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Neurology
54 notes, 165 questions and 473 flashcards.
Tier 1 is core knowledge expected of every trainee. Tier 2 is deeper or less common.
Presentations
- Approach to headache and facial painFree sampleSeparate the benign primary headache from the dangerous secondary one, with red flags, the SAH work-up, GCA, venous thrombosis and facial pain.Tier 1, approach to a presentation, 3 questions, 9 flashcards
- Approach to memory disturbanceDelirium, dementia or depression first; subjective decline versus MCI versus dementia; the reversible screen; transient global amnesia; and the rapidly progressive cases you can't miss.Tier 1, approach to a presentation, 3 questions, 8 flashcards
- Approach to seizures and first seizureSeizure or not, provoked or unprovoked, who has epilepsy after one seizure, when to start treatment, and the driving rules.Tier 1, approach to a presentation, 3 questions, 9 flashcards
- Approach to weaknessSeparate true weakness from fatigue, localise it from brain to muscle, spot the emergencies (cord compression, GBS, myasthenic crisis, tick and snake envenoming, periodic paralysis), and protect the airway.Tier 1, approach to a presentation, 3 questions, 9 flashcards
- Gait and balance disturbancesRecognising gait patterns at the bedside, the emergencies (cord compression, cerebellar stroke, Wernicke), normal pressure hydrocephalus, and falls prevention in older people.Tier 1, approach to a presentation, 3 questions, 9 flashcards
- Hearing lossConductive or sensorineural at the bedside, sudden sensorineural hearing loss as an emergency, MRI for asymmetric loss, ototoxic drugs, and hearing loss as a modifiable dementia risk.Tier 1, approach to a presentation, 3 questions, 8 flashcards
- Neuropathic painRecognising pain from a lesion of the somatosensory system, first-line amitriptyline, duloxetine or a gabapentinoid with the doses and harms, topical options, PBS rules for pregabalin, and why opioids are a poor choice.Tier 1, approach to a presentation, 3 questions, 9 flashcards
- Numbness or altered sensationLocalise first (nerve, root, polyneuropathy, cord, brainstem, thalamus or cortex), recognise the emergencies (GBS, cord compression, cauda equina, stroke), and the neuropathy blood screen with its Australian traps such as vitamin B6 and nitrous oxide.Tier 1, approach to a presentation, 3 questions, 8 flashcards
- Status epilepticusThe 5-minute rule, benzodiazepine then second-line loading by 20 minutes, refractory and super-refractory status, non-convulsive status and the causes that need their own treatment.Tier 1, approach to a presentation, 3 questions, 9 flashcards
- Visual disturbance and abnormal eye movementLocalising visual loss and diplopia, the emergencies (retinal artery occlusion, GCA, pupil-involving third nerve palsy, pituitary apoplexy), myasthenia and thyroid eye disease, and the Austroads vision standards.Tier 1, approach to a presentation, 3 questions, 9 flashcards
Key conditions
- Bell's palsy and other cranial nerve lesionsTelling Bell's palsy from a central or secondary facial palsy, prednisolone within 72 hours, eye protection, Ramsay Hunt syndrome, and localising multiple cranial neuropathies.Tier 1, condition, 3 questions, 9 flashcards
- Cerebellar disordersLocalising cerebellar signs, sorting causes of ataxia by tempo, the emergencies of cerebellar stroke and Wernicke, and the paraneoplastic and genetic ataxias.Tier 1, condition, 3 questions, 8 flashcards
- Cerebral neoplasiaMetastases, gliomas, meningioma and primary CNS lymphoma; the WHO 2021 molecular classification, the ring-enhancing lesion, steroids, seizures and the trials behind glioma treatment.Tier 1, condition, 3 questions, 9 flashcards
