Neurology

Question 1

What tracts are affected in subacute degeneration of the spinal cord?

Answer 1

Dorsal Column and Lateral corticospinal tract

Question 2

Function of spinothalamic tract?

Answer 2

Transmits pain, temperature, and crude touch sensations

Question 3

Function of dorsal column?

Answer 3

Responsible for fine touch, proprioception, vibration, and pressure sensations

Question 4

Where does decussation occur in the spinothalamic tract?

Answer 4

Level of spinal cord entry within the anterior commissure

Question 5

Spinothalamic tract:
-A lesion will lead to loss of what and where?

Answer 5

Pain and temperature on the CONTRALATERAL side below the lesion

Question 6

Where does decussation occur in the dorsal column?

Answer 6

At the level of the medulla in the medial lemniscus

Question 7

A lesion in the dorsal column will result in what?

Answer 7

loss of fine touch, vibration, and proprioception on the ipsilateral side below the level of the lesion.

Question 8

Function of lateral corticospinal tract?

Answer 8

Controls voluntary motor function, particularly fine movements of the distal limbs

Question 9

Decussation lateral corticospinal tract?

Answer 9

pyramidal decussation at the medulla, the fibers cross to the contralateral side and form the lateral corticospinal tract.

Question 10

Lesions affecting the lateral corticospinal tract will result in?

Answer 10

contralateral motor weakness, particularly affecting fine motor skills and dexterity. Upper motor neuron signs (e.g., hyperreflexia, spasticity) are seen

Question 11

Functions of anterior corticospinal tract?

Answer 11

Controls voluntary motor function, particularly for trunk and proximal limb muscles

Question 12

where does decussation occur in anterior corticospinal tract?

Answer 12

In the spinal cord, fibers from the anterior corticospinal tract cross at the level of the spinal cord to synapse with lower motor neurons in the anterior horn.

Question 13

Lesions of the anterior corticospinal tract typically result

Answer 13

weakness and impaired movement of the trunk and proximal muscles on the contralateral side.

Question 14

Site of lesion in Wernicke and Korsakoff syndrome

Answer 14

Medial thalamus and mammillary bodies of the hypothalamus

Question 15

site of lesion in Hemiballism

Answer 15

Subthalamic nucleus of the basal ganglia

Question 16

Site of lesion in Huntington chorea

Answer 16

Striatum (caudate nucleus) of the basal ganglia

Question 17

Site of lesion in Parkinsons disease?

Answer 17

Substantia nigra of the basal ganglia

Question 18

Site of lesion in Kluver-Bucy syndrome (hypersexuality, hyperorality, hyperphagia, visual agnosia

Answer 18

Amygdala

Question 19

Why does Bells Palsy cause hyperacusis?

Answer 19

facial nerve innervates the stapedius muscle (which affects how loud conduction of sound from the tympanic membrane to the cochlea

Question 20

Triad of Miller Fisher syndrome?

Answer 20

Ataxia
Ophthalmoplegia
Areflexia

Question 21

Type of dysphasia:
speech non-fluent, comprehension normal, repetition impaired

Answer 21

Brocas

Question 22

Brocas aphasia area of brain affected?

Answer 22

inferior frontal gyrus in the dominant hemisphere (which is usually on the left side for right-handed individuals).

Question 23

Mechanism of action of Riluzole for motor neuron disease?

Answer 23

Inhibits glutamate release; modestly extends survival.

Question 24

Does Amyotrophic lateral sclerosis (ALS) result in UMN or LMN signs?

Answer 24

Both UMN and LMN

Question 25

Does Progressive muscular atrophy (PMA) result in UMN or LMN signs?

Answer 25

LMN only

Question 26

Does Primary lateral sclerosis (PLS): result in UMN or LMN signs?

Answer 26

UMN signs only

Question 27

Internuclear ophthalmoplegia is caused by pathology in what part of the brain?

Answer 27

The medial longitudinal fasciculus is located in the paramedian area of the midbrain and pons

Question 28

Cranial nerve lesion ? results in down and out eye and Ptosis?

Answer 28

Third nerve Palsy

Question 29

speech fluent, but repetition poor. Comprehension is relatively intact

Answer 29

Conduction dysphasia -Arcuate fasciculus affected

Question 30

non-fluent, laboured and halting speech

Answer 30

Brocas Aphasia -Inferior frontal gyrus -Superior division of left MCA

Question 31

neologisms and nonsense sentences which is fluent

Answer 31

Wernicke's aphasia -Lesion in superior temporal gyrus -Supplied by inferior division of left MCA

Question 32

First line management of trigeminal neuralgia?

Answer 32

Carbamazepine

Question 33

Alternative differential to cauda equina syndrome. However, associated with a combination of upper and lower motor neuron signs + hyperreflexia

Answer 33

Conus Medullaris Syndrome

Question 34

A 65-year-old woman presented with a 12-hour history of sudden-onset gait unsteadiness, vomiting and headache, followed by increasing drowsiness. What is the most likely diagnosis?

Answer 34

Acute cerebellar haemorrhage

Question 35

Dilated pupil + Sluggish light reflex + Slow accommodation

Answer 35

Homes-Aide Pupil

Question 36

Brown-Séquard Syndrome Location of symptoms: -Damage to corticospinal tract? -Dorsal column? -Spinothalamic?

Answer 36

-Ipsilateral -Ipsilateral -Contralateral

Question 37

1st line Tx for moderate to severe restless leg syndrome?

Answer 37

Ropinierole, Pramipexole, rotigotine (Dopamine agonists)

Question 38

CSF Results Viral Meningitis -Opening pressure -Glucose -Fluid -Protein -WCC

Answer 38

-Normal -60/80% plasma glucose -Clear -Normal/raised -Lymphocytosis

Question 39

Bacterial Meningitis CSF results -Appearance -Glucose -Protein -WCC

Answer 39

-Cloudy -Low (Half plasma levels) -High > 1 g/l -Markedly raised polymorphic

Question 40

Cavernous sinus thrombosis -What cranial nerves would be affected?

Answer 40

-Cranial nerve 3 (Oculomotor) -> painless diplopia -Cranial Nerve 4 (Trochlea) -> Ptosis -Trigeminal V1 and V2 branches only