Presentations

Question 1

Parkinsonism with falls esp going down stairs, difficulty reading, more rigid, less tremor.

Answer 1

Progressive supra nuclear palsy.
Visual disturbances = vertical gaze palsy.
Parkinson’s plus syndrome.

Question 2

Visual hallucinations, dementia, Parkinsonism

Answer 2

Lewy body dementia

Question 3

Parkinsonism, incontinence, dizziness when getting up, erectile dysfunction, nystagmus, ataxia

Answer 3

Multiple system atrophy with autonomic and cerebellar symptoms. Parkinson’s plus syndrome.

Question 4

Alien limb sensation with apraxia and Parkinsonism

Answer 4

Corticobasal degeneration. Parkinson’s plus syndrome/

Question 5

Unilateral weakness +/- sensory loss of face arm and leg. homonymous hemianopia, dysphasia.

Answer 5

Total anterior circulation stroke. If only 2 symptoms = partial.

Question 6

Isolated homonymous hemianopia stroke

Answer 6

Posterior circulation

Question 7

Pure sensory stroke

Answer 7

Lacunar infarction

Question 8

Worst ever headache, vomiting, papilloedema, altered consciousness, Kernig’s sign

Answer 8

Subarachnoid haemorrhage

Question 9

Headache, vomiting, hypertension, altered consciousness. Symptoms come on months after trauma to head

Answer 9

Subdural haematoma

Question 10

Brief loss of consciousness following head injury then fine for a bit. Suddenly severe headache, vomiting, confusion, seizure and altered consciousness.

Answer 10

Extradural haematoma

Question 11

Bilateral headache, like a tight band on head, non-pulsatile.

Answer 11

Tension headache

Question 12

Seeing zig-zag lines feeling numb after eating chocolate, then unilateral pulsatile throbbing headache. Needs to lie in a quiet dark room

Answer 12

Migraine with aura.

Question 13

Pain on left side near eye, getting worse and worse in past couple of hours, the eye is watery and looks red. Has happened twice in past 2 days and had similar episodes last year.

Answer 13

Cluster headache.

Question 14

Woman washing her face when sudden left sided pain at her jaw which spread up to eyes. Felt like an electric shock over her face.

Answer 14

Trigeminal neuralgia.

Question 15

Male with pulsatile headache. Also tender when combing har and sometimes jaw hurts when he is eating. Suddenly his vision goes…? 🤷‍♀️🤷‍♀️🤷‍♀️

Answer 15

Giant cell arthritis with amaurosis fugax

Question 16

Last week I had gastro infection and then I got better. A day ago my feet and hands felt weak and now my lower legs and arms feel weak too.. I am sweating more than usual and have some numbness in the limbs too.

Answer 16

Gullian barre syndrome

Question 17

My wife has noticed I am slow getting up out of my chair and when I turn around from the sink I am slow. My writing has got smaller and she says I sometimes just stare at her. I find it hard to keep my hand still.

Answer 17

Parkinson’s disease.

Question 18

I have started to find it hard to speak and wet myself yesterday. Last year I had an episode where I had poor vision and my eyes hurt when I move them.

Answer 18

Multiple sclerosis

Question 19

By the end of the day I am very out of breath and find it hard to eat long big meals without having to have a break from chewing.

Answer 19

Myasthenia gravis

Question 20

Level of spinal cord termination

Answer 20

L1

Question 21

Dermatone of umbilicus

Answer 21

T10

Question 22

Nerve root for bicep tendon reflex

Answer 22

C5, C6

Question 23

Sole of foot dermatone

Answer 23

S1