Pass Med Q's

Question 1

what is neuroleptic malignant syndrome

Answer 1

rare but dangerous condition seen in patients taking antipsycotic medication

Question 2

presentation of neuroleptic malignant syndrome

Answer 2

pyrexia
muscle rigidity 
HTN, tachycardia, tachypnoea
delirium / agitation / confusion
- symptoms begin within hours to days of starting the medication

Question 3

what is raised in neuroleptic malignant syndrome

Answer 3

CK + leucocytosis

Question 4

what can occur as a consequence of neuroleptic malignant syndrome

Answer 4

AKI secondary to rhabdomyolysis

Question 5

acute management of cluster headache

Answer 5

SC Sumatriptan + oxygen

Question 6

prophylaxis for cluster headache

Answer 6

verapamil

Question 7

which anti-epileptics can cause Steven Johnston syndrome

Answer 7

lamotrigine

carbamazepine

Question 8

how long do you have to be seizure free to consider stopping anti-epileptic drugs?

Answer 8

seizure free for 2 years

- stop drugs over 2-3 month period

Question 9

what can a tentorial / uncle herniated cause

Answer 9

CN III palsy

- fixed dilated pupil, eye is down + out

Question 10

how long must you stop driving for following a TIA

Answer 10

1 month

Question 11

how long must you stop driving for after 1st unprovoked seizure

Answer 11

6 months

Question 12

bitemporal hemianopia with predominantly lower quadrants affected is caused by what?

Answer 12

craniopharyngioma

Question 13

nerve roots for knee reflex

Answer 13

L3 - L4

Question 14

nerve roots for ankle reflex

Answer 14

S1 - S2

Question 15

nerve roots for biceps reflex

Answer 15

C5 - C6

Question 16

nerve roots for triceps reflex

Answer 16

C7 - C8

Question 17

5 headache red flags that warrant imaging

Answer 17

1. vomiting more than once with no other cause
2. new motor or sensory defecit
3. decreased conscious level
4. headache assoc. with caughing/ sneezing
5. progressive headache + fever

Question 18

what is Wernicke’s aphasia

Answer 18

receptive aphasia

• patients can produce fluent speech but sentences don’t make sense
• comprehension impaired

Question 19

where is the lesion in Wernickes aphasia

Answer 19

superior temporal gyrus

Question 20

what is Brocas aphasia

Answer 20

expressive aphasia

• speech is non-fluent, laboured, halted
• comprehension normal

Question 21

where is the lesion in Brocas aphasia

Answer 21

inferior frontal gyrus

Question 22

gold standard test for venous sinus thrombosis

Answer 22

MR venogram

Question 23

what condition is suggested by a positive Hoffmans sign

Answer 23

degenerative cervical myelopathy

Question 24

most common complication following meningitis

Answer 24

sensorineural hearing loss

Question 25

what blood test can be used to differentiate between a seizure and pseudo seizure

Answer 25

prolactin | - prolactin with be raised following a seizure

Question 26

what diagnosis should be suspected in patient with unilateral hearing loss, balance problems and reduced facial sensation

Answer 26

acoustic neuroma (vestibular shwannoma)

Question 27

what reflex can be lost in an acoustic neuroma

Answer 27

corneal reflex

Question 28

Investigation of acoustic neuroma

Answer 28

MRI + audiogram

Question 29

medications post ishcaemic stroke

Answer 29

aspirin 300mg for 2 weeks then clopidogrel 75 mg daily long term

Question 30

first line treatment of trigeminal neuralgia

Answer 30

carbamazepine

Question 31

triad of symptoms wernicke's encephalopathy

Answer 31

confusion, ataxia, opthalmoplegia

Question 32

treatment of wernicke's ecephalopathy

Answer 32

Pabrinex

Question 33

hallucinations, lip smacking, plucking at clothes, deja vu are symptoms of a seizure in what part of the brain?

Answer 33

temporal lobe seizure

Question 34

what are seizures in the parietal lobe associated with?

Answer 34

sensory abnormalities

Question 35

dermatome corresponding to - thumb - middle finger - little finger

Answer 35

thumb = C6 middle finger = C7 little finer = C8

Question 36

what is a Arnold-Chiari malformation

Answer 36

downward displacement / herniation of cerebellar tonsils through foramen magnum

Question 37

what condition can an Arnold-Chiari malformation cause? | how does this present?

Answer 37

syringomyelia | - cape like loss of pain + temperature sensation (spinothalamic tract)

Question 38

tx of tremor in drug induced parkinsons

Answer 38

procyclidine

Question 39

patient with left inferior homonymous hemianopia | where is the lesion?

Answer 39

right parietal lobe

Question 40

isolated rise of protein in CSF on LP indicates what

Answer 40

Guillian Barre

Question 41

what veins are damaged in a sub-dural haemorrhage

Answer 41

bridging veins between cortex and venous sinuses

Question 42

most common psychiatric problem in parkinsons disease

Answer 42

depression

Question 43

which nerve is affected in a RAPD

Answer 43

optic nerve - affected eye will not constrict when light is shone directly in that eye - affected eye will constrict when light is shown in the other eye (consensual response)

Question 44

who typically gets idiopathic intracranial hypertension

Answer 44

young, overweight females

Question 45

features of idiopathic intracranial hypertension

Answer 45

headaches blurred vision papillodema high opening pressure on LP

Question 46

what shoulder movement is most affected in adhesive capsulitis

Answer 46

external rotation

Question 47

what is Kernig's sign

Answer 47

painful knee extension from position of hip + knee flexion | - suggests meningeal irritation e.g. meningitis, SAH

Question 48

occlusion of which artery causes complete aphasia

Answer 48

middle cerebral in the DOMINANT hemisphere | e.g left middle cerebral as most people are right side dominant

Question 49

what condition needs to be excluded in a painful third nerve palsy

Answer 49

posterior communicating artery aneurysm

Question 50

what can trigger cluster headaches

Answer 50

alcohol