Neurology Flashcards
1
Q
Tingling sensation + Poor balance + Impaired Propriopception + Brisk knee reflexes.
+ Vit B12 deficiency + Nitric oxide
A
Subacute Combined Degenaration of spinal cord.
Affected : Dorsal column + Lateral CST.
2
Q
Dorsal coloumn lesion :
A
B/L Loss of propriopcetion & Joint poisition.
Sensory loss which commonly affects lower limbs.
3
Q
B/L Loss of propriopcetion & Joint poisition.
Sensory loss which commonly affects lower limbs. Lesion ?
A
Dorsal coloumn lesion
4
Q
Lateral CST lesion:
A
B/l Spastic Paraesis.
Brisk Knee reflexes.
5
Q
Stressful event + Anterograde amnesia ( lasting for 3-4 Hours)+ anxious pt repeating same questions.+ Relieves in 24 hrs
A
Transient Global Amnesia.
6
Q
Differentiating feature b/w Tranient Global Amnesia and Epilpesy.?
A
Epilepsy lasts for Less than One hour.
TGA duration is 3-4 hours.
7
Q
Rx of Transient Global Amnesia :
A
Reassurance.
8
Q
Asteognosis :
A
Inability to identify simple objects by touch when eye are closed.
9
Q
Inability to identify simple objects by touch when eye are closed.
A
Asteognosis
10
Q
B/L Asteognosis Dx:
A
Dominant Parietal Lesion.
11
Q
In Bell’s palsy , does forehead get affected ?
A
Entire one half of face ( forehead included ) is affected.
While lowering the bell entire face on one side gets hit.
12
Q
Bells palsy , does it affect motor or sensory part of facial nerve?
A
Only motor part of facial nerve gets affected.
13
Q
Is hyperacusis a feature of Bell’s palsy ?
A
Yes.
14
Q
In UMN facial palsy, forehead gets affected ?
A
Forehead is spared in UMN Facial palsy.
15
Q
Miller Fisher syndrome, Descending or Ascending paralysis ?
A
Descending paralysis.
16
Q
H/o Diarrhoe/Food Poisoning/Campylobacter jejuni+ Anti GQ1B—opthalmoplegia+Ataxia+Areflexia
A
Miller Fischer Syndrome.
17
Q
Miller Fischer Syndrome antibodies ?
A
Anti GQ1B
18
Q
Miller Fischer Syndrome bacteria ?
A
/Campylobacter jejuni
19
Q
Miller Fischer Syndrome clinical feature ?
A
Ataxia+ opthalmoplegia+ Areflexia+ Descending paralysis .
20
Q
Confabulation is a feature of ?
A
Korsakoff
21
Q
Ipsilateral Loss of Pain & Temp of Face + C/L Loss of pain & Temp of arm + Dysphagia+Dysarthria+Nystagmus & Ataxia:
A
Wallenberg / Lateral Medullary Syndrome.
22
Q
Wallenberg / Lateral Medullary Syndrome/PICA:
A
Ipsilateral Loss of Pain & Temp of Face + C/L Loss of pain & Temp of arm + Nystagmus & Ataxia.+ dysarthria
23
Q
AICA & PICA differentiating features:
A
AICA: Facial par
lysis + Deafness + PICA features.
In PICA : only Ipsilateral Loss of Pain & Temp of Face
24
Q
Gingival hyperplasia cause?
A
CCB
25
CCB adverse ?
Gingival Hyperplasia.
26
Common early symptom of multiple sclerosis:
Lethargy.
27
Lethargy + Visual Disturbances—unable to see red colour + symptom resolved spontaneously.
Multiple Sclerosis.
28
Breastfeeding is safe in which Anti epileptic drugs ?
All Anti epileptic drugs.
29
Which anti epileptic drug causes heamorrhagic disease of the newborn?
Phenytoin.
30
SAH + CT done within 6 hours = Normal. Next step ?
Do not do LP. Consider alternative Diagnosis.
31
SAH+ CT done after 6 hours= Normal. Next step ?
Do LP , after 12 hours of onset of headache.
32
SAH Headache onset 8 hours before. CT = Normal. Next step?
Do LP after 12 hours. Ie : after ( 8 + 4) hours.
33
Deafness(SNHL)+Vertigo +Tinnitus—+Aural fullness.
Minere’s disease.
34
Minere’s :
DVT + aural fullness.
Deafness(SNHL) + Vertigo + Tinnitus .
35
Myasthenic Crisis Rx:
Plasmapheresis or IV immunoglobulins.
36
Myasthenic Crisis features :
K/c/o Myasthenia Gravis + Dyspnoea + Cyanosis.
37
Seizure + Lip smacking + post-ictal dysphasia. Affected lesion?
Temporal lobe.
38
Unable to remember what happened during the seizure. Dx ?
