Higher Functions

Question 1

Name 5 treatable metabolic causes of dementia

Answer 1

Hypothyroid
B1 deficiency
B12. deficiency
Hypophosphataemia
Uremia

Question 2

Name 2 infectious treatable causes of dementia

Answer 2

Meningitis

Neurosyphilis

Question 3

Name 2 treatable vascular causes of dementia

Answer 3

HT

Subdural haematoma

Question 4

Name 4 characteristics of narcolepsy

Answer 4

Dyssomnia characterised by

1. Excessive daytime sleepiness
2. Cataplexy (brief sudden loss muscle tone triggered by emotions)
3. Hypnagogic hallucinations:occur at sleep onset and vivid
4. Sleep paralysis (can’t move upon awakening )

Question 5

What is cortical blindness

Answer 5

Bilateral occipital lesions rendering patient blind, but Pupillary reflexes retained.

Question 6

Diagnosis narcolepsy?

Answer 6

Multiple sleep latency test (MSLT)
Sleep onset of less than 5 mins with 2 early episodes of REM

Question 7

Name 3 features of Wernicke’s encephalopathy

Answer 7

• confusion
• ophthalmoplegia
• ataxia

Question 8

How do higher function examination (12)

Answer 8

MOCA

language (aphasia)

• Fluency
• naming
• repetition
• comprehension: verbal and written
• reading, writing

Speech (dysarthria)

• lips: pppp
• tongue: tttt
• soft palate: kkkk
• coordination: ptkptkptk

Meningism

• ap movement (true Meningism = only ap movement)
• lateral (if both: probably local cause eg cervical spondolytic disease)