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Medical conditions Flashcards

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1
Q

Percentage of the population affected by migraine

A

5-10%

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2
Q

Distribution of headache most common in migraine

A

Unilateral

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3
Q

Type of aura most common in migraine

A

Fortification spectrum/scintillating scotoma

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4
Q

Symptoms of basilar migraine

A 
Headache
Aura
Difficulty speaking
Vertigo
Ringing in ears
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5
Q

Precipitants of migraine

A 
Alcohol
Cheese
Chocolate
Skipping meals
Missing sleep
Oral contraceptives
Stress
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6
Q

Most common type of sensory aura in migraine

A

Pins and needles starting in the hand on one side of the body and spreading to the face on the same side

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7
Q

Chromosome affected in Wilson’s disease

A

13

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8
Q

Usual age of onset of Wilson’s disease

A

10-25

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9
Q

Affects on the brain of Wilson’s disease

A

Degeneration of the lenticular nucleus

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10
Q

Traditional first line treatment for Wilson’s disease

A

Penicillamine

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11
Q

Percentage of the population with chronic schizophrenia who suffer from primary polydipsia

A

20%

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12
Q

Features of primary polydipsia not often seen in other causes of polydipsia

A

No complaining of thirst
No nocturnal polyuria
No nocturnal polydipsia

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13
Q

Number of seizures after which treatment with an anti-epileptic drug is usually indicated

