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Gastroenterology > Neurology > Flashcards

Neurology Flashcards

1
Q

Tingling sensation + Poor balance + Impaired Propriopception + Brisk knee reflexes.
+ Vit B12 deficiency + Nitric oxide

A

Subacute Combined Degenaration of spinal cord.

Affected : Dorsal column + Lateral CST.

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2
Q

Dorsal coloumn lesion :

A

B/L Loss of propriopcetion & Joint poisition.
Sensory loss which commonly affects lower limbs.

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3
Q

B/L Loss of propriopcetion & Joint poisition.
Sensory loss which commonly affects lower limbs. Lesion ?

A

Dorsal coloumn lesion

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4
Q

Lateral CST lesion:

A

B/l Spastic Paraesis.
Brisk Knee reflexes.

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5
Q

Stressful event + Anterograde amnesia ( lasting for 3-4 Hours)+ anxious pt repeating same questions.+ Relieves in 24 hrs

A

Transient Global Amnesia.

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6
Q

Differentiating feature b/w Tranient Global Amnesia and Epilpesy.?

A

Epilepsy lasts for Less than One hour.
TGA duration is 3-4 hours.

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7
Q

Rx of Transient Global Amnesia :

A

Reassurance.

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8
Q

Asteognosis :

A

Inability to identify simple objects by touch when eye are closed.

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9
Q

Inability to identify simple objects by touch when eye are closed.

A

Asteognosis

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10
Q

B/L Asteognosis Dx:

A

Dominant Parietal Lesion.

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11
Q

In Bell’s palsy , does forehead get affected ?

A

Entire one half of face ( forehead included ) is affected.

While lowering the bell entire face on one side gets hit.

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12
Q

Bells palsy , does it affect motor or sensory part of facial nerve?

A

Only motor part of facial nerve gets affected.

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13
Q

Is hyperacusis a feature of Bell’s palsy ?

A

Yes.

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14
Q

In UMN facial palsy, forehead gets affected ?

A

Forehead is spared in UMN Facial palsy.

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15
Q

Miller Fisher syndrome, Descending or Ascending paralysis ?

A

Descending paralysis.

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16
Q

H/o Diarrhoe/Food Poisoning/Campylobacter jejuni+ Anti GQ1B—opthalmoplegia+Ataxia+Areflexia

A

Miller Fischer Syndrome.

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17
Q

Miller Fischer Syndrome antibodies ?

A

Anti GQ1B

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18
Q

Miller Fischer Syndrome bacteria ?

A

/Campylobacter jejuni

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19
Q

Miller Fischer Syndrome clinical feature ?

A

Ataxia+ opthalmoplegia+ Areflexia+ Descending paralysis .

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20
Q

Confabulation is a feature of ?

A

Korsakoff

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21
Q

Ipsilateral Loss of Pain & Temp of Face + C/L Loss of pain & Temp of arm + Dysphagia+Dysarthria+Nystagmus & Ataxia:

A

Wallenberg / Lateral Medullary Syndrome.

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22
Q

Wallenberg / Lateral Medullary Syndrome/PICA:

A

Ipsilateral Loss of Pain & Temp of Face + C/L Loss of pain & Temp of arm + Nystagmus & Ataxia.

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23
Q

AICA & PICA differentiating features:

A

AICA: Facial par
lysis + Deafness + PICA features.
In PICA : only Ipsilateral Loss of Pain & Temp of Face

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24
Q

Gingival hyperplasia cause?

A

CCB

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25
Q

CCB adverse ?

A

Gingival Hyperplasia.

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26
Q

Common early symptom of multiple sclerosis:

A

Lethargy.

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27
Q

Lethargy + Visual Disturbances—unable to see red colour + symptom resolved spontaneously.

A

Multiple Sclerosis.

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28
Q

Breastfeeding is safe in which Anti epileptic drugs ?

A

All Anti epileptic drugs.

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29
Q

Which anti epileptic drug causes heamorrhagic disease of the newborn?

A

Phenytoin.

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30
Q

SAH + CT done within 6 hours = Normal. Next step ?

A

Do not do LP. Consider alternative Diagnosis.

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31
Q

SAH+ CT done after 6 hours= Normal. Next step ?

A

Do LP , after 12 hours of onset of headache.

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32
Q

SAH Headache onset 8 hours before. CT = Normal. Next step?

A

Do LP after 12 hours. Ie : after ( 8 + 4) hours.

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33
Q

Deafness(SNHL)+Vertigo +Tinnitus—+Aural fullness.

A

Minere’s disease.

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34
Q

Minere’s :

A

DVT + aural fullness.
Deafness(SNHL) + Vertigo + Tinnitus .

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35
Q

Myasthenic Crisis Rx:

A

Plasmapheresis or IV immunoglobulins.

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36
Q

Myasthenic Crisis features :

A

K/c/o Myasthenia Gravis + Dyspnoea + Cyanosis.

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37
Q

Seizure + Lip smacking + post-ictal dysphasia. Affected lesion?

A

Temporal lobe.

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38
Q

Unable to remember what happened during the seizure. Dx ?

A

Focal awareness impaired seizure.

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39
Q

Parkinson’s + Motor symptoms. Rx?

A

Levadopa.

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40
Q

stopping of anti-epileptic drugs

A

Seizure free for 2 years + with AED being stopped for 2-3 months.

