Neurology

Question 0

Focal seizures Rx

Answer 0

1st-line

Lamotrigine (coc reduces serum conc. by increasing elimination)
Carbamazepine (potent p450 inducer)
Levetriacetam

Question 1

T2 MRI

Answer 1

T2 = H2O white

Question 2

P450 inducer anti-epileptic

Answer 2

Carbamazepine

Topiramate

Question 3

Benign intracranial hypertension Px

Answer 3

Generalized throbbing
Worse on coughing
Eased on standing

Question 4

Bell’s palsy Rx

Answer 4

Prednisolone if within 72h of onset (speeds up recovery)

Question 5

Location of Broca’s area

Answer 5

Inferior frontal gyrus - in the dominant hemisphere

Question 6

Damage to the Broca’s area Px

Answer 6

Expressive Aphasia

Comprehend but difficulty with finding, forming and articulating words into sentences

Question 7

Damage to the Wernicke’s area

Answer 7

Receptive aphasia (jargon aphasia)
Difficulty comprehending speech but normal sounding speech but meaningless

Question 8

Commonest cause for spontaneous SAH

Answer 8

Berry aneurysms 80%

Rare - AVM

Question 9

Hallmarks of MG

Answer 9

Fatigability of muscles with no evidence of wasting, abnormal tone, sensation or reflexes

Question 10

Aetiology of MG

Answer 10

Autoimmune attack on post-synaptic acetylcholine receptors

Question 11

Lambert-eaton myasthenia syndrome (LEMS) aetiology

Answer 11

Autoimmune attack on presynaptic calcium channels - ix found calcium channels antibodies

Associated with small cell lung Ca 70%

Question 12

Px LEMS

Answer 12

Proximal arm and leg weakness wih diminishing reflexes

Question 13

MND Px

Answer 13

LMN + UMN Sx with sparing of extra-ocular muscles

Question 14

Red flags for head injury

Answer 14

Loss of consciousness at time of injury 
Neurological deficits
Vomiting >1
Altered consciousness 
Papilloedema