Neurology

Question 1

Seizures (rule)

Answer 1

Sodium valproate

then add lamotrigine or carbamazepine

other way round for focal seizures

Question 2

meningitis

Answer 2

IV ceftriaxone (for neisseria)

consider adding amoxicillin IV to cover listeria

Steroids e.g. dexamethasone to reduce hearing loss nerve damage

Question 3

acute Migraines

Answer 3

oral triptans (unless IHD)

NSAIDs

Metclopramide if nausea

Question 4

migraines prophylaxis

Answer 4

propanolol

Question 5

MS acute

Answer 5

IV Methylprednisolone

gapaentin for neuropathic pain

Question 6

MS chronic

Answer 6

Disease Modifying Treatment e.g. lemtrada

treat symptoms e.g.

• gabapentin for pain
• baclofen for spaticity
• anticholinergics for bladder dysfunction

Question 7

Parkinson

Answer 7

Co-benyldopa= Levodopa plus Bensarazide

Question 8

Stroke acute

Answer 8

CT head to exclude haemorrhage

if ischaemic:

• TPA if less than 4.5 hours after onset
• aspirin 300mg OD after a day

If haemorrhagic:
- neuro ICU referral for potential surgical intervention

Question 9

Stroke secondary prevention

Answer 9

clopidogrel 75mg OD lifelong

high dose statin 80mg OD e.g. atorvastatin

Ace inhibitor

Anticoagulant