Focal awareness impaired seizure.
39
Parkinson’s + Motor symptoms. Rx?
Levadopa.
40
stopping of anti-epileptic drugs
Seizure free for 2 years + with AED being stopped for 2-3 months.
41
Internuclear ophthalmoplegia is due to a lesion in :
If left eye adduction problem:
Medial Longitudinal Fasciculus( Paramedian area of Midbrain and pons)
Left MLF lesion.
42
Internuclear Opthalmoplegia, mnemonic :
INO
( Ipsilateral Adduction, Nystagmus opposite )
43
Stroke—arms affected + Homonymous Hemianopia:
MCA artery affected.
44
Motor neuron disease - which treatment is better NIV or Riluzole?
Non invasive ventilation.
45
Is Lisch Nodules a feature of Tuberous sclerosis ?
No.
46
Is Retinal Hamartomas a feature of Tuberous Sclerosis ?
Yes.( Hammer in the ground)
47
Is Renal angiomyolipomata a feature of Tuberous Sclerosis ?
Yes. ( Red wire around waist)
48
is Ash leaf spots a feature of Tuberous sclerosis ?
Yes ( ash of green cigar on ground)
49
Antibodies in Neuromyelitis Optica ?
NMO-igG.
50
Post hepatic Neuralgia Rx first line :
Amitryptilin.
Duloetine.
Gabapentin.
51
Post hepatic Neuralgia Rx Second line:
Tramadol.
51
RT Arm exaggerated flinging motion. Dx and Site of lesion:
Hemibalismus.
Site: Left sub thalamic nucleus of Basal Ganglia.
52
Wake up stroke + Confirmed confirmed occlusion of the proximal anterior circulation (anterior cerebral artery or middle cerebral artery). Rx?
Mechanical clot removal.
53
Auditory agnosia feature of which lobe ?
Temporal lobe lesions
54
Temporal lobe lesion Mnemonic ?
PAWS
P-prosopagnosia-difficulty recognising face.
A-Auditory agnosia
W-wernickes aphasia
S-Superior homonymous quadrantonopia.
55
Auditory agnosia:
Impairment in sound perception, despite intact hearing, cognitive function.
56
Ipsilateral weakness + Ipsilateral loss f propiopception + C/l loss of pain & temp. Dx?
Brown Sequard syndrome.
57
Restless leg syndrome. Rx?
Ropinirole ( dopamine agonist)
58
Shwartz sign in otosclerosis?
Redness of the promontory of cochlea.
59
B/L Conductive hearing loss + Tinnitus + Family history + Schwartz sign :
Otosclerosis.
60
most common complication following meningitis
SNHL.
61
gram-negative diplococci That causes meningitis ?
Neisseria Meningitis.
62
Autonomic symptoms common in GBS:
Tachycardia.
Urinary Retention.
63
Type of paralysis in GBS:
LMN weakness: Flaccid paralysis+ Decreased Reflexes.
64
loss of sensation in both of her arms and forearms, and on the back of her neck + can't feel pain and temperature + Chiari 1 malformation
Syringomyelia.
65
Painful third nerve palsy( eye deviated down and out ) :
Posterior communicating artery aneurysm.
66
Posterior communicating artery aneurysm.
Painful third nerve palsy( eye deviated down and out ) :
67
Narcolepsy is associated with
low orexin
68
strong emotions such as fear or laughter+ collapse on the spot and immediately lose consciousness + sudden unavoidable urges to sleep
Narcolepsy
69
Relapsing Remitting symptoms is a feature of :
Multiple Sclerosis.
70
Anti-NMDA receptor encephalitis:
Psychiatric features + Ovarian Teratoma.
71
first-line for spasticity in multiple sclerosis:
Baclofen and gabapentin.
72
Hypodense collection around the convexity of the brain:
Subdural Hematoma.
73
B/L spastic paraparaesis + B/L loss of pain and temp:
Anterior Spinal Artery Occlusion.
74
Anterior Spinal Artery Occlusion
B/L spastic paraparaesis (cst)+ B/L loss of pain and temp(spinothalamic):
75
Raised ICP Ass with which eye problem?
Raised ICP features?
Raised IcP: head ache worse in morning and leaning forward.
Third nerve palsy (occuomotor)
Eye deviation: down and out.
76
DVLA advice post multiple TIAs
cannot drive for 3 months
(TIA-3 letters-3 Months)
77
DVLA advice post one episode of stroke ?
Can’t drive for one Month.
78
DVLA advice post first unprovoked or isolated seizure ?
Can’t drive for 6 Months.
Seizures =six-zures
79
Parkinson’s features + O/E: problem in vertical gaze :
Progressive supranuclear palsy.
80
Does GBS have sensory problems, loss of joint sense, temperature, fine touch?
NO.
