Q2

Question 1

ant cerebral artery leads to what

Answer 1

frontal lobe
contralateral loss in foot and leg
paresis of arm and foot, relative sparing of thigh and face

Question 2

middle cerebral artery

Answer 2

hemiparesis, hemisensory loss, aphasia/dysphasia, apraxia

Question 3

ABCD2 score

Answer 3

• Age >=60 (1)
• BP >=140/90 (1)
• Clinical features unilateral weakness (2), speech disturbance without any weakness (1)
• Duration of symptoms >=60mins (2) 10-59 mins (1)
• hx of DM (1)

4 or above 300mg aspirin daily

Question 4

GCS

Answer 4

motor:

• obeys commands (6)
• localises to pain (5)
• withdraws from pain (4)
• abnormal flexion to pain (3)
• extending to pain (2)
• none (1)

verbal response:

• orientated (5)
• confused (4)
• words (3)
• sounds (2)
• none (1)

Eye opening:

• spontaneous (4)
• to speech (3)
• to pain (2)
• none (1)

Question 5

extradural haemoatoma

Answer 5

injury

Question 6

subdural haemoatoma

Answer 6

old age
alcohol
anti coag

Question 7

SAH

Answer 7

aneurysm

Question 8

acute cluster

prophylaxis

Answer 8

100% o2, subcut/nasal triptan

verapamil, pred

Question 9

new seizures
established seizure

stroke/TIA
multiple TIAs over a short period of time

Answer 9

6m no driving after assessment
1 yr seizure free

1m
3m

Question 10

TACl

Answer 10

unilateral hemiparesis and/or hemisensory loss of the face, arm, leg
HH
higher cognitive impairment

middle and anterior cerebral arteries

Question 11

PACl

Answer 11

2 of:
unilateral hemiparesis and/or hemisensory loss of the face, arm, leg
HH
higher cognitive impairment

Question 12

lacunar LACl

Answer 12

unilateral weakness and/- sensory loss
pure sensory stroke
ataxic hemiparesis

Question 13

POCl

Answer 13

cerebellar or brainstem syndrome
loss of consciousness
isolated HH

Question 14

Lambart eaton synd ABs against what
symp
assoc with what

Answer 14

ABs again pre synap calcium gated channels in NMJ

prox arms and legs weakness temporarily relieved after exertion or physical exercise

small proportion associated with small cell lung cancer

Question 15

contra indications to triptans

Answer 15

history or significant risk factors for ischaemic heart disease or cerebra vascular disease

Question 16

anterior cerebral artery

Answer 16

contra lateral hemiparesis and sensory loss

lower extremity >lower extremity

Question 17

middle cerebellar artery

Answer 17

contra lateral hemiparesis and sensory loss
upper extremity >lower
contra lateral HH
aphasia

Question 18

posteriori cerebellar artery

Answer 18

contralateral HH with macula sparing

visual agnosia

Question 19

high stepping gait

Answer 19

foot drop

Question 20

vit B12 defic

Answer 20

sensory loss

Question 21

LMN facial

UMN facial

Answer 21

all facial muscles

spares forehead

Question 22

ischaemic stroke secondary care

Answer 22

clopidegrol and statin

aspirin and dipyridamole if clopidegrol contra indicated or not well tolerated

Question 23

sodium valproate SE

Answer 23

weight gain
nausea
alopecia - hair grows back curly
ataxia
tremor
hep
pancreatitis
thrombocytopenia
teratogenic
hyponatraemia

Question 24

prophylaxis of migraines

Answer 24

propanolol or topirmate

3rd line gabapentin

Question 25

menstrual migraines proph

Answer 25

frovatriptan 2.5mg twice daily | zolmitriptan 2.5 mg three times or twice daily

Question 26

migraines during pregnancy

Answer 26

1g paracetomaol first line | 2nd line in first and second trim -aspirin 300mg or iboburfen 400mg can be used

Question 27

adverse effects of levodopa

Answer 27

``` dyskinesia on off effect [pstural hypotension cardiac arrhythmias N+V psychosis reddish discolouration of urine on standing ```

Question 28

AML

Answer 28

LMN in arms and UMN in legs

Question 29

primary lateral sclerosis

Answer 29

UMN signs only

Question 30

progressive muscular atrophy

Answer 30

LMN signs only affects distal muscles before prox best prognosis

Question 31

progressive bulbar palsy

Answer 31

palsy of tongue, muscles of chewing/swallowing and facial muscles due to loss of function of brainstem motor uncle worst prognosis

Question 32

children and migraines

Answer 32

shorter bilateral GI disturbance more predom

Question 33

intracranial idiopathic hypertension

Answer 33

blurry vision female obese headache

Question 34

most common type of MS

Answer 34

relapsing remitting

Question 35

cylizine and prochlorperazine

Answer 35

exacerbate parkinsons disease

Question 36

neuropathic pain

Answer 36

1 - amitryptalline, duloxetina, gabapentin, pregablin | 2 - tramadol (exacerbations of neuropathic pain), topical capsain (localised neuro pain)

Question 37

trigmenal neuralgia

Answer 37

carbamazapine

Question 38

osteomyelitis ix

Answer 38

MRI

Question 39

tuberous sclerosis

Answer 39

shagreen patch - roughened skin epilepsy common

Question 40

balls pals rx

Answer 40

pred for 10d | eye care - lubricants, artificial tears

Question 41

SAH LP

Answer 41

post 12 hours

Question 42

SE of triptans

Answer 42

tingling, heat, tightness (chest and throat), heaviness and pressure

Question 43

px with LBD are extremely sensitive to

Answer 43

neuroepileptic patients

Question 44

most common cause of head tremor

Answer 44

ET

Question 45

GBC commonly linked to

Answer 45

campylobacter jejuni

Question 46

treatment prakisnos tremor

Answer 46

procydlidine

Question 47

SORL1 protein

Answer 47

sporadic form of dementia

Question 48

alzheimers

Answer 48

mutations in amyloid precursor protein leading to A beta

Question 49

wilson ix

Answer 49

24 h urine collection

Question 50

subdural haematoma

Answer 50

elderly and on anti coag | fall, urinary incontinance

Question 51

balls palsy

Answer 51

loss of lacrimation

Question 52

TIA

Answer 52

should resolve within 24 h | usually resolves within 1h

Question 53

all patients with stroke should have

Answer 53

CT/MRI preferably within 24 hours | ECG

Question 54

<60 and ischaemic stroke

Answer 54

thrombophilia screen and autoantibodies and anti cardiolupin

Question 55

Erbs palsy

Answer 55

commonly cause by shoulder dystocia | C5-C6

Question 56

familial hemiplegic migraine

Answer 56

assoc with transient motor deficit

Question 57

wernickes encephalopathy

Answer 57

defic of B1

Question 58

sarcoid

Answer 58

ACE | calcium high

Question 59

phenytoin toxicity

Answer 59

present as cerebellar syndrome

Question 60

sodium valproate SE

Answer 60

nausea, drowsiness and tremor at toxic levels

Question 61

carbamazepine

Answer 61

aplastic anaemia and agranulocytosis - rare

Question 62

resting pin rolling tremor

Answer 62

parkinsons

Question 63

normal BG is

Answer 63

5.5

Question 64

extradural haeatoma

Answer 64

deterioration in approx 4-6 hours

Question 65

bulbar palsy

Answer 65

lmn

Question 66

psueodobulbar palsy

Answer 66

umn