Neuro/psych

Question 1

Name some positive symptoms of schizophrenia

Answer 1

Thought disorder
Auditory hallucinations
Delusions

Question 2

How long does a section 3 enable inpatient admission for?

Answer 2

6 months

Question 3

What is agoraphobia?

Answer 3

Fear of being in enclosed spaces where escape may be difficult

Question 4

Name a nicotinic receptor partial agonist

Answer 4

Varenicline

Question 5

What is Charles Bonnnet syndrome?

Answer 5

Temporary visual hallucinations in those with visual impairment

Question 6

How do you treat TCA overdose?

Answer 6

Lavage, emesis followed by activated charcoal in the first 12 hours of ingestion

Question 7

How long is a section 5(2) valid for?

Answer 7

72 hours

Question 8

Name the clinical features of myotonic dystrophy

Answer 8

Facial weakness
Ptosis
Hollowing of temples
Atrophy of jaw muscles
Early frontal balding

Question 9

Name a useful screening tool for eating disorders

Answer 9

SCOFF

Question 10

What is Uhthoff’s phenomenon?

Answer 10

A temporary worsening of neurological signs when the body is overheated

Question 11

What is Lhermitte’s sign?

Answer 11

An electric shock like sensation radiating down the spine when the neck is flexed

Question 12

What can be used for cluster headache prophylaxis?

Answer 12

Verapamil
Prednisolone

Question 13

What is Fregoli syndrome?

Answer 13

Where familiar people are falsely identified in strangers

Question 14

What is Othello syndrome?

Answer 14

A delusion of infidelity in partners

Question 15

What is Ekbom’s syndrome?

Answer 15

A delusion of infestation with insects

Question 16

Name some pharmacological treatments for ADHD

Answer 16

Methylphenidate
Dexamphetamine
Atomoxetine

Question 17

When should lithium levels be checked?

Answer 17

12 hours after the dose

Question 18

What is the therapeutic range for lithium?

Answer 18

0.5-1.2 mmol/l

Question 19

Name some ECG changes seen in lithium toxicity

Answer 19

Inversion of T waves
Isoelectricity
Reversible flattening

Question 20

Explain the pathophysiology of DMD

Answer 20

No dystrophin is produced

Question 21

What is the prognosis in DMD?

Answer 21

Affected boys are confined to a wheelchair by age 12 and tend to die of CV or respiratory complications by age 20-30

Question 22

What is the MOA of mirtazapine?

Answer 22

Noradrenergic and specific serotonergic antidepressant

Question 23

Name some SEs of clozapine

Answer 23

Neutropaenia
Agranulocytosis
Seizures
Myocarditis
Cardiomyopathy

Question 24

What is somatisation disorder?

Answer 24

Multiple somatic complaints
No organic pathology
Symptoms have persisted for several years
Onset usually before the age of 30

Question 25

What is the triad of normal pressure hydrocephalus?

Answer 25

Dementia
Abnormal gait
Urinary incontinence

Question 26

What is Munchausen’s syndrome characterised by?

Answer 26

1. Simulated illness
2. Pathological lying
3. Wandering from place to place

Question 27

Which drug is first line for generalised tonic clonic seizures?

Answer 27

Sodium valproate

Question 28

What is hemiballismus?

Answer 28

Involuntary flinging motions of the extremities due to infarction/haemorrhage in the contralateral subthalamic nucleus

Question 29

What does a section 2 enable?

Answer 29

Compulsory assessment for an assessment for a period of up to 28 days

Question 30

What is the treatment for TB without CNS involvement?

Answer 30

RIPE for 2 months followed by a further 4 months of RI

Question 31

What is the triad in serotonin syndrome?

Answer 31

Neuromuscular excitation, autonomic effects, altered mental status

Question 32

Name some SSRI discontinuation symptoms

Answer 32

increased mood change
restlessness
difficulty sleeping
unsteadiness
sweating
gastrointestinal symptoms: pain, cramping, diarrhoea, vomiting
paraesthesia

Question 33

What does a section 4 entail?

Answer 33

72 hour assessment order
used as an emergency, when a section 2 would involve an unacceptable delay
a GP and an AMHP or NR
often changed to a section 2 upon arrival at hospital

Question 34

Name some extrapyramidal side effects

Answer 34

Parkinsonism
acute dystonia
sustained muscle contraction (e.g. torticollis, oculogyric crisis)
may be managed with procyclidine
akathisia (severe restlessness)
tardive dyskinesia (late onset of choreoathetoid movements, abnormal, involuntary, may occur in 40% of patients, may be irreversible, most common is chewing and pouting of jaw)

Question 35

Name some features of MND

Answer 35

fasciculations
the absence of sensory signs/symptoms*
the mixture of lower motor neuron and upper motor neuron signs
wasting of the small hand muscles/tibialis anterior is common

Other features
doesn’t affect external ocular muscles
no cerebellar signs
abdominal reflexes are usually preserved and sphincter dysfunction if present is a late feature

Question 36

Name some cutaneous features of tuberous sclerosis

Answer 36

depigmented ‘ash-leaf’ spots which fluoresce under UV light
roughened patches of skin over lumbar spine (Shagreen patches)
adenoma sebaceum (angiofibromas): butterfly distribution over nose
fibromata beneath nails (subungual fibromata)
café-au-lait spots* may be seen

Question 37

Name some neurological features of tuberous sclerosis

Answer 37

developmental delay
epilepsy (infantile spasms or partial)
intellectual impairment

Question 38

Name some other features of tuberous sclerosis

Answer 38

retinal hamartomas: dense white areas on retina (phakomata)
rhabdomyomas of the heart
gliomatous changes can occur in the brain lesions
polycystic kidneys, renal angiomyolipomata
lymphangioleiomyomatosis: multiple lung cysts

Question 39

Which cranial nerves can be affected in vestibular schwannomas?

Answer 39

cranial nerve VIII: vertigo, unilateral sensorineural hearing loss, unilateral tinnitus
cranial nerve V: absent corneal reflex
cranial nerve VII: facial palsy