SBAs: neurology

Question 1

Recall the mnemonic for and the signs of cerebellar dysfunction

Answer 1

DANISH
Dysdiachokinesis
Ataxia
Nystagmus
Intention tremor
Slurred speech
Hypotonia

Question 2

Which classification system is used to classify stroke severity?

Answer 2

Oxford-Bamford

Question 3

Which classification system is used to classify TIA severity?

Answer 3

ABCD2 score

Question 4

Recall the elements of the ABCD2 score

Answer 4

Age (+1 for >60) 
BP (+1 for SBP>140/DBP>90)
Clinical features (up to +2)
Diabetes (+1)
Duration (+1 for 10-59 minutes, +2 for >60 mins)

Question 5

Which ABCD2 score requires admission?

Answer 5

> 4

Question 6

Using the surgical sieve, suggest some causes of seizure

Answer 6

Vascular: haemorrhage, ischaemic event
Iatrogenic: drug toxicity
Trauma: head injury
Autoimmune: ?
Metabolic: electrolyte imbalance, drug withdrawal
Infective: meningitis, encephalitis
Neoplastic: SOL

Question 7

What is used for the prophylaxis of migraine?

Answer 7

Beta-blockers or low dose amitryptiline (5mg0

Question 8

Which medication is used for acute presentation of migraines?

Answer 8

Sumotriptan

Question 9

Recall the symptoms of Pick’s disease

Answer 9

Increased aggression, sexual disinhibition, memory loss

Question 10

Which lobe is most commonly first affected in Alzheimer’s disease?

Answer 10

Temporal lobe

Question 11

In which sort of dementia is a step-wise functional decline characteristic?

Answer 11

Vascular

Question 12

In which sort of dementia is a fluctuating functional decline characteristic?

Answer 12

Lewy-body demenia

Question 13

Which type of dementia commonly shows features of Parkinson’s disease?

Answer 13

Lewy-body

Question 14

How is lewy-body dementia treated?

Answer 14

Choline-esterases

Question 15

Which lobe is affected in Pick’s disease?

Answer 15

Frontotemporal lobe

Question 16

What are Pick bodies composed of?

Answer 16

Tau protein

Question 17

Name 2 conditions that predispose to Berry aneurysms

Answer 17

Polycystic kidney disease

Marfan’s

Question 18

Recall mild and severe treatment options for multiple sclerosis in the acute phase

Answer 18

Mild: oral prednisolone
Severe: IV methyl prednisolone

Question 19

Recall 2 options for disease-modifying drugs in multiple sclerosis

Answer 19

Interferon beta

Monoclonal antibodies

Question 20

Which sort of headache tends to happen at the same time each day?

Answer 20

Cluster

Question 21

What is the main medical management option for cluster headache?

Answer 21

Verapamil

Question 22

What can be seen on examination of a stroke patient to tell whether a stroke has involved the brainstem or not

Answer 22

If it has involved the brainstem then there will be unilateral mouth drooping

Question 23

What is the main complication of myasthaenia gravis to be aware of?

Answer 23

Aspiration pneumonia (due to dysphagia)

Question 24

Recall 4 features of myasthaenia gravis

Answer 24

Fatigability of muscles
Ptosis
Diplopia
Dysphagia

Question 25

Which cancer are myasthaenia gravis patients particularly at risk of developing, and how is this managed?

Answer 25

Thynoma | All MG patients undergo thynectomy

Question 26

Recall the medical management of myasthaenia gravis

Answer 26

1. Anti-choline esterase (pyridostigmine) | 2. Immunosuppressant (use steroid)

Question 27

Which skin disease can result in a low IQ?

Answer 27

Neurofibromatosis type 1

Question 28

On which chromosome is the abnormality in neurofibromatosis?

Answer 28

17

Question 29

Recall 2 signs of neurofibromatosis

Answer 29

1. Cafe au lait spots | 2. Lisch nodules in the eye

Question 30

What sort of tumour are neurofibromatosis type 2 patients particularly at risk of getting?

Answer 30

Acoustic neuroma