Neuro

Question 1

thunderclp headache

Answer 1

subarachnoid haemorrhage (cf. PCKD)

Question 2

xanthochromatic lumbar puncture

Answer 2

subarachnoid haemorrhage

Question 3

lucid period after head trauma (often followed by sudden collapse or deterioration)

Answer 3

extradural haemorrhage

Question 4

cogwheel rigidity

Answer 4

Parkinson’s (spastity over rigidity)

Question 5

woody texture muscle swelling

Answer 5

Duchenne or Becker MD

Question 6

raised CK

Answer 6

muscular dystrophy

Question 7

toe-walker or + gower’s sign

Answer 7

muscular dystrophy

Question 8

mask-like expression

Answer 8

parkinson’s

Question 9

fluctuating cognitive deficit

Answer 9

lewy body dementia or delirium

Question 10

REM disturbance

Answer 10

lewy body dementia or Parkinson’s

Question 11

vivid visual hallucinations normally of children and not threatening

Answer 11

lewy body dementia

Question 12

acute onset cognitive disturbance that fluctuates

Answer 12

delirium

Question 13

personality/behaviour changes followed by dementia

Answer 13

frontotemporal dementia (Pick’s disease)

Question 14

memory and personality problems in someone w/ Hx of cardiovascular disease

Answer 14

vascular dementia

Question 15

stepwise deterioration

Answer 15

vascular dementia

Question 16

pain on loud noise

Answer 16

facial nerve (VII) palsy

Question 17

painful third nerve palsy

Answer 17

aneurysm

Question 18

myalgia + myositis + myoglobulinaemia/uria

Answer 18

rhabdomyolysis (disseminated intravascular coagulation and renal failure)

Question 19

inflammatory myopathy with poor response to steroids

Answer 19

inclusion body myositis

Question 20

weakness + frontal balding + cataracts + ptosis (often w/ onset in 30s, +ve FHx)

Answer 20

myotonic dystrophy

Question 21

leg symptoms + midline shift

Answer 21

falcine herniation

Question 22

back pain worse on coughing

Answer 22

slipped disc

Question 23

headache worse on coughing

Answer 23

posterior fossa issue

Question 24

bilateral sciatica + male sexual dysfunction

Answer 24

cauda equina

Question 25

pleocytosis on CSF

Answer 25

rules out bacterial meningitis

Question 26

migraine prophylaxis 1st line

Answer 26

propranolol, topiramate, or amitriptyline (if one not working by 3/12, try another)

Question 27

migraine prophylaxis 2nd line

Answer 27

valproate, pizotifen, gabapentin, pregablin

Question 28

injury upper brachial plexus

Answer 28

Erb’s palsy (waiters’ tip or low-five)

Question 29

injury lower brachial plexus

Answer 29

Klumpke’s palsy (claw hand)

Question 30

+ve Simmond’s test

Answer 30

Achilles tendon rupture