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41
Q

Internuclear ophthalmoplegia is due to a lesion in :

If left eye adduction problem:

A

Medial Longitudinal Fasciculus( Paramedian area of Midbrain and pons)
Left MLF lesion.

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42
Q

Internuclear Opthalmoplegia, mnemonic :

A

INO
( Ipsilateral Adduction, Nystagmus opposite )

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43
Q

Stroke—arms affected + Homonymous Hemianopia:

A

MCA artery affected.

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44
Q

Motor neuron disease - which treatment is better NIV or Riluzole?

A

Non invasive ventilation.

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45
Q

Is Lisch Nodules a feature of Tuberous sclerosis ?

A

No.

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46
Q

Is Retinal Hamartomas a feature of Tuberous Sclerosis ?

A

Yes.( Hammer in the ground)

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47
Q

Is Renal angiomyolipomata a feature of Tuberous Sclerosis ?

A

Yes. ( Red wire around waist)

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48
Q

is Ash leaf spots a feature of Tuberous sclerosis ?

A

Yes ( ash of green cigar on ground)

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49
Q

Antibodies in Neuromyelitis Optica ?

A

NMO-igG.

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50
Q

Post hepatic Neuralgia Rx first line :

A

Amitryptilin.
Duloetine.
Gabapentin.

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51
Q

Post hepatic Neuralgia Rx Second line:

A

Tramadol.

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51
Q

RT Arm exaggerated flinging motion. Dx and Site of lesion:

A

Hemibalismus.
Site: Left sub thalamic nucleus of Basal Ganglia.

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52
Q

Wake up stroke + Confirmed confirmed occlusion of the proximal anterior circulation (anterior cerebral artery or middle cerebral artery). Rx?

A

Mechanical clot removal.

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53
Q

Auditory agnosia feature of which lobe ?

A

Temporal lobe lesions

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54
Q

Temporal lobe lesion Mnemonic ?

A

PAWS
P-prosopagnosia-difficulty recognising face.
A-Auditory agnosia
W-wernickes aphasia
S-Superior homonymous quadrantonopia.

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55
Q

Auditory agnosia:

A

Impairment in sound perception, despite intact hearing, cognitive function.

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56
Q

Ipsilateral weakness + Ipsilateral loss f propiopception + C/l loss of pain & temp. Dx?

A

Brown Sequard syndrome.

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57
Q

Restless leg syndrome. Rx?

A

Ropinirole ( dopamine agonist)

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58
Q

Shwartz sign in otosclerosis?

A

Redness of the promontory of cochlea.

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59
Q

B/L Conductive hearing loss + Tinnitus + Family history + Schwartz sign :

A

Otosclerosis.

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60
Q

most common complication following meningitis

A

SNHL.

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61
Q

gram-negative diplococci That causes meningitis ?

A

Neisseria Meningitis.

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62
Q

Autonomic symptoms common in GBS:

A

Tachycardia.
Urinary Retention.

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63
Q

Type of paralysis in GBS:

A

LMN weakness: Flaccid paralysis+ Decreased Reflexes.

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64
Q

loss of sensation in both of her arms and forearms, and on the back of her neck + can’t feel pain and temperature + Chiari 1 malformation

A

Syringomyelia.

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65
Q

Painful third nerve palsy( eye deviated down and out ) :

A

Posterior communicating artery aneurysm.

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66
Q

Posterior communicating artery aneurysm.

A

Painful third nerve palsy( eye deviated down and out ) :

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67
Q

Narcolepsy is associated with

A

low orexin

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68
Q

strong emotions such as fear or laughter+ collapse on the spot and immediately lose consciousness + sudden unavoidable urges to sleep

A

Narcolepsy

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69
Q

Relapsing Remitting symptoms is a feature of :

A

Multiple Sclerosis.

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70
Q

Anti-NMDA receptor encephalitis:

A

Psychiatric features + Ovarian Teratoma.

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71
Q

first-line for spasticity in multiple sclerosis:

A

Baclofen and gabapentin.

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72
Q

Hypodense collection around the convexity of the brain:

A

Subdural Hematoma.

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73
Q

B/L spastic paraparaesis + B/L loss of pain and temp:

A

Anterior Spinal Artery Occlusion.

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74
Q

Anterior Spinal Artery Occlusion

A

B/L spastic paraparaesis (cst)+ B/L loss of pain and temp(spinothalamic):

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75
Q

Raised ICP Ass with which eye problem?

Raised ICP features?

A

Raised IcP: head ache worse in morning and leaning forward.

Third nerve palsy (occuomotor)

Eye deviation: down and out.

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76
Q

DVLA advice post multiple TIAs

A

cannot drive for 3 months

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77
Q

DVLA advice post one episode of stroke ?

A

Can’t drive for one Month.

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78
Q

DVLA advice post first unprovoked or isolated seizure ?

A

Can’t drive for 6 Months.

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79
Q

Parkinson’s features + O/E: problem in vertical gaze :

A

Progressive supranuclear palsy.

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80
Q

Does GBS have sensory problems, loss of joint sense, temperature, fine touch?

A

NO.
GBS predominantly has motor problems.

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81
Q

K/c/o CKD+ Loss of sensation B/L, loss of of joint sense+ fine touch. Dx?