GBS predominantly has motor problems.
81
K/c/o CKD+ Loss of sensation B/L, loss of of joint sense+ fine touch. Dx?
Uraemic Polyneuropathy.
82
Dx of MS:
MRI flair : To identify Demyelinating lesions.
83
trinucleotide in Huntington's
CAG
( Hunt or be caged)
84
Family History + Recent aggressive behaviour+ Depression + Chorea:
Hungtintons chorea.
85
Facial palsy + spares forehead. Dx: stroke or Bell’s palsy ?
Stroke.
Spares forehead: UMN lesion: Stroke.
Involves Forehead : LMN: Bell’s Palsy.
86
Ataxic telangiectasia Gene ?
ATM gene.
87
Cerebellar Ataxia + Telangiectasia + IGA deficiency = Recurrent infection. Dx?
Ataxia telangiectasia.
88
Tried to climb a tree when he was drunk but fell, hitting a few branches on the way down+ fingers of the left hand are flexed into a claw position. There is a loss of sensation along the ulnar aspect of the whole hand and arm.
Klumpkey’s Paralysis.
89
Medication overuse headache: for analgesia and Opioids :
simple analgesia + triptans: stop abruptly
opioid analgesia: withdraw gradually
90
loss of temperature and pain sensation on the medial aspect of both hands and elbows. Proprioception and vibration sensation are preserved.Dx?
Syrinomyelia.
91
Multiple sclerosis patient with bladder dysfunction
Ultrasound to assess bladder emptying.
92
Absent Ankle Reflex.UMN or LMN ?
LMN lesion.
93
Extensor plantar is UMN or LMN ?
UMN lesion.
94
Extensor plantar+Absent ankle reflex + sensation intact. Dx?
UMN lesion +. LMN lesion + sensation intact= ALS.
95
Stevens-Johnson syndrome
Adverse of which anti epileptics?
Lamotrigine.
96
Klumpke's paralysis, which nerve root damage ?
T1 nerve root damage.
97
Focal seizures, Rx?
Lamotrigine or Levetiracetam
98
Gingival hyperplasia ass with which leukemia ?
AML.
99
Distal weakness + red reflex in eyes + glycosuria :
Myotonic Dystrophy.
100
Anti-epileptic drugs is most likely to cause visual field defects?
Vigabatrin
101
sumatriptan: 5HT?
5HT 1 agonist.
No. 1 organ is Brain.
Agonist when you are in agony.
102
trigger for cluster headaches
Alcohol.
(Alcohol-relieving factor in essential tremors)
103
Neurofibromatosis type 1 Which chromosome ?
Chromosome 17.
104
Apomorphine acts on which receptor ?
Dopamine receptor agonist.
105
acute angle closure glaucoma, which anti epileptic ?
Topiramate.
106
Autosomal Dominant+ K/c/o Migraine with Auras + Low Mood + Stroke like symptoms + cognitive impairment + MRI= Multiple cerebral infarcts + Notch 3 gene mutation.
CADASIL.
107
Mutation in CADASIL :
NOTCH 3 gene.
108
MRI findings in CADASIL :
Multiple Cerebral Infarctions.
109
Migraine with aura+ Recurrent TIAs or stroke. Dx?
CADASIL.
110
Wernicke's encephalopathy
Confusion, gait ataxia, nystagmus + ophthalmoplegia
111
Confusion, gait ataxia, nystagmus + ophthalmoplegia
Wernicke's encephalopathy
112
5 year old + Ataxia + Recurrent chest infection :
Ataxia telangiectasia.
113
Age group affected in Ataxia Telangiectasia :
0-5 year old.
114
Age group affected in friericks ataxia :
10-14 year old.
115
Which anti epileptic causes cerebellar syndrome ? ( ataxia, nystagmus, slurred speech )?
Phenytoin.
116
Bilateral vestibular schwannomas+
Multiple intracranial schwannomas. Dx and chromosome ?
NF2 and chromosome 22.
117
mnemonic for peripheral neuropathy :
I am very numbed.
Isoniazid
Amiodarone.
Metronidazole.
Vincristine.
Nitrofurantoin.
118
Mnemonic for shy dagger/ Multi system Atrophy :
Wet wobbly wacky grandpa:
Parkinson’s + ED+Postural Hypotension+Urinary incontinence + *****Cerebellar sign( Ataxia)******
119
Drugs most useful in the management of tremor for Parkinson’s ?
Benzhexol ( trihexyphenidyl.)
119
Downbeat nystagmus is seen in :
Arnold chiari malformation.
Cerebellar tonsils LOWERING itself in brainstem—DOWNBEAT nystagmus.
120
Renal angiomyolipoma ass with which Neurocutaneous Condition?
Tuberous Sclerosis.
121
Myotonic dystrophy ECG feature:
Prolonged PR interval.
