Prep 7

Question 1

lip smacking, fiddling fingeres
dysphasia
de ja vu
emotional disturbance

Answer 1

temporal lobe focal seizure

Question 2

posturing, peddling legs, pelvic thrust

Answer 2

frontal lobe focal seizure (motor)

Question 3

tingling, numbness, pain

Answer 3

parietal lobe focal seizure (sensory)

Question 4

spots, lines, flashes

Answer 4

occipital focal seizure (visual cortex)

Question 5

disulfram

Answer 5

promotes abstinence (makes you sick when drink alcohol)

Question 6

acamprosate

Answer 6

reduces craving

Question 7

What is wernikes encepalopathy and what can it progress to

Answer 7

neurological lesions due to thiamine deficiency
triad - ophthalmoplegia, ataxia, confusion
classically seen in alcoholics due to thiamine (B1 deficiency)
korsakoffs - presence of amnesia (chronic)

Question 8

Dementia in old man, severe behavioural changes, was embarrassing grandchildren/family

Answer 8

frototemporal dementia

Question 9

Woman with children, N&V, then sudden onset dizziness lasting 2 weeks

Answer 9

acute labyrinthitis (viral infection in labyrinth hearing can be affected in contrast to vestibular neuritis hearing not affected)

Question 10

standing up from chair and dizzy

Answer 10

orthostatic hypotension (primary autonomic failure in PD and LBD) secondary autonomic failure in diabetes
drug induced
volume depleted

Question 11

side effect of levodopa

Answer 11

peak dose dyskinesia

postural hypotension

Question 12

painful neck, horners

Answer 12

carotid dissection

Question 13

MCA stroke

Answer 13

hemipariesis and sensory loss, homonimous hemianopia (both on contralateral side)
aphasia

Question 14

early signs of opioid toxicity

Answer 14

confusion, delirium
vomitting
pinpoint pupils
drowsy

Question 15

RTA hit on side of head and deteriorated in A&E

Answer 15

extra-dural

Question 16

pathology of PD

Answer 16

loss of dopaminergic neurons in substantia nigra

Question 17

neurotransmitter low in alzeihmers

Answer 17

Ach

degeneration of neurones in grey matter of cortex, amyloid plaque and neurofibrillary tangles

Question 18

neurotransmitter low in depression

Answer 18

5-ht

Question 19

nerve in extensor compartment of lower leg

Answer 19

(anterior compartment)

deep fibular nerve

Question 20

epse

Answer 20

akathesia (restlessness)
tardive dyskinesia
parkinsonism
acute dystonia

Question 21

neurotransmitter affected in myasthenia gravis

Answer 21

Ach

Question 22

headache with tingling in arms

Answer 22

migraine with aura

Question 23

headache and stiff shoulders

Answer 23

polymyalgia rheumatica with GCA (ESR >40, biopsy shows giant cells classically skip lesions)

Question 24

head lagging and dysphonia

Answer 24

myasthenia gravis (anti ACHABs and single fibre EMG)

Question 25

c5

Answer 25

side of arm

Question 26

l1

Answer 26

groin

Question 27

nerve supplying quadraceps

Answer 27

femoral nerve

Question 28

investigation for prolapsed disc

Answer 28

MRI

Question 29

investigation for SAH if CT normal

Answer 29

LP

Question 30

Papilloedema, headache and hemiparesis

Answer 30

CT look for SOL

Question 31

pappilloedema on fundoscopy

Answer 31

dilated veins loss of optic disc margins elavation of optic disc loss of optic cup

Question 32

alcoholic haemorhage

Answer 32

sub dural

Question 33

boxer haemorrhage

Answer 33

extra dural

Question 34

unconscious after rta

Answer 34

diffuse axonal injury

Question 35

hallucinations and parkinsonism

Answer 35

LB dementia

Question 36

behaviour and language change

Answer 36

frontotemporal dementia

Question 37

positive femoral nerve stretch test

Answer 37

L3, L4 disc prolapse

Question 38

sensory loss on dorsum of foot, weakness of big toe dorsi flexion

Answer 38

L5 nerve compression

Question 39

sensory loss over anterior thigh

Answer 39

L3,L4 prolapse

Question 40

senspry loss posterorlateral aspect of leg and lateral foot

Answer 40

s1 nerve compression

Question 41

lowering intracranial pressure in SOL

Answer 41

dexamethasone

Question 42

UMN and LMN signs

Answer 42

motor neurone disease

Question 43

nerve supply to the tongue

Answer 43

anterior 2/3rds: taste VII, sensation V3 (lingual division of mandibular) posterior 1/3rd: taste and sensation glossopharygneal IX motor all: hypoglossal XII

Question 44

hypertension and flame shaped haemorrhages

Answer 44

retinal vein occlusion

Question 45

ataxia and past pointing

Answer 45

cerebeller lesion

Question 46

triad of normal pressure hydrocephalus

Answer 46

dementia urinary incontinance gait disturbances

Question 47

Nystagmus of right eye looking to right and failure of left eye to cross midline on looking to right

Answer 47

internuclear ophthalmoplegia | left MLF lesion

Question 48

LOC when turning head sharply

Answer 48

vertebrobasilar insuffieciency

Question 49

what is sydenhams chorea

Answer 49

rapid jerking like movements | occurs in children after GAS infection (can be presenting feature of rheumatic fever)

Question 50

oligoclonal bands in csf

Answer 50

MS

Question 51

vertical diplopia when walking down stairs

Answer 51

SO4 palsy

Question 52

what is a reflex anoxic seizure and what classically causes it

Answer 52

syncope classically seen in children fallowing bump to the head

Question 53

axillary nerve palsy

Answer 53

deltoid weakness | loss of sensation over regemental badge area

Question 54

low-grade fever, local tenderness at L3

Answer 54

discitis

Question 55

lorry driver, stiff and tender back

Answer 55

mechanical back pain

Question 56

sudden shooting pain while performing lifting

Answer 56

prolapsed disc

Question 57

ipsilateral facial weakness and facial sensory loss | ataxia

Answer 57

pontine stroke

Question 58

Contralateral homonymous hemianopia with macular sparing

Answer 58

posterior cerebral artery stroke

Question 59

musculocutaneous nerve palsy

Answer 59

pain, tingling and reduced sensation over lateral forearm | waekness of elbo flexion and supination

Question 60

median nerve palsy

Answer 60

(weakness in carpal tunnel syndrome) paralysis of thenar muscles cant abduct and opose thumb (ape hand) sensory loss to middle ring

Question 61

ulnar nerve palsy

Answer 61

loss of sensation in ring and pinky | cubital tunnel syndrome

Question 62

radial nerve palsy

Answer 62

wrist drop