Quiz Neuro

Front 1

Frontal lobe responsible for? (3)

Back 1

Executive Function, Movement, Broca's Speech

Front 2

Parietal Lobe (3)

Back 2

Sensory, Numeracy, Spacial awareness

Front 3

Temporal lobe (5)

Back 3

Auditory, Olfactory, Memory, Emotions, Wernicke's

Front 4

Occipital (1)

Back 4

Visual

Front 5

Two named signs of Meningitis

Back 5

Kernig's
Brudzinski's

Front 6

What is Kernig's sign?

Back 6

Flex hip and knee. Extend knee.

Pain and resistance

Front 7

What is Brudzinski's sign?

Back 7

Flex neck cause flex hips and knees

Front 8

Name 4 types of headache

Back 8

Cluster
Tension-type
Temporal Arteritis
Migraine

Front 9

What are the features of a cluster headache?

Back 9

30-90mins
5M:F
30-50yrs
At a particular time of day

Front 10

Tension type headache features

Back 10

Dull/Tight/Pressure
Radiates to occipitut
Poor response to analgesia

Front 11

Features of Temporal Arteritis (3)

Back 11

Scalp tenderness, tender non-pulsatile temporal arteries
Systemic anorexia, wt loss, depression, fever
Diploplia, central scotoma, TIA

Front 12

Definition of a stroke

Back 12

Focal neurological deficit lasting longer than 24hrs as a result of a vascular lesion

Front 13

Causes of stroke (3)

Back 13

Ischaemic (80)
Haemorrhagic (15)
Subarachnoid (5)

Front 14

Pathological evolution of stroke (5)

Back 14

Oxygen deprivation.
Energy dependent membrane ionic pumps fail
Cytotoxic oedema + depolarisation
Ca entry, glutamate release
Organelle damage, apoptosis

Front 15

What are the homeostatic responses to falling O2 perfusion of the brain (3)

Back 15

Initial vasodilation
Increase in Oxygen extraction
Infarction

Front 16

Ix in Stroke (3++)

Back 16

Simple : BP, BM, pulse (AF), ECG
Bloods : FBC, U&E, Lipids, Glucose, TFT, Syphilis, SLE autoantibodies, protein Sand C, antithrombin III, sickle cell, Clotting, Cardiac doppler
Special : CT (may take 12hrs to show)

Front 17

3 components of GCS

Back 17

Eyes
Verbal
Motor

Front 18

Eyes score

Back 18

Max 4
None
Pain
Speech
Spontaneous

Front 19

Verbal Score

Back 19

Max 5

None
Incomprehensible
Inappropriate
Disorientated
Orientated

Front 20

Motor Score

Back 20

Max 6

None
Pain extension
Pain flexion
Pain withdrawl
Pain localised
Obeys verbal

Front 21

What is it called when patients have a "curtain coming down" over one eye

Back 21

Amaurosis fugax - carotids?

Front 22

TACS requires (3)

Back 22

hemiplegia
higher cortical dysfunction
hemianopia

Front 23

PACS requires

Back 23

2 of TACS
or lone higher cortical dysfunction

Front 24

Pure motor dysfunction with no eye or higher cortical signs is a

Back 24

Lacunar

Front 25

Common causes of SAH(3)

Back 25

Berry (80%)
AV malformation (10%)
Other

Front 26

Mx of SAH (5)

Back 26

Nimodipine (Ca antag) prevent spasm?
ECG
Analgesia
Fluids
CT for neurosurg/radio

Front 27

Organisms in neonatal meningitis

Back 27

Listeria
Strep Group B
Proteus
E Coli

Front 28

Causes of encephalitis (4)

Back 28

HSV (infancy - generalised; adult - trigeminal reactivation)
HZV - painful vesicular rash
Mumps, CoxSachie, CMV, EBV, Rabies

Front 29

Specific antivirals in encephalitis (2)

Back 29

HSV - Acyclovir IV
CMV - Ganciclovir IV

Front 30

Define epilepsy

Back 30

A tendancy to have seizures

Front 31

Classify seizures into two subgroups

Back 31

Generalised
Partial (focal)

Front 32

What subtypes come into Generalised seizures (5)

Back 32

Petit mal
Grand mal
Myoclonic
Tonic
Atonic

Front 33

Subclassify Partial (focal) seizures

Back 33

Simple and Complex
Simple - have no altered consciousness, alert - Jacksonian/Todd's
Complex - Altered consciousness but no LOC - automations, hallucinations

Front 34

Four stages of Grand Mal Seizure

Back 34

Prodromal partial seizure - simple or complex
Tonic Phase - rigid, collapse, apnoeic
Clonic - tongue biting, urinary continence
Confused, disorientated, headache sleepy

Front 35

Three common treatments for epilepsy, what would you use if your patient was on the COCP

