Neurology

Question 1

Vitamin B6 overdosing, most likely thing to happen?

Answer 1

Peripheral neuropathy

Question 2

Laughter followed by collapse / syncope

Answer 2

Cataplexy

Question 3

Cabergoline risks?

Answer 3

Fibrosis (pulmonary/retroperitoneal)

Question 4

Bells palsy upper or lower motor?

Answer 4

LMN lesion

Question 5

Rx of ischaemic stroke?

Answer 5

A combination of thrombolysis AND thrombectomy is recommend for patients with an acute ischaemic stroke who present within 4.5 hours

Question 6

Essential tremor features:

Answer 6

Features
postural tremor: worse if arms outstretched
improved by alcohol and rest
most common cause of titubation (head tremor)

Question 7

Precipitant of MG after ACS event?

Answer 7

B blocker can cause myasthenia crisis

penicillamine
quinidine, procainamide
beta-blockers
lithium
phenytoin
antibiotics: gentamicin, macrolides, quinolones, tetracyclines

Question 8

Cluster headache risk factor

Answer 8

Cluster headaches are more common in men (3:1) and smokers. Alcohol may trigger an attack and there also appears to be a relation to nocturnal sleep

Question 9

CI to triptans

Answer 9

IHD
or CVD

Question 10

Bilateral acoustic neuromas

Answer 10

Neurofibromatosis type 2

Question 11

Examination finding for DCM?

Answer 11

Hoffmans sign

Question 12

Bells palsy Rx?

Answer 12

Pred

Question 13

CSF protein in GBS?

Answer 13

Raised

the weakness is classically ascending i.e. the legs are affected first
reflexes are reduced or absent
sensory symptoms tend to be mild (e.g. distal paraesthesia) with very few sensory signs

Question 14

Where is the lesion?

Homonymous hemianopia with macular sparing?

Answer 14

Occipital cortex

Question 15

Meds for post herpetic neuralgia?

Answer 15

NICE recommend using amitriptyline, duloxetine, gabapentin or pregabalin first-line.

Question 16

Useful for managing tremor in drug induced Parkinsonism?

Answer 16

Procyclidine

Question 17

Parkinsons med with reduced effectiveness over time?

Answer 17

Levodopa

Question 18

Other featured of Bells Palsy

Answer 18

patients may also notice
post-auricular pain (may precede paralysis)
altered taste
dry eyes
hyperacusis

Question 19

Believing someone has been replaced by an imposter?

Answer 19

Capgras sundrome

Question 20

Cotard syndrome?

Answer 20

Believing someone is dead

Question 21

what anti-epipletpci can cause peripheral neuropathy?

Answer 21

Phenytoin

Question 22

Saturday night palsy, what nerve?

Answer 22

Radial

Question 23

Wernickes aphasia

Answer 23

Recepive aphasia

Question 24

Loss of corneal reflex

Answer 24

Think acoustic neuroma

Question 25

Distinguish between MND and MG

Answer 25

Eyes are spared in MND

Question 26

For stroke to be total circulation involvement, what criteria?

Answer 26

The following criteria should be assessed: 1. unilateral hemiparesis and/or hemisensory loss of the face, arm & leg 2. homonymous hemianopia 3. higher cognitive dysfunction e.g. dysphasia Total anterior circulation infarcts (TACI, c. 15%) involves middle and anterior cerebral arteries all 3 of the above criteria are present

Question 27

Ix for demyelination lesions?

Answer 27

MRI with contrast

Question 28

Best anti-emetic in parkinsons?

Answer 28

Domperidone

Question 29

Frontal lobe seizure presentation in children?

Answer 29

Jacksonian movement (clonic movements travelling proximally) indicates frontal lobe epilepsy

Question 30

Brocas = Exprssive (think BE for BEN) Frontal

Answer 30

qWernickes = Receptive Temporal

Question 31

Cushings reflex

Answer 31

widening pulse pressure bradycardia irregular breathing Hypertension

Question 32

Pituitary tumour visual field defect?

Answer 32

Bitemporal heminopia with upper quadrant defect

Question 33

Stroke with R hemiplegia, visual loss?

Answer 33

R homonymous hemianopia

Question 34

Glaucoma visual field defect?

Answer 34

Unilateral peripheral visual defect

Question 35

Craniopharyngioma visual field defect?

Answer 35

Bitemporal hemianopia with lower quad defect

Question 36

TIA and driving?

Answer 36

No driving 28 days and don't have to tell DVLA

Question 37

Neuroleptic malignant syndrome featuresD

Answer 37

It occurs within hours to days of starting an antipsychotic (antipsychotics are also known as neuroleptics, hence the name) and the typical features are: pyrexia muscle rigidity autonomic lability: typical features include hypertension, tachycardia and tachypnoea agitated delirium with confusion

Question 38

Most common symptom of posterior circulation stroke?

Answer 38

Dizziness

Question 39

What is Lhermitte's sign?

Answer 39

tingling in her hands which comes on when she flexes her neck.

Question 40

Target time for thrombectomy in ischaemic stroke?

Answer 40

The standard target time for thrombectomy in acute ischaemic stroke is 6 hours

Question 41

Essential tremor inheritance pattern?

Answer 41

Autosomal dominant

Question 42

Huntingtons disease chromosome?

Answer 42

4 Autosomal dominant Affects men and women equally

Question 43

CN III features

Answer 43

Ptosis, Down and out, Mydriasis

Question 44

Seizures and driving

Answer 44

Epilepsy/seizures - all patient must not drive and must inform the DVLA first unprovoked/isolated seizure: 6 months off if there are no relevant structural abnormalities on brain imaging and no definite epileptiform activity on EEG. If these conditions are not met then this is increased to 12 months for patients with established epilepsy or those with multiple unprovoked seizures: may qualify for a driving licence if they have been free from any seizure for 12 months if there have been no seizures for 5 years (with medication if necessary) a 'til 70 licence is usually restored withdrawawl of epilepsy medication: should not drive whilst anti-epilepsy medication is being withdrawn and for 6 months after the last dose

Question 45

Brain mets and diplopia

Answer 45

Think CN 6

Question 46

If clopidogrel not tolerated after stroke?

Answer 46

Use aspirin