Neurology

Question 1

‘Thunderclap’ headache

Answer 1

subarachnoid haemorrhage (cf. PCKD)

Question 2

Xanthochromic LP

Answer 2

SAH (cf fresh blood - traumatic tap)

Question 3

Lucid period after head trauma (often followed by sudden collapse or deterioration)

Answer 3

extradural haemorrhage

Question 4

Cogwheel rigidity

Answer 4

Parkinson’s (spastity over rigidity)

Question 5

“Woody Texture” muscle swelling

Answer 5

Duchenne or Becker MD

Question 6

Raised CK

Answer 6

MD

Question 7

Toe walker or positive gowers sign

Answer 7

Muscular Dystrophy

Question 8

“Mask-like” Expression

Answer 8

Parkinson’s

Question 9

“Fluctuating” Cognitive Deficit

Answer 9

Lewy Body Dementia or Delirium

Question 10

REM disturbance

Answer 10

Lewy Body Dementia or PD

Question 11

Vivid visual hallucinations normally of children and not threatening

Answer 11

Lewy Body Dementia

Question 12

“Acute Onset” Cognitive disturbance that fluctuates

Answer 12

Delirium

Question 13

Personality/behaviour changes and then dementia

Answer 13

Frontotemporal dementia (Pick's
disease)

Question 14

Memory and personality problems in someone with a history of cardiovascular disease

Answer 14

Vascular dementia

Question 15

Stepwise deterioration

Answer 15

vascular dementia

Question 16

Pain on loud noise

Answer 16

Facial nerve palsy

Question 17

Painful third nerve palsy

Answer 17

aneurysm

Question 18

myalgia + myositis + myoglobulinaemia/uria

Answer 18

Rhabdo (-> DIC and Renal failure)

Question 19

Inflammatory myopathy with poor response to steroids

Answer 19

inclusion body myositis

Question 20

Weakness + frontal balding + cataracts + ptosis

Answer 20

myotonic dystrophy (onset 30s, +ve
FHx)

Question 21

Leg symptoms + midline shift

Answer 21

Falcine herniation

Question 22

Back pain worse on coughing

Answer 22

slipped disk

Question 23

Headache worse on coughing

Answer 23

posterior fossa issue

Question 24

BL sciatica + male sexual dysfunction

Answer 24

cauda equina

Question 25

Pleocytosis on CSF

Answer 25

rules out bacterial meningitis

Question 26

Migraine prophylaxis

Answer 26

1st line propranolol, topiramate or amitriptyline; 2nd line valproate,
pizotifen, gabapentin, pregabalin (if one drug does not work by 3/12, try another)

Question 27

Injury upper brachial plexus

Answer 27

Erb’s palsy (waiters tip) - more common, associated with

shoulder dystocia I

Question 28

Injury lower brachial plexus

Answer 28

Klumpke’s palsy (claw hand)

Question 29

+ve Simmond’s test

Answer 29

Achilles tendon rupture