NEURO Q's

Question 1

what modality of imaging is preferred in patients with suspected TIA requiring brain imaging

Answer 1

MRI brain with diffusion-weighted imaging is the preferred modality in patients with suspected TIA who require brain imaging

Question 2

brown sequard syndrome is a result of

Answer 2

lateral hemisection of the spinal cord

Question 3

brown sequard syndrome features include

Answer 3

ipsilateral weakness below the lesion
ipsilateral loss of proprioception and vibration sensation
contralateral loss of pain and temperature sensation

Question 4

why does brown sequard syndrome cause contralateral loss in temp/pain sensation?

Answer 4

because the pathway for pain/temperature sensation decussates at the level of the nerve root.

Question 5

Which type of motor neuron disease carries the worst prognosis?

Answer 5

progressive bulbar palsy

Question 6

what are the types of motor neurone disease

Answer 6

amyotrophic lateral sclerosis

primary lateral sclerosis

progressive muscular atrophy

progressive bulbar palsy.

Question 7

what are the features of amyotrophic lateral sclerosis

Answer 7

typically LMN signs in arms and UMN signs in legs

in familial cases, the gene responsible lies on chromosome 21 and codes for superoxide dismutase

Question 8

features of primary lateral sclerosis

Answer 8

UMN signs only

Question 9

features of progressive muscular dystrophy

Answer 9

LMN signs only
affects distal muscles before proximal
carries best prognosis

Question 10

features of progressive bulbar palsy

Answer 10

palsy of the tongue, muscles of chewing/swallowing and facial muscles due to loss of function of brainstem motor nuclei
carries worst prognosis

Question 11

Axillary freckles are indicative of

Answer 11

neurofibromatosis type 1

Question 12

what is the inheritance pattern for NF1 and NF2

Answer 12

autosomal dominant
NF1 = chr 17
NF2 = chr 22

Question 13

features of NF1

Answer 13

Café-au-lait spots (>= 6, 15 mm in diameter)
Axillary/groin freckles
Peripheral neurofibromas
Iris hamatomas (Lisch nodules) in > 90%
Scoliosis
Pheochromocytomas

Question 14

features of NF2

Answer 14

Bilateral vestibular schwannomas

Multiple intracranial schwannomas,
mengiomas and ependymomas

Question 15

Sudden onset vertigo and vomiting, dysphagia, ipsilateral facial pain and temperature loss, contralateral limb pain and temperature loss and ataxia = occlusion of which artery

Answer 15

posterior inferior cerebellar artery