Neuro

Question 1

Normal intracranial pressure?

Answer 1

0-10 mmhg

Question 2

Name 5 causes raised intracranial pressure?

Answer 2

• Primary/metastatic tumours
• head injury
• haemorrhage
• meningoencephalitis, brain abscess
• hydrocephalus, cerebral oedema, status epilepticus

Question 3

Name 4 symptoms raised intracranial pressure?

Answer 3

• Headache worse in morning
• drowsy, irritable
• vomiting
• seizures

Question 4

Name 4 signs raised intracranial pressure? (5)

Answer 4

• Cushing’s response = falling pulse + rising bp
• coma
• Cheyne - stokes respiration (alt between hyperventilation + apnoea )
• pupil changes (constriction first, later dilatation)
• papilloedema
  → absent venous pulsation at the disc + vessel engorgement
  -→ disc margins red (hyperaemic)
  → disc margins blurry, haemorrhages in retina

Question 5

Name 5 features migraine

Answer 5

POUND

• pulsatile headache
• hours duration 4-72
• uni lateral
• Nausea, voriting
• disabling headache

Question 6

Differential acute confusional state? (5)

Answer 6

Aeiou

• apoplexy (brain injury), (trauma, stroke, aneurysm, hypoxaemia, subdural haemorrhage, neuroglycopenic haemorrhage, avm..)
• epilepsy /seizures
• infection / inflammation
• opiate + other drugs
• urea/metabolic (electrolytes, thyroid…)

Question 7

Symptom subarachnoid haemorrhage?

Answer 7

Thunderclap headache

Question 8

Name lesion of neuromuscular junction

Answer 8

Myasthenia gravis

Question 9

Lp findings cryptococcal meningitis (6)

Answer 9

• Protein: high
• WBC: mild lymphocytosis
• glucose: low
• Clat positive
• India ink stain positive
• fungal culture positive
  High opening pressure

Question 10

CSF Tb meningitis? (5)

Answer 10

Appearance: turbid/viscous
Neutrophils: normal or high (0-200 /mm3)
Lymphocytes: very high (100-300)
Protein: elevated (0.5-3.0 g/L)
Glucose: very low (<1/3 blood glucose)
ADA positive!

Question 11

Name 4 neurological areas affected in b12 deficiency

Answer 11

• Peripheral nerves: glove + stocking parasthesiae, loss ankle reflexes
• spinal cord: subacute combined degeneration of cord (post columns + corticospinal tract w/ umn signs)
• cerebrum: dementia, optic atrophy
• autonomic neuropathy

Question 12

Identify picture 12

Answer 12

SuB = banana

Subdural haematoma

• crescent shape
• bridging veins

Question 13

Identify picture 13

Answer 13

Epi = pie

Epidural haematoma

• middle meningeal artery
• convex/lens shaped