Exam

Question 1

Diagnostic tests for viral meningitis? (3)

Answer 1

Viral culture of throat swab, stool

Viral PCR on CSF

Question 2

Distinguishing features of viral encephalitis? (2)

Answer 2

Focal neurological deficit

Decreased GCS

Question 3

Important features of the history to ask about in viral encephalitis? (2)

Answer 3

Recent travel, occupational exposure

Question 4

Bacterial meningitis causative organisms:

a) old/immunosuppressed
b) neonates
c) young children/ older childen/adults

Answer 4

a) consider listeria, TB
b) group b strep, listeria, E.coli
c) pneumococcal, meningococcal

Question 5

Initial blind antibiotic therapy in suspected bacterial meningitis

Answer 5

IV cefotaxime + amoxicillin if listeria suspected

Also give steroids with first dose

Question 6

Antibiotic for confirmed meningococcal meningitis

Answer 6

Benzylpenicillin/ampicillin

Question 7

When is meningitis contact prophylaxis required and what is given?

Answer 7

Meningococcal; ciprofloxacin

Question 8

70% of mutations in Duchenne MD are..

Answer 8

Large deletions in the dystrophin gene

Question 9

What area of the brain is atrophied prominently in Huntingtons?

Answer 9

The caudate nucleus

Question 10

Genes causing autosomal dominant Alzheimers (3)

Answer 10

APP

presenilin 1 and 2

Question 11

Bilateral acoustic neuromas are a sign of what inherited condition?

Answer 11

Neurofibromatosis 2

Question 12

Features which distinguish tuberous sclerosis from NF?(3)

Answer 12

Shagreen patches
Subungual fibromas
Epilepsy

Question 13

CT findings in subdural haemorrhage

Answer 13

Crescent-shaped hyperdensity (acute) or hypodense (chronic)

Question 14

Surgical management of subdural haemorrhage

Answer 14

Burr hole

Craniotomy + drainage

Question 15

Medical conditions which predispose to Berry aneurysms?

Answer 15

Ehlers-Danlos

adult polycystic kidney disease

Question 16

Feature of the history/imaging which points strongly to a diagnosis of extra dural haemorrhage?

Answer 16

Lucid period

Imaging- lentiform hyperdensity (limited by skull sutures)

Question 17

What is the commonest cause of encephalitis and what area of the brain does it usually affect?

Answer 17

Herpes simplex; temporal lobe