A

Uraemic Polyneuropathy.

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82
Q

Dx of MS:

A

MRI flair : To identify Demyelinating lesions.

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83
Q

trinucleotide in Huntington’s

A

CAG
( Hunt or be caged)

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84
Q

Family History + Recent aggressive behaviour+ Depression + Chorea:

A

Hungtintons chorea.

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85
Q

Facial palsy + spares forehead. Dx: stroke or Bell’s palsy ?

A

Stroke.

Spares forehead: UMN lesion: Stroke.
Involves Forehead : LMN: Bell’s Palsy.

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86
Q

Ataxic telangiectasia Gene ?

A

ATM gene.

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87
Q

Cerebellar Ataxia + Telangiectasia + IGA deficiency = Recurrent infection. Dx?

A

Ataxia telangiectasia.

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88
Q

Tried to climb a tree when he was drunk but fell, hitting a few branches on the way down+ fingers of the left hand are flexed into a claw position. There is a loss of sensation along the ulnar aspect of the whole hand and arm.

A

Klumpkey’s Paralysis.

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89
Q

Medication overuse headache: for analgesia and Opioids :

A

simple analgesia + triptans: stop abruptly
opioid analgesia: withdraw gradually

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90
Q

loss of temperature and pain sensation on the medial aspect of both hands and elbows. Proprioception and vibration sensation are preserved.Dx?

A

Syrinomyelia.

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91
Q

Multiple sclerosis patient with bladder dysfunction

A

Ultrasound to assess bladder emptying.

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92
Q

Absent Ankle Reflex.UMN or LMN ?

A

LMN lesion.

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93
Q

Extensor plantar is UMN or LMN ?

A

UMN lesion.

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94
Q

Extensor plantar+Absent ankle reflex + sensation intact. Dx?

A

UMN lesion +. LMN lesion + sensation intact= ALS.

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95
Q

Stevens-Johnson syndrome
Adverse of which anti epileptics?

A

Lamotrigine.

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96
Q

Klumpke’s paralysis, which nerve root damage ?

A

T1 nerve root damage.

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97
Q

Focal seizures, Rx?

A

Lamotrigine or Levetiracetam

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98
Q

Gingival hyperplasia ass with which leukemia ?

A

AML.

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99
Q

Distal weakness + red reflex in eyes + glycosuria :

A

Myotonic Dystrophy.

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100
Q

Anti-epileptic drugs is most likely to cause visual field defects?

A

Vigabatrin

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101
Q

sumatriptan: 5HT?

A

5HT 1 agonist.

No. 1 organ is Brain.
Agonist when you are in agony.

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102
Q

trigger for cluster headaches

A

Alcohol.

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103
Q

Neurofibromatosis type 1 Which chromosome ?

A

Chromosome 17.

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104
Q

Apomorphine acts on which receptor ?

A

Dopamine receptor agonist.

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105
Q

acute angle closure glaucoma, which anti epileptic ?

A

Topiramate.

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106
Q

Autosomal Dominant+ K/c/o Migraine with Auras + Low Mood + Stroke like symptoms + cognitive impairment + MRI= Multiple cerebral infarcts + Notch 3 gene mutation.

A

CADASIL.

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107
Q

Mutation in CADASIL :

A

NOTCH 3 gene.

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108
Q

MRI findings in CADASIL :

A

Multiple Cerebral Infarctions.

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109
Q

Migraine with aura+ Recurrent TIAs or stroke. Dx?

A

CADASIL.

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110
Q

Wernicke’s encephalopathy

A

Confusion, gait ataxia, nystagmus + ophthalmoplegia

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111
Q

Confusion, gait ataxia, nystagmus + ophthalmoplegia

A

Wernicke’s encephalopathy

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112
Q

5 year old + Ataxia + Recurrent chest infection :

A

Ataxia telangiectasia.

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113
Q

Age group affected in Ataxia Telangiectasia :

A

0-5 year old.

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114
Q

Age group affected in friericks ataxia :

A

10-14 year old.

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115
Q

Which anti epileptic causes cerebellar syndrome ? ( ataxia, nystagmus, slurred speech )?

A

Phenytoin.

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Perfectly
116
Q

Bilateral vestibular schwannomas+
Multiple intracranial schwannomas. Dx and chromosome ?

A

NF2 and chromosome 22.

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117
Q

mnemonic for peripheral neuropathy :

A

I am very numbed.
Isoniazid
Amiodarone.
Metronidazole.
Vincristine.
Nitrofurantoin.

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118
Q

Mnemonic for shy dagger/ Multi system Atrophy :

A

Wet wobbly wacky grandpa:

Parkinson’s + ED+Postural Hypotension+Urinary incontinence + Cerebellar sign( Ataxia)*

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119
Q

Drugs most useful in the management of tremor for Parkinson’s ?

A

Benzhexol ( trihexyphenidyl.)

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119
Q

Downbeat nystagmus is seen in :

A

Arnold chiari malformation.

Cerebellar tonsils LOWERING itself in brainstem—DOWNBEAT nystagmus.

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120
Q

Renal angiomyolipoma ass with which Neurocutaneous Condition?

A

Tuberous Sclerosis.

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121
Q

Myotonic dystrophy ECG feature:

A

Prolonged PR interval.

