Neuro

Question 1

Give 3 causes of peripheral neuropathies?

Answer 1

Drugs, Alcohol, Vitamin deficiency, Infection, Diabetes

Question 2

How long does a cluster headache typically last?

Answer 2

15-180 mins

Question 3

Give 3 characteristics of a cluster headache?

Answer 3

Unilateral orbital pain, restlessness/agitation, rapid onset of severe pain

Question 4

Give 3 characteristics of a tension headache?

Answer 4

Bilateral, pressing/tightening quality, not aggravated by exercise

Question 5

Give 3 characteristics of a tension headache?

Answer 5

Unilateral face pain within trigeminal distribution, duration 1 second - 2 mins, electric shock like

Question 6

What visual changes often precede migraine?

Answer 6

Flashing lights and zig-zag lines

Question 7

Give 3 characteristics of a migraine?

Answer 7

Attacks last 4-72 hours, unilateral, pulsing quality, aggravated by exercise, can experience nausea, vomitting, photophobia or phonophobia

Question 8

Give 3 triggers of a migraine?

Answer 8

Oral contraceptive pill, hangovers, chocolate, caffeine, travel

Question 9

Give 3 features of epileptic seizures?

Answer 9

Can wake from sleep, rhythmical jerks, tongue biting, incontinence, post-itcal state of drowsiness, fatigue

Question 10

Give a medication you could give to someone with a migraine?

Answer 10

Sumitriptan

Question 11

Give two microbiological agents that can cause meningitis?

Answer 11

Neisseria meningitides, strep pneumoniae, E.coli, H. Influenzae

Question 12

Give 3 risk factors for meningitis?

Answer 12

IVDU, crowding, immunocompromised, diabetes, malignancy

Question 13

What is the typical clinical presentation of meningitis?

Answer 13

Headache, neck stiffness, fever

Altered mental state, papilloedema, rash

Question 14

What antibiotic do you give for meningitis?

Answer 14

Cefotaxime

Question 15

What cells of the PNS does MS attack?

Answer 15

Oligiodendrocytes

Question 16

What is the clinical presentation of MS?

Answer 16

Difficulty swallowing, double vision, painful eye movement, tremor, Bladder involvement, weakness, numbness and tingling in limbs, symptoms worsen in heat

Question 17

Give 3 features of cerebellar disease?

Answer 17

Intention tremor, nystagmus, slurred speech, hypotonia, ataxia

Question 18

What are 3 symptoms of a raised ICP?

Answer 18

Headache (worse on waking)
Nausea and Vomiting
Papilloedema (blurred vision)
Reduced conscious level

Question 19

What are 4 red flag signs of brain tumour?

Answer 19

Weight loss, altered consciousness, papilloedema, headache+seizure

Question 20

Give 4 symptoms of a brain tumour?

Answer 20

Raised ICP, epilepsy, lethargy and tiredness, progressive neurological deficit

Question 21

What can cause an extradural haemorrhage?

Answer 21

Fractured temporal or parietal bone

Question 22

Which type of haemorrhage has a lucid interval?

Answer 22

Extradural haemorrhage

Question 23

What would a CT head show for a patient with an extra-dural haemorrhage?

Answer 23

Convex haematoma

Question 24

Give 3 risk factors for a subdural haemorrhage?

Answer 24

Elderly patients, epileptics, patients on anticoagulation, alcoholics

Question 25

Give 3 symptoms of subdural haemorrhage?

Answer 25

Fluctuating consciousness, headache, personality change, unsteadiness

Question 26

What would a CT head show for a patient with an subdural haemorrhage?

Answer 26

Crescent shaped haematoma

Question 27

Give 3 signs of a subarachnoid haemorrhage?

Answer 27

Thunderclap headache, neck weakness, photophobia, reduced consciousness, vomiting, collapse

Question 28

Give 3 clinical features of a LMN lesion?

Answer 28

Decreased muscle tone, fasciculation's, reflexes absent, muscle wasting

Question 29

How do you distinguish MND from MS and peripheral neuropathy?

Answer 29

MND there is no sensory loss of sphincter disturbance

Question 30

What does MND never effect?

Answer 30

Eye movement

Question 31

Give 3 symptoms of MND?

Answer 31

Weak grip, stumbling gait, foot drop, aspiration pneumonia

Question 32

What is the characteristic pattern of muscle weakness in UMN lesion?

Answer 32

Upper limb flexor stronger than extensor | Lower limb extensor stronger than flexor

Question 33

What are the characteristics findings in a patient with parkinson's?

Answer 33

Tremor (worst at rest), hypertonia (cog-wheel rigidity), bradykinesia (shuffling gait, slow to initiate movement)

Question 34

What is first line treatment for Parkinsons?

Answer 34

L-Dopa

Question 35

Give 2 contraindications to thrombolysis after a stroke?

Answer 35

Recent surgery past 3 months, severe liver disease, patient on anticoagulation

Question 36

How long do you have to thrombolyse someone post onset of stroke symptoms?

Answer 36

4. 5 hours

Question 37

Give 2 clinical features of an ACA stroke?

Answer 37

Leg weakness, incontinence, gait apraxia

Question 38

Give 2 clinical features of an MCA stroke?

Answer 38

Speech disturbance, facial droop, arm and leg weakness

Question 39

Give 2 clinical features of an PCA stroke?

Answer 39

Homonymous hemianopia, visual disturbance

Question 40

Give 3 red flag symptoms of caudal equina syndrome?

Answer 40

Sciatica, saddle anaesthesia, bladder/bowel dysfunction, flaccid leg weakness

Question 41

Give 3 causes of a TIA?

Answer 41

Cardioembolism (eg AF), atherothromboembolism, hyper viscosity eg malaria