Neurology

Question 1

Innervation of Adductor Policis

Answer 1

Ulnar nerve. Froment’s sign. Can be positive in golfer’s elbow injuries.

Question 2

Charcot Marie Tooth disease

Answer 2

Charcot–Marie–Tooth disease (CMT) is one of the hereditary motor and sensory neuropathies of the peripheral nervous system characterized by progressive loss of muscle tissue and touch sensation across various parts of the body. Currently incurable, this disease is the most commonly inherited neurological disorder, and affects about one in 2,500 people.[1][2] CMT was previously classified as a subtype of muscular dystrophy.

Symptoms of CMT usually begin in early childhood or early adulthood, but can begin later. Some people do not experience symptoms until their early 30s or 40s. Usually, the initial symptom is foot drop early in the course of the disease. This can also cause hammer toe, where the toes are always curled. Wasting of muscle tissue of the lower parts of the legs may give rise to a “stork leg” or “inverted champagne bottle” appearance. Weakness in the hands and forearms occurs in many people as the disease progresses.

Loss of touch sensation in the feet, ankles, and legs, as well as in the hands, wrists, and arms occurs with various types of the disease. Early- and late-onset forms occur with ‘on and off’ painful spasmodic muscular contractions that can be disabling when the disease activates. High-arched feet (pes cavus) or flat-arched feet (pes planus) are classically associated with the disorder.[3] Sensory and proprioceptive nerves in the hands and feet are often damaged, while unmyelinated pain nerves are left intact. Overuse of an affected hand or limb can activate symptoms including numbness, spasm, and painful cramping.

Question 3

Area of brain most commonly affected in Wilson’s

Answer 3

Basal Ganglia. Manifests in dysarthria, tremor and Parkinsonian features. Kayser-Fleischer rings on the eyes commonly associated.

Question 4

Neurofibrillary tangles (of Tau) and senile plaques are pathologically consistent with which disease?

Answer 4

Alzheimer’s

Question 5

Neuronal cell loss and atrophy, particularly of the caudate and putamen are pathologically consistent with which disease?

Answer 5

Huntington’s

Question 6

Round neuronal inclusion bodies of aggregated protein, the major of which is alpha synuclein, plus senile plaques but not NFT are pathologically consistent with which disease?

Answer 6

Lewy-Body dementia

The round neuronal inclusion bodies of aggregated protein, the major of which is alpha synuclein are called Lewy Bodies

Question 7

Round silver staining inclusions, containing hyperphosphorylated Tau protein, microvacuolation and neuronal loss, swollen neurones, myelin loss and astrocytic gliosis are pathologically consistent with which disease?

Answer 7

Pick’s disease (frontotemporal dementia)

The Round silver staining inclusions are called Pick bodies

Question 8

Neurofibrillary tangles (NFT) but not senile plaques are pathologically consistent with which disease?

Answer 8

Punch-drunk syndrome (dementia pugilistica / chronic traumatic encephalopathy)

Question 9

What is the triad characterising Wenicke’s Encephalopathy?

Answer 9

Ataxia, Confusion, Ophtalmoplegia (e.g. 6th nerve palsy)

Question 10

Visual field defect caused by parietal lobe lesions?

Answer 10

Inferior homonymous quadrantinopia

PITS = Parietal Inferior, Temporal Superior

Question 11

Visual field defect caused by temporal lobe lesions?

Answer 11

Superior homonymous quadrantinopia

PITS = Parietal Inferior, Temporal Superior