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Assessment > Medical conditions > Flashcards

Medical conditions Flashcards

1
Q

Percentage of the population affected by migraine

A

5-10%

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2
Q

Distribution of headache most common in migraine

A

Unilateral

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3
Q

Type of aura most common in migraine

A

Fortification spectrum/scintillating scotoma

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4
Q

Symptoms of basilar migraine

A 
Headache
Aura
Difficulty speaking
Vertigo
Ringing in ears
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5
Q

Precipitants of migraine

A 
Alcohol
Cheese
Chocolate
Skipping meals
Missing sleep
Oral contraceptives
Stress
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6
Q

Most common type of sensory aura in migraine

A

Pins and needles starting in the hand on one side of the body and spreading to the face on the same side

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7
Q

Chromosome affected in Wilson’s disease

A

13

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8
Q

Usual age of onset of Wilson’s disease

A

10-25

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9
Q

Affects on the brain of Wilson’s disease

A

Degeneration of the lenticular nucleus

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10
Q

Traditional first line treatment for Wilson’s disease

A

Penicillamine

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11
Q

Percentage of the population with chronic schizophrenia who suffer from primary polydipsia

A

20%

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12
Q

Features of primary polydipsia not often seen in other causes of polydipsia

A

No complaining of thirst
No nocturnal polyuria
No nocturnal polydipsia

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13
Q

Number of seizures after which treatment with an anti-epileptic drug is usually indicated

A

2

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14
Q

First line treatment for focal seizures

A

Carbamazepine

Lamotrigine

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15
Q

First line treatment for generalised tonic clonic seizures

A

Sodium valproate

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16
Q

First line treatment for absence seizures

A

Ethosuximide

Sodium valproate

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17
Q

First line treatment for myoclonic seizures

A

Sodium valproate

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18
Q

First line treatment for tonic or atonic seizures

A

Sodium valproate

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19
Q

Primary management for psychogenic polydipsia

A

Fluid restriction

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20
Q

Inheritance pattern of Wilson’s disease

A

Autosomal recessive

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21
Q

First line treatment for tonic clonic seizures if sodium valproate unsuitable

A

Lamotrigine

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22
Q

Percentage of epilepsy deaths caused by SUDEP

A

20-30%

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23
Q

Age group more at risk of SUDEP

A

Adults

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24
Q

Main risk factor for SUDEP

A

Frequent generalised tonic clonic seizures

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25
Q

Risk reduction strategies to prevent SUDEP

A

Nocturnal supervision

Nocturnal listening device

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26
Q

Definition of SUDEP

A

Sudden, unexpected, non-traumatic death of someone with epilepsy
Can be a preceding seizure but deaths due to status epilepticus do not count
No structural or toxicological cause of death found on post-mortem

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27
Q

Most common cause of polyuria

A

Diabetes insipidus

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28
Q

Disease resulting from vitamin A deficiency

A

Night blindness/nyctalopia

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29
Q

Diseases resulting from vitamin B1 (thiamine) deficiency

A

Beriberi

Wernicke-Korsakoff syndrome

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30
Q

Disease resulting from vitamin B3 deficiency

A

Pellagra

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31
Q

Disease resulting from vitamin C deficiency

A

Scurvy

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32
Q

Disease resulting from vitamin D deficiency

A

Rickets

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33
Q

Features of vitamin B3 deficiency (pellagra)

A

Dementia
Dermatitis
Diarrhoea

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34
Q

Most common cause of vitamin B3 deficiency (pellagra)

A

Alcoholism

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35
Q

Features of wet berbieri disease

A

Signs and symptoms of heart failure

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36
Q

Features of dry berieri disease

A 
Difficulty walking
Loss of sensation in the lower legs
Paralysis of the lower legs
Confusion
Vomiting
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37
Q

Features of vitamin B12 deficiency

A 
Seborrhoeic dermatitis
Atrophic glossitis
Angular cheilitis
Confusion
Increased sleep
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38
Q

Features of vitamin B12 deficiency

A 
Anaemia
Lower limb neuropathy
Lethargy
Glossitis
GI upset
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39
Q

Features of folate deficiency

A

Often asymptomatic
Glossitis
Rarely paraesthesia, numbness, cognitive changes

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40
Q

Dietary sources of folate

A

Green vegetables
Pulses
Fortified cereals, bread etc.

