Clinical examination

Question 1

What is a non-invasive perfusion MRI methodology used to quantify cerebral blood flow?

Answer 1

Arterial spin labelling

Question 2

What is a statement of respect?

Answer 2

Affirmative statements that are genuine and appropriate indicating respect and dignity which offer positive reinforcement

Question 3

What are T1 images on MRI most useful for?

Answer 3

Assessment of normal brain structure

Question 4

Which MRI image closely resembles CT?

Answer 4

T1

Question 5

Which MRI image is the only one that allows for contrast with gadolinium?

Answer 5

T1

Question 6

What colour is blood on CT scan and T1 MRI?

Answer 6

White

Question 7

Blood oxygen level dependent measurement is a technique used in which imaging study?

Answer 7

Functional MRI - can be detected in T2 sequence

Question 8

Examples of tests for visuospatial functioning

Answer 8

Judging line orientation
Ray Osterrieth test
Clock drawing test

Question 9

What can be used to measure the concentration of different metabolites in the brain?

Answer 9

Magnetic resonance spectroscopy

Question 10

How long after occasional cannabis use can it be detected in the urine?

Answer 10

3 days

Question 11

How long after regular cannabis use can it be detected in the urine?

Answer 11

Up to 4 weeks

Question 12

If a patient can follow commands and repeat phrases but has non-fluent speech, what is the problem?

Answer 12

Transcortical motor aphasia

Question 13

What improves with amobarbital infusion?

Answer 13

Organic muteness

Question 14

What is confrontation technique useful for in clinical interview?

Answer 14

Help the patient face a difficult aspect of their problems

Question 15

What is visual agnosia?

Answer 15

Failure to recognise objects despite adequate perception

Question 16

If primitive reflexes are present, what does it suggest?

Answer 16

Significant damage to frontal lobe

Question 17

What is digital subtraction angiography?

Answer 17

Visualises blood vessels in a bony or dense soft tissue area

Question 18

Which component is better seen on CT than MRI?

Answer 18

Calcification - this may be invisible on MRI

Question 19

BMI equation

Answer 19

Weight/height squared

Question 20

What does diffusion tensor imaging measure?

Answer 20

Measures at macroscopic level the extent of myelination of white matter fibres using fractional anisotropy - a measure of the degree and directionality of water molecules

Question 21

If urine and plasma osmolality is low, what is the diagnosis?

Answer 21

Psychogenic polydipsia

Question 22

If urine osmolality is high, what is the diagnosis?

Answer 22

SIADH

Question 23

In schizophrenia, which anatomical structure in the brain is most consistently reduced in size?

Answer 23

Insula

Other structures affected include - anterior cingulate cortex, dorsolateral prefrontal cortex, thalamus

Question 24

What are intracytoplasmic inclusion bodies?

Answer 24

Lewy bodies

Question 25

Which metabolic abnormalities can lengthen QTc?

Answer 25

Hypokalaemia Hypocalcaemia Hypomagnesaemia

Question 26

How does acute intermittent porphyria often present?

Answer 26

Abdominal pain, constipation and neuropathy | AIP - do not tend to have cutaneous manifestation

Question 27

How is acute intermittent porphyria inherited?

Answer 27

Autosomal dominant

Question 28

Which medications can trigger AIP?

Answer 28

Oestrogens Barbituates Benzodiazepines Diclofenac

Question 29

Investigation of choice for AIP

Answer 29

Urinary porphyrins

Question 30

Management of AIP

Answer 30

Aims to reduce haem synthesis by administration of haemin

Question 31

Constructional apraxia is typically caused by lesion in which hemisphere

Answer 31

Right

Question 32

Alexia without agraphia is seen in lesions of which vessel

Answer 32

Posterior cerebral

Question 33

What finding on SPECT is seen in Alzheimer's disease?

Answer 33

Decrease in temporal perfusion

Question 34

Which symptom of wernicke's encephalopathy responds earliest when thiamine is replaced?

Answer 34

Opthalmoplegia

Question 35

What is anomic dysphasia?

Answer 35

Where patient shown an object the patient cannot tell its name

Question 36

Lesion in which area causes anomic dysphasia?

Answer 36

Dominant temporo-parietal junction - language cortex

Question 37

On MMSE, how many points are awarded for orientation in time?

Answer 37

5

Question 38

On MMSE, how many points are awarded for recall?

Answer 38

3

Question 39

Balint's syndrome triad

Answer 39

Simultanagnosia Optic ataxia Oculomotor apraxia

Question 40

Which scan uses a synthetic radionucleotide to obtain brain images?

Answer 40

PET

Question 41

When performing tasks, which area of the brain is highlighted on fMRI?

Answer 41

Primary motor cortex

Question 42

In Ray Osterreich Complex figure test, what do patients with right hemisphere lesion do?

Answer 42

Fail to reproduce global pattern but copy isolated details

Question 43

In Ray Osterreich Complex Figure test, what do people with left hemisphere lesions do?

Answer 43

Capture global picture but not finer details

Question 44

EEG in metabolic encephalopahthy

Answer 44

Generalised diffuse delta and theta waves

Question 45

Characteristic of senile pupil

Answer 45

Sluggish light and accommodation reaction

Question 46

When might you see REM in daytime?

Answer 46

Sleep deprivation Narcolepsy Withdrawal from stimulants

Question 47

How long can amphetamines be detected in urine for?

Answer 47

48 hours

Question 48

How long can codeine & morphine be detected in urine for?

Answer 48

48 hours

Question 49

Visuospatial ability is the function of which lobe?

Answer 49

Parietal

Question 50

Which brain regions are crucial for non-declarative memory?

Answer 50

Basal ganglia Limbic system Somatosensory cortices

Question 51

What is the most common opportunistic infection in AIDS?

Answer 51

Toxoplasmosis

Question 52

MRI findings of toxoplasmosis

Answer 52

Multiple ring-shaped contrast enhancing lesions