12.11.14 MCQ questions

• Things I got wrong

  • Severe, frequent migraine - Paracetamol not working

    • Amitriptyline

  • Brain tumors look a bit like haemorrhage on CT

    • But they have OEDEMA around them

  • Numbness in R leg, spreading to both legs and arms over 4 days, with UMN signs

    • Acute MS

  • Sudden onset N+V with severe headache; Gets better; CT normal

    • Do an LP

    • Not sure why

  • Drug-induced tremor and rigidity in L arm?

    • Metoclopramide (dopamine antagonist)

    • Not carbamazepine (stabilizes the inactivated state of Voltage-gated sodium channels)

  • Acute endocrine dysfunction following TBI?

    • SIADH

  • Feature suggesting generalised seizure

    • Tongue-biting > Urinary incontinence

  • 64 year-old smoker, gradually progressive tremor, worse when using hands, worse on left

    • Essential tremor

  • Thrombolysis of acute ischaemic stroke

    • Alteplase ONLY

    • No anti-platelets or heparin

Other notes

• • Cerebral salt-wasting syndrome (CSWS)

    • Rare endocrine condition featuring hyponatremia and dehydration in response to trauma/injury or the presence of brain tumors

  • DLB

    • Ffluctuating cognition with great variations in attention and alertness from day to day and hour to hour

    • Recurrent visual hallucinations

    • Motor features of Parkinson's

  • Parkinson's plus (with extra features)

    • Multiple system atrophy

    • Progressive supranuclear palsy

    • Corticobasal degeneration

    • Dementia with Lewy bodies?

  • Synucleinopathies vs tauopathies