Neurosciences

Question 1

What are the red flag symptoms of trigeminal neuralgia?

Answer 1

Sensory changes
Deafness or other ear problems
History of skin or oral lesions that could spread perineurally
Pain only in the ophthalmic division of the trigeminal nerve (eye socket, forehead, and nose), or bilaterally
Optic neuritis
A family history of multiple sclerosis
Age of onset before 40 years

Question 2

What is t he management for bells palsy?

Answer 2

Prednisolone and eye care advice - eye drops and lubricants

Question 3

When do you give dexamethasone in meningitis?

Answer 3

If patient is over 3 months and no signs of sepsis

Question 4

What area of the brain is affected in a focal seizure with lip smacking?

Answer 4

Temporal

Question 5

What is management of suspected TIA in GP?

Answer 5

300mg aspirin and specialist review in 24hrs

Question 6

What are the first line medications for spasticity in MS?

Answer 6

Baclofen and Gabapentin

Question 7

What medication is used for meningococcal meningitis prophylaxis?

Answer 7

Oral ciprofloxacin or rifampicin

Question 8

What movements are typically spared in MND?

Answer 8

Eye movements

Question 9

What are the features and management of essential tremor?

Answer 9

Postural tremor - worse if arms outstretched
Improved by alcohol and rest
Most common cause of head tremor
Management - propranolol

Question 10

What is the most common cause of viral meningitis in adults?

Answer 10

Coxsackie B

Question 11

What medication is used for reducing relapsing multiple sclerosis?

Answer 11

Natalizumab

Question 12

What medications are used in treatment of non-falciparum malaria?

Answer 12

Primaquine

Question 13

What medications are used in treatment of falciparum malaria?

Answer 13

ACT therapy

Question 14

What motor neurone disease carries the worst prognosis?

Answer 14

Progressive bulbar palsy

Question 15

What is the first line medication for a female and males with myoclonic seizures?

Answer 15

Levetiracetam for females
Sodium valproate for males

Question 16

What are the features of herpes simplex 1 encephalitis?

Answer 16

Fever, headache, psychiatric symptoms, seizures, focal features - aphasia

Question 17

How is Motor neurone disease shown on nerve conduction studies?

Answer 17

Normal

Question 18

What neuro condition has normal nerve studies, MRI with ongoing neurological symptoms?

Answer 18

MND - Amytrophic lateral sclerosis

Question 19

What do trophozoites indicate in blood film?

Answer 19

Malaria

Question 20

What feeding tube is preferred in patients with MND?

Answer 20

Percutaneous gastrostomy tube

Question 21

What are the action potentials seen in carpel tunnel?

Answer 21

Prolongation in both sensory and motor axons

Question 22

What is the sign in MS when there is a tingling in hands/ shooting down spine when neck is flexed?

Answer 22

Lhermitte’s sign

Question 23

What anaesthetic agent would someone with myasthenia gravis be resistant too?

Answer 23

Suxamethonium

Question 24

What is a risk factor for neuralgia parasthetica?

Answer 24

Sudden weight gain

Question 25

What is the treatment of acute myasthenia crisis?

Answer 25

Plasmapheresis and IV immunoglobulin

Question 26

How does neurogenic thoracic outlet syndrome present?

Answer 26

Muscle wasting of hands, numbness, tingling and possible autonomic symptoms

Question 27

What is uhthoff’s phenomenon?

Answer 27

Neurological symptoms exacerbated by increases in body temperature - MS association

Question 28

How is dyskinetic cerebral palsy described and where is the damage in brain located?

Answer 28

Abnormal involuntary movements, twisting and slow writhing movements
Basal ganglia and substantial nigra

Question 29

What nerve can be damaged in mid shaft humeral fracture and how can you test for it?

Answer 29

Radial - extends the risk

Question 30

What is the tendon divided during carpal tunnel surgery?

Answer 30

Flexor retinaculum