122
Which one of the following factors indicates a poor prognosis in patients with multiple sclerosis?
Male sex?
123
Miosis or Mydriasis in Holmes adie’s pupils ?
Mydriasis ( Huge pupil in Holmes adie’s pupils, Hesitant reaction to light( sluggish reaction )
124
no history of a diarrhoeal illness, good or bad prognosis in GBS ?
Good prognosis.
125
Is Wilson’s ass with Parkinson’s?
Yes.
126
Is dementia pugilistica Ass with Parkinson’s ?
Yes.
127
Is lead poisoning ass with Parkinson’s ?
No.
128
Notable feature in Creutzfeldt-Jakob disease Which differentiates it from others ?
Notable Jerk ( MYOCLONUS) + Rapid onset Dementia.
129
Creutzfeldt-Jakob disease MRI sign :
Hockey Stick Sign.
130
MS causes UMN or LMN ?
UMN only.
131
Age group of Motor neuron disease :
50-70 years.
132
ondansetron 5H ?
5HT3 antagonist.
Ondans(three)on
133
IV phenytoin S/E :
Hypotension.
134
Patient Started on carbamazepine— they may see a return of seizures after 3-4 weeks of treatment d/t:
D/t Autoinduction.
135
preferred way to support nutrition in patents with motor neuron disease
Percutaneous gastrostomy tube (PEG)
136
Natalizumab can cause reactivation of which Virus ? And leading to ?
JC virus.
Progressive multifocal leukoencephalopathy (PML).
137
Subarachnoid haemorrhage: if rebleeding is suspected (e.g. sudden worsening of neurological symptoms) →
Repeat CT.
138
Which neuropathic pain med to avoid in Open angle Glaucoma?
Amitryptiline.
139
speech non-fluent, comprehension normal, repetition impaired
Broca’s aphasia. ( Broken speech)
Inferior frontal gyrus-
140
seizures in the morning/following sleep deprivation—H/o Sleepover:
Juvenile Myoclonic Seizures.
141
Antiemetic causing prolonged QT interval and increased risk of polymorphic VT
Ondansetron.
142
Ondansetron cardiac S/E:
Antiemetic causing prolonged QT interval and increased risk of polymorphic VT
143
telangiectasias of the eyes Present as:
Bloodshot eyes.
144
Ataxia + Recurrent chest infection + Blood shot eyes.Dx:
Ataxia Telangiectasia.
145
idiopathic intracranial hypertension. Rx?
Acetazolamide.
146
Worsening Headache+ Intermittent loss of vision+ Pulse synchronous tinnitus +B/L blurring of optic disc. Dx;
Idiopathic Intracranial Hypertension.
147
Ipsilateral numbness of face+ Ipsilateral Horners (ptosis, miosis, anhydrosis, ) + Dysphagia + Ataxia + Nystagmus :
PICA.
148
Drug given in subarachnoid haemorrhages
Nimodipine.
149
Hallucination+Agitation + Anti NMDA positive. Dx and Firs line IX?
Anti-NMDA receptor encephalitis.
First Ix: Pelvic Ultrasound.
150
small area of erythema with central blistering on his right elbow + sensation is reduced in the C5-6 dermatomes bilaterally
Syringomyelia.
151
13 years old girl + sudden jerks in arms + Zone out episodes in school:
Juvenile Myocclonic seizures.
152
Restless legs syndrome - the single most important blood test
serum ferritin.
153
common cause of restless legs syndrome (RLS) is :
Iron deficiency.
154
H/o sinusitis/ear infection—Fever + Headache + Vomitting + CT: Ring enhancing lesion. Dx:
Brain abscess.
155
contraindicated in absence seizures
Carbamazepine.
156
Progressive weakness of Arm+Shoulder+ Hip + Facial ms weakness ( Difficulties in closing eyes, smiling, blowing) + Abnormal in retinal arteries.Dx:
Facioscapulohumeral muscular dystrophy
157
Tibial nerve function and supply :
PIT : Plantar flexion, inversion.
Supply : Medial aspect of Foot.
158
Common peroneal nerve function :
Common penis nerve: Towards Dick : Dorsiflexion.
Supply to lateral part of foot.
159
Feature to Parkinson’s disease and helps differentiate it from other causes of Parkinsonism :
Assymetrical tremors.
160
Eye symptoms in Acoustic Neuroma :
Absent corneal reflex.D/t CN 5
161
Parkinson's disease - most common psychiatric problem is :
Depression
162
Chorea is caused by damage to T which part of brain?
basal ganglia, in particular the Caudate nucleus
163
severe headache+ pyrexia+ CT head = temporal lobe changes
Herpes simplex encephalitis
164
Epilepsy + pregnancy = ___ folic acid
5 MG.
165
Motor neuron disease medication RX?
