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Neurology > FRACP questions > Flashcards

FRACP questions Flashcards

1
Q

Meniere disease

A
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2
Q

HINTS test in ongoing vertigo

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3
Q

DBS in PD

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4
Q

Stroke vs stroke mimic

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5
Q

Thrombectomy in acute stroke mgt

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6
Q

Tenecteplase vs alteplase for best outcome prior to performing endovascular thrombectomy

A
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7
Q

Brown Sequard syndrome

A

Hemisection of the spinal cord

Extent of symptoms depend on level of injury but hey always include:

  • contralateral loss of pain and temperature sensation
  • ipsilateral loss of fine touch and vibratory sensation
  • ipsilateral loss of motor function

Pure brown-sequard syndrome is rare

Common causes are trauma, tumor, ischaemic/infarction and MS

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8
Q

Rubrospinal tract

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9
Q

Transverse myelitis

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10
Q

Optic neuritis

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11
Q

Multiple Sclerosis features

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12
Q

CLIPPERS

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13
Q

Progressive multifocal leukoencephalopathy

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14
Q

Ocrelizumab used in which MS?

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15
Q

BPPV

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16
Q

Essential tremor

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17
Q

Tremor in PD

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18
Q

Right parietal infarct

A

hemiparesis + homonymous quadrantopia and hemispatial neglect

Lesion in occipital lobe - also homonomous hemianopia but with macular sparing

19
Q

pneumonic PITS for quadrant hemianopias location

A

Parietal - inferior

Temporal - superior

20
Q

PRES

A

Posterior reversible encephalopathy syndrome

  • Assoc with HTN, kidney disease, malignancy, dialsyis dpendency

Refers to a syndrome of reversible subcortical vasogenic oedema in patients with acute neurological symptoms.

Early brain MRI usually demonstrates ivasogenic oedema in the parieto-occipital regions of both cerebral hemispheres.

Common presentations:

  • seizure (85% of cases), headachee, amaurosis, altered mental status, N+V, transient motor deficits.

If recognized and treated promptly (aggresive BP management by 20% of MAP and seizure management and supportive care) - rapid onset symptoms and radiological features usually resolve within days to weeks.

21
Q

Normal pressure hydrocephalus

A

Normal pressure hydrocephalus charterized by 3 things:

  1. gait impairment (gait apraxia)
  2. dementia
  3. urinary incontiennce

Treatment = CSF drainage, surgical placement of VP shunt

22
Q
A
23
Q

Wallenbergs syndrome

A
  • *_Posterior inferior cerebellar artery (vertebral)
  • Lateral med_ullary (Wallenberg) syndrome** (PICA or vertebral artery occlusion)
  • vertigo, diplopia (due to vestibular nuclear involevemtnet)
  • hoarseness, dysarthria (involvement of nucleus ambiguus)
  • numbness of ipsilateral face (trigeminal spinal nucleus) and contralateral limb loss of pain and temp (due to spinothalamic tract)
  • ipsilateral horner’s
24
Q

Cluster headache

A

strictly unilateral phonophobia and photophobia

same side as cluster ehadache

25
Q

When to CT prior to LP?

A
  1. presence of papilloedema
  2. recent ehad trauma on hx
  3. konwn or suspected intracranial lesions
  4. focal neurological fidnings
  5. depresed level of consciousness
26
Q

IIH treatment options

A

WEIGHT loss, acetazolamide, frusemide, topirmate in the past

Corticosteroids - more harm then benefit

27
Q

Gene mutation linked with FALS

A

SOD1 mutation

28
Q

Which ix is most useful in making the diagnosis of motor neuron disease?

A

EMG - electromyogram!

Denervation is afeature in all forms of MND except primary lateral scleorosis us confirmed on EMG. Chronic partial denervation with preserved motor conduction velocity is characteristic,

29
Q

Kennedys syndrome

A

X-linked disorder

No UMN signs

Assoc with gynomastia and infertility

LMN disease - progressive weakness and wasting limb and bulbar muscles begins in malesin mid-adult life and is conjoined with androgen insensitivity and manifested by gynaecomastia and reduced fertility.

Two distiingushin features from ALS are the absence of signs of pyramidial tract disease (spasticity) and the presence of a subtle sensory neuropathy in some patients

30
Q

In MND which intervention most likely to prolong survival?

A

NIV

31
Q

Riluzole

A

sodium channel blocker that inhibits glutamate release

32
Q

Primary muscular atrophy vs primary lateral sclerosis

A

Primary muscular atrophy = LMN signs OINLY

Primary lateral sclerosis = UMN signs ONLY

33
Q

Amytrophic lateral sclerosis

A

LAS = UMN + LMN + bulbar dysfunction + respiratory failure. Also cramps and fasciulations

34
Q

Most common cause of death in MND?

A

Respiratory failure

35
Q

Carnazepine pharmacology

A
36
Q

Phenytoin side effects

A
  • osteoporosis
  • ataxia
  • nystagmus
  • gingival hyperplasia
  • coursenung f facial features
  • loss of libido
  • hormone dysfunction
  • bone marroe hypoplasia
37
Q

Which AED has the most teratogenic effect in pregnancy?

A

VALPROATE

(VERY bad)

major malformations - congenital heart disease, neural tube defects, urogenital defects and cleft lips or palates

38
Q

Vigabatrin side effects

A

Drowsiness (most common), neuropsych symptoms, weigth gain, visual field changes

39
Q

Topiramate

A

Weight loss

40
Q

AED choice in combination with OCP?

A

Sodium valproate

41
Q

Which drug should be avoided in Juvenile myoclonic epilepsy?

A

Carmabazepine

  • may aggravate JME, so it is important to uncover any history of jerking, especially in the morning
42
Q

What is the most common symptom of excess levodopa?

A

Nausea and vomiting

43
Q
A

Neurology (3 decks)

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