Neurology

Question 1

What is the long term management options for MS?

Answer 1

1st line- natalizumab (most effective)

other- beta interferon

Question 2

What are the buzzword symptoms for uncal herniation?

(same as transtentorial)

Answer 2

ipsilateral occulomotor nerve palsy and contralateral hemiplegia

location- temporal lobe

Question 3

What is Cushing’s Triad?

Answer 3

1. Hypertension
2. Bradycardia
3. Widened Pulse Pressure

Question 4

What are the main triggers of myasthenia gravis?

Answer 4

beta blockers, lithium, gentamicin

Question 5

What is the 1st line management for a myoclonic seizure in females?

(*special rule)

Answer 5

1st line- levetiracetam

(usually lamotrogine then levetiricam but this is an exception)

Question 6

What MND sub-type carries the worst prognosis?

Answer 6

Progressive bulbar palsyis the correct answer as it carries the worst prognosis among the motor neuron disease variants

Question 7

What does rombergs positive mean?
b) what does rinnes positive mean

Answer 7

a) romberg posiitve- means pathology present of DCML tract

b) Rinnes positive- means HEALTHY ear

Question 8

After a patient has a TIA what is your next line urgent investigation

Answer 8

1st line- carotid doppler

(can do carotid endarterectomy if >70%)

Question 9

Summarise the Glasgow Coma Scale

LEARN- do not be a lazy ass

Answer 9

MoVE (6,5,4)

Motor
(+6)- obeys commands
(+5)- localises pain
(+4)- normal flexion
(+3)- abnormal flexion
(+2)- abnormal extension
(+1)- nothing

Verbal (5)
(+5)- orientated
(+4)- confused
(+3)- words
(+2)- sounds
(+1)- none

Eyes (4)
(+4)- spontaneous
(+3)- sound
(+2)- to pressure
(+1)- none

<8 indicates endotracheal intubation

Question 10

What nerves pass through thr following cranial fossa?
a) foramen rotundum
b) foramen ovale
c) hypoglossal canal
d) jugular foramen

Answer 10

foramen rotundum-V2 (maxillary)

foramen ovale- V3 (mandibular)

hypoglossal canal - hypoglosaal nervw

jugular foramen - glossophrayngeal and vagus, accessory (VAG

Question 11

What are the x4 main features of optic neuritis in MS?

(*MUST KNOW in MLA paper)

Answer 11

1. painful eye movements
2. red desaturation
3. central scotoma- hole in centre vision
4. RAPD defect

Question 12

What is ‘split hand syndrome?’

Answer 12

characterised by ‘thenar wasting’, common features of ALS (ALS has UMN and LMN features)

Question 13

What is the management of diabetic nepropathy?

Answer 13

ACE inhibitor or angiotensin-II receptor antagonist

(same as CKD)