- Chronic inflammatory demyelinating polyradiculoneuropathyWeakness worse proximally and distally over more than 8 weeks with demyelinating conduction studies. The EAN/PNS 2021 criteria, the mimics (anti-MAG, POEMS, MMN, CMT, amyloid), nodopathies, and IVIg, steroids and plasma exchange.Tier 1, condition, 3 questions, 9 flashcards
- Common mononeuropathiesMedian, ulnar, radial, common peroneal, femoral and lateral femoral cutaneous nerve lesions; telling them from root lesions at the bedside, nerve conduction timing, and when a mononeuropathy is really mononeuritis multiplex.Tier 1, condition, 3 questions, 9 flashcards
- Dementia syndromesTelling Alzheimer, vascular, Lewy body and frontotemporal dementia apart, cholinesterase inhibitors and memantine on the PBS, anti-amyloid antibodies and ARIA, and managing behavioural symptoms without harm.Tier 1, condition, 3 questions, 9 flashcards
- EpilepsyClassifying the epilepsy, choosing and monitoring antiseizure medication, drug interactions, drug resistance and surgery, pregnancy, older people, withdrawal and SUDEP.Tier 1, condition, 3 questions, 9 flashcards
- Guillain-Barré syndromeAcute immune polyradiculoneuropathy. Variants and antibodies, the red flags and Australian mimics, EGRIS and mEGOS, IVIg or plasma exchange, and the supportive care that prevents death.Tier 1, condition, 3 questions, 9 flashcards
- Intracerebral and subarachnoid haemorrhageHaemorrhagic stroke from the first hour to secondary prevention, with blood pressure targets, anticoagulant reversal, the INTERACT3 care bundle, surgery, and aneurysmal SAH complications.Tier 1, condition, 4 questions, 10 flashcards
- Ischaemic strokeRecognising stroke and its mimics, reperfusion with tenecteplase and thrombectomy, stroke unit care, and secondary prevention by mechanism.Tier 1, condition, 4 questions, 9 flashcards
- Migraine and primary headache disordersDiagnosing migraine, tension-type and cluster headache, acute and preventive treatment including CGRP drugs and PBS rules, medication overuse, and migraine in pregnancy.Tier 1, condition, 3 questions, 10 flashcards
- Multiple sclerosisTypical attacks and red flags, the 2024 McDonald criteria, mimics such as NMOSD and MOGAD, relapse treatment, and choosing and monitoring disease-modifying therapy.Tier 1, condition, 3 questions, 9 flashcards
- Neurological manifestations of systemic disease and paraneoplastic syndromesParaneoplastic syndromes by the Graus 2021 criteria (high-risk phenotypes, antibody risk groups, tumour screening), checkpoint inhibitor neurotoxicity, and the neurology of diabetes, thyroid, liver, kidney, connective tissue disease, sarcoid and deficiency states.Tier 1, condition, 3 questions, 9 flashcards
- Peripheral neuropathy, acquired and hereditaryPattern recognition (length-dependent, demyelinating, small fibre, ganglionopathy, mononeuritis multiplex), reading nerve conduction studies, diabetic and chemotherapy neuropathy, paraproteins and amyloid, Charcot-Marie-Tooth and HNPP, and foot protection.Tier 1, condition, 3 questions, 10 flashcards
- Spinal cord and nerve root compressionLocalising cord, conus, cauda equina and root lesions, malignant cord compression (MRI whole spine within 24 hours, dexamethasone, SINS, surgery and radiotherapy), epidural abscess, degenerative cervical myelopathy, and radiculopathy where imaging, opioids and pregabalin add little.Tier 1, condition, 3 questions, 10 flashcards
- Transient ischaemic attackTIA as a medical emergency, telling it from its mimics, why ABCD2 alone shouldn't triage, and same-day imaging and secondary prevention.Tier 1, condition, 3 questions, 9 flashcards
- TremorClassifying tremor by when it appears, separating essential tremor from Parkinson disease, dystonic, drug-induced and functional tremor, and treating essential tremor.Tier 1, condition, 3 questions, 8 flashcards
- Trigeminal neuralgiaBrief electric-shock facial pain in V2 or V3, MRI for every patient, carbamazepine first with HLA testing where relevant, and when to refer for microvascular decompression.Tier 1, condition, 3 questions, 8 flashcards
