Medicine (Weight loss)

Question 1

Give the 3 classifications of weight loss

Answer 1

5% loss = mild
5-10% loss = moderate
>10% loss = high

Question 2

In history taking, give 4 systems which need to be investigated in the systemic enquiry

Answer 2

GI
Endocrine
Psychological
Neurological

Question 3

Give 4 examinations which should be considered when someone presents with weight loss

Answer 3

1. Neck exam
2. PR
3. Breast
4. Brief Cardio/resp/GI

Question 4

Give 4 blood tests and one imaging option to be considered in weight loss

Answer 4

FBC, U&E, TFT, Bone profile

CXR

Question 5

Define sarcopenia

Answer 5

A major component of frailty, the loss of skeletal muscle mass and strength as a result of aging

Question 6

Give the SIGECAPS symptoms of depression

Answer 6

Sleep disorder
Interest deficit
Guilt
Energy deficit 
Concentration deficit 
Appetite disorder
Psychomotor agitation
Suicidality

Question 7

Give 2 drug treatment options for depression

Answer 7

1. Sertraline (SSRI)

2. Mirtazapine (SNRL)

Question 8

Give 3 ways in which neurological disorders can cause weight loss

Answer 8

1. Abnormal movement (calorie deficit)
2. Decreased appetite
3. Dysphagia

Question 9

What pathology a shuffling gait and freezing tend to represent?

Answer 9

Extra-pyramidal disease

Question 10

What examination test can be used to assess a proprioception defect?

Answer 10

Romberg’s test

Question 11

Describe the symptoms fo a cerebellar pathology (DANISH)

Answer 11

Dysdiadochokinesia 
Ataxia
Nystagmus on eye movement 
Intention tremor 
Slurred speech 
Hypotonia/heel toe test

Question 12

Define Parkinson’s disease

Answer 12

• Progressive neurological condition caused by death of dopamine secreting neurons within substantia nigra of the brain

Question 13

Give 3 classes of drug treatment for Parkinson’s

Answer 13

Levodopa
Dopamine agonists
MAO B inhibitors

Question 14

Define Multiple Sclerosis and give 3 symptoms

Answer 14

Demyelination of neuron sheaths

1. Pins and needles
2. Visual disturbance
3. Ataxia

Question 15

Give 3 signs of MS on examination

Answer 15

Spasticity
Hyper-reflexia
Upgoing plantars

Question 16

What 2 things may be found in CSF from a LP in MS?

Answer 16

Increased protein

Oligoclonal bands

Question 17

What is Uhthoff’s phenomenon?

Answer 17

Temporary worsening of symptoms following exposure to heat in MS

Question 18

What is Lhermitte’s sign?

Answer 18

Electrical sensation that runs down the back when bending the neck in MS

Question 19

Define motor neurone disease and give 3 symptoms

Answer 19

Rare neurodegenerative disorders that selectively affect motor neurones

1. Weakness
2. Speech Problems
3. Cognitive impairment

Question 20

Give 3 signs which may be seen on examination in motor neurone disease

Answer 20

1. Fasciculations
2. Brisk reflexes
3. Increased tone

Question 21

What is the main diagnostic test for motor neurone disease?

Answer 21

Nerve conduction studies

Question 22

Define Huntington’s disease and give 3 symptoms

Answer 22

Autosomal dominant neurodegenerative condition with genetic anticipation

1. Chorea
2. Dystonia
3. Slow eye movement

Question 23

Which test confirms a diagnosis of Huntington’s disease?

Answer 23

Genetic testing

Question 24

Give 3 drugs used to relieve the symptoms of Huntington’s disease

Answer 24

Anti-psychotics
Anti-Depressants
Mood stabilisers

Question 25

Give 3 drugs used to relieve the symptoms of motor neurone disease

Answer 25

Baclofen
Anticholinergics
Anti-depressants

Question 26

Give 3 drugs used to relieve the symptoms of MS

Answer 26

1. Rituximab
2. Analgesia
3. Neuropathic pain relief