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How Good at Neurology are you? – Questions
  1. Paul Goldsmith*,
  2. Graham Lennox*,
  3. Julian Ray
  1. *Department of Neurology and
  2. Department of Neurophysiology, Addenbrooke’s Hospital, Cambridge, UK. Email; pg255{at}; drslennox{at}; j.l.ray{at}


1. Please consider the following:

A 45-year-old man needs treatment for an inflammatory neurological condition refractory to steroids. Treatment options include:

  1. intravenous immunoglobulin (IVIg)

  2. methotrexate

  3. azathioprine

  4. cyclosporine

  5. cyclophosphamide

Which of the above drugs would you most wish to avoid, or only administer with extreme caution, if he also had:

  1. interstitial lung disease

  2. gout

  3. IgA deficiency

  4. renal failure

  5. haemorrhagic cystitis

2. Please study Fig. 1 (reproduced with kind permission from Dr P. Bain):

This patient is most likely to have which of the following type of tremor:

  1. Dystonic tremor of right arm?

  2. Dystonic tremor of left arm?

  3. Holmes tremor?

  4. Cerebellar tremor?

3. Please read the following passage.

A 46-year-old hairdresser was referred to the psychiatric service because she believed she was a witch. She had been sacked from her job six months previously because of her increasingly erratic

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