Pass Med Q's 2

Question 1

what does the Barthel index assess

Answer 1

disability / dependence in activities of daily living in stroke patients

Question 2

what is affected in subacute combined degeneration of spinal cord

Answer 2

dorsal + lateral columns

• loss of proprioception + vibration sense
• distal parastheseia

Question 3

criteria for thrombectomy in ischaemic stroke

Answer 3

• within 6 hours of symptom onset if confirmed occlusion of proximal anterior circulation
• between 6-24 hours if confirmed occlusion of proximal anterior circulation PLUS potential to salvage brain tissue, as shown on CT

Question 4

treatment of idiopathic intracranial HTN

Answer 4

weight loss
acetazolamide
topiramate – added benefit of weight loss

Question 5

what is Uhthoff’s phenomenon

Answer 5

worsening of vision following rise in body temperature

- seen in MS

Question 6

what is Lhermitte’s syndrome

Answer 6

parasthseia in limbs following neck flexion

- seen in MS, cervical stenosis, subacute combined degeneration of spinal cord

Question 7

if there is macula sparing, where is the lesion likely to be?

Answer 7

occipital cortex

- supplied by posterior cerebral artery

Question 8

which anti-epileptic can cause peripheral neuropathy

Answer 8

phenytoin

Question 9

headache that is worse on standing, improves when lying flat

Answer 9

spontaneous intracranial hypotension

• results from CSF leak
• marfans syndrome is a risk factor

Question 10

tumour arising from falx cerebri causing symptoms by compression - what is the tumour?

Answer 10

a meningioma

Question 11

how does a Jacksonian March seizure present

Answer 11

starts by affecting a peripheral body part e.g toe/finger and then spreads over the respective foot/hand

Question 12

what is autonomic dysreflexia

Answer 12

clinical syndrome that occurs in patients with a spinal injury at, or above, T6

• hypertension
• flushing
• sweating

Question 13

presentation of internuclear ophthalmoplegia

Answer 13

affected eye fails to ADDuct

contralateral eye abducts but with nystagmus

Question 14

how should medication be administered in parkinsons patient who usually takes oral levodopa if they develop an unsafe swallow

Answer 14

switch to dopamine agonist patch to prevent acute dystonia

Question 15

axillary freckling

Answer 15

NF1

Question 16

what diet can be useful in childhood epilepsy that is difficult to control and unresponsive to medication

Answer 16

ketogenic diet

Question 17

what is a quick test you can do to check if nasal fluid from a trauma patient is CSF?

Answer 17

test for glucose

- will be +ve in CSF and -ve in mucus

Question 18

treatment of headache following LP

Answer 18

caffeine + fluids

Question 19

Jacksonian March seizures indicate epilepsy in what lobe of the brain

Answer 19

frontal lobe

Question 20

best imaging for diagnosing an acoustic neuroma

Answer 20

MRI of cerebellopontine angle

Question 21

symptoms of wenicke’s encephalopathy

Answer 21

nystagmus/opthalmoplegia, ataxia, confusion

• due to B1 deficiency
• confabulation = development of Korsakoff syndrome

Question 22

which anaesthetic can patients with myasthenia gravis be resistant to

Answer 22

suxamethonium

Question 23

eye deviated up + outwards

Answer 23

4th CN palsy

Question 24

proximal muscle weakness that initially improves with exercise suggests what

Answer 24

Lambert eaton syndrome

Question 25

presentation of neurogenic thoracic outlet syndrome

Answer 25

painless muscle wasting of the hands with weakness of grasp/grip
reynauds
numbness/tingling

Question 26

weakness of foot dorsiflexion + eversion

lateral lower leg sensory loss

Answer 26

common peroneal nerve lesion