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41
Q

Causes of vitamin B12 deficiency

A

Inadequate consumption e.g. in a vegan diet
Impaired absorption e.g. pernicious anaemia, gastric resection, IBD, chemotherapy related irradiation of the ileum
Drugs e.g. colchicine, metformin

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42
Q

Dietary sources of vitamin B12

A

Animal protein

Oral replacement

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43
Q

Issue with replacing folate first if someone is deficient in both folate and B12

A

Can unmask neurological symptoms of B12 deficiency

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44
Q

Condition which in males causes ambiguous or externally appearing female genitalia at birth, but with testes, and virilisation at puberty. In females causes excessive virilisation.

A

17-beta hydroxysteroid dehydrogenase 3 deficiency

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45
Q

Condition which affects only genetic males and at birth causes atypical genitalia ranging from externally female appearing to male appearing with small penis and hypospadias. There are normal internal male genitalia and often undescended testes. Virilisation occurs at puberty but usually little body hair

A

5-alpha reductase 2 deficiency

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46
Q

Condition affecting genetic males where there is either partial or complete inability of the cells to respond to androgens. Phenotype can be male with some reduced virilisation through to female depending on degree of inability to respond to androgens

A

Androgen insensitivity syndrome

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47
Q

Group of disorders characterised by impaired cortisol synthesis which can lead to increased or decreased glucocorticoids, mineralocorticoids, and sex steroids

A

Congenital adrenal hyperplasia

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48
Q

Types of classic congenital adrenal hyperplasia

A

Salt-wasting

Simple-virilising

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49
Q

Features of salt-wasting congenital adrenal hyperplasia

A

Insufficient aldosterone production and hyponatraemia
Vomiting
Dehydration and hypovolaemia in infancy

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50
Q

Features of simple-virilisation congenital adrenal hyperplasia

A

In females - ambiguous genitalia at birth

In males - often no signs at birth. Early virilisation during childhood

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51
Q

Causative organism of Lyme disease

A

Borrelia Burgdorferi

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52
Q

Illness seen in people who handle pets (especially tropical birds) characterised by macular rashes, fever, joint pains and splenomegaly

A

Chlamydia pstitaccii

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53
Q

Causative organism of syphilis

A

Treponema pallidum

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54
Q

Three core features of multisystem atrophy

A

Parkinsonism
Autonomic failure
Cerebellar ataxia

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55
Q

Three presentations of multisystem atrophy

A

Shy-Drager syndrome
Striatonigral degeneration
Olivopontocerebellar atrophy

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56
Q

Central feature of Shy-Drager syndrome

A

Autonomic symptoms

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57
Q

Central feature of Striatonigral degeneration

A

Parkinsonism

58
Q

Central feature of olivopontocerebellar atrophy

A

Cerebellar features

59
Q

Syndrome associated with acoustic neuromas

A

Neurofibromatosis II

60
Q

Features of acoustic neuroma

A

CN VIII features - hearing loss, tinnitus, dizziness
CN V features - absent corneal reflex
CN VII features - facial palsy

61
Q

Investigation of choice for acoustic neuroma

A

MRI cerebellopontine angle

62
Q

Sex who more commonly suffers from cluster headaches

A

Male

63
Q

Features of a cluster headache

A 
Severe pain lasting up to two hours
Occurs most/every day for several weeks at a time
Pain around one eye with watering
Nasal stuffiness
Restlesness
Miosis and ptosis in a minority of cases
64
Q

Management for cluster headaches

A

100% oxygen

Triptan

65
Q

Classical cause of Guillain-Barré syndrome

A

Campylobacter jejuni

66
Q

Features of Guillain-Barré syndrome

A

Progressive ascending weakness of all four limbs
Few sensory symptoms
Occasionally back pain in early stages
Areflexia
Cranial nerve symptoms
Autonomic involvement e.g. urinary retention

