Neurology

Question 1

left homonymous hemianopia - where’s the lesion?

incongruous defects = congruous defects =

Answer 1

right optic tract

Question 2

homonymous quadrantanopias - where’s the lesson?

Answer 2

PITS (Parietal-Inferior, Temporal-Superior)

Question 3

incongruous defects

Answer 3

optic tract lesion

Question 4

congruous defect

Answer 4

optic radiation lesion or occipital cortex

Question 5

Anterior cerebral artery stroke features

Answer 5

Contralateral hemiparesis and sensory loss, lower extremity > upper

Question 6

Middle cerebral artery stroke features

Answer 6

Contralateral hemiparesis and sensory loss, upper extremity > lower
Contralateral homonymous hemianopia
Aphasia

Question 7

Posterior cerebral artery stroke features

Answer 7

Contralateral homonymous hemianopia with macular sparing

Visual agnosia

Question 8

Weber’s syndrome stroke locations and features

Answer 8

(branches of the posterior cerebral artery that supply the midbrain)
Ipsilateral CN III palsy
Contralateral weakness of upper and lower extremity

Question 9

Posterior inferior cerebellar artery (lateral medullary syndrome, Wallenberg syndrome) stroke features

Answer 9

Ipsilateral: facial pain and temperature loss
Contralateral: limb/torso pain and temperature loss
Ataxia, nystagmus

Question 10

Anterior inferior cerebellar artery (lateral pontine syndrome)

Answer 10

PICA plus ipsilateral: facial paralysis and deafness

Question 11

Retinal/ophthalmic artery stroke features

Answer 11

Amaurosis fugax

Question 12

Basilar artery stroke features

Answer 12

‘Locked-in’ syndrome

Question 13

Lacunar stroke features and association

Answer 13

present with either isolated hemiparesis, hemisensory loss or hemiparesis with limb ataxia

associated with hypertension

Question 14

Amyotrophic lateral sclerosis (ALS)

Answer 14

A type of motor neurone disease (MND).
Degeneration of neurones in the motor cortex and in the ventral spinal cord produces mixed UMN and LMN signs. There are no associated sensory deficits.

Question 15

Guillain-Barre syndrome (GBS) is…

Answer 15

inflammatory peripheral neuropathy
a recent bacterial or viral infection.
Lower motor neurone signs and sensory disturbances

Question 16

Cervical spondylotic myelopathy is…

Answer 16

Cervical spondylosis is the term used for osteoarthritis of the spine resulting in cord compression
LMN signs at the level of the compression (ie. upper limb if the lesion is below C5) with UMN signs below (in the lower limb).
Patients usually complain of neck pain and stiffness.

Question 17

Charcot-Marie-Tooth syndrome is…

Answer 17

a hereditary sensory and motor peripheral neuropathy. lower motor neurone signs in all limbs and reduced sensation (more pronounced distally).

Question 18

Lambert-Eaton myasthenic syndrome

Answer 18

rare autoimmune disorder involving the neuromuscular junction, so LMN signs will be present.
associated with small-cell lung cancer.

Question 19

CNIII Palsy results in:

Answer 19

Palsy results in
ptosis
‘down and out’ eye
dilated, fixed pupil

Question 20

CNIV Palsy results in:

Answer 20

Palsy results in defective downward gaze → vertical diplopia

Question 21

CN VI palsy results in:

Answer 21

Palsy results in defective abduction → horizontal diplopia

Question 22

Craniopharyngioma

Answer 22

• Most common paediatric supratentorial tumour
• solid/cystic tumour of the sellar region that is derived from the remnants of Rathke’s pouch.
. hormonal disturbance, symptoms of hydrocephalus or bitemporal hemianopia.

• Investigation requires pituitary blood profile and MRI. Treatment is typically surgical with or without postoperative radiotherapy.