Riluzole
166
common consequence of subarachnoid haemorrhage
SIADH.
167
Hyperintense T2 signal extending across the spinal cord, between the levels of T9 and T12.Dx?
Transere Myelitis.
168
Common cause of Transvere Myelitis ?
HIV
Varicella.
169
Blistering Rash +weakness of both legs + with upgoing plantars bilaterally, reflexes are brisk+ loss of fine touch sensation below the umbilicus.
Transverse Myelitis secondary to varicella.
170
Klumpke's paralysis features :
Wasting of the thenar and hypothenar eminence + claw hand + reduced sensation in ulnar distribution.
171
Pancoast tumour + Wasting of the thenar and hypothenar eminence + claw hand + reduced sensation in ulnar distribution.
Klumpke's paralysis.
172
Klumpke’s paralysis affects ulnar or radial distribution ?
Ulnar.
173
Recurrent falls at old age + Fluctuating consciousness. Which type of Haemorrhage ?
Sub Dural Haemorrhage.
174
sudden, brief (< 100 ms) and almost shock-like involuntary single jerks of his face and right upper limb. The movements are stimulus-sensitive and provoked by touching. Dx and Rx ?
Myoclonic Seizure.
Rx: Sodium Valproate.
175
Phaeochromocytoma, renal cell cancer → ?
Von Hippel-Lindau syndrome
176
Uraemic polyneuropathy is sensory or motor ?
Predominantly sensory loss
( Loss of sensation in lower limbs)
177
Acetazolamide MOA:
carbonic anhydrase inhibito
178
Drooling of saliva in people with Parkinson's disease.Rx?
Glycopyrronium Bromide
179
neck pain
wide-based, ataxic or spastic gait
upper motor neuron weakness in the lower legs - increased reflexes, increased tone and upgoing plantars
bladder dysfunction e.g. urgency, retention
Cervical spondylitic myelopathy
Rx: Cervival Decompression Surgery.
180
2nd line in Status epilepticus :
Life Saving Power drugs in Status:
Levetiracetam or Sodium Valproate Phenytoin or
181
Bell's palsy. Rx?
Oral Prednisolone within 72 hours of onset.
182
Clumsiness in walking + Foot Drop + Weakness + Sensory ( Numbness + tingling in foot. ) + Distal muscle wasting( Pes cavus + High arch foot) + High stepping gait :
Charcot marrie tooth disease.( Can’t move toes)
183
UMN or LMN in Charcot marrie Tooth ?
LMN
184
Acute onset U/L severe pain in shoulder—subsided—shoulder or scapular weakness for several days.s
Brachial neuritis.
185
Brachial neuritis.
Acute onset U/L severe pain in shoulder—subsided—shoulder or scapular weakness for several days.s
186
Small area of erythema in hand + cape like sensation loss in upper limbs + Spastic weakness in lower limbs + upgoing plantar :
Syringomyelia ( CST tract affected—UMN weakness below the lesion)
187
K/c/o Parkinson’s/scizophrenia + pyrexia
muscle rigidity
autonomic lability: typical features include hypertension, tachycardia and tachypnoea
agitated delirium with confusion
Neuroleptic Malignant syndrome.
Rx: Dantrolene.
188
Differentiating feature between Neuroleptic malignant syndrome and serotonin syndrome:
Myoclonus : only in serotonin.
189
ExtraDural haemorrhage which artery or veins are involved ?
Extradural = ExtraMural haemorrhage.
Middle meningeal artery involvement.
190
What kidney involvement in Tuberous sclerosis?
Renal angiomyolipomata.
191
Subarachnoid haemorrhage: if rebleeding is suspected:
Repeat CT
192
Does SLE caused raised protein in csf and facial nerve palsy?
No
193
Which type of motor neuron disease carries the worst prognosis?
Progressive bulbar palsy
194
otitis externa Rx :
Topical corticosteroid + aminoglycoside.
195
H/o Swim/Holiday—Itchy red ear+ Typanic membrane= Clear+
Otitis external.
196
Meds causing raised intracranial hypertension:
Steroid
Oc pills.
197
common peroneal neuropathy, what to avoid ?
Leg crossing, squatting or kneeling may cause a foot drop
198
Anti Hu antibodies
who kicked my chair (pain) and then fell over (ataxia)
Sensory neuropathy and ataxia
Small cell lung cancer.
199
antibodies are associated with painful sensory neuropathy in patients with small cell lung cancer?
Anti hu.
200
ovarian cancer. She presents due to 'unsteadiness'. On examination there is evidence of nystagmus and past-pointing. Which one of the following antibodies is most likely to be present?
Anti yo
Yo-varian cancer.
201
antibodies is associated with ocular opsoclonus-myoclonus in patients with breast cancer?