67
Q

Features of normal pressure hydrocephalus

A

Gait instability
Urinary incontinence
Dementia

68
Q

Most common age to develop MS

A

20-40

69
Q

More common sex to develop MS

A

Female

70
Q

Countries where MS is the most common

A

Countries furthest away from the equator

71
Q

Three clinical types of MS

A

Primary progressive
Relapsing remitting
Secondary progressive

72
Q

Most common clinical type of MS

A

Secondary progressive

73
Q

General effect of pregnancy on MS

A

Fewer relapses during pregnancy

No effect on long term prognosis

74
Q

Common eye signs of MS

A

Optic neuritis - painful unilateral visual loss
Internuclear ophthalmoplegia - diplopia and/or nystagmus due to midbrain lesion
Ocular motor cranial nerve lesion - issue with eye movements

75
Q

Sign in MS where symptoms worsen in hot temperatures

A

Uthoff’s phenomenon

76
Q

Sign in MS where an electrical sensation runs down the back on bending the neck

A

Lhermitte’s sign

77
Q

Percentage of MS which is primary progressive

A

5-10%

78
Q

Percentage of MS which is relapsing remitting

A

20-30%

79
Q

Percentage of MS which is secondary progressive

A

60%

80
Q

Percentage of patients with sarcoidosis who have psychiatric problems

A

20%

81
Q

Most common psychiatric problems in sarcoidosis

A

Depression

Psychosis

82
Q

Pathological process in sarcoidosis

A

Granulomata - collections of inflammatory cells - forming in various body parts

83
Q

Most common areas of the body affected by granulomata in sarcoidosis

A

Lungs
Skin
Lymph nodes

84
Q

Rash often seen in sarcoidosis

A

Erythema nodosum

85
Q

Clinical features of progressive supranuclear palsy

A

Loss of balance
Lunging forward when walking
Dementia
Difficulty moving the eyes vertically

86
Q

Most common Parkinson’s plus syndromes

A

Multiple system atrophy (Shy-Drager syndrome, striatonigral degeneration, and sporadic olivopontocerebellar atrophy)
Progressive supranuclear palsy
Corticobasal degeneration

87
Q

Modern equivalents for the subtypes of multiple system atrophy

A

MSA with predominant parkinsonism
MSA with cerebellar features
No new equivalent for Shy-Drager syndrome

88
Q

Top three most common brain tumours in children

A

Astrocytoma
Medulloblastoma
Ependymoma

89
Q

Top four most common primary brain tumours in adults

A

Glioblastoma multiforme
Anaplastic astrocytoma
Meningioma

90
Q

Most common kind of brain tumour in adults

A

Metastasis

91
Q

Pathology of a bulbar palsy

A

Lower motor neuron lesion of CN IX, X and XII

92
Q

Pathology of a pseudobulbar palsy

A

Upper motor neuron lesion of CN IX, X and XII

93
Q

Features of bulbar palsy

A 
Absent gag reflex
Wasted tongue
Tongue fasciculations
Nasal speech
Absent or normal jaw jerk
Normal emotions
94
Q

Features of pseudobulbar palsy

A 
Increased gag reflex
Spastic tongue
Increased jaw jerk
Spastic dysarthria
Labile emotions
95
Q

Clinical features of amyotrophic lateral sclerosis

A

Both upper and lower motor neuron signs

96
Q

Alternative names for amyotrophic lateral sclerosis

A

Motor neuron disease

Lou Gehrig’s disease

97
Q

Pathology of Brown-Séquard syndrome

A

Damage to one whole half of the spinal cord

98
Q

Tracts affected in Brown-Séquard syndrome

A

UMN pathway of the corticospinal tract
Dorsal column
Spinothalamic tract

99
Q

Features of Brown-Séquard syndrome

A

Ipsilateral spastic weakness below the site of the lesion
Ipsilateral loss of proprioception and touch below the site of the lesion
Contralateral loss of pain and temperature below the site of the lesion

