Neuro

Question 1

34 yo F found unresponsive, good bp and pulse, next step?

Answer 1

Check glucose

hyper and hypoglycemia can cause mental state abnormalities

Question 2

What is a red flag for cauda equina syndrome?

Answer 2

Sudden loss of bowel sphincter control ( bladder or bowel)

Question 3

Person with a serious infection ( can be anything, even food poisoning) and now they have mild weakness of upper limbs, a bilateral lower motor neuron facial palsy and no knee and ankle jerk reflexes- diagnosis?

Answer 3

Guillain- Barre Syndrome

( typically 1-3 weeks after infection)

lower limbs affected first, then ascends

Question 4

F with dysarthria, intention tremor (hand shakes uncontrollably when writing with right hand) and ataxic gait- lesion in what area?

Answer 4

cerebellar hemisphere

Question 5

first line for myoclonic seizure (horrible head movements)

Answer 5

sodium valproate

Question 6

sudden severe occipital headache + recurrent sprains and shoulder dislocations + hypertension - best next management?

Answer 6

non contrast CT brain scan (to confirm that this is subarachnoid haemorrhage)

Question 7

suspected SAH but CT head scan is -ve, next most appropriate investigation to order?

Answer 7

lumbar puncture

Question 8

60 yo M + pain and weakness in legs + change in gait (scissoring) + brisk jaw jerk + brisk bilateral reflexes - diagnosis?

Answer 8

primary lateral sclerosis

all symptoms are UMN lesions, which is characteristic of PLS

Question 9

Parkinson triad of tremor, hypertonia and bradykinesia plus vertical gaze palsy- diagnosis?

Answer 9

progressive supranuclear palsy (PSP) - a parkinson plus syndrome

Question 10

Haemorrhagic stroke risk factors

Answer 10

sympathomimetic drugs (cocaine, amphetamines), age, male sex, haemophilia, cerebral amyloid angiopathy/ hypertension, anticoags

Question 11

lesion in cerebellum on left side –> symptoms on ______ side

Answer 11

left

unilateral cerebellar lesions cause ipsilateral symptoms

Question 12

Broca’s aphasia is due to lesion of the ___________ gyrus

Answer 12

inferior frontal

Question 13

Broca’s and Wernicke’s areas are connected by the _________. A lesion here produces ________ aphasia.

Answer 13

arcuate fasciculus

conduction aphasia, characterised by fluent speech but an awareness of errors.

Question 14

Vitamin B12 deficiency causes _______________ of the spinal cord

Answer 14

subacute combined degeneration

Question 15

Wernicke’s area is supplied by the ____________________

Answer 15

inferior division of the left MCA

Question 16

________ lobe lesions may cause anosmia

Answer 16

Frontal

Question 17

_______ is investigation of choice in cerebellar disease

Answer 17

MRI

Question 18

______________ is due to a lesion in the medial longitudinal fasciculus

Answer 18

Internuclear ophthalmoplegia