Anti Ri
202
degenerative cervical myelopathy (DCM)? Gold standard test ?
MRI Spine
203
Myasthenia gravis pathophysiology
antibodies against acetylcholine receptors
204
What scoring system can be used to quantify the disability in activities of daily living? In stroke patient
The Barthel index
205
Treatment of Ramsay Hunt syndrome Rx
oral aciclovir and corticosteroids
206
Fever flu + auricular pain is often the first feature
facial nerve palsy
vesicular rash around the ear
other features include vertigo and tinnitus
Ramsay Hunt syndrome
207
Baclofen MOA
agonist of GABA receptors
208
209
speech fluent, but repetition poor. Comprehension is relatively intact
Conduction dysphasia:
Arcuate fasciculus
210
speech fluent, comprehension abnormal, repetition impaired
Wernicke’s aphasia( Wulta-Pulta speech)
Broadman area 22 in superior temporal Gyrus.
211
first-line for spasticity in multiple sclerosis
Baclofen.
212
What cancer is most commonly associated with Von hippel Lindau syndrome?
Renal cell carcinoma.
213
Tumour suppressor gene in Von hippel lindau syndrome in which chromosome ?
Chromosome 3.( Tree behind Von Hippo)
214
How to differentiate MSA and Normal pressure hydrocephalus ?
presence of dementia and abscense of cerebellar signs points towards Normal pressure hydrocephalus.
215
Uhthoff 's phenomenon:
where neurological symptoms are exacerbated by increases in body temperature is typically associated with multiple sclerosis
216
generalised weakness. Examination of her face reveals bilateral ptosis, dysarthric speech and a slow-relaxing grip. What is the most likely diagnosis?
Myotonic dystrophy.
217
Slow relaxing grip , think :
Myotonic Dystrophy.
218
Prophylaxis of migraine in asthamatic migraine :
Non asthamatic migraine :
Topiramate in asthamatic
Propranolol in non asthamatic
219
Cluster headache - acute treatment:
subcutaneous sumatriptan + 100% O
220
Contralateral hemiparesis and sensory loss with the lower extremity being more affected than the upper.
Anterior cerebral artery
A= two slanting lines of legs look like legs.
221
Frontal lobe lesion :
DP + broca’s aphasia+ inability to generate a list + anosmia.
Disinhibition.
Perseveration.
222
Perseveration is caused by which lobe lesion ?
Parietal lobe lesion.
223
Tonic clinic seizure Rx:
Sodium Valproate.
(ST)
224
Progressive supra nuclear palsy—Vertical or horizontal gaze palsy ?
Vertical gaze palsy.
225
He described three episodes of sudden, forceful contraction of both arms and legs, each lasting one-to-two seconds with no loss of consciousness
Myoclonic seizure.
226
H/o Diarrhoe. Weakness that improves after exercise:
Lambert Eaton Syndrome.
227
Difference between Myasthenia and Lambert Eaton :
Lambert Eaton improves after exercise
Myasthenia worsens after exercise.
228
First line in status epilepticus
IV lorazepam
229
Facioscapulohumeral muscular dystrophy, which type of inheritance ?
Autosomal Dominant.
230
Old man+ Dysmetria+Ataxia+ Horizonal nystagmus. Dx:
Cerebellar Stroke.
231
Pyrodostigmine MOA:
Long acting acetylcholinesterase inhibitors.
232
Sudden painless loss of vision in Von hippel Lindau Syndrome is due to :
Retinal hemangioma.
233
post-dural puncture headache Rx:
Blood patch.
234
Which anaemia and due to what deficiency in Phenytoin ?
Macrocytic anaemia due to folate deficiency.
235
Quinine S/e :
B/L tinnitus.
236
Tinnitus is caused by which antimalarial ?
Quinine.
237
Why cocp is contraindicated in migraine ?
Increased risk of Ischaemic stroke.
238
Which meds help in preventing attacks of Minere’s ?
Betahistine.
239
Anti GAD antibodies :
Stiff man syndrome
240
K/C/O colorectal cancer + C/o stiffness. Which antibodies ?
Anti GAD
241
Neuropathic pain, which opioids?
Tramadol.
242
Vertigo lasting for days. Dx?
Vestibulat neuritis.
243
vertigo lasting for 30-60 mins. Dx?
Minere’s
244
Vertigo lasting for seconds.Dx?
BPPV.
245
Deafness type in Minere’s:
SNHL
246
Ondansetron acts on which part of the brain ?
Medulla oblangata.
247
Common precipitator of Myasthenic crisis :
Bisoprolol.
248
Which drug is used in treatment of Multiple sclerosis ?
B interferon.
249
Does Carbon Monoxide lead to chorea?
Yes.
250
Which rheumatoid condition leads to chorea ?
SLE.
