Neurology

Question 1

Parietal Lobe lesion deficits (5)

Answer 1

Sensory inattention
Astereognosis (inability to identify objects purely by touch)
Apraxias (difficulty in planning motor function)
Inferior homonymous quadrantinopia
Gerstmann’s syndrome (lesion of dominant parietal): alexia, acalculia, finger agnosia and right-left disorientation

Question 2

Occipital lobe lesion deficits (3)

Answer 2

Cortical blindness
homonymous hemianopia (with macular sparing)
Visual agnosia

Question 3

Temporal Lobe Lesion (4)

Answer 3

Auditory agnosia
Superior homonymous quadrantinopia
prosopagnosia (difficulty recognising faces)
Wernickes aphasia - word substituion, neologisms but speech remains fluent

Question 4

Frontal lob lesions (5)

Answer 4

Disinhibition
Expressive aphasia - located on the posterior aspect of the frontal lobe, in the inferior frontal gyrus. Speech is non-fluent, laboured, and halting
Perseveration
Anosmia
Inability to generate a list

Question 5

Cerebellar lesions

Answer 5

Midline lesions: gait and truncal ataxia

Hemisphere lesions: intention tremor, past pointing, dysdiadokinesis, nystagmus

Question 6

Medial thalamus and mammillary bodies of the thalamus

Answer 6

Wernicke and Korsakoff syndrome

Question 7

Substantia Nigra of the basal ganglia

Answer 7

PD

Question 8

Subthalamic nucleus of the basal ganglia

Answer 8

Hemiballism

Question 9

Striatum (caudate nucleus) of the BG

Answer 9

Huntingtons chorea

Question 10

Amygdala

Answer 10

Kluver-Bucy syndrome (hypersexuality, hyperorality, hyperphagia, visual agnosia

Question 11

Organic causes of miosis (small pupil)

Answer 11

Argyll-robertson pupil - accomodation is preserved
Old age
COngenital 
Pontine haemorrhage
Horners syndrome

Question 12

Drug causes of miosis (small pupil)

Answer 12

Opiates
PArasympathetics - pilocarpine
Organophosphate toxicity

Question 13

Neuropathic pain first line

Answer 13

Amitryptiline, duloxetine, gabapentin or pregabalin

Question 14

Trigeminal neuralgia first line

Answer 14

CBZ

Question 15

GBS monitoring

Answer 15

FVC

Question 16

GBS prognosis

Answer 16

20% have permanent disability

5% die

Question 17

Causes of macroglossia (5)

Answer 17

Hypothyroidism
Acromegaly
Amyloidosis 
DMD
mucopolysaccharidosis (e.g. Hurler syndrome)

Question 18

Peripheral neuropathy predominant motor

Answer 18

Guillain-Barre syndrome
porphyria
lead poisoning
hereditary sensorimotor neuropathies (HSMN) - Charcot-Marie-Tooth
chronic inflammatory demyelinating polyneuropathy (CIDP)
diphtheria

Question 19

Peripheral neuropathy predominant sensory

Answer 19

diabetes
uraemia
leprosy
alcoholism
vitamin B12 deficiency
amyloidosis

Question 20

Ab against pre-synaptic voltage gated calcium channel in the peripheral nervous system

Answer 20

Lambert Eaton myasthenic syndrome

A/w small cell lung and breast Ca

Question 21

Anti-Hu paraneoplastic features

Answer 21

A/w small cell lung Ca and neuroblastomas
painful sensory peripheral neuropathy
Cerebellar syndrome
Encephalomyelitis

Question 22

Anti-Yo paraneoplastic features

Answer 22

A/w ovarian and breast Ca

Cerebellar syndrome

Question 23

Anti-GAD paraneoplastic features

Answer 23

a/e colorectal, breast and small cell lung Ca
DIffuse hypertonia (stiff persons syndrome)

Question 24

Anti-Ri paraneoplastic features

Answer 24

A/w breast and samll cell lung Ca

Ocular opsonus-myoclonus

Question 25

Purkinje cell Ab paraneoplastic features

Answer 25

Breast Ca | peripheral neuropathy

Question 26

Contrlateral hemiparesis and sensory loss, lower>upper limb - likely artery

Answer 26

Anterior cerebral

Question 27

Contralateral hemiparesis and sensory loss upper>lower - inc face Contralateral homonymous hemianopia Aphasias

Answer 27

Middle cerebral artery

Question 28

Contralateral homonymous hemianopia with macular sparing | Visual agnosia

Answer 28

Posterior cerebral artery

Question 29

Ipsilateral CN III palsy | Contralateral weakness of upper and lower extremity

Answer 29

Webers syndrome - bracnhes of posterior artery that supply midbrain

Question 30

Ipsilateral: facial pain and temperature loss Contralateral: limb/torso pain and temperature loss Ataxia, nystagmus

Answer 30

Posterior inferior cerebellar artery

Question 31

Amaurosis fugax

Answer 31

opthalmic/retinal artery

Question 32

Locked in syndrome

Answer 32

basilar artery

Question 33

Lacunar stroke

Answer 33

present with either isolated hemiparesis, hemisensory loss or hemiparesis with limb ataxia strong association with hypertension common sites include the basal ganglia, thalamus and internal capsule

Question 34

Sodium valproate SEs (10)

Answer 34

``` HypoNa pancreatitis hepatitis Thrombocytopenia Teratogenic Nausea Inc appetite and weight gain Ataxia Tremor Alopecia - regrowth may be curly ```

Question 35

Migraine pregnancy

Answer 35

first line paracetemol | Aspirin 300mg or ibuprofen 400mg second line in 1st and 2nd trimester

Question 36

Drug causes of gingival hyperplasia

Answer 36

Phenytoin CCBs - esp nifedipine Ciclosporin

Question 37

Condition causing gingival hyperplasia

Answer 37

AML

Question 38

Temporal lobe epilepsy HEAD

Answer 38

Hallucinaitons Epigastric rising/Emotional Automatisms - lip smacking/grabbing Deja vu/Dysphasia post ictal

Question 39

Frontal lobe epilepsy

Answer 39

Head/leg movements Posturing Post ictal weakness

Question 40

Parietal lobe epilepsy

Answer 40

parasthesia

Question 41

Occipital lobe epilepsy

Answer 41

floaters/flashers