34

management of myasthenia gravis

Answer 34

pyridostigime immunosuppresion - prednisolone thymectomy

Question 35

abrupt onset unilateral complete facial weakness sagging of mouth drooping

Answer 35

bells palsy

Question 36

management of bells palsy

Answer 36

within 72 hours - prednisolone protect eyes use tape at night

Question 37

infection prior symmetrical ascending weakness reduced reflexes facial weakness

Answer 37

guillain barre

Question 38

investigation for guillain barre

Answer 38

nerve conduction studies CSF LFT CRP

Question 39

what to give if prolonged seizure > 5 minutes

Answer 39

IV lorazepam rectal diazepam