Neuro

Question 1

Unilateral, severe periorbital headache with tearing and conjunctival erythema

Answer 1

Cluster headache

Question 2

Prophylactic treatment for migraine

Answer 2

Antihypertensives, antidepressants, anticonvulsants, dietary changes

Question 3

The most common pituitary tumour

Treatment?

Answer 3

Prolactinoma

Dopamine agonists e.g bromocriptine or cabergoline

Question 4

A 55 year old patient presents with acute ‘broken speech’. What type of aphasia?

What lobe and vascular distribution?

Answer 4

Broca aphasia

Frontal lobe. Left MCA distribution

Question 5

Most common cause of subarachnoid haemorrhage (SAH)

Answer 5

Trauma

Second is berry aneurysm

Question 6

Crescent shaped hyper density on CT that does not cross the midline

Answer 6

Subdural haematoma - bridging veins torn

Question 7

A history significant for initial altered mental status with an intervening lucid interval. Diagnosis?

Most likely source?

Treatment?

Answer 7

Epidural haematoma

Middle meningeal artery

Requires neurosurgical evacuation

Question 8

CSF findings with SAH

Answer 8

Raised ICP, RBCs, xanthochromia

Question 9

Albuminocytologic dissociation

Answer 9

Guillain-Barré syndrome (high protein in CSF without a significant rise in cell count)

Question 10

Cold water is flushed into a patient’s ear, and the fast phase of the nystagmus is toward the opposite side. Normal or pathological?

Answer 10

Normal

Question 11

Most common primary sources of metastasis to the brain

Answer 11

Lung, breast, skin (melanoma), kidney, GI

Question 12

May be seen in children who are accused of inattention in class and are often confused with ADHD

Answer 12

Absence seizures

Question 13

The most frequent presentation of intracranial neoplasm

Answer 13

Headache

Primary neoplasms are much less common than brain mets

Question 14

Most common cause of seizures in kids 2-10yrs

Answer 14

Infection, febrile seizures, trauma, idiopathic

Question 15

Most common cause of seizures in young adults 18-35yrs

Answer 15

Trauma, EtOH withdrawal, brain tumour

Question 16

First line medication for status epilepticus

Answer 16

IV benzodiazepine

Question 17

Confusion, ophthalmoplegia, ataxia

Answer 17

Wernicke encephalopathy due to a deficiency of thiamine

Question 18

What % lesion in a symptomatic patient is an indication for carotid endarterectomy?

Answer 18

70%

Question 19

Most common causes of dementia

Answer 19

Alzheimer’s disease and vascular/multi-infarct

Question 20

A combined upper motor neuron (UMN) & lower motor neuron disorder (LMN)?

Answer 20

Amyotrophic lateral sclerosis (ALS)

Question 21

Rigidity and stiffness with unilateral resting tremor and masked fancies

Answer 21

Parkinson’s disease

Question 22

The mainstay of Parkinson therapy

Answer 22

Levodopa/ carbidopa

Question 23

Treatment for Guillain-Barré syndrome

Answer 23

IVIG or plasmapheresis

Avoid steroids

Question 24

Rigidity and stiffness that progress to choreiform movements, accompanied by moodiness and altered behaviour

Answer 24

Huntington disease

Question 25

A 6 year old girl presents with a port-wine stain in the V1 distribution as well as with intellectual disability, seizures, and ipsilateral leptomeningeal angioma

Answer 25

Sturge-Weber syndrome

Treat symptomatically

Possible focal cerebral resection of the affected lobe

Question 26

Multiple cafe au lait spots on skin

Answer 26

Neurofibromatosis 1

Question 27

Hyperphagia, hypersexuality, hyperorality & hyperdocility

Answer 27

Klüver-Bucy syndrome (amygdala)

Question 28

May be administered to a symptomatic patient to diagnose myasthenia gravis

Answer 28

Edrophonium