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122
Q

Which one of the following factors indicates a poor prognosis in patients with multiple sclerosis?

A

Male sex?

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123
Q

Miosis or Mydriasis in Holmes adie’s pupils ?

A

Mydriasis ( Huge pupil in Holmes adie’s pupils, Hesitant reaction to light( sluggish reaction )

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124
Q

no history of a diarrhoeal illness, good or bad prognosis in GBS ?

A

Good prognosis.

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125
Q

Is Wilson’s ass with Parkinson’s?

A

Yes.

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126
Q

Is dementia pugilistica Ass with Parkinson’s ?

A

Yes.

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127
Q

Is lead poisoning ass with Parkinson’s ?

A

No.

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128
Q

Notable feature in Creutzfeldt-Jakob disease Which differentiates it from others ?

A

Notable Jerk ( MYOCLONUS) + Rapid onset Dementia.

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129
Q

Creutzfeldt-Jakob disease MRI sign :

A

Hockey Stick Sign.

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130
Q

MS causes UMN or LMN ?

A

UMN only.

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131
Q

Age group of Motor neuron disease :

A

50-70 years.

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132
Q

ondansetron 5H ?

A

5HT3 antagonist.

Ondans(three)on

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133
Q

IV phenytoin S/E :

A

Hypotension.

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134
Q

Patient Started on carbamazepine— they may see a return of seizures after 3-4 weeks of treatment d/t:

A

D/t Autoinduction.

135
Q

preferred way to support nutrition in patents with motor neuron disease

A

Percutaneous gastrostomy tube (PEG)

136
Q

Natalizumab can cause reactivation of which Virus ? And leading to ?

A

JC virus.
Progressive multifocal leukoencephalopathy (PML).

137
Q

Subarachnoid haemorrhage: if rebleeding is suspected (e.g. sudden worsening of neurological symptoms) →

A

Repeat CT.

138
Q

Which neuropathic pain med to avoid in Open angle Glaucoma?

A

Amitryptiline.

139
Q

speech non-fluent, comprehension normal, repetition impaired

A

Broca’s aphasia. ( Broken speech)
Inferior frontal gyrus-

140
Q

seizures in the morning/following sleep deprivation—H/o Sleepover:

A

Juvenile Myoclonic Seizures.

141
Q

Antiemetic causing prolonged QT interval and increased risk of polymorphic VT

A

Ondansetron.

142
Q

Ondansetron cardiac S/E:

A

Antiemetic causing prolonged QT interval and increased risk of polymorphic VT

143
Q

telangiectasias of the eyes Present as:

A

Bloodshot eyes.

144
Q

Ataxia + Recurrent chest infection + Blood shot eyes.Dx:

A

Ataxia Telangiectasia.

145
Q

idiopathic intracranial hypertension. Rx?

A

Acetazolamide.

146
Q

Worsening Headache+ Intermittent loss of vision+ Pulse synchronous tinnitus +B/L blurring of optic disc. Dx;

A

Idiopathic Intracranial Hypertension.

147
Q

Ipsilateral numbness of face+ Ipsilateral Horners (ptosis, miosis, anhydrosis, ) + Dysphagia + Ataxia + Nystagmus :

A

PICA.

148
Q

Drug given in subarachnoid haemorrhages

A

Nimodipine.

149
Q

Hallucination+Agitation + Anti NMDA positive. Dx and Firs line IX?

A

Anti-NMDA receptor encephalitis.

First Ix: Pelvic Ultrasound.

150
Q

small area of erythema with central blistering on his right elbow + sensation is reduced in the C5-6 dermatomes bilaterally

A

Syringomyelia.

151
Q

13 years old girl + sudden jerks in arms + Zone out episodes in school:

A

Juvenile Myocclonic seizures.

152
Q

Restless legs syndrome - the single most important blood test

A

serum ferritin.

153
Q

common cause of restless legs syndrome (RLS) is :

A

Iron deficiency.

154
Q

H/o sinusitis/ear infection—Fever + Headache + Vomitting + CT: Ring enhancing lesion. Dx:

A

Brain abscess.

155
Q

contraindicated in absence seizures

A

Carbamazepine.

156
Q

Progressive weakness of Arm+Shoulder+ Hip + Facial ms weakness ( Difficulties in closing eyes, smiling, blowing) + Abnormal in retinal arteries.Dx:

A

Facioscapulohumeral muscular dystrophy

157
Q

Tibial nerve function and supply :

A

PIT : Plantar flexion, inversion.
Supply : Medial aspect of Foot.

158
Q

Common peroneal nerve function :

A

Common penis nerve: Towards Dick : Dorsiflexion.
Supply to lateral part of foot.

159
Q

Feature to Parkinson’s disease and helps differentiate it from other causes of Parkinsonism :

A

Assymetrical tremors.

160
Q

Eye symptoms in Acoustic Neuroma :

A

Absent corneal reflex.D/t CN 5

161
Q

Parkinson’s disease - most common psychiatric problem is :

A

Depression

162
Q

Chorea is caused by damage to T which part of brain?

A

basal ganglia, in particular the Caudate nucleus

163
Q

severe headache+ pyrexia+ CT head = temporal lobe changes

A

Herpes simplex encephalitis

164
Q

Epilepsy + pregnancy = ___ folic acid

A

5 MG.

165
Q

Motor neuron disease medication RX?