100
Q

Most common cause of subacute combined degeneration of the spinal cord

A

Vitamin B12 deficiency

101
Q

Tracts affected in subacute combined degeneration of the spinal cord

A

Dorsal tract

Lateral corticospinal tract

102
Q

Features of subacute combined degeneration of the spinal cord

A

Bilateral spastic weakness

Bilateral loss of proprioception and vibration sensation

103
Q

Cause of anterior cord syndrome

A

Ischaemia of the anterior spinal artery

104
Q

Tracts affected in anterior cord syndrome

A

Lateral corticospinal tracts

Lateral spinothalamic tracts

105
Q

Features of anterior cord syndrome

A

Bilateral spastic weakness

Bilateral loss of pain and temperature sensation

106
Q

Cause of syringomyelia

A

Cyst or cavity forming within the spinal cord

107
Q

Tracts affected in syringomyelia

A

Ventral horns

Lateral spinothalamic tracts

108
Q

Features of syringomyelia

A

Flaccid weakness especially of the hands

Loss of pain and temperature sensation

109
Q

Clinical features of a subdural haemorrhage

A

Headache
Signs of raised ICP
Fluctuating consciousness

110
Q

Risk factor for subdural haemorrahge

A

Old age
Alcohol excess
Anticoagulation

111
Q

Pathology of a subdural haemorrhage

A

Collection of blood between the dura mater and the arachnoid mater

112
Q

Clinical features of an epidural haematoma

A

Features of raised ICP

Lucid interval

113
Q

Pathology of an epidural haematoma

A

Collection of blood between the outside of the dura mater and the skull

114
Q

Most common site for an epidural haematoma

A

Temporal region due to a ruptured middle meningeal artery

115
Q

Features of trigeminal neuralgia

A

Severe facial pain lasting up to a minute
Often triggered by light touch
Limited to one or more divisions of the trigeminal nerve
Electric-shock like

116
Q

First line treatment for trigeminal neuralgia

A

Carbamazepine

117
Q

Alternative name for obesity hypoventilation syndrome

A

Pickwickian syndrome

118
Q

Serum osmolality seen in SIADH

A

Decreased - <275mOsm/kg

119
Q

Urine osmolality seen in SIADH

A

Increased - >100mOsm/kg

120
Q

Urine sodium seen in SIADH

A

Increased - >20mmol/L

121
Q

Season SIADH is seen more commonly in

A

Summer

122
Q

Age and sex more often affected by SIADH

A

Older, female

123
Q

First line treatment for SIADH

A

Fluid restriction

124
Q

Second line treatment for SIADH

A

Demeclocycline

125
Q

Drugs most commonly causing SIADH

A

Antidepressants - especially SSRIs and SNRIs
Carbamazepine
Cyclophosphamide

126
Q

Medical causes of SIADH

A

CNS causes - infections, tumours, bleeds, hydrocephalus, MS, GBS, MSA
Cancers - SCLC, mesothelioma, GI cancers, GU cancers, lymphoma, sarcoma
Pneumonia, lung abscess, sarcoidosis

127
Q

Features of corticobasal degeneration

A 
Asymmetrical symptoms
Apraxia
Aphasia
Parkinsonism
Alien hand syndrome
128
Q

Immunoglobulin in the CSF which has a specific response in anti-NMDA encephalitis

A

IgG

129
Q

Most common subtype of CJD

A

sCJDMM1 and sCJDMV1

130
Q

HIV associated condition which has been eradicated following introduction of HAART

A

HIV related toxoplasmosis

131
Q

Risk factors for pancreatitis relevant to psychiatry

A

Heavy alcohol use

Eating disorders

132
Q

Characteristic presentation of parotitis

A

Painless swellings on the face, usually resolve spontaneously

133
Q

Type of seizures associated with auras

A

Complex partial

134
Q

Seizure location associated with auras

A

Temporal lobe

135
Q

CNS cells most commonly infected by HIV

A

Macrophages

Microglia

136
Q

Most common CNS opportunistic infection among patients with AIDS

A

Toxoplasma gondii

137
Q

Usual inheritance pattern of acute intermittent porphyria

A

Autosomal dominant

138
Q

Most common symptom of acute intermittent porphyria

A

Abdominal pain

139
Q

Treatment for an acute attack of acute intermittent porphyria

A

Haemin

10% glucose infusion

140
Q

Prion disease which has the slowest course

A

Kuru

141
Q

Incubation period of kuru before symptoms become evident

A

Up to 40 years

142
Q

Features of Kleine Levin syndrome

A 
Hypersomnolence
Hyperphagia
Hypersexuality
Confusion
Irritability
Restlessness
Euphoria
Delusions/hallucinations

Assessment (22 decks)

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