- Vertigo and dizzinessSorting dizziness by timing and triggers, catching posterior circulation stroke in acute vestibular syndrome, and treating BPPV, vestibular neuritis, vestibular migraine, Ménière disease and PPPD.Tier 1, condition, 3 questions, 9 flashcards
Ophthalmological conditions
- Horner syndromeThe three-neuron pathway, how associated signs localise the lesion, apraclonidine testing, and why a painful acute Horner syndrome is carotid dissection until imaging says otherwise.Tier 1, condition, 3 questions, 7 flashcards
- NystagmusTelling peripheral from central nystagmus, the localising patterns (downbeat, upbeat, pendular, periodic alternating, INO), positional nystagmus in BPPV, drug causes and treatment.Tier 1, condition, 3 questions, 8 flashcards
- Optic neuritisTypical versus atypical optic neuritis, the 2022 international criteria, AQP4 and MOG testing, what the ONTT showed about steroids, and the MS risk after a first episode.Tier 1, condition, 3 questions, 8 flashcards
- Papilloedema and raised intracranial pressureTelling papilloedema from pseudopapilloedema, the same-day work-up for raised intracranial pressure, the Friedman criteria for IIH, and protecting vision with weight loss, acetazolamide and surgery.Tier 1, condition, 3 questions, 8 flashcards
Parkinson disease and related conditions
- Atypical parkinsonism: MSA, PSP and corticobasal degenerationFree sampleTelling multiple system atrophy, progressive supranuclear palsy and corticobasal syndrome from Parkinson disease, the MDS 2022 MSA and MDS 2017 PSP criteria, what imaging can and cannot separate, and symptom-led multidisciplinary care.Tier 1, condition, 3 questions, 10 flashcards
- Parkinson diseaseMDS diagnostic criteria and red flags for atypical parkinsonism, levodopa and its alternatives, motor fluctuations, non-motor symptoms, and safe hospital care.Tier 1, condition, 3 questions, 10 flashcards
Less common or complex conditions
- Cerebral venous sinus thrombosisWho gets cerebral venous thrombosis, the four clinical patterns, why a normal CT and D-dimer don't exclude it, anticoagulating through venous haemorrhage, DOACs after the acute phase, and when to call for endovascular treatment or craniectomy.Tier 2, condition, 3 questions, 9 flashcards
- Functional neurological disorderMaking a positive diagnosis of functional weakness, movement disorder and dissociative seizures, what DSM-5-TR requires, how to explain it, and the Australian 2025 treatment recommendations.Tier 2, condition, 3 questions, 8 flashcards
- Idiopathic intracranial hypertensionWho gets IIH and who needs a harder look for another cause, triaging by vision rather than headache, acetazolamide and weight loss (IIHTT, IIH:WT), the emerging GLP-1 evidence, surgery for threatened sight, and the exam traps.Tier 2, condition, 3 questions, 8 flashcards
- Limbic encephalitisSubacute amnesia, seizures and psychiatric change from inflammation of the medial temporal lobes; the Graus 2016 criteria, which antibody goes with which picture and tumour, why aciclovir comes first and immunotherapy shouldn't wait for the antibody result.Tier 2, condition, 3 questions, 9 flashcards
- Motor neurone diseaseMixed upper and lower motor neurone signs without sensory loss, the mimics you must exclude (multifocal motor neuropathy, cervical myelopathy, Kennedy disease), EMG and Gold Coast criteria, riluzole, tofersen for SOD1, and timing NIV and gastrostomy.Tier 2, condition, 3 questions, 9 flashcards
- Myasthenia gravisFatigable ocular, bulbar and proximal weakness, AChR and MuSK antibodies, CT for thymoma, pyridostigmine then steroids and steroid-sparing therapy, thymectomy after MGTX, crisis management, the drugs that worsen MG, and the new FcRn and complement agents on the PBS.Tier 2, condition, 3 questions, 9 flashcards
