Neurology

Question 1

What are the nerve roots of the Ankle reflex?

Answer 1

S1-S2

Question 2

What are the nerve roots for the Knee reflex?

Answer 2

L3-L4

Question 3

What are the nerve roots for the Biceps reflex?

Answer 3

C5-C6

Question 4

What are the nerve roots for the Triceps reflex?

Answer 4

C7-C8

Question 5

What is the best diagnostic investigation in suspected TIA?

Answer 5

Diffusion-weighted MRI scan

Question 6

What is Hoover’s sign used for?

Answer 6

To differentiate between organic and non-organic causes of leg paresis

Question 7

Signs of an anterior cerebral artery stroke?

Answer 7

Contralateral hemiparesis
Lower extremity affected more than upper
No face weakness or speech impairment

Question 8

Signs of a middle cerebral artery stroke?

Answer 8

Contralateral hemiparesis
Upper extremity affected worse than lower
Contralateral homonymous hemianopia

Question 9

First line medication for myoclonic seizures?

Answer 9

Sodium valproate in Men
Levetiracetam in Women

Question 10

Signs of temporal lobe seizure?

Answer 10

Epigastric aura
Automatisms e.g. lip smacking, grabbing, finger plucking

Question 11

First line treatment in atonic/tonic seizures?

Answer 11

Valproate in males
Lamotrigine in women

Question 12

Signs of Posterior Inferior Cerebellar Artery (PICA) Stroke?

Answer 12

Ataxia
Nystagmus
Dysphagia
Ipsilateral facial sensory loss
Contralateral upper and lower limb sensory loss

Question 13

What cranial nerves run through the cavernous sinus?

Answer 13

III, IV , Branches 1 and 2 of V and VI

Question 14

Which artery infarct causes locked-in syndrome?

Answer 14

Basilar artery

Question 15

Signs of an anterior inferior cerebellar artery infarct?

Answer 15

Similar to PICA with additional ipsilateral facial paralysis and deafness

Question 16

Signs of a pontine haemorrhage?

Answer 16

May have Hx of poorly controlled HTN
Reduced GCS
Paralysis
Bilateral pin point pupils

Question 17

Signs of stroke in midbrain branches of posterior cerebral artery (Weber’s syndrome)?

Answer 17

Ipsilateral oculomotor palsy
Contralateral weakness of upper and lower extremity

Question 18

What does fixed dilation of affected pupil in III nerve palsy suggest?

Answer 18

A ‘surgical’ cause - something is compressing the nerve e.g. bleed or tumour - urgent CT head needed if this happens

Question 19

Investigation for Guillain-Barre Syndrome?

Answer 19

Lumbar puncture - elevated protein and normal WCC

Question 20

Cause of superior homonymous quadrantanopia?

Answer 20

Temporal lobe lesion on the contralateral side

Question 21

Cause of inferior homonymous quadrantanopia?

Answer 21

Parietal lobe lesion on contralateral side