Extras

Question 1

Histopathology in Alzheimer’s?

Answer 1

Beta-amyloid plaques and neurofibrillary tangles made of tau protein.

Question 2

What should you always consider in an acute presentation of a patient with chronic alcohol use?

Answer 2

Hypoglycaemia - check glucose!

Question 3

What is seen on an MRI in vascular dementia?

Answer 3

Extensive white matter changes and infarcts

Question 4

Give the MMSE scores for:

a) mild
b) mod
c) severe dementia

Answer 4

a) 21-26
b) 10-20
c) <10

Question 5

Mx of normal pressure hydrocephalus?

Answer 5

1) Do an LP - see if relieving the pressure resolves the symptoms

2) If it does - insert a ventriculoperitoneal shunt

Question 6

Side effects of carbamazepine?

CARBA MEAN

Answer 6

Confusion
Ataxia
Rashes
Blurred vision
Aplasic anaemia
Marrow (bone marrow) suppression
Eosinophilia
ADH release
Neutropenia

Question 7

What antidepressant should be avoided in patients also taken an anticoagulant (e.g. warfarin)?

Answer 7

SSRIs - increase risk of bleeding

Question 8

Differentiating thought blocking from thought withdrawal?

Answer 8

In thought blocking - when patient starts talking again, they will talk about an entirely different topic.

Question 9

What is a delusion of guilt?

Answer 9

Also referred to as delusions of sin or worthlessness, this delusion is characterised by the belief that one deserves to be punished.

Usually, the ‘sin’ is an innocent error out of proportion to the guilt felt.

Question 10

What condition are delusions of guilt often associated with?

Answer 10

Severe depression

Question 11

CT findings in normal pressure hydrocephlaus?

Answer 11

Enlarged ventricles and absent sulci

The sulci are absent as they are compressed by the ventricles which allows for the pressure to be normal despite the CSF increase.

Question 12

Why is pressure normal in normal pressure hydrocephlaus?

Answer 12

The sulci are compressed by the ventricles - allows for pressure to be normal.

Question 13

Define a delusional perception

Answer 13

A delusion that is formed in response to an external stimulus without any logical sense.

Question 14

CSF findings in autoimmune encephalitis?

Answer 14

Antibodies against NMDA receptors.

Question 15

Features of autoimmune encephalitis?

Answer 15

• confusion
• seizures
• movement disorders
• behavioural changes
• emotional lability
• psychosis
• congitive impairment
• reduced conscious level

Question 16

Mx of autoimmune encephalitis?

Answer 16

IV methylprednisolone & IV immunoglobulins

Question 17

What part of the brain is responsbile for the fight or flight response?

Answer 17

Amygdala

The left amygdala appears to be larger in individuals diagnosed with anxiety disorders.

Question 18

What area of the brain appears to be enlarged in individuals with anxiety disorders?

Answer 18

Left amygdala

Question 19

Give 3 examples of LOW-intensity psychosocial interventions in the mx of depression

Answer 19

1) Individual guided self-help (based on principles of CBT)

2) Computerised CBT

3) Structured group physical activity programme

Question 20

What are 3 examples of HIGH intensity psychological therapies in depression?

Answer 20

1) CBT

2) Interpersonal therapy (IPT)

3) Behavioural activation

Question 21

What is behavioural activation?

Answer 21

Getting people to act according to a plan rather than based on how they feel.

E.g. going on a walk every day

Question 22

Depression is associated with a decrease in which neurotransmitters in the brain? (2)

Answer 22

1) Serotonin

2) Noradrenaline

Question 23

How long do patients need to stay on SSRIs for if they have had 2 or more periods of depression?

Answer 23

At least 2 years

Question 24

What is the target range of lithium for relapse prevention?

Answer 24

0.60-0.8 mmol/L