Back 35

Sodium Valproate
Carbamezapine - enzyme inducer
Phenytoin - EI

Front 36

Define status epilepticus

Back 36

Tonic/Clonic phases >30mins

Front 37

Mx of status epilepticus

Back 37

Airway - on side/O2
IV access - fluids, anticonvulsant levels, drug, alcohol, glucose,
Diazepam 10mg Rectal
IV phenytoin
General anaesthetic

Front 38

4 types of syncope

Back 38

Vasovagal - <venous return
Cardiac - bradycardia
Carotid Sinus - induce brady
Effort - aortic stenosis, obstructive cardiomyopathy

Front 39

Triad of Parkinson's Disease

Back 39

Bradykinesia
Inc Tone
Resting Tremor

Front 40

Male of Female prevelance

Back 40

Equal

Front 41

Tell me about the pathology of Parkinson's disease

Back 41

atrophy of dopaminergic neurons, fall in dopamine in striatum with hyaline Lewy bodies in the Sub Nigra

Front 42

Medication for a young parkinsonian in order as things progress (3+)

Back 42

Ropinirole (Dop agonist)
L-dopa (6-18month)
Benserazide (dopa-decarboxylase inhibitor)

Selegiline (MAO-B Inhib)
Entacapone (COMT)

Front 43

Define dementia

Back 43

global deterioration of higher cognitive function and personality without lowered consciousness

Front 44

Fx of Wernicke's Aphasia

Back 44

Fluent
Decreased comprehension

Front 45

Fx of Broca's Aphasia

Back 45

Non-Fluent
Good comprehension

Front 46

Fx of Lewy Body dementia

Back 46

Lewy (hyaline) bodies in cerebral cortex (like PD in BG). Hard to distinguish from Alzheimer's but with visual hallucinations

Front 47

What is Huntington's Chorea

Back 47

Rare autosomal dom degenerative frontal lobe and caudate nucleus. Face, hands, dysarthria, gait.
DNA marker of trinucleotide repeat

Front 48

Age of presentation MS

Back 48

30-40's

Front 49

4 areas of demyelination in MS

Back 49

Periventricular (slurred speech)
Brainstem (Ataxia, nystagmus, urinary retention)
Optic nerves (scotoma, diploplia)
Cervical spinal cord (weakness, numbness, tingling)

Front 50

Patterns of MS progression with percentages (3)

Back 50

Relapse/Remitting 80
Primary progressive 12
Fulminant 8

Front 51

Treatments for MS (3)

Back 51

Azothioprine
B interferon
Short steroid bursts for relapses

Front 52

Name 4 Muscular dystrophies

Back 52

Myotonic dystrophy
Duchenne Musc Dystrophy
Polymyositis
Inclusion Body myositis

Front 53

Describe the course of Guillan Barre Syndrome

Back 53

Ascending weakness and numbness over 3/52. 20% affect facial/respiratory mm. 80% resolve fully. 15% deficit. 4% die.

Front 54

Cause of Guillan Barre

Back 54

autoallergic demyelinating postinfective (70%) monophasic illness (CMV/Camp Bacter)

Front 55

Right sided UMN signs and loss of pain and temperature perception. Left sided loss of vibration and proprioreception.

diagnosis?

Back 55

Brown Sequard Syndrome
L cervical spinal cord lesion

Corticospinal (ipsilateral spastic paralysis)
Spinothalamic tract (contralateral pain and temperature)
Doral columns (ipsilateral fine touch, proprioreception and vibration)

Front 56

myasthenia gravis is caused by what in 90%

Back 56

autoimmune against ACh receptors

Front 57

Presenting features of MG (5+)

Back 57

extraocular, bulbar, facial, neck, limb weakness

look specifically for ptosis, diploplia, NORMAL REFLEXES

Front 58

Mx of MG (4)

Back 58

Anticholinesterase
Immune suppression (steroid/azothioprine)
Thymectomy (pre-50)
Plasmaphoresis

Front 59

causes of unilateral CN VII palsy

Back 59

Bells palsy
CPA tumour
Mononeuritis - sarcoid, diabetes, lyme
Ramsay Hunt syndrome
Parotid tumour
Pontine lesion - vascular/demyelinating

Front 60

good discriminating test between benign and parkinsonian tremor

Back 60

smell test
DAT scan for dopamine depletion

Front 61

mx of tremor

Back 61

b blocker
gabapentin

Front 62

ix for suspected SAH

Back 62

CT
AND LUMBAR PUNCTURE IF NEG

Front 63

mx of migraine due to vigorous activity

Back 63

beta blocker

Front 64

Sx of cerebello-pontine angle lesion

Back 64

CN V, VI, low VII and VIII

Front 65

young female complains of difficulty swallowing with a sensation of lump in throat

Back 65

globus hystericus