Neurology

Question 1

Parietal lobe Injury

Answer 1

Defect in attention in the contra-lateral visual feidl
astereognosis
constructional apraxia (ND)
dressing apraxia (ND)
ideomotor apraxia (D)
right hemisphere parietal lesions commonly produce visual neglect

Question 2

Wernicke Area

Answer 2

Found in the left posterior superior temporal gyrus
causes receptive aphasia

Question 3

Damage to inferior parietal lobe

Answer 3

Angular gyrus
causes: GERSTMANN Syndrome
- acalculia
- agraphia
- agnosia
- impaired right and left discrimination
- finger agnosia

Question 4

Injury to left sided tempo-parietal lesion

Answer 4

impaired working memory
reduced digit span

Question 5

Miller Fisher Syndrome

Answer 5

variant of Guillain Barre Syndrome
- proximal muscle weakness: bilateral shoulder girdle pain and weakness
- affects eye muscles: blurred vision,diplopia, nystagmus, difficulty with lateral gaze
- reduced deep tenson reflexes
- ataxic gait
contrast to GB as USUALLY starts with DISTAL peripheral lower limb weakness symmetrically

Question 6

Multiple sclerosis

Answer 6

Focal neurological signs due to focal demyelination
USUALLY upper motor neuron signs

Question 7

Myotonic Dystrophy

Answer 7

AD
slow progressive muscle wasting and weakness
impaired relaxation of handgrip is FIRST sig

Question 8

Motor Neurone Disease

Answer 8

muscle weakness
speech and swallowing problems
difficulty with breathing
combination of upper and lower motor neuron signs such as brisk reflexes, fasciculations, muscle weakness

Question 9

Hereditary Motor and Sensory neuropathy (HMSN)

Answer 9

gradual onset of muscle weakness + SENSORY sx

Question 10

Guillain Barre Syndrome definition

Answer 10

acute
immune polyneuropathy

Question 11

Guillan Barre causes

Answer 11

URTI/UTI precede symptoms of GBS
campylobacter jejuni

Question 12

GBS sx

Answer 12

ascending paralysis starts in LL (LEGS UP
symmetrical
flaccid muscle tone
hyporeflexia/areflexia
autonomic disturbances
neuromuscular ventilatory failure: SOB, morning headaches, reduced FVC

Question 13

GBS ix

Answer 13

CSF: normal WCC, normal glucose, raised protien
NCS: delayed conduction velocity showing demyelination of peripheral nerves
spirometry: reduced FVC
ECG: arrhythmia

Question 14

GBS tx

Answer 14

IVIG + plasma exchange
supportive therapy: NGT, ventilation, pressure care, analgesia

Question 15

GBS long term complication

Answer 15

weakness
paresthesia
fatigue

Question 16

What are the classical symptoms of a migraine

Answer 16

unilateral throbbing headache, associated with nausea, vomiting, photophobia, phonophobia and aura, paresthesia,
lasting 4-72 hours

Question 17

What is the classification for migraine

Answer 17

Episodic <15 days in a month
Chronic >15 days in a month
Migraine with aura
Migraine without aura

Question 18

What are the RF for migraines

Answer 18

stress, menstruation, fasting, caffeine, irregular sleep pattern

Question 19

What factors increase the risk of developing chronic migraine

Answer 19

sleep disorders, excessive use of anti-migraine meds, emotional stress, obesity, increased episodic activity, anxiety, head injury

Question 20

What is the acute treatment for migraines

Answer 20

Ibuprofen 400mg, Aspirin 900mg, paracetamol 1000mg
Sumatriptan 50-100mg orally or SC/Intransal
Anti-emetics