Neuro 2

Question 1

Mx of brain abscess?

Answer 1

IV ceftriaxone
metronidazole

++ intracranial pressure management

Question 2

Mx

Answer 2

surgical - craniotomy and debridement

IV abx: Cef +metronidazole

dexamethasone for pressure

Question 3

which antidiabetic medication cause hypogylcaemia?

Answer 3

gliclazide and semaglutide

Question 4

Gliclazide MOA?

Answer 4

sulfonylurea

Question 5

HSV encephalitis

mx?

Answer 5

affects temporal lobes
> aphasia

HSv1

aciclovir

Question 6

IX encephalitis

Answer 6

CSF : raised protein and WCC

PCR for HSV
CT

MRi > CT

EEG ; 2hz

Question 7

Triptans moa

Answer 7

serotonin antagonism

acute mx

Question 8

why would Indomethacin help with headaches?

Answer 8

inhibits prostaglandin synthesis
NSAID

reduce inflammation

Question 9

mx of raised intracranial pressure?

Answer 9

acetazolamide - carbonic anhydrase inhibitor

Question 10

topiramate

Answer 10

anticonvulsant

> inhibits sodium channel gates

Question 11

what is internuclear opthaloplegia?

Answer 11

lesion which affects fibres crossing between
CN 6 and 3

impaired eye movements nystagmus
failure of adduction in affected eye

Question 12

neuroleptic malignant syndrome compared to SS?

Answer 12

NMS is very fast / hours

muscle rigidity and raised CK is pointing more to NMS

Question 13

NMS

Answer 13

massive glutamate release = neurotoxicity and muscle damage

pyrexia
rigidity
delirium
temp
CK raised
leukocytosis

Question 14

Mx of NMS?

Answer 14

stop antipsychotic
IV fluids for renal

Question 15

cluster headache?

Answer 15

15- 2 hours

intense sharp pain around one area (eye)

> redness
lacrimation
lid swelling
miosis / ptosis

Question 16

Mx of cluster headache?

Answer 16

100% O2
subcut triptan

prophylaxis?
> verapamil

Question 17

unilateral pupillary dilatation in an extradural haemorrhage occurs why?

Answer 17

raised ICP

= transtentorial herniation

raised pressure causes temporal lobe to herniate through tentorial notch

compresses ipsilateral 3rd cranial nerve

= dilated pupil

ptosis
down and out eye deviation

Question 18

why is the radial nerve particularly vulnerable to compression?

Answer 18

winds around humerous in the spiral groove

‘wrist drop’

inaibility to extend wrist

Question 19

Ulner nerve innervates?

Answer 19

intrinsic hand muscles

FINGER abductiona nd adduction

sensory medial 1 1/2 fingers

Question 20

Mx for a thyroid storm?

Answer 20

IV hydrocortisone
propranolol
IV fluids

Question 21

Mx of Myasthenic crisis?

Answer 21

plasmapheresis to remove circulating abs

IV IG to diminsh activity of disease

Question 22

Mx of addisonian crisis?

Answer 22

IV hydrocortisone
IV fluids
glucose
ab

Question 23

Tensilon test

Answer 23

IV edrophonium reduces muscle weakness temporarily

Question 24

steven johnson syndrome?

Answer 24

rash
confusion
febrile and breathless

Question 25

MRI with or without contrast to view demyelinating lesions?

Answer 25

with contrast to view plaques

Question 26

fourth nerve palsy

Answer 26

affected eye appears to deviate upwards when straight ahead

vertical diplopia
drift upwards and rotate outwards

superior oblique muscle paralysis

Question 27

transverse myelitis?

Answer 27

CNs

hyperreflexia
bladder / bowel dysfunction