Neuro 2

Question 1

Biceps reflex dermatome

Answer 1

C5, C6 PICK UP STICK

Question 2

Triceps reflex dermatome

Answer 2

C7, C8 Shut the gate

Question 3

Dermatomal patch covering the regimental pat h

Answer 3

C5

Question 4

dertmatome to thumb

Answer 4

C6

Question 5

Dermatome to middle finger

Answer 5

C7

Question 6

dermatome to little finger

Answer 6

C8

Question 7

dermatome to medial elbow

Answer 7

T1

Question 8

Where must you touch for UL dermatomal sensation

Answer 8

axilla (c5) 
thumb (C6) 
middle (C7) 
little finger (C8) 
inside of elbow (T1)

Question 9

what nerve roots make up the mussculocutaneous nerve

Answer 9

C5-C7

Question 10

fuction of musculocutaenous

Answer 10

innervates biceps, brachialis, coracobrachialis > flexion of arm at elbow

Question 11

nerve roots of median nerve

Answer 11

C7-T1

Question 12

function of median N

Answer 12

SENSORY to lat 3.5 fingers

MOTOR to anterior forearm and LOAF muscles of hand (flexion of wrist, thenar eminence)

Question 13

nerve roots of axillary

Answer 13

C5, C6

Question 14

functions of Axillary N

Answer 14

Motor to teres minor and deltoid (abduction of arm beyond first 15 degrees)

Sensory to reegimental patch

Question 15

Radial nerve roods

Answer 15

C5-T1

Question 16

function of radial nerve

Answer 16

posterioor arm and forearm muscles

cutaneous to possterior arm / forearm and dorsal lat 3.5 fingers

Question 17

How do you check radial, median and ulnar nerve sensation in the hand

Answer 17

Radiial: side of thumb

median: medial 3.5 fingers
ulnar: at 1.5 fingers

Question 18

how od you commonly damage musculocutaenous nerve

Answer 18

breast surgery

Question 19

cause of lateral medullary syndrome

Answer 19

OCCLUSION of POSTERIOR INFERIOR CEREBELLAR AARTERY

Question 20

sx lateral medullary syndrome

Answer 20

cerebellum:
- ataxia
- nystagmus

brainstem:
- ipsilat: dysphagia, facial numbness, HOrners
- contralat: limb sensory loss

Question 21

when should you refer for specialist review someone with TIA

Answer 21

<24h if within 7 days since FIRST TIA

><7 days if more than 7 days from first TIA

Question 22

what should you do if pt presents with more than one TIA

Answer 22

CRESCENDO TIA > you need to admit and invesitgatw

Question 23

when should you admit and investigate someone with TIA

Answer 23

• crescendo TIA (more than 1)
• suspected cardioembolic source
• severe carotid stenosis
• patient on warfarin / doac or with bleeding disoorder

Question 24

what must you do if hhaemorrhagic transformation in TIA

Answer 24

STOP all anticoagulants

lower BP

Question 25

what does a contralateral homonymous hemianopia with macular sparing suggest?

Answer 25

that the lesion is in the occipital cortex

Question 26

how can you tell the difference between prolactimona and craniopharyngioma causing a bitemporal hemianopia

Answer 26

prolactinoma: UQ> LQ craniophharyngioma: LQ>UQ

Question 27

features of neuroleptic malignant syndrome

Answer 27

Confusion Autonomic lability (hypertension, tachycardia and tachypnoea) Rigidity Pyrexia

Question 28

what investigations must you do for BELL's

Answer 28

NONE - usually clinical dx

Question 29

what does WHITE on head CT mean

Answer 29

HYPERDENSE region = acute clotted blood, from haemorrhage

Question 30

what does BLACK on head CT mean

Answer 30

HYPODENSE (dark) region = ishaemic infarct, chronic clotted blood

Question 31

differentials for cerebellar disease

Answer 31

``` V- stroke (vertebrobasilar) i - encephalitis, abscess T - Trauma (raised ICP) A - MS, Paraneoplastic cerebellar dege M - ethanol, poisons, N- Posterior fossa tumour ```

Question 32

ix for cerebellar disease

Answer 32

Bloods: ETOH, FBC, UE, LFT, CLotting, Ceruloplasmin (Wilson) ECG (arrythma) CSF (oligoclonal bands for MS) MRI (posterior cranial fossa)

Question 33

what do you see on NC CT for ischaemic stroke

Answer 33

hyperdense artery loss of grey white matter interface hypodense area

Question 34

how do you treat trigeminal neuralgia

Answer 34

carbamazepine

Question 35

complex regional pain sydrome fts

Answer 35

``` PORTS: Pain Oedema Restriction of Movement Temperature/ colour change Stiffness ```

Question 36

what is pituitary aapopexy

Answer 36

sudden enlargement of the pituitary gland | usually due to haemorrhage or infarction of tumour

Question 37

fts of pituitary apopexy

Answer 37

sudden onset headache similar to that seen in subarachnoid haemorrhage vomiting neck stiffness visual field defects: classically bitemporal superior quadrantic defect extraocular nerve palsies features of pituitary insufficiency e.g. hypotension/hyponatraemia secondary to hypoadrenalism

Question 38

how do you manage pituitary apopexy

Answer 38

steroids URGENTLY to replace lack of AACTH | fluid balance > surgery