Neurology

Question 1

Upper vs lower motor neuron signs?

Answer 1

UPPER vs LOWER
Wasting: mild vs prominent
Fasciculations: none vs some
Tone: inc. vs dec./normal
Weakness: pyramidal (upper extensor + lower flexor) vs yes
Reflexes: inc. +/- clonus vs dec./absent
Plantar response: extensor/normal vs normal

Question 2

Spastic paraparesis
Definition?
Causes?

Answer 2

UMN pattern of weakness in lower limbs

Causes:

• Demyelination e.g. MS
• Cord compression
• Syringiomyelia
• Transverse myelitis
• Hereditary spastic paraplegia
• Cervical spine osteoarthritis
• Parasagittal meningioma

Question 3

Wernicke’s aphasia
Definition? Lesion?

Broca’s aphasia
Definition? Lesion?

Conductive aphasia
Definition? Lesion?

Answer 3

Fluent speech, impaired comprehension
Superior temporal gyrus

Non-fluent speech, normal comprehension
Inferior frontal gyrus

Fluent speech, poor repetition
Arcuate fasciculus (connection between Wernicke + Broca)

Question 4

Von Hippel-Lindau syndrome
Definition?
Features?

Answer 4

autosomal dominant condition predisposing to neoplasia

cerebellar haemangiomas: 
retinal haemangiomas
Cysts (renal, spidydimal, pancreatic, hepatic)
phaeochromocytoma
endolymphatic sac tumours
clear-cell renal cell carcinoma

Question 5

Subarachnoid Haemorhage

Investigations?

Answer 5

CTH

LP - at least 12h post headache to allow xanthochromia to form

Question 6

Tuberous sclerosis
Definition?
Features?

Answer 6

Genetic. autosomal dominant inheritance. Neurocutaneous.

ASHLEAF
A- Ash leaf spots
S- Shagreen patches
H- Heart Rhabdomyomas
L- Lung lumphanfioleiomyomatosis
E- Epilepsy
A- Angiomylolipoma in kidney
F- Facial angiofibroma

Question 7

Migraines

Mx during pregnancy?

Answer 7

Pregnancy
1st line = paracetamol
2nd line = NSAIDs (1st/2nd trimester)