A

2

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14
Q

First line treatment for focal seizures

A

Carbamazepine

Lamotrigine

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15
Q

First line treatment for generalised tonic clonic seizures

A

Sodium valproate

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16
Q

First line treatment for absence seizures

A

Ethosuximide

Sodium valproate

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17
Q

First line treatment for myoclonic seizures

A

Sodium valproate

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18
Q

First line treatment for tonic or atonic seizures

A

Sodium valproate

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19
Q

Primary management for psychogenic polydipsia

A

Fluid restriction

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20
Q

Inheritance pattern of Wilson’s disease

A

Autosomal recessive

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21
Q

First line treatment for tonic clonic seizures if sodium valproate unsuitable

A

Lamotrigine

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22
Q

Percentage of epilepsy deaths caused by SUDEP

A

20-30%

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23
Q

Age group more at risk of SUDEP

A

Adults

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24
Q

Main risk factor for SUDEP

A

Frequent generalised tonic clonic seizures

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25
Risk reduction strategies to prevent SUDEP
Nocturnal supervision | Nocturnal listening device
26
Definition of SUDEP
Sudden, unexpected, non-traumatic death of someone with epilepsy Can be a preceding seizure but deaths due to status epilepticus do not count No structural or toxicological cause of death found on post-mortem
27
Most common cause of polyuria
Diabetes insipidus
28
Disease resulting from vitamin A deficiency
Night blindness/nyctalopia
29
Diseases resulting from vitamin B1 (thiamine) deficiency
Beriberi | Wernicke-Korsakoff syndrome
30
Disease resulting from vitamin B3 deficiency
Pellagra
31
Disease resulting from vitamin C deficiency
Scurvy
32
Disease resulting from vitamin D deficiency
Rickets
33
Features of vitamin B3 deficiency (pellagra)
Dementia Dermatitis Diarrhoea
34
Most common cause of vitamin B3 deficiency (pellagra)
Alcoholism
35
Features of wet berbieri disease
Signs and symptoms of heart failure
36
Features of dry berieri disease
``` Difficulty walking Loss of sensation in the lower legs Paralysis of the lower legs Confusion Vomiting ```
37
Features of vitamin B12 deficiency
``` Seborrhoeic dermatitis Atrophic glossitis Angular cheilitis Confusion Increased sleep ```
38
Features of vitamin B12 deficiency
``` Anaemia Lower limb neuropathy Lethargy Glossitis GI upset ```
39
Features of folate deficiency
Often asymptomatic Glossitis Rarely paraesthesia, numbness, cognitive changes
40
Dietary sources of folate
Green vegetables Pulses Fortified cereals, bread etc.
41
Causes of vitamin B12 deficiency
Inadequate consumption e.g. in a vegan diet Impaired absorption e.g. pernicious anaemia, gastric resection, IBD, chemotherapy related irradiation of the ileum Drugs e.g. colchicine, metformin
42
Dietary sources of vitamin B12
Animal protein | Oral replacement
43
Issue with replacing folate first if someone is deficient in both folate and B12
Can unmask neurological symptoms of B12 deficiency
44
Condition which in males causes ambiguous or externally appearing female genitalia at birth, but with testes, and virilisation at puberty. In females causes excessive virilisation.
17-beta hydroxysteroid dehydrogenase 3 deficiency
45
Condition which affects only genetic males and at birth causes atypical genitalia ranging from externally female appearing to male appearing with small penis and hypospadias. There are normal internal male genitalia and often undescended testes. Virilisation occurs at puberty but usually little body hair
5-alpha reductase 2 deficiency
46
Condition affecting genetic males where there is either partial or complete inability of the cells to respond to androgens. Phenotype can be male with some reduced virilisation through to female depending on degree of inability to respond to androgens
Androgen insensitivity syndrome
47
Group of disorders characterised by impaired cortisol synthesis which can lead to increased or decreased glucocorticoids, mineralocorticoids, and sex steroids
Congenital adrenal hyperplasia
48
Types of classic congenital adrenal hyperplasia
Salt-wasting | Simple-virilising
49
Features of salt-wasting congenital adrenal hyperplasia
Insufficient aldosterone production and hyponatraemia Vomiting Dehydration and hypovolaemia in infancy
50
Features of simple-virilisation congenital adrenal hyperplasia
In females - ambiguous genitalia at birth | In males - often no signs at birth. Early virilisation during childhood
51
Causative organism of Lyme disease
Borrelia Burgdorferi
52
Illness seen in people who handle pets (especially tropical birds) characterised by macular rashes, fever, joint pains and splenomegaly
Chlamydia pstitaccii
53
Causative organism of syphilis
Treponema pallidum
54
Three core features of multisystem atrophy
Parkinsonism Autonomic failure Cerebellar ataxia
55
Three presentations of multisystem atrophy
Shy-Drager syndrome Striatonigral degeneration Olivopontocerebellar atrophy
56
Central feature of Shy-Drager syndrome
Autonomic symptoms
57
Central feature of Striatonigral degeneration
Parkinsonism
58
Central feature of olivopontocerebellar atrophy
Cerebellar features
59
Syndrome associated with acoustic neuromas
Neurofibromatosis II
60
Features of acoustic neuroma
CN VIII features - hearing loss, tinnitus, dizziness CN V features - absent corneal reflex CN VII features - facial palsy
61
Investigation of choice for acoustic neuroma
MRI cerebellopontine angle
62
Sex who more commonly suffers from cluster headaches
Male
63
Features of a cluster headache
``` Severe pain lasting up to two hours Occurs most/every day for several weeks at a time Pain around one eye with watering Nasal stuffiness Restlesness Miosis and ptosis in a minority of cases ```
64
Management for cluster headaches
100% oxygen | Triptan
65
Classical cause of Guillain-Barré syndrome
Campylobacter jejuni
66
Features of Guillain-Barré syndrome
Progressive ascending weakness of all four limbs Few sensory symptoms Occasionally back pain in early stages Areflexia Cranial nerve symptoms Autonomic involvement e.g. urinary retention
67
Features of normal pressure hydrocephalus
Gait instability Urinary incontinence Dementia
68
Most common age to develop MS
20-40
69
More common sex to develop MS
Female
70
Countries where MS is the most common
Countries furthest away from the equator
71
Three clinical types of MS
Primary progressive Relapsing remitting Secondary progressive
72
Most common clinical type of MS
Secondary progressive
73
