chatgptSAQs Flashcards
(41 cards)
stroke differentials
Haemorrhagic stroke, TIA, seizure
hypoglycaemia or space-occupying lesion,
Ix after stroke
CT is first-line to rule out haemorrhage before thrombolysis. HbA1c and lipids are useful for long-term risk assessment. Consider also:
U&Es (contrast safety, baseline)
ECG (AF evidence)
Blood glucose (rule out hypoglycaemia)
MS RF
What are key risk factors or associated conditions?
✅ Your answer: Female sex, Caucasian background, family history/genetic predisposition, optic neuritis
Feedback: Excellent. These are well-recognised MS risk factors. You could also consider:
Vitamin D deficiency
Epstein-Barr virus (EBV) exposure
Smoking
with MS specify
relapsing and remitting, secondary progressive, and primary progressive
Pd RF
Name three possible risk factors or contributing factors.
✅ Your answer: Genetic/family history, male sex, older age
Feedback: All correct. Sporadic Parkinson’s is more common, but a positive family history can increase risk. Additional associations (for interest):
Pesticide exposure
Rural living
Repeated head trauma
But your core list is spot on.
clinical signs of PD
What clinical signs would you look for to support your diagnosis?
✅ Your answer: Shuffling gait, hypomimia (Parkinsonian facies), micrographia, dysarthria, cogwheel rigidity, bradykinesia, postural instability, glabellar tap (Myerson’s sign)
Feedback: Excellent detail here. This shows great clinical awareness.
You might also add resting pill-rolling tremor
Decreased arm swing when walking is another subtle sign
✅ Very well-rounded answer.
younger pd pts med
Consider dopamine agonists (e.g. pramipexole) in younger patients.
A 22-year-old university student is brought in by friends after a witnessed episode of loss of consciousness associated with limb jerking and tongue biting. He recovered spontaneously after a few minutes.
Based on loss of consciousness, tonic-clonic movements, tongue biting, and post-ictal recovery, the most likely diagnosis is generalised tonic-clonic seizure (GTCS), not a myoclonic seizure specifically. Myoclonic seizures are brief jerks without loss of consciousness and are common in juvenile myoclonic epilepsy—but this case fits GTCS better.
tonic clonic Differentals
List three differential diagnoses for this presentation.
✅ Your answer: Functional neurological disorder (FND), epilepsy, drug toxicity
Feedback: Nice variety. You’ve included both organic and non-organic causes.
Also consider:
Syncope with convulsive movements
Non-epileptic attack disorder (NEAD)
Hypoglycaemia
migraine diagnosis specify
with or without aura
common migraine triggers
List common triggers and risk factors for this condition.
✅ Your answer: Alcohol, cheese, stress, illness
Feedback: Excellent. These are some of the best-known migraine triggers. You might also consider:
Sleep disturbances
Dehydration
Hormonal changes (e.g. menstruation)
Bright lights or strong smells
headache/migraine red flags
Red flags that warrant neuroimaging include:
First or worst headache ever
Thunderclap headache (sudden onset, max intensity in <1 min)
Neurological deficit (motor, sensory, cranial nerve signs)
Change in headache pattern
New onset headache in immunosuppressed or cancer patients
Headache with seizure
Headache with papilloedema
migraine mx
Acute: Triptans (e.g. sumatriptan) + NSAIDs or paracetamol
Prophylactic:
First-line: Propranolol or topiramate
Others: Pizotifen, amitriptyline, candesartan
For menstrual migraines: oestrogen supplementation or NSAIDs
MND ALS pathophysiology
Progressive degeneration of both upper motor neurons (UMN) in the corticospinal tract and lower motor neurons (LMN) in anterior horn cells.
Leads to muscle weakness, wasting (LMN), spasticity and hyperreflexia (UMN).
Usually sporadic but 5-10% familial with mutations in genes like SOD1.
The exact cause is unknown; involves glutamate excitotoxicity, oxidative stress, mitochondrial dysfunction.
ALS differentials
Primary lateral sclerosis (pure UMN)
Progressive muscular atrophy (pure LMN)
Cervical myelopathy (cord compression)
Multifocal motor neuropathy (immune-mediated)
MS typically has sensory signs, which ALS does not
Parkinson’s disease is less likely here but consider in differential if rigidity and bradykinesia dominate.
Ix ALS
Your answer: MRI brain and spine
Feedback: Correct, MRI is important to exclude mimics such as cervical cord compression or MS plaques. Also:
Nerve conduction studies and EMG to confirm denervation and widespread LMN involvement.
Blood tests to exclude mimics (B12, TFTs, autoimmune markers)
No specific diagnostic test for ALS, diagnosis is clinical supported by these tests.
ALS prognosis
Your answer: Riluzole; prognosis 1–5 years; supportive care eventually needed
Feedback: Right track! Expand with:
Riluzole modestly prolongs survival by reducing glutamate excitotoxicity.
Edaravone is another drug used in some countries.
Multidisciplinary supportive care (speech therapy, respiratory support including NIV, nutrition with PEG tube, physiotherapy) is crucial.
Manage symptoms: spasticity (baclofen), sialorrhea (glycopyrrolate), pain, emotional support.
Prognosis is poor, median survival ~3–5 years, respiratory failure is common cause of death.
cataracts rf
Old age, smoking, family history — All spot on.
You can also consider:
Diabetes mellitus
Prolonged corticosteroid use
UV light exposure
Trauma or previous eye surgery
cataracts differentials
Age-related macular degeneration (AMD), glaucoma — Good picks.
You might add:
Diabetic retinopathy
Posterior capsular opacification (post cataract surgery)
Refractive error or presbyopia (for vision complaints)
AACG RF
Hypermetropia (farsightedness), Asian ethnicity, steroid use — All valid.
You could also add:
Age >50
Female sex
Family history
Pupil dilation (e.g., from anticholinergics or dim lighting)
AACG Ix
Tonometry (to check intraocular pressure) and gonioscopy (to assess angle closure) are the key diagnostic tools — excellent.
You could also include:
Slit lamp examination (to look for corneal oedema, shallow anterior chamber)
Fundoscopy (may show optic disc cupping if prolonged)
Visual acuity assessment
Pupil examination (mid-dilated fixed pupil is typical)
DM retinopathy ix pre surgery
Visual acuity testing
Fundoscopy/slit lamp with lens
OCT — good for macular oedema or ruling out AMD
Additional gold standard:
Fluorescein angiography — to assess retinal perfusion and leakage, esp. pre-laser
conjunctivitis vs dry eye
Conjunctivitis usually has more redness and discharge; dry eye is a chronic irritation with blurry vision that worsens throughout the day.
A 45-year-old woman complains of eye dryness, gritty sensation, and occasional blurred vision, worsening throughout the day.
dry eye syndrome (also known as keratoconjunctivitis sicca),