- Myopathy, acquired and geneticProximal weakness with normal sensation and reflexes, a stepwise workup built on CK, TSH, antibodies, EMG, MRI and biopsy, the acquired causes a physician must catch (statins and anti-HMGCR, steroids, thyroid, colchicine, inclusion body myositis) and the genetic myopathies seen in adults (FSHD, OPMD, Pompe, McArdle, mitochondrial).Tier 2, condition, 3 questions, 8 flashcards
- Normal pressure hydrocephalusThe gait-first triad, ventriculomegaly with DESH, who to send for a tap test or lumbar drain, what the PENS shunt trial showed, and the shunt complications physicians meet.Tier 2, condition, 3 questions, 8 flashcards
- Unusual stroke syndromesBrainstem and thalamic syndromes that are easy to miss, and the uncommon causes of stroke in younger adults (dissection, venous thrombosis, RCVS, CADASIL, moyamoya, vasculitis, Fabry disease), with the test and first treatment for each.Tier 2, condition, 3 questions, 9 flashcards
Genetic neurological disorders
- Huntington disease and inherited dementia syndromesFree sampleCAG repeat thresholds, anticipation, the triad of chorea, psychiatric change and dementia, the predictive testing protocol, symptomatic treatment, and the other inherited dementias worth testing for.Tier 1, condition, 3 questions, 9 flashcards
- Myotonic dystrophyDM1 and DM2 genetics and anticipation, the multisystem picture behind grip myotonia, cardiac conduction surveillance and sudden death, anaesthetic risk, and congenital DM through the mother.Tier 1, condition, 3 questions, 9 flashcards
Investigations and procedures
- AudiometryReading a pure tone audiogram (symbols, air-bone gap, WHO grades, classic shapes), speech scores, tympanogram types and acoustic reflexes, with worked examples and when the result means MRI, steroids or a hearing aid.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Cognitive or brain function assessmentTesting cognition domain by domain at the bedside, reading an ACE-III or Mini-ACE profile, frontal tests, when to ask for neuropsychology, how biomarkers fit, and the results that change management.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- CT and MRI brain imagingChoosing CT or MRI, reading a CT head in order, what each MRI sequence shows (DWI and ADC, FLAIR, SWI, contrast), how blood ages on CT, ring-enhancing lesions, contrast and MRI safety, and pregnancy.Tier 2, medical sciences concept, 3 questions, 9 flashcards
- Lumbar puncture and CSF analysisWhen to do a lumbar puncture and when to delay it, reading CSF in order (pressure, cells, protein, glucose, lactate), traumatic taps and xanthochromia, oligoclonal bands, albuminocytological dissociation, dementia biomarkers and RT-QuIC, CSF in delirium, and post-dural puncture headache.Tier 2, medical sciences concept, 3 questions, 9 flashcards
- Neuro-ophthalmic examination: eye movements, fundoscopy and visual testingHow to test and record acuity, colour vision, pupils, fields, fundi and eye movements, what each abnormal finding localises to, worked examples, the accuracy of bedside tests against perimetry and photography, and the Austroads vision thresholds.Tier 2, medical sciences concept, 3 questions, 9 flashcards
Neurophysiological studies
- Electroencephalography (EEG)What EEG records, routine versus sleep-deprived, ambulatory and video-EEG, reading the background and discharges, classic patterns (3 Hz spike-wave, JME, LPDs, triphasic waves, CJD), ICU terminology, yield and over-reading, and when the result changes management.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Electromyography, nerve conduction studies and muscle biopsyWhen to order nerve conduction studies, needle EMG, repetitive stimulation and muscle biopsy, how to read a report step by step with typical values and worked examples, the yield and blind spots of each test, and the results that change treatment.Tier 2, medical sciences concept, 3 questions, 9 flashcards