Neurology

Question 1

Symptoms from B12 deficiency

Answer 1

Parasthesia

Personality changes

Question 2

Symptoms from Folate deficiency

Answer 2

peripheral neuropathy

Question 3

Features on EEG of childhood absence epilepsy?

Answer 3

3 per second spike and wave discharges

Question 4

Features on EEG of tonic clonic seizure?

Answer 4

10 Hz activity during tonic phase

Slow waves during clonic phase

Question 5

Treatment of status epilepticus?

Answer 5

1. ABC , IV glucose, IV thiamine
2. IV Benzodiazepines (lorazepam)
   - x2
3. Phosphenytoin OR phenytoin
4. ICU with infusion of midazolam/propofol/phenobarbitol

Question 6

Indication for starting anti epileptics ?

Answer 6

EEG: abnormal spine, poly spike discharge, spike wave complex 
Abnormal neuro exam 
Findings on MRI 
Nocturnal seizure 
Unprovoked recurrent seizures

Question 7

What is atonic seizure?

Treatment of atonic seizure?

Answer 7

No LOC
No Tone

Valproate

Question 8

Treatment of absence seizure?

Answer 8

ethosuxamide

Question 9

Treatment trigenimal neuralgia?

Answer 9

Carbamazepine

Question 10

Investigations for myasthenia gravis?

Answer 10

Tensilon test

Anti Acetylcholine R assay Ab

Icepack over eyelids

MRI/CT for thymoma

Question 11

Symptoms of myasthenia gravis

Answer 11

Ptosis
Double vision
Fatigue
Weakness

Question 12

Treatment myasthenia gravis ?

Answer 12

pyridostigmine

acethylcholine esterase inhibitor

Question 13

What is lambert-eaton?

Answer 13

Ab against Ca channels

Mostly paraneoplastic cause from SCC

Question 14

Symptoms of lamberton eaton?

Answer 14

Proximal muscle weakness

Reduced reflexes

Question 15

Diagnosis of Gillian Barre?

Answer 15

Protein +++ in LP

Question 16

Cause of Gillian Barre?

Answer 16

Campylobacter
EBV
other infection

Question 17

Treatment of Gillian Barre?

Answer 17

IVIG

Question 18

Findings on LP for Multiple Sclerosis?

Answer 18

Oligoclonal bands on LP

MRI: Periventricular white matter plaques

Question 19

What is Lhermitts phenomenon?

Answer 19

Flexion of the neck causes shock waves sensation down the leg

Question 20

What is Uhthoff’s Phenomenon?

Answer 20

Worsening of symptoms in the heat

Question 21

What is the acute treatment of MS?

Answer 21

IV prednisolone

Question 22

What are disease modifying agents for MS?

Answer 22

Teriflunomide
Interfuron beta

Symptomatic treatment for spasticity, bladder dysfunction, pain, fatigue, depression, constipation, sexual dsfxn

Education, counselling g

Question 23

Indication for good prognosis?

Answer 23

Young 
Female 
Relapse/Remitting 
Optic neuritis 
Low burden of disease on MRI

Question 24

Acute stroke treatment?

Answer 24

1. rtPA - recombinant tissue plasminogen activator
   - if within 4.5 hours of onset of symptoms
2. Aspirin if did not get rtPA
3. Withhold antihypertensive therapy
4. Avoid hyperglycaemia
5. lower temperature if febrile
6. DVT prophylaxis
7. NPO if dysphagia

Question 25

Secondary stroke prevention treatment?

Answer 25

``` Antiplatelet agent (aspirin, if happened while on aspirin, clopidogrel) Anticoagulant if found to have AF HTN control Diabetes control Commence statin Cease smoking Exercise Carotid endarterectomy if > 70 w/ sx surgery or > 80% occlusion ```

Question 26

Contraindications to rtPA

Answer 26

``` Prior SAH Pregnant Recent GI or urinary hemorrhage Recent LP or arterial function Recent major surgery (14 days) Minor sx ```

Question 27

Features of an MCA stroke?

Answer 27

Contralateral UL + Face Motor + sensory If L side: aphasia (dominant ) If R side: neglect

Question 28

Features of an ACA stroke?

Answer 28

Contralateral LL | Motor + sensory

Question 29

Features of PCA stroke?

Answer 29

Homonymous hemianopia / Quandrantanopia

Question 30

Features of Posterior Internal Capsule Infarct?

Answer 30

Pure motor hemiparesis

Question 31

Features of a thalamic infarct?

Answer 31

Pure sensory deficit

Question 32

Opening pressure in idiopathic intracranial HTN

Answer 32

> 20 mmhg

Question 33

Features of anterior pons infarct?

Answer 33

Dysarthrria Facial weakness Dysphagia Mild hand weakness/clumsiness

Question 34

Which areas are lacunar?

Answer 34

``` Internal Capsule Pons Thamalus Deep MCA Basilar Vertebral arteries ```

Question 35

Syndrome of of posterior inferior cerebellar artery infarct?

Answer 35

Wallenberg Syndrome

Question 36

What's Wallenberg syndrome?

Answer 36

Ipsilateral ataxia Nystagmus Ipsilateral Horner Sensory: ipsilateral face, contralateral body to pain and temp

Question 37

Syndrome of Vertebral artery infarct?

Answer 37

Medial medullary syndrome

Question 38

Features of medial medullary syndrome?

Answer 38

Contralateral motor Contralateral discriminative touch deficit (intact temp/pain) CN XII lesion

Question 39

Features of proximal basilar artery stroke?

Answer 39

CN VI palsy Impaired horizontal EOM Vertical nystagmus Miosis

Question 40

What causes locked in Syndrome?

Answer 40

Basilar artery clot

Question 41

Features of distal basilar artery stroke?

Answer 41

Reduced LOC | CN III Palsy