Neuro Bank

Question 1

Acute migraine treatment - 1st line

Answer 1

oral triptan + NSAID/paracetamol

Question 2

Acute migraine treatment: aged 12-17

Answer 2

nasal triptan + NSAID/paracetamol

Question 3

Acute migraine treatment - 2nd line

Answer 3

metoclopramide or prochlorperazine

+/- non-oral NSAID/triptan

Question 4

Migraine prophylaxis - 1st line

Answer 4

topiramate or propranolo

Question 5

Migraine prophylaxis - 2nd line

Answer 5

10 sessions of acupuncture

Question 6

Migraine prophylaxis - menstrual migraine

Answer 6

frovatriptan or zolmitriptan

Question 7

Classical features of vestibular schwannoma

Answer 7

-vertigo
-sensorineural hearing loss
-tinnitus
-absent corneal reflex

Question 8

Parkinsons treatment: first line - motor symptoms affecting QOL

Answer 8

Levodopa

Question 9

Parkinsons treatment: first line - motor symptoms not affecting QOL

Answer 9

Dopamine agonist (ropinirole, bromocriptine, cabergoline)
/
Levodopa
/
MAO-B inhibitor (selegiline)

Question 10

Parkinsons treatment: 2nd line

Answer 10

Levodopa plus adjunct:
-dopamine agonist
-MAO-B inhibitor
-COMT inhibitor (entacapone)

Question 11

Common features of MND

Answer 11

-fasciculations
-no sensory signs
-LMN + UMN signs
-wasting

Question 12

Peripheral neuropathy - causes of predominantly motor

Answer 12

GBS
lead poisining
HSMN - CMT
CIDP
diptheria
porphyria

Question 13

Peripheral neuropathy - causes of predominantly sensory

Answer 13

diabetes
leprosy
B12 deficiency
amyloidosis
uraemia

Question 14

Features of bell’s palsy

Answer 14

LMN facial nerve palsy - forehead affected

Sometimes: post-auricular pain, altered taste, dry eyes, hyperacusis

Question 15

Management of Bell’s palsy

Answer 15

Prednisolone 1mg/kg 10 days

Within 72 hours of onset

Eye care

Question 16

Guillain-Barre - classic features

Answer 16

Progressive weakness of all four limbs
-LL > UL
-Proximal > distal
-Minimal sensory
-areflexia
-cranial nerves - diplopa
- autonomic - retention

Question 17

Neuropathic pain - 1st line

Answer 17

amitriptyline, duloxetine, gabapentin or pregabalin

Question 18

Neuropathic pain - 2nd line

Answer 18

Try one of the other of: amitriptyline, duloxetine, gabapentin or pregabalin

Question 19

Neuropathic pain - 3rd line

Answer 19

Tramadol rescue therapy

Question 20

Neuropathic pain - topical

Answer 20

Capsaicin

Question 21

MS treatment - acute relapse

Answer 21

High dose steroids - methylprednisolone 5 days

Question 22

MS treatment - reducing relapse rate

Answer 22

Beta-interferon

Question 23

MS treatment - fatigue

Answer 23

Amantadine

Question 24

MS treatment - spasticity

Answer 24

Baclofen/gabapentin/diazepam

Question 25

MS treatment - oscillopsia

Answer 25

Gabapentin

Question 26

L3 nerve root compression

Answer 26

-Sensory loss over anterior thigh
-Weak quadriceps
-Reduced knee reflex
-Positive femoral stretch test

Question 27

L4 nerve root compression

Answer 27

-Sensory loss anterior knee
-Weak quadriceps
-Reduced knee reflex
-Positive femoral stretch test

Question 28

L5 nerve root compression

Answer 28

-Sensory loss dorsum of foot
-Weakness in foot and big toe dorsiflexion
-Reflexes intact
-Positive sciatic nerve stretch test

Question 29

S1 nerve root compression

Answer 29

-Sensory loss posterolateral leg and lateral foot
-Weakness in plantar flexion
-Reduced ankle reflex
-Positive sciatic nerve stretch test

Question 30

Drugs used in mild to moderate Alzheimer’s: 1st line

Answer 30

Acetylcholinesterase inhibitor: donepezil, galantamine or rivastigmine

Question 31

Drugs used in Alzheimer’s: 2nd line

Answer 31

Memantine (NMDA antagonist)