Neurology

Question 1

Painful third nerve palsy

Answer 1

posterior communicating artery aneurysm

Question 2

Wernicke’s dysphasia:

Answer 2

speech fluent, comprehension abnormal, repetition impaired

Question 3

Lateral medullary syndrome - PICA lesion

Answer 3

cerebellar signs, contralateral sensory loss & ipsilateral Horner’s

Question 4

‘Fasciculations’

Answer 4

think motor neuron disease

Question 5

Distal sensory loss, tingling + absent ankle jerks/extensor plantars + gait abnormalities/Romberg’s positive →

Answer 5

subacute combined degeneration of the spinal cord

Question 6

Patients often present with reduces Glasgow coma score, quadriplegia, miosis, and absent horizontal eye movements.

Answer 6

Pontine haemorrhage

Question 7

Brain abscess:

Answer 7

IV 3rd-generation cephalosporin + metronidazole

Question 8

Middle-aged, personality changes, involuntary movements

Answer 8

?Huntington’s disease

Question 9

fatigable, painless muscle weakness that improved with rest

Answer 9

myasthenia gravis

Question 10

Contralateral homonymous hemianopia with macular sparing and visual agnosia

Answer 10

posterior cerebral artery

Question 11

presents with lower limb stiffness and imbalance

Answer 11

degenerative cervical myelopathy [DCM]

Question 12

suspected encephalitis

Answer 12

Start aciclovir in all cases of suspected encephalitis

Question 13

Urinary incontinence + gait abnormality + dementia

Answer 13

normal pressure hydrocephalus

Question 14

first line radiological investigation for suspected stroke

Answer 14

Non-contrast CT head scan