Mock KT

Question 1

Structural abnormalities of the CNS which may present at birth

Answer 1

1. Anencephaly is caused by a failure of formation of the forebrain
2. Spina bifida is a form of meningo-myelocele
3. Dandy Walker syndrome is associated with failure of development of the cerebellum.
4. Microcephaly is caused by development of a small brain
5. Meningo-myelocele is caused by failure of closure of the caudal end of neural tube

Question 2

Relationship of hippocampal sclerosis to epilepsy

Answer 2

• Neuronal loss and reorganisation of hippocampul structures
• related to the later development of temporal love epilepsy
• Related to febrile convulsions (not sure if a cause of or caused by)
• Commonest associated lesion of focal epilepsy

Question 3

GABA synthesis, storage and recycling

Answer 3

Synthesised from glutamate
catalysed by glutamic acid decarboxylase (GAD)
Loaded and stored in vesicles by vesicular GABA transporter using the proton gradient
Released at synapse
reuptake by transporters on glia and GABA neuron and others
No transport back to neuron from glia, requires more new synthesis of GABA

Question 4

Long term complications of Parkinson

Answer 4

Dementia
Ons and Offs
Dyskinesias
Falls
Swallowing difficulties
Speech difficulties

Question 5

What molecular events may lead to physical dependence to opioids

Answer 5

Acute morphine- acutely inhibits firing of LC through Gi
Chronic treatment- LC neurons return to normal firing rates (Gs upregulated to match Gi)

Withdrawal- increase in LC firing (LC is hypersensitive)

Question 6

Side effects of typical antipsychotics and the mechanism by which they are manifested

Answer 6

EPS

• Akathisia
• Parkinsonian like symptoms including bradykinesia , resting tremor
• Due to suppression of dopamine activity in Caudate, putamen

Tardive dyskinesoa

• due to dopamine receptor upregulation- supersensitivity
• Other effects include drowsiness, restlessness, dry mouth, or blurring of vision

Question 7

Why does correctly diagnosing the epilepsy syndrome affect patient management

Answer 7

• influences antiepileptic drug choices
• influences who needs brain imaging
• influences who needs an EEG
• influences the safety of the patient (if they have seizures with no warning)

Question 8

What factors influence antiepileptic drug choices in women

Answer 8

Teratogenicity
drug-drug interactions with COCP
and
Side effects of weight gain/menstrual irregularity