A

Riluzole

166
Q

common consequence of subarachnoid haemorrhage

A

SIADH.

167
Q

Hyperintense T2 signal extending across the spinal cord, between the levels of T9 and T12.Dx?

A

Transere Myelitis.

168
Q

Common cause of Transvere Myelitis ?

A

HIV
Varicella.

169
Q

Blistering Rash +weakness of both legs + with upgoing plantars bilaterally, reflexes are brisk+ loss of fine touch sensation below the umbilicus.

A

Transverse Myelitis secondary to varicella.

170
Q

Klumpke’s paralysis features :

A

Wasting of the thenar and hypothenar eminence + claw hand + reduced sensation in ulnar distribution.

171
Q

Pancoast tumour + Wasting of the thenar and hypothenar eminence + claw hand + reduced sensation in ulnar distribution.

A

Klumpke’s paralysis.

172
Q

Klumpke’s paralysis affects ulnar or radial distribution ?

A

Ulnar.

173
Q

Recurrent falls at old age + Fluctuating consciousness. Which type of Haemorrhage ?

A

Sub Dural Haemorrhage.

174
Q

sudden, brief (< 100 ms) and almost shock-like involuntary single jerks of his face and right upper limb. The movements are stimulus-sensitive and provoked by touching. Dx and Rx ?

A

Myoclonic Seizure.
Rx: Sodium Valproate.

175
Q

Phaeochromocytoma, renal cell cancer → ?

A

Von Hippel-Lindau syndrome

176
Q

Uraemic polyneuropathy is sensory or motor ?

A

Predominantly sensory loss
( Loss of sensation in lower limbs)

177
Q

Acetazolamide MOA:

A

carbonic anhydrase inhibito

178
Q

Drooling of saliva in people with Parkinson’s disease.Rx?

A

Glycopyrronium Bromide

179
Q

neck pain
wide-based, ataxic or spastic gait
upper motor neuron weakness in the lower legs - increased reflexes, increased tone and upgoing plantars
bladder dysfunction e.g. urgency, retention

A

Cervical spondylitic myelopathy

Rx: Cervival Decompression Surgery.

180
Q

2nd line in Status epilepticus :

A

Life Saving Power drugs in Status:

Levetiracetam or Sodium Valproate Phenytoin or

181
Q

Bell’s palsy. Rx?

A

Oral Prednisolone within 72 hours of onset.

182
Q

Clumsiness in walking + Foot Drop + Weakness + Sensory ( Numbness + tingling in foot. ) + Distal muscle wasting( Pes cavus + High arch foot) + High stepping gait :

A

Charcot marrie tooth disease.( Can’t move toes)

183
Q

UMN or LMN in Charcot marrie Tooth ?

A

LMN

184
Q

Acute onset U/L severe pain in shoulder—subsided—shoulder or scapular weakness for several days.s

A

Brachial neuritis.

185
Q

Brachial neuritis.

A

Acute onset U/L severe pain in shoulder—subsided—shoulder or scapular weakness for several days.s

186
Q

Small area of erythema in hand + cape like sensation loss in upper limbs + Spastic weakness in lower limbs + upgoing plantar :

A

Syringomyelia ( CST tract affected—UMN weakness below the lesion)

187
Q

K/c/o Parkinson’s/scizophrenia + pyrexia
muscle rigidity
autonomic lability: typical features include hypertension, tachycardia and tachypnoea
agitated delirium with confusion

A

Neuroleptic Malignant syndrome.
Rx: Dantrolene.

188
Q

Differentiating feature between Neuroleptic malignant syndrome and serotonin syndrome:

A

Myoclonus : only in serotonin.

189
Q

ExtraDural haemorrhage which artery or veins are involved ?

A

Extradural = ExtraMural haemorrhage.

Middle meningeal artery involvement.

190
Q

What kidney involvement in Tuberous sclerosis?

A

Renal angiomyolipomata.

191
Q

Subarachnoid haemorrhage: if rebleeding is suspected:

A

Repeat CT

192
Q

Does SLE caused raised protein in csf and facial nerve palsy?

A

No

193
Q

Which type of motor neuron disease carries the worst prognosis?

A

Progressive bulbar palsy

194
Q

otitis externa

A

Topical corticosteroid + aminoglycoside.

195
Q

H/o Swim/Holiday—Itchy red ear+ Typanic membrane= Clear+

A

Otitis external.

196
Q

Meds causing raised intracranial hypertension:

A

Steroid
Oc pills.

197
Q

common peroneal neuropathy, what to avoid ?

A

Leg crossing, squatting or kneeling may cause a foot drop

198
Q

Anti Hu antibodies

A

who kicked my chair (pain) and then fell over (ataxia)

Sensory neuropathy and ataxia

Small cell lung cancer.

199
Q

antibodies are associated with painful sensory neuropathy in patients with small cell lung cancer?

A

Anti hu.

200
Q

ovarian cancer. She presents due to ‘unsteadiness’. On examination there is evidence of nystagmus and past-pointing. Which one of the following antibodies is most likely to be present?

A

Anti yo

Yo-varian cancer.

201
Q

antibodies is associated with ocular opsoclonus-myoclonus in patients with breast cancer?

