Neurology

Question 1

Sudden unilateral weakness with facial drooping and slurred speech

Answer 1

Ischemic stroke

RF - (mostly like IHD), smoking, T2DM, hypertension, Atrial fibrillation, valvular disease, carotid stenosis, intracranial stenosis

Question 2

Occipital thunderclap headache, neck stiffness, photophobia

Answer 2

Subarachnoid haemorrhage

RF - ADPKD, hypertension, smoking, family history

Question 3

Patient has fluctuating consciousness, symptoms gradually worsen

Answer 3

Subdural haemorrhage

Can be caused by car crash, violent attack, (deceleration injuries, abused children- shaken baby syndrome)

Higher risk in elderlies and alcoholics

Question 4

Patient gets better from unilateral weakness then rapidly deteriorates

Answer 4

Epidural haemorrhage

(Head trauma)

Question 5

Pain with eye movement and blurry vision, altered sensation - burning/pins and needles, weakness

Answer 5

Multiple sclerosis

Question 6

Bilateral symmetrical ascending weakness

Answer 6

Guillain barre syndrome
- Precedes infection

(Campylobacter jejunui, possible EBV, cytomegalovirus)

Question 7

Fluctuating weakness that is worse on exertion and at the end of the day

Answer 7

myasthenia gravis

• ptosis, diplopia, speech fatigue

Question 8

Proximal muscle weakness that improves with use

Answer 8

Lambert-eaton syndrome

(RF - Small cell lung cancer)

• dry mouth

Question 9

Progressively worsening weakness that starts in hands and feet, experiences fasciculation and hypertonia

Answer 9

MND/ALS

• Most likely has family history

Question 10

Muscle weakness in distal muscles with muscle atrophy and foot drop

Answer 10

Charcot-marie tooth disease

Question 11

Unilateral throbbing headache, n+v, photophobia

Answer 11

MIgraine

CHOCOLATES

Question 12

Bilateral constricting headache of mild to moderate intensity

Answer 12

Tension headache

• Skipping meals
• Dehydration

Question 13

Severe unilateral pain around the eye, red eye, tearing

Answer 13

Cluster headache

• Strong smells
• Alcohol

Question 14

Sudden sharp facial pain with brushing teeth, shaving, chewing

Answer 14

Trigeminal neuralgia

• associated with multiple sclerosis

Question 15

Unilateral electric pain from buttock radiating down leg, motor weakness and numbness

Answer 15

Sciatica

Question 16

Bilateral sciatica, numbness on sitting down, incontinence of bladder and bowel

Answer 16

Cauda equina

(Spinal surgery, spinal trauma, lumbar disc herniation)

Question 17

Loss of motor control and proprioception ipsilaterally, loss of temperature and pain sensation contralaterally

Answer 17

Brown sequard syndrome

Question 18

Personality change, uncontrollable limb jerking, memory impairment

Answer 18

Huntington’s disease

Question 19

Gradual memory loss, confusion, inability to recognise people

Answer 19

Alzheimer’s disease

Question 20

Personality change, speech difficulties

Answer 20

Frontotemporal dementia

• Family history of MND

Question 21

Visual hallucinations, parkinsonism

Answer 21

Lewy-body dementia

Question 22

Cognitive decline (e.g. memory loss) with previous history of stroke/vascular issues

Answer 22

Vascular dementia

RF - old, obese, hypertension, smoking

Question 23

Neck stiffness, fever, photophobia, headache

Answer 23

Meningitis

Question 24

Resting tremor, rigidity, makes smaller movements, shuffling gait

Answer 24

Parkinson’s disease

Question 25

Upper extremity weakness - brushing teeth, dressing Muscle spasms, shortness of breath

Answer 25

Amyotrophic lateral sclerosis UEW - can be both UMN and LMN Muscle spasm - LMN

Question 26

Coughing and choking on liquids and eventually foods. Difficult to arise from chairs.

Answer 26

Amyotrophic lateral sclerosis Coughing and choking - both UMN and LMN LMN - proximal muscle weakness