Neuro

Question 1

1st line Rx focal seizure?

Answer 1

Lamotrigine or Keppra

2nd line = carbamezepine or zonisadmide

Question 2

1st line Rx for tonic clonic seizures men vs women

Answer 2

Men = Sodium valproate

Women = Lamotrigine or keppra

Question 3

1st line Rx absence seizure ?

Answer 3

Ethosuximide

Question 4

What medication can aggravate absence seizures?

Answer 4

Carbamazepine

Question 5

1st line Rx myoclonic seizures?

Answer 5

Men = sodium valproate
Women = Keppra

Question 6

1st line Rx tonic or atonic seizure?

Answer 6

Men = sodium valproate
Women = Lamotrigine

Question 7

Driving rules re seizures:

Answer 7

1st seizure = 6 month ban

IF MRI structural changes / EEG = 12 months

12 months after last seizure can apply to DVLA to drive

Question 8

65% of patients with RR MS progress to what?

Answer 8

2* progressive

Question 9

What is Uhtoff phenomenon?

Answer 9

Vision worse when cold in people with demyelinating disorders

Question 10

Ix of MS

Answer 10

MRI (HIGH SIGNAL T2 lesions)

DAWSONS fingers on FLAIR

Question 11

What is shown on CSF in MS?

Answer 11

Oligoclonal bands / High IgG

ALSO remember delayed vision provoked potentials

Question 12

Acute Rx of MS?

Answer 12

PO/IV Methylpred

Question 13

Rx of oscillopsia in MS?

Answer 13

Gabapentin

Question 14

Rx of spasticity in MS?

Answer 14

Gabapentin or Baclofen

Question 15

What Rx reduces risk of relapse in MS?

Answer 15

DMARDS

Question 16

What helps with fatigue in MS?

Answer 16

Amantidine / CBT

Question 17

Parkinsons disease TriadS

Answer 17

Bradykinesia, Trempr, Rigidity

Question 18

Parkinson’s disease Dx?

Answer 18

SPECT Scan

Question 19

1st Line Rx of Parkinsons if motor symptoms affecting QOL?

Answer 19

Levodopa

Question 20

1st line Rx of Parkinsons if motor symptoms not bothering QOL?

Answer 20

Dopamine agonist or Levodopa or MAO - B inhibitor

Question 21

What can be used for excessive drooling in Parkinson’s ?

Answer 21

Glycoporinium bromide

Question 22

What is levodopa usually combined with to reduce side effects?

Answer 22

with a decarboxylase inhibitor (e.g. becoming levodopa)

Question 23

SEs of LEVODOPA?

Answer 23

Dry mouth
Anorexia
Palpitations
Psychosis
Postural hypotension

ACUTE DYSTONIA IF ACUTELY STOP

Question 24

Name a few dopamine agonists

Answer 24

Bromocriptine, Ropinorole, Cabergoline

Question 25

What is required before starting dopamine agonists and why?

Answer 25

CXR, ECHO, ESR, Creatinine Can cause pulmonary, cardiac and retroperitoneal fibrosis

Question 26

Prophylactic Rx of migraine?

Answer 26

Propranolol or Topirimate (avoid in woman of child bearing age)q

Question 27

Acute Rx of migraine?

Answer 27

Triptan NSAID Paracetamol IF age 12-17 use nasal triptan

Question 28

Acute Rx of cluster headache?

Answer 28

Oxygen / Triptan

Question 29

Prophylaxis of cluster headache?

Answer 29

Verapamil

Question 30

Biceps Reflex

Answer 30

C5/C6

Question 31

Triceps Reflex

Answer 31

C7/C*

Question 32

Knee Reflex

Answer 32

L3/L4

Question 33

Ankle Reflex

Answer 33

S1/S2

Question 34

Ulnar nerve is which root ?

Answer 34

C8/T1

Question 35

Radial nerve damage causes...

Answer 35

Wrist drop (C5-C8)

Question 36

Median nerve damage =

Answer 36

Carpa; Tunnel C6, C8, T1

Question 37

Leg and foot dermatomes

Answer 37

L4 = knee cap L5 = big toe / dorm of foot S1 = Lateral foot / Small toe

Question 38

What symptoms with anterior cerebral artery stroke?

Answer 38

Contralateral heme-paresis and sensory loss LOWER EXTREMITY > upper extremity

Question 39

MCA stroke symptoms?

Answer 39

Hemiparesis and aphasia UPPER > lower

Question 40

Posterior cerebral artery stroke symptoms?

Answer 40

Contralateral homonymous hemianopia with macular sparing Visual agnosia

Question 41

Webers syndrome

Answer 41

Ipsilateral CN III Palsy Contralateral weakness of upper and lower limbs Branches of PCA supplying midbrain

Question 42

What is another name for posterior inferior cerebellar artery syndrome?

Answer 42

Lateral medullary syndromeH

Question 43

How does lateral medullary syndrome present?

Answer 43

Ipsilateral facial pain and temp loss. Contralateral limb/torso pain and tempo loss Ataxia / Nystgamus

Question 44

How does anterior inferior cerebellar artery syndrome present?

Answer 44

Ipsilateral facial paralysis and deafness

Question 45

What is locked in syndrome?

Answer 45

Basilar artery stroke

Question 46

Lacunar stroke presentation?

Answer 46

Isolated hemi-paresis / hemi-sensory or loss of limb ataxia.

Question 47

What is the cut off for statin?

Answer 47

If cholesterol >3.5

Question 48

When can thrombectomy be used?

Answer 48

6 hours from symptoms onset + thrombolysis (if 4.5hrs from onset)

Question 49

When should carotid endarterectomy be considered?

Answer 49

If stenosis >50% (perform within 7 days)

Question 50

Abx for brain abscess?

Answer 50

Ceftriaxone (or other 3rd gen cephalosporin ) + metronidazole Usually need craniotomy

Question 51

In stroke pts, what side is their heminopia?

Answer 51

Same side

Question 52

Where is the lesion if macular sparing visual defect?

Answer 52

Occipital cortex

Question 53

What epilepsy drug can cause megaloblastic anaemia?

Answer 53

Phenytoin (can alter folate metabolism)

Question 54

Patorid pathology causes what type of lesion?

Answer 54

Lower motor neurone facial palsy (similar to bells palsy)

Question 55

What is Capgras syndrome?

Answer 55

thinking your relative replaced by an imposter

Question 56

What is the most common symptoms of POCS?

Answer 56

Dizziness

Question 57

Anti-emetic of choice in PD?

Answer 57

Domperidone

Question 58

What is Brocas aphasia and where is the lesion?

Answer 58

Expressive = Frontal lobe Comprehension okay but bad speech

Question 59

What is Wernickes aphasia and where is the lesion?

Answer 59

Receptive - Temporal Lobe No comprehension but speech okay