neuro

Question 1

symptoms of weber’s syndrome

Answer 1

Ipsilateral CN III palsy
Contralateral weakness of upper and lower extremity

Question 2

symptoms of wallenburgs

Answer 2

Ipsilateral: facial pain and temperature loss
Contralateral: limb/torso pain and temperature loss
Ataxia, nystagmus

Question 3

symptoms of lateral pontine syndrome

Answer 3

Contralateral: limb/torso pain and temperature loss
Ataxia, nystagmus
Ipsilateral: facial paralysis and deafness

Question 4

symptoms of a total anterior inferior cerebellar artery infarct

Answer 4

contralateral hemiparesis, contralateral homonymous hemianopia and a higher sensory deficit like aphasia, agnosia

Question 5

symptoms of a partial anterior inferior cerebellar artery infact

Answer 5

either contralateral hemiparesis and contralateral homonymous hemianopia or a higher sensory deficit on its own.

Question 6

symptoms of a posterior inferior cerebellar artery infarct

Answer 6

ipsilateral conjugate gaze dysfunction, cerebellar ataxia, bilateral motor and sensory nerve deficit, ipsilateral cranial nerve palsy with contralateral hemiparesis or isolated hemianopia due to vertebrobasilar arteries

Question 7

symptoms of a basilar artery stroke

Answer 7

locked in syndrome

Question 8

symptoms of a lacunar stroke

Answer 8

pure sensory stroke, or pure motor stroke with no high sensory deifict like aphasia, agnosia

Question 9

How would you treat a AICA and PICA stroke

Answer 9

do a medical thrombectomy 6 hours after symptom presentation, for PICA- offer 12 hours after symptoms onset

Question 10

what to do within 4.5 hours of a ischaemic stroke

Answer 10

thrombolysis with alteplase

Question 11

What are the four characteristics to do a decompressive hemicraniectomy

Answer 11

severe stroke symptoms, less than 60 years old, reduced consciousness and CT defined infarct of atleast 50% of the middle cerebral artery

Question 12

difference between stroke and TIA

Answer 12

no infarct is seen on the CT and symptoms resolve within 1 hour

Question 13

when should someone with TIA be referred to the TIA clinic

Answer 13

more than 1 crescendo a week, present 1 week after symptoms should be referred to within one week.

Question 14

Three features of a cerebral venous sinus thrombosis presentation

Answer 14

opthalmoplegia, unilateral headache with photophobia and horner’s syndrome

Question 15

ehler danos connective tissue disorder is a risk factor for which neurological disorder

Answer 15

subarachnoid haemorrhage

Question 16

what is a sentinel headache

Answer 16

sudden intense persistent headache that precedes a subarachnoid haemorrhage

Question 17

which has a headache after coitus

Answer 17

subarachnoid haemorrhage

Question 18

for which haemorrhage does hypertension not need to be monitiored in a clinical setting

Answer 18

subarachnoid haemorrhage- give nimodipine which is a ccb and reduced vasospasm.

Question 19

What is the investigation pathway for someone with suspected subarachnoid haemorrhage

Answer 19

within 6 hours on symptoms onset do a CT, if this shows hyperattenuation do a CT angiogram and diagnose with subarachnoid. if not on the CT do a magnetic resonance angiogram and a digital subtraction angiogram to double check. If they do not present within 6 hours of symptom onset - do a lumbar punction for CSF. if positive for blood and bilirubin do a CT angiogram.

Question 20

Which haemorrhage is common is elderly alcoholics

Answer 20

subdural

Question 21

Which haemorrhage is blood in between the dura and arachnoid

Answer 21

sub dural

Question 22

Which haemorrhage is blood in between the pia and arachnoid

Answer 22

subarachnoid

Question 23

Which haemorrhage shows up as lemons in the CT

Answer 23

extra dural

Question 24

Which haemorrhage shows up as bananas in the CT

Answer 24

subdural

Question 25

causes of delirium

Answer 25

Pain, Infection, Nutrition, Constipation, Hydration Medication Environment PINCH ME

Question 26

migrane episode length

Answer 26

4-72 hours

Question 27

is amaurosis fugax painful

Answer 27

classic monocular painless temporary loss of vision seen in a TIA and polyrheumatica

Question 28

risks for haemorrhagic and ischaemic strokes

Answer 28

haemorrhagic: arteriovenous malformations, ischaemic: atrial fibrillation

Question 29

sinusitis vs raised intracranial pressure features

Answer 29

sinusitis: worse when leaning forwards and raised intracranial pressure is worse in the morning and when coughing

Question 30

which conditions cause an upper and lower defect in bitemporal homonymous hemianopia

Answer 30

upper: pituitary tumour
lower: craniopharyngioma

Question 31

uvula deviated away from the side of lesion
loss of gag reflex

Answer 31

cranial nerve 10

Question 32

difference between trali and taco

Answer 32

trali is pulmonary oedema with hypotension
taco is pulmonary oedema with hypertension

Question 33

common consequence to subarachnoid haemorrhage

Answer 33

SIADH

Question 34

hat in CSF suggest that meningitis is bacterial

Answer 34

csf glucose less than half of plasma glucose, polymorphs, csf protein more than 1,5g

Question 35

prophylaxis for cluster headaches

Answer 35

verapamil

Question 36

first, second and third line for migrane prophylaxis

Answer 36

1) propanol 2) topiramate 3) amitriptyilline

Question 37

acute medciation for migranes

Answer 37

sumatriptan

Question 38

treatment for cluster headahce

Answer 38

sumatriptan with oxygen