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MRCPsych > Clinical examination > Flashcards

Clinical examination Flashcards

1
Q

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

A

Arterial spin labelling

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2
Q

What is a statement of respect?

A

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

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3
Q

What are T1 images on MRI most useful for?

A

Assessment of normal brain structure

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4
Q

Which MRI image closely resembles CT?

A

T1

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5
Q

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

A

T1

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6
Q

What colour is blood on CT scan and T1 MRI?

A

White

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7
Q

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

A

Functional MRI - can be detected in T2 sequence

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8
Q

Examples of tests for visuospatial functioning

A

Judging line orientation
Ray Osterrieth test
Clock drawing test

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9
Q

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

A

Magnetic resonance spectroscopy

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10
Q

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

A

3 days

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11
Q

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

A

Up to 4 weeks

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12
Q

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

A

Transcortical motor aphasia

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13
Q

What improves with amobarbital infusion?

A

Organic muteness

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14
Q

What is confrontation technique useful for in clinical interview?

A

Help the patient face a difficult aspect of their problems

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15
Q

What is visual agnosia?

A

Failure to recognise objects despite adequate perception

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16
Q

If primitive reflexes are present, what does it suggest?

A

Significant damage to frontal lobe

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17
Q

What is digital subtraction angiography?

A

Visualises blood vessels in a bony or dense soft tissue area

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18
Q

Which component is better seen on CT than MRI?

A

Calcification - this may be invisible on MRI

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19
Q

BMI equation

A

Weight/height squared

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20
Q

What does diffusion tensor imaging measure?

A

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

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21
Q

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

A

Psychogenic polydipsia

22
Q

If urine osmolality is high, what is the diagnosis?

A

SIADH

23
Q

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

A

Insula

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

24
Q

What are intracytoplasmic inclusion bodies?

A

Lewy bodies

25
Q

Which metabolic abnormalities can lengthen QTc?

A

Hypokalaemia
Hypocalcaemia
Hypomagnesaemia

26
Q

How does acute intermittent porphyria often present?

A

Abdominal pain, constipation and neuropathy

AIP - do not tend to have cutaneous manifestation

27
Q

How is acute intermittent porphyria inherited?

A

Autosomal dominant

28
Q

Which medications can trigger AIP?

A

Oestrogens
Barbituates
Benzodiazepines
Diclofenac

29
Q

Investigation of choice for AIP

A

Urinary porphyrins

30
Q

Management of AIP

A

Aims to reduce haem synthesis by administration of haemin

31
Q

Constructional apraxia is typically caused by lesion in which hemisphere

A

Right

32
Q

Alexia without agraphia is seen in lesions of which vessel

A

Posterior cerebral

33
Q

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

A

Decrease in temporal perfusion

34
Q

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

A

Opthalmoplegia

35
Q

What is anomic dysphasia?

A

Where patient shown an object the patient cannot tell its name

36
Q

Lesion in which area causes anomic dysphasia?

A

Dominant temporo-parietal junction - language cortex

37
Q

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

A

5

38
Q

On MMSE, how many points are awarded for recall?

A

3

39
Q

Balint’s syndrome triad

A

Simultanagnosia
Optic ataxia
Oculomotor apraxia

40
Q

Which scan uses a synthetic radionucleotide to obtain brain images?

A

PET

41
Q

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

A

Primary motor cortex

42
Q

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

A

Fail to reproduce global pattern but copy isolated details

43
Q

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

A

Capture global picture but not finer details

44
Q

EEG in metabolic encephalopahthy

A

Generalised diffuse delta and theta waves

45
Q

Characteristic of senile pupil

A

Sluggish light and accommodation reaction

46
Q

When might you see REM in daytime?

A

Sleep deprivation
Narcolepsy
Withdrawal from stimulants

47
Q

How long can amphetamines be detected in urine for?

A

48 hours

48
Q

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

A

48 hours

49
Q

Visuospatial ability is the function of which lobe?

A

Parietal

50
Q

Which brain regions are crucial for non-declarative memory?

A

Basal ganglia
Limbic system
Somatosensory cortices

51
Q

What is the most common opportunistic infection in AIDS?

A

Toxoplasmosis

52
Q

MRI findings of toxoplasmosis

A

Multiple ring-shaped contrast enhancing lesions

MRCPsych (19 decks)

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