Passmed Questions Wrong

Question 1

Difference in presentation between sagittal sinus, lateral sinus and cavernous sinus thrombosis?

Answer 1

• sagittal: empty delta sign on venography
• lateral: 6th and 7th nerve palsies
• cavernous: ophthalmoplegia, periorbital oedema, trigeminal neuralgia

Question 2

How does a pontine haemorrhage present?

Answer 2

• reduced GCS
• bilateral pinpoint pupils
• paralysis

Question 3

What happens if you take folate supplements before B12 replacement?

Answer 3

• subacute combined degeneration of the spinal cord
• affecting dorsal columns, spinocerebellar and corticospinal tracts
• distal sensory loss, absent ankle jerks/extensor planters, gait abnormality/Romberg’s positive

Question 4

What is spontaneous intracranial hypotension?

Answer 4

• rare cause of headaches due to CSF leak (usually from thoracic nerve root sleeves)
• increased risk with CTD e.g. Marfan’s
• strong relationship with posture

Question 5

How is hemianopia related to side of paresis?

Answer 5

same side