Neurology

Question 1

Migraine treatment

Answer 1

1 line

Ibuprofen etc

2 line

Sumatriptan

Prevention:

Propanolol
Sodium valproate
Verapamil
Amitriptyline
Pixotifen

Question 2

Cluster headache treatment

Answer 2

Acute: O2
Then sumatriptan SC

Question 3

Status epilepticus

Answer 3

O2
Midazolam IV or IM

Question 4

CPR

Answer 4

2 breaths
30 compressions - depth 5 cm

100 beats/min

If 2 people, change every 2 min

Lower half of sternum

Question 5

Left-sided neglect

Answer 5

Right MCA stroke

Question 6

Onset in vascular dementia

Answer 6

Sudden

With Alzheimer, it’s insidious and slow

Question 7

Difference between complex and simple partial seizures

Answer 7

No loss of consciousness in simple seizures

Question 8

Partial seizure treatment

Answer 8

Carbamazepine

Question 9

Brain structures stimulated for treatment of Parkinson’s disease

Answer 9

Globus pallidus
Subthalamic nucleus
Thalamus

Question 10

Alzheimer disease characteristics

Answer 10

Neuronal loss in cerebral cortex, hippocampus and temporal lobe

Loss of synapses

Later stages: cerebral cortex and hippocampus shrink

Hydrocephalus

Microscopic changes :

Amyloid plague
Fibrillary tangles

Question 11

Upper motor neuron disease

Answer 11

Spastic paralysis
Hyper reflexia
Positive Babinski reflex

Question 12

Treatment of subarachnoid haemorrhage

Answer 12

Nimodipine to reduce probability of stroke

(As vasospasm is a common complication of subarachnoid blood)

Question 13

Corneal abrasion on examination and impaired corneal sensation

Answer 13

Trigeminal nerve

Question 14

UMNL + urinary incontinence =

Answer 14

Transverse myelitis

Question 15

Arms muscle wasting
Legs tone increased
Unsteady gate
Shock sensation in the spine

Answer 15

Spinal cord compression

Question 16

Recent memory issues
Urinary incontinence
Gait issues

Answer 16

Normal pressure hydrocephalus - often after subarachnoid haemorrhage

• decreases absorption of CSF

Question 17

Obese pregnant woman with headache and papilloedema

Answer 17

Idiopathic intracranial hypertension
- MRI

Question 18

Teenage girl with frequent headaches and growth delay

Answer 18

Craniopharyngioma = supracellar mass on MRI

Question 19

Hemi neglect syndrome - neglecting the left side

Answer 19

Lesion of right parietal lobe

Question 20

Most common site for ischaemic stroke

Answer 20

MCA

Question 21

Shoulder abduction and elbow extension diminished

Loss of sensation over the right deltoid area

Answer 21

Injury to brachial plexus

Question 22

Driving after a stroke

Answer 22

No driving for 4 weeks

Then driving assessment by occupational therapist

Question 23

Cause of post-operative confusion

Answer 23

Hypoxia due to hyperventilation as a result of sedative drugs

Test - arterial blood gases

Question 24

Tongue innervation

Answer 24

General sensation - trigeminal nerve

Taste - anterior 2/3 - facial nerve

Posterior 1/3 glossopharyngeal nerve IX

Question 25

Common reaction to lamotrigine

Answer 25

Fever and rash up to 2 months after taking it!!!

Question 26

PICA = lateral Medullary syndrome

Answer 26

Vertigo, decreased hearing Horner syndrome Loss of sensation in face ipsilateral and limbs contralateral

Question 27

Pregnant Severe headache Hypotension Double vision Vision loss

Answer 27

Pituitary apoplexy MRI required

Question 28

If INR is high but no haemorrhage on CT

Answer 28

Skip one dose of warfarin

Question 29

Difference between drug induced Parkinsonism and Parkinson’s disease

Answer 29

DIP doesn’t have resting tremor Bilateral

Question 30

Vertigo Right side hearing loss Double vision Numbness of left limbs

Answer 30

Vertebro basillar insufficiency