Neurology 1

Question 1

Commonest myopathy in patients > 50 yrs old?

Answer 1

Inclusion body myositis

Question 2

Mutation of what filament causes Udd myopathy?

Answer 2

Titin filament

Question 3

what antibodies a/w Thymoma + MG?

Answer 3

Ryanodine and Titin

Question 4

Medication for psychosis in Parkinson?

Answer 4

Clozapine -D1/2 and noradrenergic antagonist

Question 5

Medications for depression in Parkinson?

Answer 5

• TCA - amitriptyline
• Dopamine agonist - Pramipexole
• SSRI

Question 6

Medication for REM sleep disorder in Parkinson?

Answer 6

Benzodiazepines

Question 7

Anti-epileptics follows non-linear kinetics

Answer 7

Phenytoin

Gabapentin

Question 8

Thalamus blood supply?

Answer 8

Lenticulostriate arteries ( branch from M1)

Question 9

Cervical nerve root exits from vertebrae where?

Thoracic nerve root exits from vertebrae where?

Answer 9

Cervical always exit above corresponding vertebrae

Thoracic always exit below corresponding vertebrae

Question 10

Motor cell bodies found in where?

Answer 10

Anterior Horn ( LMN symptoms if affected)

Question 11

1st order neurons if affected - what signs?

2nd order neurons if affected - what signs?

Answer 11

1st order - UMN

2nd order - LMN

Question 12

Grey matter consist of?

White matter consist of ?

Answer 12

Grey matter = Anterior and posterior horn

White matter =Spinothalamic, corticospinal tract, Posterior column

Question 13

posterior horn function?

Answer 13

Sensory input from dorsal root ganglia

Question 14

1st order neuron mean?
2nd order neuron mean?
3rd order neuron mean?

Answer 14

1st order = Sensory neurons to CNS - Cell body in Dorsal root ganglion

2nd order = 1st order neuron synapse to 2nd order neurons and 2nd order cell body is in spinal cord/brainstem

3rd order = 2nd order neuron synapse to 3rd order in thalamus and bring message to appropriate cerebral cortex

Question 15

Spinothalamic tract decussates where? and crosses what?

Answer 15

1 - 2 segment below medulla

Cross anterior commissure

Question 16

In brown-sequard lesion - why no bladder dysfunction?

Answer 16

Need bilateral disruption of descending autonomic pathways

Question 17

In brown-sequard lesion - where UMN and LMN?

Answer 17

UMN - if hit 1st order neurons - below lesion

LMN - if hit 2nd order neurons - at level of lesion

Question 18

posterior cord syndrome causes?

Answer 18

Demyelination/ Nutritional

Rarely ischemia as there’s multiple branches

Question 19

Anterior cord syndrome cause?

Answer 19

Ischemia - only one anterior spinal cord artery

Question 20

MRI scan suggestive of stroke < 4.5 hours?

Answer 20

DWI - ischemic lesions + Normal FLAIR

Question 21

Oxygen in stroke?

Answer 21

No role unless have respiratory issue

Question 22

Most important modifiable risk factor for ischemic and hemorrhagic stroke?

Answer 22

Hypertension

Question 23

Anti-HTN most suitable for stroke patients?

Answer 23

ACEI or ARB

Thiazide

Question 24

In what group of population cannot use clopidogrel and why?

Answer 24

Chinese (up to 15%) - CYP 2C19 POOR metabolisers

Question 25

Highest risk of stroke within one month - what cause?

Answer 25

Large vessel atherosclerosis

Question 26

CEA should be perform when? for;
Asymptomatic carotid stenosis
Symptomatic carotid stenosis

Answer 26

Asymptomatic/ non-disabling - 70% and above

Symptomatic - 50 - 69%

Question 27

INTRACRANIAL artherosclerosis treatment?

Answer 27

Aggressive medical treatment

Question 28

B-Amyloid deposition in cerebral vasculature

• Cerebral amyloid?
• Alzheimers?

Answer 28

Cerebral amyloid : leptomeningeal and cortical fashion - AB42

Alzheimers : Parenchymal AB40

Question 29

Amaurosis fugax associated with what?

Answer 29

1. GCA
2. TIA
3. Severe ipsilateral carotid stenosis
4. Retinal emboli/hypoperfusion

Question 30

Tranexamic acid role in ICH?

Answer 30

Fewer death within 1 week

No difference in mortality/functional outcome in 3 months