High yield osmosis

Question 1

If a patient needs a aortic aneurysm to be diagnosed but has a pre existing renal condition what is the gold standard test

Answer 1

MRI

contrast for CT cannot be taken up in renal insufficiency

Question 2

Main management for type B Aortic dissection

Answer 2

beta blockers

Question 3

What proteins build up in the brain for alzhemiers disease

Answer 3

Amyloid

Question 4

Staining for amyloidosis

Answer 4

Apple green

congo red

Question 5

Generalised tonic clonic seizure? Treatment

Answer 5

Loss of consciousness -> period of confusion
tonic -> clonus
tonic, incontinence, groaning, irregular breathing

can cause partial seizure - olfactory problems

Treatment: sodium valproate -> lamotrigine/carbamazepine

Question 6

Focal Seizure? Treatment?

Answer 6

Hearing, speech, memory and emotions - temporal lobe tumours

Hallucinations
Memory flashbacks
Déjà vu
Doing strange things on autopilot

confused FIRST

carbamazepine/lamotrigine
2nd: sodium valproate/levetiracetam

Question 7

Absence seizure? Treatment?

Answer 7

Brief lapse in muscle control - petit mal
loss of awareness
blank stare
CHILDHOOD

Lennox-Gastaut syndrome

sodium valproate
lamotrigine

or ethosuxamide - blocks T type calcium channels

EEG scans will show >2.5 
Hz
 spike-and-
slow wave
 discharges.

Question 8

Myoclonic seizure?

Answer 8

Awake during episodes

juvenile myoclonic epilepsy.

First line: sodium valproate
Other options: lamotrigine, levetiracetam or topiramate

Question 9

Side effects of sodium valproate

Answer 9

Teratogenic so patients need careful advice about contraception
Liver damage and hepatitis
Hair loss
Tremor

Question 10

Side effects of carbamazepine

Answer 10

Agranulocytosis
Aplastic anaemia
Induces the P450 system so there are many drug interactions

Question 11

First Line therapy for status epilepticus? What is it called if consciousness isn’t regained after medication

Answer 11

benzodiazepines
e.g. midazolam

refractory SE

secure airway first

Question 12

Difference between complex and partial seizure

Answer 12

Complex you lose conscientnes s

Question 13

Common epileptic syndromes in infants

Answer 13

west syndromes

Question 14

Diagnostic test for Lennox gastroux syndrome

Answer 14

<2.5
Hz
spike-wave pattern on EEG, and
intellectual disability

seizures multiple

Question 15

Antibodies to test for antiphospholipid syndrome

Answer 15

anticardiolipin and lupus antibody, anti b2 glycoprotein

causes stillbirth