General effect of pregnancy on MS
Fewer relapses during pregnancy | No effect on long term prognosis
74
Common eye signs of MS
Optic neuritis - painful unilateral visual loss Internuclear ophthalmoplegia - diplopia and/or nystagmus due to midbrain lesion Ocular motor cranial nerve lesion - issue with eye movements
75
Sign in MS where symptoms worsen in hot temperatures
Uthoff's phenomenon
76
Sign in MS where an electrical sensation runs down the back on bending the neck
Lhermitte's sign
77
Percentage of MS which is primary progressive
5-10%
78
Percentage of MS which is relapsing remitting
20-30%
79
Percentage of MS which is secondary progressive
60%
80
Percentage of patients with sarcoidosis who have psychiatric problems
20%
81
Most common psychiatric problems in sarcoidosis
Depression | Psychosis
82
Pathological process in sarcoidosis
Granulomata - collections of inflammatory cells - forming in various body parts
83
Most common areas of the body affected by granulomata in sarcoidosis
Lungs Skin Lymph nodes
84
Rash often seen in sarcoidosis
Erythema nodosum
85
Clinical features of progressive supranuclear palsy
Loss of balance Lunging forward when walking Dementia Difficulty moving the eyes vertically
86
Most common Parkinson's plus syndromes
Multiple system atrophy (Shy-Drager syndrome, striatonigral degeneration, and sporadic olivopontocerebellar atrophy) Progressive supranuclear palsy Corticobasal degeneration
87
Modern equivalents for the subtypes of multiple system atrophy
MSA with predominant parkinsonism MSA with cerebellar features No new equivalent for Shy-Drager syndrome
88
Top three most common brain tumours in children
Astrocytoma Medulloblastoma Ependymoma
89
Top four most common primary brain tumours in adults
Glioblastoma multiforme Anaplastic astrocytoma Meningioma
90
Most common kind of brain tumour in adults
Metastasis
91
Pathology of a bulbar palsy
Lower motor neuron lesion of CN IX, X and XII
92
Pathology of a pseudobulbar palsy
Upper motor neuron lesion of CN IX, X and XII
93
Features of bulbar palsy
``` Absent gag reflex Wasted tongue Tongue fasciculations Nasal speech Absent or normal jaw jerk Normal emotions ```
94
Features of pseudobulbar palsy
``` Increased gag reflex Spastic tongue Increased jaw jerk Spastic dysarthria Labile emotions ```
95
Clinical features of amyotrophic lateral sclerosis
Both upper and lower motor neuron signs
96
Alternative names for amyotrophic lateral sclerosis
Motor neuron disease | Lou Gehrig's disease
97
Pathology of Brown-Séquard syndrome
Damage to one whole half of the spinal cord
98
Tracts affected in Brown-Séquard syndrome
UMN pathway of the corticospinal tract Dorsal column Spinothalamic tract
99
Features of Brown-Séquard syndrome
Ipsilateral spastic weakness below the site of the lesion Ipsilateral loss of proprioception and touch below the site of the lesion Contralateral loss of pain and temperature below the site of the lesion
100
Most common cause of subacute combined degeneration of the spinal cord
Vitamin B12 deficiency
101
Tracts affected in subacute combined degeneration of the spinal cord
Dorsal tract | Lateral corticospinal tract
102
Features of subacute combined degeneration of the spinal cord
Bilateral spastic weakness | Bilateral loss of proprioception and vibration sensation
103
Cause of anterior cord syndrome
Ischaemia of the anterior spinal artery
104
Tracts affected in anterior cord syndrome
Lateral corticospinal tracts | Lateral spinothalamic tracts
105
Features of anterior cord syndrome
Bilateral spastic weakness | Bilateral loss of pain and temperature sensation
106
Cause of syringomyelia
Cyst or cavity forming within the spinal cord
107
Tracts affected in syringomyelia
Ventral horns | Lateral spinothalamic tracts
108
Features of syringomyelia
Flaccid weakness especially of the hands | Loss of pain and temperature sensation
109
Clinical features of a subdural haemorrhage
Headache Signs of raised ICP Fluctuating consciousness
110
Risk factor for subdural haemorrahge
Old age Alcohol excess Anticoagulation
111
Pathology of a subdural haemorrhage
Collection of blood between the dura mater and the arachnoid mater
112
Clinical features of an epidural haematoma
Features of raised ICP | Lucid interval
113
Pathology of an epidural haematoma
Collection of blood between the outside of the dura mater and the skull
114
Most common site for an epidural haematoma
Temporal region due to a ruptured middle meningeal artery
115
Features of trigeminal neuralgia
Severe facial pain lasting up to a minute Often triggered by light touch Limited to one or more divisions of the trigeminal nerve Electric-shock like
116
First line treatment for trigeminal neuralgia
Carbamazepine
117
Alternative name for obesity hypoventilation syndrome
Pickwickian syndrome
118
Serum osmolality seen in SIADH
Decreased - <275mOsm/kg
119
Urine osmolality seen in SIADH
Increased - >100mOsm/kg
120
Urine sodium seen in SIADH
Increased - >20mmol/L
121
Season SIADH is seen more commonly in
Summer
122
Age and sex more often affected by SIADH
Older, female
123
First line treatment for SIADH
Fluid restriction
124
Second line treatment for SIADH
Demeclocycline
125
Drugs most commonly causing SIADH
Antidepressants - especially SSRIs and SNRIs Carbamazepine Cyclophosphamide
126
Medical causes of SIADH
CNS causes - infections, tumours, bleeds, hydrocephalus, MS, GBS, MSA Cancers - SCLC, mesothelioma, GI cancers, GU cancers, lymphoma, sarcoma Pneumonia, lung abscess, sarcoidosis
127
Features of corticobasal degeneration
``` Asymmetrical symptoms Apraxia Aphasia Parkinsonism Alien hand syndrome ```
128
Immunoglobulin in the CSF which has a specific response in anti-NMDA encephalitis
IgG
129
Most common subtype of CJD
sCJDMM1 and sCJDMV1
130
HIV associated condition which has been eradicated following introduction of HAART
HIV related toxoplasmosis
131
Risk factors for pancreatitis relevant to psychiatry
Heavy alcohol use | Eating disorders
132
Characteristic presentation of parotitis
Painless swellings on the face, usually resolve spontaneously
133
Type of seizures associated with auras
Complex partial
134
Seizure location associated with auras
Temporal lobe
135
CNS cells most commonly infected by HIV
Macrophages | Microglia
136
Most common CNS opportunistic infection among patients with AIDS
Toxoplasma gondii
137
Usual inheritance pattern of acute intermittent porphyria
Autosomal dominant
138
Most common symptom of acute intermittent porphyria
Abdominal pain
139
Treatment for an acute attack of acute intermittent porphyria
Haemin | 10% glucose infusion
140
Prion disease which has the slowest course
Kuru
141
Incubation period of kuru before symptoms become evident
Up to 40 years
142
Features of Kleine Levin syndrome
``` Hypersomnolence Hyperphagia Hypersexuality Confusion Irritability Restlessness Euphoria Delusions/hallucinations ```

Assessment (22 decks)

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