Neurology

Question 1

thunderclap headache

Answer 1

subarachnoid haemorrhage

Question 2

Xanthroxhromic lumbar puncture

Answer 2

subarachnoid haemorrhage

Question 3

lucid period after head trauma, often followed by sudden collapse or deterioration

Answer 3

extradural haemorrhage

Question 4

cogwheel rigidity

Answer 4

Parkinson’s

Question 5

woody texture muscle swelling

Answer 5

Duchenne or Becker muscular dystrophy

Question 6

raised CK

Answer 6

muscular dystrophy

Question 7

toe walker or positive Gowers sign

Answer 7

muscular dystrophy

Question 8

mask-like expression

Answer 8

Parkinson’s

Question 9

fluctuating cognitive deficit

Answer 9

Lewy body dementia or delirium

Question 10

vivid visual hallucinations of children and not threatening

Answer 10

lewy body dementia

Question 11

acute onset cognitive disturbance that fluctuates

Answer 11

delirium

Question 12

personality/behavioural changes and then dementia

Answer 12

frontotemporal dementia (Pick’s disease)

Question 13

memory and personality problems in someone with a history of cardiovascular

Answer 13

vascular dementia

Question 14

Stepwise deterioration

Answer 14

vascular dementia

Question 15

pain on loud noise

Answer 15

facial nerve palsy (?)

Question 16

myalgia +myositis + myoglobulinaemia/uria

Answer 16

rhabdomyolysis leading to DIC and renal failure

Question 17

inflammatory myopathy with resistance to steroids

Answer 17

inclusion body myosotis

Question 18

weakness + frontal balding + cataracts + ptosis

Answer 18

myotonic dystrophy (onset 30s + FHx)

Question 19

leg symptoms + midline shift in brain

Answer 19

falcine herniation

Question 20

back pain worse on coughing

Answer 20

slipped disc (? ribs, resp pain surely as well)

Question 21

headache worse on coughing

Answer 21

posterior fossa issue (? sinusitis, raised ICP)

Question 22

bilateral sciatica + male sexual dysfunction

Answer 22

cauda equina

Question 23

pleocytosis (presence of abnormally numerous lymphocytes) on CSF

Answer 23

rules out bacterial meningitis

Question 24

migraine prophylaxis first line (3)

Answer 24

propranolol
topiramate
amitriptyline

Question 25

migraine prophylaxis second line (4)

Answer 25

valproate
pizotifen
gabapentin
pregablain

if one does not work for 3/12 try another

Question 26

Injury to upper brachial plexus, commonly shoulder dislocation

Answer 26

Erb’s palsy (waiters tip)

Question 27

Injury to lower brachial plexus

Answer 27

Klumpke’s palsy (claw hand)

Question 28

positive Simmond’s test

Answer 28

achilles tendon rupture