251
Ataxia Telangiectasia Mode of inheritance ?
Autosomal recessive
Taxi= small auto
252
Parinaud syndrome occurs due to :
Dorsal Midbrain lesion.
253
MRI finding of Wernickes :
Enhancement of mammillary bodies
254
Known space occupying mass+ Ipsilateral optic atrophy + contralateral papiloedema =
Foster Kennedy syndrome.
Optic atrophy D/t direct damage from space occupying lesion.
255
Left sided optic atrophy + Rt eye papilloedema + known mass in brain. Dx: and location of mass ?
Foster Kennedy syndrome.
Mass in left frontal side.
256
EEG of Myoclonic seizures And focal:
brief bursts of poly-spike and wave discharge during ictal episodes.
abnormal discharges in one specific area.
257
Comprehension in brocas?
Normal.
258
Essential tremors.
Rx in asthamatic and non asthmatic
In non asthma : Propranolol.
In Asthmatic : Primodine.
259
Parkinson’s—develops tremors( Motor symptoms which does not affect day to day life):
Dopamine receptor agonist ( Ropinirole )
260
Lambert Eaton affects which antibodies :
voltage gated calcium channel antibodies.
261
bilateral vestibular schwannomas feature of which neurocutaneous disorder ?
Neurofibromatosis 2.
262
Absence seizures - ____ become seizure free in adolescence
90-95%
263
Lambert Eaton is ass with which cancer ?
Small cell lung cancer
264
B/L vitreous haemorrhage + ataxia. Dx?
Von hippel Lindau Syndrome
265
Is impotence a feature of Lambert Eaton ?
yes.
266
Is renal failure a feature of neuroleptic malignant syndrome ?
Yes
267
Is Multiple sclerosis UMN or LMN?
UMN type of weakness.
268
Patient with migraine + taking PCM—failed to relieve symptoms. Reasons ?
Patient with migraine experience delayed gastric emptying.
Therefore PPI is added.
269
Seizures + fibromata under nail + hypopigmentation patches. Dx?
Tuberous sclerosis.
270
Peripheral Neuropahty is a feature of which Anti epileptic drug ?
Phenytoin.
271
Cabergoline S/e:
Pulmonary fibrosis.
272
Guillain-Barre syndrome Conduction studies finding :
Reduced conduction velocities.
273
Pergolide S/E:
Pulmonary Fibrosis.
274
Which Parkinson’s S/E is pulmonary fibrosis :
Cabergoline.
Pergolide.
275
Ondansetron S/E:
Constipation
QTc prolongation.
276
Migraine in pregnancy Rx:
1st line: Paracetamol
2nd line: NSAID( Ibuprofen)
277
Is phonophobia a feature of Migraine ?
Yes.
278
Antiemetic with extrapyramidal S/E:
Metclopramide
279
Ear related S/E in facial nerve paralysis :
Hyperacusis.
280
Herpes simplex encephalitis
Rx: IV acyclovir + supportive treatment.
281
Small cell lung cancer+ B/L leg weakness + hyporeflexia+ Dry mouth + erectile Dysfunction: Dx:
Lambert Eaton
282
degenerative cervical myelopathy.RX:
Urgent referral to spine or neurosurgery.
283
Seizure affecting a peripheral body part such as a toe, finger or section of the lip and then spreads quickly 'marches' over the respective foot, hand or face—marches to tonic clonic
Jacksonian march.
284
Jacksonian march.
Seizure affecting a peripheral body part such as a toe, finger or section of the lip and then spreads quickly 'marches' over the respective foot, hand or face—marches to tonic clonic
285
Lumber Puncture headache pathology:
Leaking of cerebrospinal fluid from the dura.
286
Isolated alexia. Lesion ?
Corpus callosum.
287
Palatal Myoclonus is caused by lesion in which part of brain ?
Olivary nucleus.
288
Gerstmann syndrome
is a constellation of acalculia, right-left disorientation, finger agnosia and agraphia.
289
Gerstmann syndrome Lesion :
C/L parietal lobe.
290
Right handed man—Rt left disorientation+ acalculia+ finger agnosia+ agraphia. Dx and site of lesion:
Gerstmann syndrome.
Lesion= left parietal lobe lesion.
291
Which examination is specific to degenerative cervical myelopathy [DCM?
Positive Hoffman sign.
292
worsening bilateral upper limb paraesthesias and leg stiffness+ H/o back pain+ Lumbar spondylitis.Dx and Ix:
Dx: Degenerative cervical Myopathy.
Ix: MRI cervical spine.
293
Features uncommon in drug-induced parkinsonism:
Tremors and rigidity.
294
1st and 2nd line in generalised tonic clonic seizure:
1st: Sodium Valproate.
2nd: lamotrigine.
295
Migraine on PCM. No relief in symptoms, Next step?
