Neurology MSRA passmed

Question 1

Jacksonian movement (clonic movements travelling proximally

Answer 1

Frontal lobe seizures

Question 2

seizures with sensory abnormalities?

Answer 2

PArietal lobe

Question 3

seziures with aura - lip smacking/ clothes plucking, rising epigastric sensation?

Answer 3

Temporal lobe seizures

Question 4

Absolute CI to thrombolysis in stroke?

Answer 4

ICH, seizures, cancer sus, SAH, stroke/ injury in 3 months before, LP 7 days before, GI bleed 3 weeks before, Oesophageal varices, HTN>200/120mmHg

Question 4

Relative CI to thrombolysis?

Answer 4

• Pregnancy
• Concurrent anticoagulation (INR >1.7)
• Haemorrhagic diathesis
• Active diabetic haemorrhagic retinopathy
• Suspected intracardiac thrombus
• Major surgery / trauma in the preceding 2 weeks

Question 5

Lacunar stroke features?

Answer 5

purely motor/
purely sensory
sensorimotor stroke
ataxic hemiparesis
ipsilateral weakness and limb ataxia that is out of proportion to the motor deficit
dysarthria-clumsy hand syndrome
affect: internal capsule, thalamus and basal ganglia.

Question 6

Bilateral median N Dysfunction and twitches in elderly “fibrillation” think?/ hx of carpal tunne/ new imbalance/ sensnory/motor dysfunction

Answer 6

Degenerative cervical myelopathy.
MRI: gold standardL

Question 7

fever, headache, malaise focal neurology, seizures, immunocompromised. what does CT show? dx?

Answer 7

CT: temporal lobe/ frontal changes (hypodensities). CSF: lymphocytosis and raised protein.
HSV encephalitis

Question 8

asymmetric limb weakness, fasciculations, tibialis anterior wasting, small hand muscle wasting

Answer 8

ALS MND. risk frontotemporal dementia

Question 9

Features of tuberus sclerosis?

Answer 9

AD, epilepsy, retinal haematoma, ash leaf spots, shagreen patches, sublingual fibromata, adenoma sebaceum

Question 10

Neurofibromatosis features?

Answer 10

lisch nodules, AD, cafe au lait spots, phaechromocytomas, axillary/ groinfreckles,
NF2: acoustic neuroma, cns tumours