Presentation
4 headache red flags (+ lucky you!! + bonus 100 for the name of the criteria)
Any 4 of:
Systemic sx (including fever), Hx or FHx of malignancy, neurological deficit, sudden onset, age >50, positional, precipitated by sneezing/ coughing/ exercise, papilloedema, pregnancy, painful eye, post-trauma, immunosuppression, painkiller overuse
(+ SNOOP4)
What vessel is affected in subdural haemorrhage
Bridging veins
What would you see on the LP analysis in bacterial meningitis?
4 of:
Cloudy, high opening pressure, neuts, high protein, low glucose
Absence seizure medication
Ethosuximide
Broadly name the extra features of Progressive Supranuclear Palsy and Multiple System Atrophy.
PSP: eye problems - difficulty looking up/down and blinking, double vision, staring expression
MSA: autonomic failure - urinary incontinence, orthostatic hypotension
What is the Huntingtons nucleotide repeat?
CAG
"Ring enhancing brain lesions" on CT - what are you thinking?
(clue for -100 points)
Toxoplasmosis
Surgical management in pituitary adenoma with compressional symptoms
Trans-sphenoidal
Name 2 symptoms of an occipital lobe lesion
2 of:
Homonymous hemianopia with macular sparing, Visual agnosia, Cortical blindness
Specifically explain the pathophysiology of Parkinson's disease (would be 3 marks in an SAQ)
Loss of (nigrostriatal) dopaminergic neurons in the pars compacta of the substantia nigra
Most sensitive investigation for Myasthenia Gravis?
Single fibre electromyography
Cluster headache acute management (be specific)
100% oxygen + SC sumatriptan
Name this sign and associated condition: "Paresthesiae in limbs on neck flexion"
Lhermitte's sign - MS
4 RFs for SAH
Any 4 of:
HTN, smoking, FHx, ADPKD, age, alcohol, ehlers-danlos, marfans, NF-1
4 indications for head CT within 1 hour of admission
Any 4 of:
GCS <13 initially, GCS <15 2hours after injury, suspected open/ depressed skull fracture, basal skull fracture signs, post-traumatic seizure, focal neurological deficit, >1 episode of vomiting since injury
(+200 for previous 1st line and why it's no longer 1st line)
Pregabalin/ gabapentin
(previously dopamine receptor agonists eg. ropinirole, but high incidence of augmentation and impulse control disorders)
Name 2 skin changes in tuberous sclerosis
Any 2 of:
Hypopigmented "ash-leaf" spots (fluoresce under UV light), Shagreen patches (Roughened patches of skin over lumbar spine), Adenoma sebaceum (angiofibromas over nose), Fibromata under nails, Cafe au lait spots
What chromosomes have the neurofibromatosis gene mutations in type 1 and type 2? (stinker)
(+ bonus 100 for inheritance pattern)
NF1: 17
NF2: 22
(+ autosomal dominant)
Which brain Ca does this sound like on the biopsy histology report...
"spindle cells in concentric whorls and calcified psammoma bodies"
(+ name 4 other brain tumours for +100 points)
Meningioma
(pilocytic astrocytoma, glioblastoma multiforme, medulloblastoma, craniopharyngioma, vestibular schwannoma, haemangioblastoma, ependymoma, pituitary adenoma, oligodendroglioma, mets)
3 management steps for TIA <7 days ago
(all 3 or womp womp)
STAT dose aspirin 300mg
Senior review within 24 hours
Secondary prevention with clopidogrel + statin