Start 2nd line : Tristan’s.
296
Does sodium valproate cause tremors ?
Yes
297
B/L paraesthesia over radial side of arm. Dx
Degenerative cervical myelopathy.
298
Hearing loss in vestibular neuritis ?
No
299
first line and most appropriate Rx for GBS
first line: Plasma exchange
Most appropriate : IV Immunoglobulins.
300
Should you treat hypertension in initial phase of management of stroke ?
NO.
301
Electric shock like pain lasting for 30-60 seconds + on side of the face.Dx:
Trigeminal neuralgia.
302
Rx for Trigeminal neuralgia :
Carbamazapine.
303
Stroke symptoms after 4.5 hours o onset. Rx
out of window period.
Rx: Aspirin.
(No thrombectomy in question)
304
left congruous homonymous hemianopia
Rt occipital cortex lesion.
C=Congrous=Cortex
305
Monitoring of respiratory function in Guillain-Barré syndrome:
Forced vital capacity.
306
Stroke symptoms withing 4.5 hours:
Thrombolysis and thrombectomy.
307
H/o carpal tunnel syndrome refractory to treatment+ new onset weakness of lower legs and imbalance. Rx:
Degenerative cervical myelopathy.
308
Vision worse going downstairs. Which nerve palsy ?
4th nerve palsy.—Trochlear nerve palsy.
LR6 SO4—Trochlear supplies superior oblique—function to look down.
309
which part of this child's hypothalamus would be affected causing weight gain if there is a lesion ?
Venteromedial area of hypothalamus.
310
Sodium valproate causes inhibition or induction of the P450 system?
Inhibition.
311
H/o viral urti + headache+ confusion+ hearing voices
+ MRI: Assymetric and poorly marginated hyperintense T2 weighted and flair lesion :
Acute disseminated encephalomyelitis.
312
Unable to perceive stimuli in the superior temporal field of his left eye and the superior nasal field of his right eye:
Right Temporal Lobe.
PITS
313
subacute combined degeneration of the spinal cord, which vitamin deficiency ?
Vitamin B12.
314
bitemporal hemianopia with predominately the lower quadrants being affected.
Cranipharyngioma.
Lowe= superior chias all compression
PICS: parietal=inferior, craniopharyngioma=superior
315
Famliy history of ear issues+ B/L conductive hearing loss.
Otosclerosis.
316
Stroke symptoms, 5 hours of onset. Rx:
it’s between 4.5-5.5 : therefore = thrombectomy.
317
Examination reveals a right incongruous homonymous hemianopia:
Left optic tract lesion.
318
Stroke symptoms + 5 hours of onset. K/C/O Afib. Rx:
Outside window period.
Rx: Aspirin + Anticoagulation ( warfarin) after 2 weeks.
319
blind spots in the bottom left quarter in both eyes.
Right parietal
320
Examination reveals an inferior homonymous quadrantanopia.
PITS
Inferior= superior optic radiation in parietal lobe.
321
visual field changes would be most consistent with a left parietal lobe lesion?
Right homonyous quadrantonopias.
322
Ropinirole is :
Dopamine agonist
323
Anti epileptics most ass with weight gain:
Sodium valproate.
324
bitemporal hemianopia with predominately the upper quadrants being affected
PICS
Upper = lower affected.
Lower is pituitary.
325
operation to remove a meningioma in his left temporal lobe. What sort of visual field defect is he at risk of having following the procedure?
Rt superior homonymous quadrantonopia.
326
Internuclear ophthalmoplegia
Medial longitudinal fasisculus ( paramedical area of midbrain and pons)
327
How to diagnose BPPV?
Dix-Hallpike test:
328
Stroke patient outside window. K/C/O high cholesterol. Aspirin given. Next treatment:
Clopidogrel + statin after 14 days.
329
H/o fracture and cast + Fracture healed + Shooting pain + Swelling + Tenderness
Complex regional pain syndrome.
330
Tremors worse during stress+ worse on outstretched hand+ improved by alcohol.
Essential tremors.
331
point which is specific to essential tremors and differentiate it from Parkinson’s tremors :
Tremors get worse on outstretched hands.
332
Pt on warfarin had a fall. no sign of injury and no fall in GCS.Next step ?
patient on warfarin should have CT scan within 8 hours regardless of the injury
333
What are affected first in Miller Fisher syndrome ?
Eye symptoms are affected first—causing opthalmoplegia.
334
Rx for BPPV ?
Apply epply.
Epply’s manoeuvre.
335
Double vision + reduced reflexes + wide gait :
Miller fisher syndrome.
336
Additional features ass with Freidricks ataxia /
Optic Atophy
Dysarthria
Pes cavus.
337
Cause of vomitting and loss of consciousness in Sub arachnoid Haemorhage ?
Mass effect
