Niwroloji

Question 1

What are the causes of thiamine (vitamin B1 ) deficiency?

Answer 1

Alcohol excess

Malnutrition

Question 2

What does wernicke’s encephalopathy cause?

Answer 2

Nystagmus, ophthalmoplegia and ataxia. (b1 deficiency)

Question 3

Whst is an epileptic-like seizure but with no characteristic electrical discharges called?

Answer 3

Psychogenic non-epileptic seizures

Question 4

What are lacunar infarcts?

Answer 4

Small infarcts around the basal ganglia, thalamus, internal capsule and pons

Question 5

What are the symptoms of lacunar infarct?

Answer 5

Unilateral weakness of (+- sensory deficit) of any combination of face arm and leg
Pure sensory stroke
Ataxic hemiparesis

Question 6

Define ataxia

Answer 6

Term for group of disorders that affect co-ordination, balance and speech

Question 7

In what part of the brain are early alzheimers changes likely to be seen?

Answer 7

Temporal lobe

Question 8

What is Bell’s palsy?

Answer 8

An idiopathic facial nerve palsy typically giving unilateral faciak nerve weakness with involvement of the forehead as it affects the lower motor neurones

Question 9

Dementia-y symptoms and Cardiovascular risk factors means what?

Answer 9

Vascular dementia

Question 10

Dementia-y symptoms in a 20-40yr old and strong family history means what?

Answer 10

Huntington’s disease

Question 11

Dementia-y symptoms and myoclonic jerks?

Answer 11

CJD (creutzfeldt-jakob disease)

Question 12

Dementia-y symptoms and visual hallucinations?

Answer 12

Lewy body dementia

Question 13

Dementia-y symptoms, dysphagia, dyspraxia and problems with spacial navigations and visual awareness and persucatory beliefs

Answer 13

Alzheimer’s disease

Question 14

Dementia-y symptoms with executive function impairment and personality change

Answer 14

Picks disease/ fronto-temporal dementia

Question 15

Dementia-y symptoms with urinary incontinence and abnormal gait

Answer 15

Normal pressure hydrocephalus

Question 16

What pathological features are associated with Levy body dementia ?

Answer 16

Alpha synuclien

Question 17

Donepezil and galantamine are examples of what?

Answer 17

Cholinesterase inhibitors

Question 18

Rivastigmine is an example of what?

Answer 18

Butyl and acetylcholinesterase inhibitors

Question 19

What type of medication is an NMDA receptor blocker?

Answer 19

Memantine

Question 20

What is the treatment for Alzheimer’s dementia?

Answer 20

Donepezil, rivastigmine and galantamine are licensed for mild to moderate
Memantine for moderate to severe Alzheimer’s

Question 21

What are the components of a neurological ROS?

Answer 21

Headache
Fits, faints or funny turns
Vision
Hearing
Speech and swallow
Sensation
Balance or coordination
Memory

Question 22

What are headache red flags

Answer 22

Sudden onset high severity headache
Headache with fever
New onset neurological deficit
New onset cognitive dysfunction
Change in personality
Impaired level of consciousness
Recent head trauma (within past three months)
Headache triggered by cough, sneeze, exercise, or changes in posture.
Headache associated with halos around lights or headaches that get worse in the dark.
Headache associated with jaw claudication and scalp tenderness.

Question 23

20 minutes episodes of unilateral, debilitating episodes of retro-orbital pain with eye redness and watering means what?

Answer 23

Cluster Headache

Question 24

Headache triggered by changes in position or exertion. Vision changes on leaning forward means what?

Answer 24

Increased inter cranial pressure

Question 25

Describe common presentation of sinusitis?

Answer 25

Facial tenderness and rhinorrhea

Question 26

Tight band like painful sensation precipitated by stress means what?

Answer 26

Tension headache

Question 27

Describe common presentation of trigeminal neuralgia

Answer 27

Brief, stabbing pain when brushing teeth or chewing

Question 28

Describe common presentation for migraine

Answer 28

Unilateral, pounding, multiple triggers, lasts for hours, aversion to bright lights and loud noises, may be precipitated by aura

Question 29

Describe common presentation for acute glaucoma

Answer 29

Pain around eye, blurred vision with halos around lights

Question 30

Photophobia, neck stiffness and fever means what?

Answer 30

Meningitis

Question 31

Sudden onset excruciating headache likely means what?

Answer 31

Sub-arachnoid hemorrhage

Question 32

Scalp tenderness and unilateral jaw claudication means what ?

Answer 32

Temporal Arteritis

Question 33

What is TLC?

Answer 33

Transient Loss of Consciousness

Question 34

What TLC is triggered by suddenly standing up?

Answer 34

Postural hypotension

Question 35

What is cause of TLC triggered by vigorous exercise in you person?

Answer 35

Hypertrophic cardiomyopathy/ cardiogenic syncope

Question 36

Collapse on shaving / whilst turning head likely to be due to?

Answer 36

Carotid sinus hypersensitivity

Question 37

What does TLC due to aortic stenosis look like?

Answer 37

Chest pain, breathlessness and collapse on exertion

Question 38

TLC with palpitations and chest pain beforehand. Family history of early death. Indicative of what?

Answer 38

Arrhythmia/ cardiogenic syncope

Question 39

Vasovagal syncope is caused by what? And preceded by what?

Answer 39

Pain, micturition, fear and prolonged standing. Preceded by sweating, nausea and pallor. No confusion

Question 40

Twitching and jerking in the morning means what?

Answer 40

Early morning myoclonus

Question 41

Violent shaking, head moving from side to side, arching back, episodes of stillness before starting again and forced eye closure means what?

Answer 41

Psychogenic non-epileptic attack

Question 42

Crying out, falling to the floor, period of stiffness followed by rhythmic jerking that gradually decreases in amplitude and frequency, confused for 30mins afterwards means what?

Answer 42

Generalized tonic-clinic seizure

Question 43

What are the signs of upper motor neuron lesion ?

Answer 43

Increased reflexes and increased tone

Question 44

What are the signs of lower motor neurons lesion?

Answer 44

Decreased reflexes, normal/decreased tone, fasciculations.

Question 45

Tonic-clinic seizure, what immediate assessments do you want?

Answer 45

Vvitals and O2 sats, BM, ECG, neuronexam and bloods to check for acute metabolic disturbances e.g. hyponatraemia, hypocalcaemia

Question 46

What is a stereotypical pattern for seizures? (They’re almost always the stereotype)

Answer 46

They take the same for with similar sequences of events, can arise from sleep, they tend to cluster, not especially effected by stress, and emotional shocks,

Question 47

What % of epilepsy cases are medically refractory

Answer 47

20-30%

Question 48

What are the signs of cerebellar lesions?

Answer 48

``` D -Dysmetria (past-pointing) A - Ataxia N- Nystagmus I- Intension tremor S-Slurred staccato speech H-Hypotonia ```

Question 49

What are the causes of cerebellar disorders

Answer 49

``` P-paraneoplastic A-alcohol S-stroke/sclerosis T-trauma R-rare fredricks I-iatrogenic E-endocrine (hypothyroid) S-space occupying lesions ```