Neurology

Question 1

22 year old female, OBESE
2 week history of daily headaches
Bilateral across her forehead, constant throughout the day and worse on bending over
Not associated with aura
Fundoscopy: blurring of optic disc

Answer 1

Young woman + high BMI + headache + visual symptoms= Idiopathic intracranial hypertension

Question 2

State the classic triad of Horner’s syndrome

Answer 2

Mitosis + ptosis + enophthalmos +/- anhydrosis

Question 3

State the typical features of neuroleptic malignant syndrome.

Answer 3

The following symptoms occur within hours to days of starting an antipsychotic ( neuroleptics ):
1. Pyrexia
2. Muscle rigidity
3. Autonomic lability: hypertension, tachycardia, tachypnoea
4. Agitated delirium with confusion.

Question 4

37 year old
3 month history of vertigo and hearing loss on the left side.
Absent corneal reflex on the left eye.

Answer 4

Acoustic neuroma.

CN affected:
VII: hearing loss, vertigo, tinnitus
V: Absent corneal reflex
VII: Facial palsy

Question 5

Which cranial nerves mediate the corneal reflex?

Answer 5

1. Nasociliary branch of the ophthalmic branch ( V1 ) of the trigeminal nerve ( CN V )
2. Temporal and zygomatic branches of the facial nerve. ( CN VII )

Question 6

Middle aged adult
Recurrent episodes of vertigo, tinnitus and sensorineural hearing loss
Sensation of aural fullness or pressure
Nystagmus
+ve Rhomberg test

Answer 6

Ménière’s disease

Question 7

Numbness, tingling and burning pain in the outer part of the thigh. Name the syndrome and the nerve that is compressed.

Answer 7

Meralgia paresthetica or Bernhardt-Roth syndrome
It involves the compressing of the lateral cutaneous nerve of the thigh.

Question 8

State the type of tremor:

Postural tremor ( worse if arms outstretched)
Improved by alcohol and rest
Most common cause of titubation ( head tremor )
Affects both upper limbs
Autosomal dominant condition

Answer 8

Essential tremor

Question 9

Features of Horner’s syndrome

Answer 9

Miosis
Ptosis
Enopththalmos
Anhidrosis

Question 10

Name the vitamin deficiency:
Multiple non-healing ulcers
Feeling unwell for many months
Pale conjunctivae
Poor dentition

Answer 10

Vitamin C deficiency

Question 11

If clopidogrel is contraindicated or not tolerated, what is the secondary prevention for stroke?

Answer 11

Aspirin

Question 12

Patient with absent triceps reflex. Which nerve root does this correspond to?

Answer 12

C7-C8