Exam 4

Question 1

Damage to one or more peripheral nerves, usually in association with a systemic cause (e.g. rheumatoid, vasculitis, diabetes)

Answer 1

Mononeuritis multiplex

Question 2

Symptoms of Guillaine-Barre syndrome

Answer 2

Progressive ascending weakness (although usually proximal rather than distal)

Question 3

Management of Guillaine-Barre syndrome (2)

Answer 3

IV immunoglobulin +/- mechnaical ventilation

Question 4

Onset in puberty of weak legs and foot drop +/- sensory or reflex loss

Answer 4

Charcot-Marie tooth

Question 5

Inheritance of CMT

Answer 5

Usually autosomal dominant

Question 6

Mostly sensory neuropathies (2)

Answer 6

Diabetes

Renal failure/uraemia

Question 7

Mixed neuropathies (5)

Answer 7

b12/folate deficiency
Thiamine deficiency
Vasculitis
SLE
Amyloidosis

Question 8

What is implied by a positive Rombergs test?

Answer 8

Implies sensory (i.e. proprioception) ataxia rather than a cerebellar ataxia

Question 9

What is Froment’s sign?

Answer 9

Flexion of thumb when grasping a piece of paper, in order to compensate for weak adductor pollicus. Indicates ulner nerve palsy

Question 10

Mechanisms of radial nerve palsy (2)

Answer 10

Humeral shaft fracture

“Saturday night palsy”

Question 11

C5-C7 brachial plexus injury. What is this caused by and how does it present?

Answer 11

Erb’s palsy, caused by shoulder dystocia. Arm in “waiter tip” position

Question 12

C8-T1 injury. What is this caused by and what are the features?

Answer 12

Klumpke’s palsy, excessive arm traction at birth. Claw hand, small muscle wasting

Question 13

Which condition may co-exist with Klumpke’s palsy?

Answer 13

Horner’s syndrome

Question 14

Major pathological hallmarks of Alzheimer’s disease (3)

Answer 14

Cortical atrophy with sparing of brainstem and cerebellum
Ventricular dilatation
Neurofibrillary tangles and amyloid beta plaques

Question 15

Pathological hallmarks of Lewy body dementia (3)

Answer 15

Lewy bodies (alpha-synuclein inclusions within the cytoplasm)
Degeneration of substantia negra
Degeneration of cortex

Question 16

Symptoms of dementia (5)

Answer 16

Cognitive impairment
Mood disturbance
Apathy
Agitation
Wandering

Question 17

What type of neurones are loss in AD? What areas? (4)

Answer 17

Cholinergic neurones

Question 18

Pharmacological management of AD (2)

Answer 18

AChesterase inhibitors- rivastigmine, donepizil, galantamine

Memantine (anti-GABA)

Question 19

Distinguishing features of Lewy body dementia? (2)

Answer 19

Hallucinations

Parkinsonian features

Question 20

Distinguishing features of frontotemporal dementia? (2)

Answer 20

Disinhibition

Emotional unconcern