Investigations

Question 1

Patients with new onset cranial autonomic features require what imaging?

Answer 1

MRI brain and MR angiogram

Question 2

What imaging is used for suspected brain tumours?

Answer 2

CT and MRI

Question 3

What imaging is used for suspected meningiomas?

Answer 3

CT and MRI

Question 4

What investigations may be used to diagnose viral meningitis?

Answer 4

CSF PCR
Viral stool culture
Throat swabs

Question 5

What investigation is mainly used to diagnose bacterial meningitis?

Answer 5

Lumbar puncture

Question 6

Four tubes of CSF are taken from a lumbar puncture in bacterial meningitis. What is each tube tested for?

Answer 6

Tube 1 - haematology
Tube 2 - microbiology
Tube 3 - chemistry
Tube 4 - haematology

Question 7

What imaging modality is used to distinguish between bleeds and infarcts in the week following a stroke?

Answer 7

CT

Question 8

What can pick up congenital hydrocephalus antenatally?

Answer 8

USS

Question 9

What imaging is mainly used to detect normal pressure hydrocephalus?

Answer 9

CT

Question 10

in idiopathic intracranial hypertension, lumbar puncture pressure is above what?

Answer 10

25 cm CSF

Question 11

Give some investigations that may be used for spontaneous intracranial hypertension

Answer 11

MRI

Lumbar puncture

Question 12

What investigation must be done in any patient who has fallen due to a suspected seizure?

Answer 12

ECG

Question 13

Give some indications for an acute CT in patients who have fallen due to a suspected seizure

Answer 13

Skull fracture
Deteriorating GCS
Focal signs
Head injury

Question 14

Give the four main uses of an EEG

Answer 14

Classifying epilepsy
Confirm non-epileptic attacks
Surgical evaluation
Confirm non-convulsive status

Question 15

What imaging is used to diagnose multiple sclerosis?

Answer 15

MRI

Question 16

What is typically found in the CSF of MS patients?

Answer 16

Oligoclonal bands

Question 17

What investigations are used in sleep disorders?

Answer 17

Overnight polysomnography

Multiple sleep latency test

Question 18

In patients with narcolepsy CSF can be measured for low levels of what?

Answer 18

Hypocretin

Question 19

Patients with suspected cauda equina syndrome must get what imaging in an emergency?

Answer 19

MRI

Question 20

What imaging is commonly used to assess disc prolapse?

Answer 20

MRI

Question 21

Peripheral neuropathies are diagnosed using which investigations?

Answer 21

Electromyography (EMG)

Nerve conduction studies

Question 22

Give some examples of peripheral neuropathies which may be diagnosed through EMG or NCS

Answer 22

Guillain Barre syndrome
Acute/chronic inflammatory demyelinating polyradiculopathy
Hereditary motor and sensory neuropathy (Charcot-Marie-Tooth disease)

Question 23

What antibody is present in myasthenia gravis?

Answer 23

Anti-AChR (antibody to acetyl choline receptors)

Question 24

What test may be done if anti-AChR level is normal but myasthenia gravis is still suspected?

Answer 24

Electromyography (EMG)

Question 25

What investigations are commonly done in suspected motor neurone disease?

Answer 25

MRI

EMG and NCS

Question 26

What investigations are commonly used in suspected subarachnoid haemorrhage?

Answer 26

CT
Lumbar puncture
Cerebral angiography

Question 27

What is seen in the lumbar puncture of an SAH patient?

Answer 27

Xanthochromic CSF

Question 28

What is the gold standard investigation in subarachnoid haemorrhage?

Answer 28

Cerebral angiography

Question 29

What urgent investigation is used in intracerebral haemorrhage?

Answer 29

CT

Question 30

In patients with ICH with a suspected vascular anomaly what investigation is done?

Answer 30

Angiography

Question 31

What imaging is used to confirm the diagnosis of intraventricular haemorrhage?

Answer 31

CT