A

Anti Ri

202
Q

degenerative cervical myelopathy (DCM)? Gold standard test ?

A

MRI Spine

203
Q

Myasthenia gravis pathophysiology

A

antibodies against acetylcholine receptors

204
Q

What scoring system can be used to quantify the disability in activities of daily living? In stroke patient

A

The Barthel index

205
Q

Treatment of Ramsay Hunt syndrome Rx

A

oral aciclovir and corticosteroids

206
Q

Fever flu + auricular pain is often the first feature
facial nerve palsy
vesicular rash around the ear
other features include vertigo and tinnitus

A

Ramsay Hunt syndrome

207
Q

Baclofen MOA

A

agonist of GABA receptors

208
Q
A
209
Q

speech fluent, but repetition poor. Comprehension is relatively intact

A

Conduction dysphasia:
Arcuate fasciculus

210
Q

speech fluent, comprehension abnormal, repetition impaired

A

Wernicke’s aphasia( Wulta-Pulta speech)
Broadman area 22 in superior temporal Gyrus.

211
Q

first-line for spasticity in multiple sclerosis

A

Baclofen.

212
Q

What cancer is most commonly associated with Von hippel Lindau syndrome?

A

Renal cell carcinoma.

213
Q

Tumour suppressor gene in Von hippel lindau syndrome in which chromosome ?

A

Chromosome 3.( Tree behind Von Hippo)

214
Q

How to differentiate MSA and Normal pressure hydrocephalus ?

A

presence of dementia and abscense of cerebellar signs points towards Normal pressure hydrocephalus.

215
Q

Uhthoff ‘s phenomenon:

A

where neurological symptoms are exacerbated by increases in body temperature is typically associated with multiple sclerosis

216
Q

generalised weakness. Examination of her face reveals bilateral ptosis, dysarthric speech and a slow-relaxing grip. What is the most likely diagnosis?

A

Myotonic dystrophy.

217
Q

Slow relaxing grip , think :

A

Myotonic Dystrophy.

218
Q

Prophylaxis of migraine in asthamatic migraine :

Non asthamatic migraine :

A

Topiramate in asthamatic

Propranolol in non asthamatic

219
Q

Cluster headache - acute treatment:

A

subcutaneous sumatriptan + 100% O

220
Q

Contralateral hemiparesis and sensory loss with the lower extremity being more affected than the upper.

A

Anterior cerebral artery

A= two slanting lines of legs look like legs.

221
Q

Frontal lobe lesion :

A

DP + broca’s aphasia+ inability to generate a list + anosmia.

Disinhibition.
Perseveration.

222
Q

Perseveration is caused by which lobe lesion ?

A

Parietal lobe lesion.

223
Q

Tonic clinic seizure Rx:

A

Sodium Valproate.
(ST)

224
Q

Progressive supra nuclear palsy—Vertical or horizontal gaze palsy ?

A

Vertical gaze palsy.

225
Q

He described three episodes of sudden, forceful contraction of both arms and legs, each lasting one-to-two seconds with no loss of consciousness

A

Myoclonic seizure.

226
Q

H/o Diarrhoe. Weakness that improves after exercise:

A

Lambert Eaton Syndrome.

227
Q

Difference between Myasthenia and Lambert Eaton :

A

Lambert Eaton improves after exercise
Myasthenia worsens after exercise.

228
Q

First line in status epilepticus

A

IV lorazepam

229
Q

Facioscapulohumeral muscular dystrophy, which type of inheritance ?

A

Autosomal Dominant.

230
Q

Old man+ Dysmetria+Ataxia+ Horizonal nystagmus. Dx:

A

Cerebellar Stroke.

231
Q

Pyrodostigmine MOA:

A

Long acting acetylcholinesterase inhibitors.

232
Q

Sudden painless loss of vision in Von hippel Lindau Syndrome is due to :

A

Retinal hemangioma.

233
Q

post-dural puncture headache Rx:

A

Blood patch.

234
Q

Which anaemia and due to what deficiency in Phenytoin ?

A

Macrocytic anaemia due to folate deficiency.

235
Q

Quinine S/e :

A

B/L tinnitus.

236
Q

Tinnitus is caused by which antimalarial ?

A

Quinine.

237
Q

Why cocp is contraindicated in migraine ?

A

Increased risk of Ischaemic stroke.

238
Q

Which meds help in preventing attacks of Minere’s ?

A

Betahistine.

239
Q

Anti GAD antibodies :

A

Stiff man syndrome

240
Q

K/C/O colorectal cancer + C/o stiffness. Which antibodies ?

A

Anti GAD

241
Q

Neuropathic pain, which opioids?

A

Tramadol.

242
Q

Vertigo lasting for days. Dx?

A

Vestibulat neuritis.

243
Q

vertigo lasting for 30-60 mins. Dx?

A

Minere’s

244
Q

Vertigo lasting for seconds.Dx?

A

BPPV.

245
Q

Deafness type in Minere’s:

A

SNHL

246
Q

Ondansetron acts on which part of the brain ?

A

Medulla oblangata.

247
Q

Common precipitator of Myasthenic crisis :

A

Bisoprolol.

248
Q

Which drug is used in treatment of Multiple sclerosis ?

A

B interferon.

249
Q

Does Carbon Monoxide lead to chorea?

A

Yes.

