clinical 5

Question 1

The symptoms of Parkinson’s disease are characteristically asymmetrical or symmetrical

Answer 1

asymmetrical

Question 2

when is parkinsons tremor most noticeable

Answer 2

at rest

Question 3

Hz of essential tremor

Answer 3

6-8 Hz

Question 4

first line treatment for essential tremor

Answer 4

propanolol

Question 5

Urinary incontinence + gait abnormality + dementia =

Answer 5

normal pressure hydrocephalus

Question 6

which neuropathies have sensory loss

Answer 6

• diabetes
• uraemia
• leprosy
• alcoholism
• vitamin B12 deficiency

Question 7

which neuropathies have mostly motor loss

Answer 7

• Guillain-Barre syndrome
• porphyria
• lead poisoning

Question 8

what is dysesthesia

Answer 8

abnormal sensation

Question 9

dopamine agonists tend to end in what letters

Answer 9

-ine

Question 10

which Parkinson drug group is associated with pulmonary fibrosis

Answer 10

dopamine receptor agonists

Question 11

what is dyskinesia

Answer 11

involuntary writhing movements

Question 12

drug given in motor neuron disease

Answer 12

Riluzole

Question 13

how does Riluzole (motor neuron drug) work

Answer 13

prevents stimulation of glutamate receptors

Question 14

Fluctuating confusion/consciousness following fall

Answer 14

subdural haematoma

Question 15

risk factors for a subdural haematoma

Answer 15

old age, alcoholism and anticoagulation

Question 16

what is genetic anticipation

Answer 16

hereditary diseases have an earlier age of onset through successive generations.

Question 17

most common presentation of MS

Answer 17

optic neuritis

Question 18

2 main categories of seizure

Answer 18

primary and partial

Question 19

types of primary seizure (3)

Answer 19

simple partial
complex partial
partial with secondary generalised

Question 20

types of primary (4)

Answer 20

absent
tonic-clonic
myoclonic
atonic

Question 21

describe simple partial seizure

Answer 21

remain aware
focal symptoms
NO post ictal

Question 22

remain aware
focal symptoms
NO post ictal

Answer 22

simple partial

Question 23

describe complex partial

Answer 23

impaired awareness
post-octal symptoms
usually temporal lobe affected

Question 24

lobe most commonly affected in complex partial

Answer 24

temporal

Question 25

how do simple and complex partial seizures differ

Answer 25

in complex you lose awareness and have post-ictal symptoms, where in simple you do not

Question 26

seizure: stops mid sentence, pause, then carries on from where they left

Answer 26

absence seizure

Question 27

time an absence seizure lasts

Answer 27

less than 10 seconds

Question 28

seizure: loss of consciousness, stiff limbs, jerking

Answer 28

tonic-clonic seizure

Question 29

which seizures do you get post-ictal confusion

Answer 29

- tonic-clonic | - complex

Question 30

jerk in seizure called

Answer 30

clonic

Question 31

stiff limbs in seizure called

Answer 31

tonic

Question 32

seizure: jerk of limb, face or trunk

Answer 32

myoclonic seizure

Question 33

seizure: disobedient limb

Answer 33

myoclonic seizure

Question 34

seizure: sudden loss of sucre tone causing a fall

Answer 34

atonic seizure

Question 35

focal seizure of temporal lobe with have what symptoms

Answer 35

- no recollection - deja vu - jambs vu - dysphagia - terror/panic/elation (hippocampus) - delusional behaviour

Question 36

focal seizure of frontal lobe with have what symptoms

Answer 36

motor features

Question 37

focal seizure of parietal lobe with have what symptoms

Answer 37

sensory disturbance (tingling, numbness)

Question 38

focal seizure of occipital lobe with have what symptoms

Answer 38

visual phenomena (spots, lines, flashes)

Question 39

seizure, what lobe of brain: visual

Answer 39

occipital

Question 40

seizure, what lobe of brain: motor

Answer 40

frontal

Question 41

seizure, what lobe of brain: sensory

Answer 41

parietal

Question 42

part of brain if emotional disturbance seizure

Answer 42

hypocampus

Question 43

when do you consider drugs for epilepsy

Answer 43

after 2nd fit (unless reasons such a structural etc for first fir)

Question 44

what frequency of fit will you consider not using drugs

Answer 44

if every 2 years

Question 45

drug for generalised tonic clonic fit

Answer 45

sodium valproate or lamotrigine (lamot better tolerated)

Question 46

drug for absence seizures

Answer 46

sodium valproate, lamotrigine, ethosuximide

Question 47

drug for partial seizure +/- secondary general

Answer 47

carbamazepine

Question 48

teratogenic anti epileptic

Answer 48

sodium valproate

Question 49

must not give sodium valproate to woman of child bearing age, give...

Answer 49

lamotrigine

Question 50

anti-epileptics that DO NOT go into breast milk

Answer 50

carbamazepine and valproate

Question 51

which anti-epileptic does go into milk but is safe for baby

Answer 51

lamotrigine

Question 52

which seizure do NOT give lamotrigine because it makes it worse

Answer 52

tonic, atonic, myoclonic

Question 53

carbamazepine for which

Answer 53

all partial

Question 54

first line for all general

Answer 54

valproate or lamotrigine (lamotrigine for woman of child bearing age)

Question 55

process for switching epileptic drugs

Answer 55

over lap. build up new drug dose and reduce previous drug dose

Question 56

howling do you take to build up epileptic drug dose

Answer 56

2-3 months

Question 57

which epileptic drug causes increased appetite and weight gain

Answer 57

sodium valproate

Question 58

which drugs are liver enzyme inducing

Answer 58

carbamazepine and phenytoin