Neurology

Question 1

Seizure Pathophysiology

• *“Good” transmitters** which reduce seizures (2) - drugs potentiate these
• *“Bad” transmitters** which increase seizures (4) - drugs block these

Answer 1

Good - K channels, GABA
Bad - Glutamate, AMPA, NMDA, Na channel

Question 2

Gerstmann Syndrome
Anatomical Location
Features (5)

Answer 2

Angular gyrus of the lower dominant parietal lobe
-associated with posterior circulation stroke
Features

• Agraphia
• Constructional apraxia
• Acalculia
• Left/Right dissociation
• Finger agnosia

Question 3

TPA in acute stroke - indication and contraindications

Answer 3

Question 4

Treatment of choice for trigeminal neuralgia

Answer 4

carbamazepine - 100mg BD to TDS, works within a few days

Question 5

Auto-antibody of Lambert Eaton Myasthenic Syndrome

Answer 5

Anti- Voltage Gated Calcium Channel

Question 6

Rate of congenital abnormalities in women taking AEDs
and
Advice re folic acid

Answer 6

Rate: 4 - 6%
Approximately double the national average of women without epilepsy
Folic acid
5mg daily for at least 3 months before and after conception

Question 7

Both hemicrania continua and paroxysmal hemicrania both respond 100% to

Answer 7

Indomethacin!

This is the diagnostic criteria

Question 8

Sydenham Chorea

• causative infection
• first line AEDs
• What else should the patient be on?

Answer 8

Question 9

Pharmacological management of Tics

Answer 9

Question 10

Glial cells

Answer 10

Oligodendrocytes are what is lost/defective in MS

Question 11

Types of nerve fibres

Answer 11

Question 12

Brown Sequard Syndrome

Answer 12

Question 13

Pathogenesis of GBS
-most common preceeding infection

Answer 13

Question 14

GBS: Presentation

Answer 14

Question 15

Prognosis of GBS

Answer 15

Question 16

Atypical degenerative causes of Parkinsonism: PSP

Answer 16

Question 17

Atypical degenerative causes of Parkinsonism: MSA

Answer 17

triad of: autonomic failure, parkinsonism and cerebellar signs

*autonomic failure does not present so early on in disease of PD whereas in MSA they can develop autonomic failure and orthostatic hypotension quite early on

Question 18

Atypical degenerative causes of Parkinsonism: CBA

Answer 18

Alien hand!

Question 19

Braak Stages of PD

Question 20

Risk factors and Protective Factors for Parkinson’s Disease

Answer 20

Question 21

Treatment Options/Principles in PD

Answer 21

• While medications improve motor and non-motor symptoms, they do not improve balance

Question 22

Treatment of Other Aspects of PD

Answer 22

Question 23

Management of Essential Tremor

Answer 23

Question 24

• *Carbamazepine**
• mechanism
• use
• contraindications (4)
• pregnancy?
• HLA we test for, who is more likely to have it
• HLA we don’t test for

Answer 24

Question 25

Ethosuximide - mechanism - use - contraindications (1) - pregnancy?

Answer 25

Question 26

Initial Management of Tonic-Clonic Seizures

Answer 26

Question 27

Gabapentin

Answer 27

Question 28

Lennox-Gastaut Syndrome

Answer 28

Question 29

Familial Hemiplegic Migraine

Answer 29

RARREEE weakness that takes up to 72 hours to resolve assoc with strong family histroy must rule out stoek and TIA FHM1 is assoc with CANA1A gene

Question 30

Chronic Migraine Definition

Answer 30

Question 31

Lifestyle modifications for Migraine (8)

Answer 31

Question 32

Guide to Prophylaxis choice in Migraine

Answer 32

Question 33

Types of localised focal epilepsies and characteristics

Answer 33

TLE = single most common form of epilepsy! Risk factors - prolonged febrile convulsions and CNS infections Most common cause of drug refractory epilepsy requiring surgery!

Question 34

Low CSF pressure HA

Answer 34

Worse in evening **improved on lying flat.** may be associated with 'coat-hanger' pain across the shoulders of pulsatile tinnitus. **Intracranial pressure \< 6cmH20** may be **spontaneous o**r f**ollow trauma or post LP**

Question 35

Epilepsy classification

Answer 35

Question 36

Definition and Epidemiology of Epilepsy

Answer 36

Question 37

Helpful investigations in Epilepsy

Answer 37

Question 38

Response to optimally used AED therapy

Answer 38

If failure of first therapy (after reaching optimal dose, ensuring compliance), gradually switch to another monotherapy. May go to dual IF already efficacy, felt that severe therapy unlikely to respond to single therapy

Question 39

Therapies for patients with drug-resistant epilepsy who are not surgical candidates. LOW YIELD, but just be aware

Answer 39

Question 40

Side Effects of Anterior temporal lobectomy for treatment of temporal lobe epilepsy

Answer 40

Question 41

Natalizumab

Answer 41

Question 42

Biggest issue with each MS medication

Answer 42

Question 43

Best and Worst MS drugs for pregnancy **-Tira, Di and Natalie** are happy they got pregnant

Question 44

Risk factors for PML with natalizumab

Answer 44

Question 45

MS vs PML - presentation

Answer 45

Question 46

Fingolimod

Answer 46

AVOID in pregnancy

Question 47

Fingolimod Cardiac Monitoring

Question 48

Glatiramer

Answer 48

**BEST** for pregnancy

Question 49

Causes of Seizures in the Elderly

Answer 49

Question 50

Teriflunomide

Answer 50

WORST in pregnancy - AVOID

Question 51

Dimethylfumarate

Answer 51

WORST tolerated but relatively safe in pregnancy NO live vaccines

Question 52

Ocrelizumab

Answer 52

Question 53

Alemtuzumab

Answer 53

Question 54

Interferon Beta - What are 4 reasons why you wouldn't use interferon beta?

Answer 54

Question 55

Daclizumab - mechanism of action and reason for withdrawal

Answer 55

mAb anti CD25 (interleukin 2) SC injection every 4 weeks **_Caused meningoencephalitis_**