250
Q

Which rheumatoid condition leads to chorea ?

A

SLE.

251
Q

Ataxia Telangiectasia Mode of inheritance ?

A

Autosomal recessive

Taxi= small auto

252
Q

Parinaud syndrome occurs due to :

A

Dorsal Midbrain lesion.

253
Q

MRI finding of Wernickes :

A

Enhancement of mammillary bodies

254
Q

Known space occupying mass+ Ipsilateral optic atrophy + contralateral papiloedema =

A

Foster Kennedy syndrome.

Optic atrophy D/t direct damage from space occupying lesion.

255
Q

Left sided optic atrophy + Rt eye papilloedema + known mass in brain. Dx: and location of mass ?

A

Foster Kennedy syndrome.
Mass in left frontal side.

256
Q

EEG of Myoclonic seizures And focal:

A

brief bursts of poly-spike and wave discharge during ictal episodes.

abnormal discharges in one specific area.

257
Q

Comprehension in brocas?

A

Normal.

258
Q

Essential tremors.
Rx in asthamatic and non asthmatic

A

In non asthma : Propranolol.
In Asthmatic : Primodine.

259
Q

Parkinson’s—develops tremors( Motor symptoms which does not affect day to day life):

A

Dopamine receptor agonist ( Ropinirole )

260
Q

Lambert Eaton affects which antibodies :

A

voltage gated calcium channel antibodies.

261
Q

bilateral vestibular schwannomas feature of which neurocutaneous disorder ?

A

Neurofibromatosis 2.

262
Q

Absence seizures - ____ become seizure free in adolescence

A

90-95%

263
Q

Lambert Eaton is ass with which cancer ?

A

Small cell lung cancer

264
Q

B/L vitreous haemorrhage + ataxia. Dx?

A

Von hippel Lindau Syndrome

265
Q

Is impotence a feature of Lambert Eaton ?

A

yes.

266
Q

Is renal failure a feature of neuroleptic malignant syndrome ?

A

Yes

267
Q

Is Multiple sclerosis UMN or LMN?

A

UMN type of weakness.

268
Q

Patient with migraine + taking PCM—failed to relieve symptoms. Reasons ?

A

Patient with migraine experience delayed gastric emptying.
Therefore PPI is added.

269
Q

Seizures + fibromata under nail + hypopigmentation patches. Dx?

A

Tuberous sclerosis.

270
Q

Peripheral Neuropahty is a feature of which Anti epileptic drug ?

A

Phenytoin.

271
Q

Cabergoline S/e:

A

Pulmonary fibrosis.

272
Q

Guillain-Barre syndrome Conduction studies finding :

A

Reduced conduction velocities.

273
Q

Pergolide S/E:

A

Pulmonary Fibrosis.

274
Q

Which Parkinson’s S/E is pulmonary fibrosis :

A

Cabergoline.
Pergolide.

275
Q

Ondansetron S/E:

A

Constipation
QTc prolongation.

276
Q

Migraine in pregnancy Rx:

A

1st line: Paracetamol
2nd line: NSAID( Ibuprofen)

277
Q

Is phonophobia a feature of Migraine ?

A

Yes.

278
Q

Antiemetic with extrapyramidal S/E:

A

Metclopramide

279
Q

Ear related S/E in facial nerve paralysis :

A

Hyperacusis.

280
Q

Herpes simplex encephalitis

A

Rx: IV acyclovir + supportive treatment.

281
Q

Small cell lung cancer+ B/L leg weakness + hyporeflexia+ Dry mouth + erectile Dysfunction: Dx:

A

Lambert Eaton

282
Q

degenerative cervical myelopathy.RX:

A

Urgent referral to spine or neurosurgery.

283
Q

Seizure affecting a peripheral body part such as a toe, finger or section of the lip and then spreads quickly ‘marches’ over the respective foot, hand or face—marches to tonic clonic

A

Jacksonian march.

284
Q

Jacksonian march.

A

Seizure affecting a peripheral body part such as a toe, finger or section of the lip and then spreads quickly ‘marches’ over the respective foot, hand or face—marches to tonic clonic

285
Q

Lumber Puncture headache pathology:

A

Leaking of cerebrospinal fluid from the dura.

286
Q

Isolated alexia. Lesion ?

A

Corpus callosum.

287
Q

Palatal Myoclonus is caused by lesion in which part of brain ?

A

Olivary nucleus.

288
Q

Gerstmann syndrome

A

is a constellation of acalculia, right-left disorientation, finger agnosia and agraphia.

289
Q

Gerstmann syndrome Lesion :

A

C/L parietal lobe.

290
Q

Right handed man—Rt left disorientation+ acalculia+ finger agnosia+ agraphia. Dx and site of lesion:

A

Gerstmann syndrome.
Lesion= left parietal lobe lesion.

291
Q

Which examination is specific to degenerative cervical myelopathy [DCM?

A

Positive Hoffman sign.

292
Q

worsening bilateral upper limb paraesthesias and leg stiffness+ H/o back pain+ Lumbar spondylitis.Dx and Ix:

A

Dx: Degenerative cervical Myopathy.
Ix: MRI cervical spine.

293
Q

Features uncommon in drug-induced parkinsonism:

A

Tremors and rigidity.

