Neuro

Question 1

What level spinal cord injury causes autonomic dysreflexia?

Answer 1

Above T6

Question 2

Which causes sensorineural hearing loss: AICA or PICA?

Answer 2

AICA

Question 3

How to differentiate Pontine/Basilar strke vs opioid overdose quickly?

Answer 3

Torch: In stroke the pinpoint pupils ARE reactive to light. Only POORLY reactive in opioid overdose

Question 4

Wernike’s encephalopathy, what two investigations?

Answer 4

• DECREASED red cell transketolase
• MRI

Question 5

Korsakoff Syndrome 2 main features:

Answer 5

Antero and retrograde amnesia
Confabulation

Question 6

Mneumonic for homonymous quadratanopias

Answer 6

PITS
Parietal-Inferior Radiations

Temporal-Superior Radiations

Question 7

Where is the lesion: Macular sparing hom.hemaiopia?

Answer 7

occipital cortex

Question 8

Where is the lesion: incongruous vs congruous hom.hemaniopia

Answer 8

Incong: optic tract
Cong: radiations or occipital lobe

Question 9

Bitemporal hemaniopia: what is the pattern of upper vs lower quadrant of the hemaniopia?

Answer 9

Worse on lower= SUPERIOR compression

Worse of upper: INFERIOR compression (pituitary tumour)

Question 10

In vestibular schwannoma what does the involvement of CN5 cause?

Answer 10

Absent corneal reflex

Question 11

Which genetic condition is associated with BILATERAL vestibular schwannoma?

Answer 11

NF2

Question 12

What is surgical 3rd nerve palsy?

Answer 12

Addition of dilated pupil to:
- ptosis
- Down out deviation

Question 13

Trigeminal Neuralgia 1st line?

Answer 13

Carbemazepine

Question 14

Which stroke syndrome (AND ARTERY) causes dysphagia, ipsi facial pain/temp loss, ipsi ataxia, vertigo&nystagmus?

Answer 14

Wallenberg’s Syndrome - PICA

Question 15

Main CI for triptans?

Answer 15

IHD, Cerebrovascular disease

Question 16

Name 3 red flags for a concerning cause of trigeminal neuralgia

Answer 16

• Age under 40 onset
• Sensory changes
• Fx MS
• ONLY opthalm lesion
• Optic neuritis
• Ear problems
• Hx skin lesions

Question 17

Which stroke syndrome (AND ARTERY) causes CN3 palsy and contralateral hemipareis?

Answer 17

Weber’s Syndrome
PCA penetrating branches

Question 18

Define chronic tension type headache

Answer 18

Occurs on 15 or more days per months

Question 19

Prophylaxis of tension headaches

Answer 19

10 sessions of acupuncture over 5-8 weeks

Question 20

If 1st line migraine Mx isn’t tolerated, what is added?

Answer 20

Oral metoclopramide or prochlorperazine
Consider: non-oral triptan and NSAID

^Cautious metoclopramide in kids!!

Question 21

Migraine prophylaxis 1st and 2nd line

Answer 21

1st: Propanolol, topiramate (terato!), amitryptaline
2nd: acupuncture

Question 22

Prophylaxis of menstrual migraines?

Answer 22

Mini-proph with:
Frovatriptan or zolmitriptan

Question 23

1st line migrain in pregnany acute

Answer 23

1g paracetomol
(2nd NSAID 1st 2nd trimester only)

Question 24

Prophylaxis of cluster headaches?

Answer 24

Verapamil
or tapered prednnisolone

Question 25

Investigation for cluster headaches?

Answer 25

MMRI with gadolinium

Question 26

Investigation of vestibular schwannoma

Answer 26

MRI cerebellopontine angle

Question 27

What antibiotics are used in mx of brain abcess

Answer 27

IV 3rd gen cephalosporin and metronidazole

Question 28

What drug is is used for intracranial pressure mx in brain abcess?

Answer 28

Dexamethosone

Question 29

Give 3 differences between stroke in MCA and ACA

Answer 29

MCA: - Upper worse than Lower - Aphasia - Homonymous Hemaniopia (ACA Lower worse than upper)

Question 30

List 3 drugs which are risk factors for IIH?

Answer 30

Combined pill Tetracylines (e.g.lymecycline) Steroids Retinoids Lithium

Question 31

GBS - Most important diagnostic investigation finding?

Answer 31

Lumbar Puncture Raised protein, Normal WBCs

Question 32

You see a Parkinson's patient with - Erectile dysfunction - Unilateral symptoms What is the cause of their Parkinsons?

Answer 32

Multiple System Atrophy