294
Q

1st and 2nd line in generalised tonic clonic seizure:

A

1st: Sodium Valproate.
2nd: lamotrigine.

295
Q

Migraine on PCM. No relief in symptoms, Next step?

A

Start 2nd line : Tristan’s.

296
Q

Does sodium valproate cause tremors ?

A

Yes

297
Q

B/L paraesthesia over radial side of arm. Dx

A

Degenerative cervical myelopathy.

298
Q

Hearing loss in vestibular neuritis ?

A

No

299
Q

first line and most appropriate Rx for GBS

A

first line: Plasma exchange

Most appropriate : IV Immunoglobulins.

300
Q

Should you treat hypertension in initial phase of management of stroke ?

A

NO.

301
Q

Electric shock like pain lasting for 30-60 seconds + on side of the face.Dx:

A

Trigeminal neuralgia.

302
Q

Rx for Trigeminal neuralgia :

A

Carbamazapine.

303
Q

Stroke symptoms after 4.5 hours o onset. Rx

A

out of window period.
Rx: Aspirin.

(No thrombectomy in question)

304
Q

left congruous homonymous hemianopia

A

Rt occipital cortex lesion.

C=Congrous=Cortex

305
Q

Monitoring of respiratory function in Guillain-Barré syndrome:

A

Forced vital capacity.

306
Q

Stroke symptoms withing 4.5 hours:

A

Thrombolysis and thrombectomy.

307
Q

H/o carpal tunnel syndrome refractory to treatment+ new onset weakness of lower legs and imbalance. Rx:

A

Degenerative cervical myelopathy.

308
Q

Vision worse going downstairs. Which nerve palsy ?

A

4th nerve palsy.—Trochlear nerve palsy.

LR6 SO4—Trochlear supplies superior oblique—function to look down.

309
Q

which part of this child’s hypothalamus would be affected causing weight gain if there is a lesion ?

A

Venteromedial area of hypothalamus.

310
Q

Sodium valproate causes inhibition or induction of the P450 system?

A

Inhibition.

311
Q

H/o viral urti + headache+ confusion+ hearing voices
+ MRI: Assymetric and poorly marginated hyperintense T2 weighted and flair lesion :

A

Acute disseminated encephalomyelitis.

312
Q

Unable to perceive stimuli in the superior temporal field of his left eye and the superior nasal field of his right eye:

A

Right Temporal Lobe.

PITS

313
Q

subacute combined degeneration of the spinal cord, which vitamin deficiency ?

A

Vitamin B12.

314
Q

bitemporal hemianopia with predominately the lower quadrants being affected.

A

Cranipharyngioma.

Lowe= superior chias all compression

PICS: parietal=inferior, craniopharyngioma=superior

315
Q

Famliy history of ear issues+ B/L conductive hearing loss.

A

Otosclerosis.

316
Q

Stroke symptoms, 5 hours of onset. Rx:

A

it’s by 4.5-5.5 : therefore = thrombectomy.

317
Q

Examination reveals a right incongruous homonymous hemianopia:

A

Left optic tract lesion.

318
Q

Stroke symptoms + 5 hours of onset. K/C/O Afib. Rx:

A

Outside window period.

Rx: Aspirin + Anticoagulation ( warfarin) after 2 weeks.

319
Q

blind spots in the bottom left quarter in both eyes.

A

Right parietal

320
Q

Examination reveals an inferior homonymous quadrantanopia.

A

PITS

Inferior= superior optic radiation in parietal lobe.

321
Q

visual field changes would be most consistent with a left parietal lobe lesion?

A

Right homonyous quadrantonopias.

322
Q

Ropinirole is :

A

Dopamine agonist

323
Q

Anti epileptics most ass with weight gain:

A

Sodium valproate.

324
Q

bitemporal hemianopia with predominately the upper quadrants being affected

A

PICS

Upper = lower affected.
Lower is pituitary.

325
Q

operation to remove a meningioma in his left temporal lobe. What sort of visual field defect is he at risk of having following the procedure?

A

Rt superior homonymous quadrantonopia.

326
Q

Internuclear ophthalmoplegia

A

Medial longitudinal fasisculus ( paramedical area of midbrain and pons)

327
Q

How to diagnose BPPV?

A

Dix-Hallpike test:

328
Q

Stroke patient outside window. K/C/O high cholesterol. Aspirin given. Next treatment:

A

Clopidogrel + statin after 14 days.

329
Q

H/o fracture and cast + Fracture healed + Shooting pain + Swelling + Tenderness

A

Complex regional pain syndrome.

330
Q

Tremors worse during stress+ worse on outstretched hand+ improved by alcohol.

A

Essential tremors.

331
Q

point which is specific to essential tremors and differentiate it from Parkinson’s tremors :

A

Tremors get worse on outstretched hands.

332
Q

Pt on warfarin had a fall. no sign of injury and no fall in GCS.Next step ?

A

patient on warfarin should have CT scan within 8 hours regardless of the injury

333
Q

What are affected first in Miller Fisher syndrome ?

A

Eye symptoms are affected first—causing opthalmoplegia.

334
Q

Rx for BPPV ?

A

Apply epply.
Epply’s manoeuvre.

335
Q

Double vision + reduced reflexes + wide gait :

A

Miller fisher syndrome.

336
Q
A

Gastroenterology (4 decks)

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