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1

Urinary incontinence + gait abnormality + dementia

normal pressure hydrocephalus

2

a reversible cause of dementia seen in elderly patients ?

normal pressure hydrocephalus

3

variant of fast score to assess stroke risk?

stROke ROsier score

4

Obese, young female with headaches and blurred vision, think?

idiopathic, intercranial hypertension.

5

idiopathic intercranial hypertension treatment?

weight loss and diuretic (acetazolamide)

6

two drugs that may cause peripheral neuropathy? "feels like walking on cotton wool"

nitrofurentoin and metronidazole

7

Normal pressure hydrocephalus management?

Normal pressure hydrocephalus

8

What is the most common presentation of multiple sclerosis?

optic neuritis

9

worsening of vision following rise in body temperature?

Uhthoff's phenomenon: worsening of vision following rise in body temperature. Seen in MS

10

Colours, particularly reds, may appear "washed out" or less bright than usual. Which eye condition?

optic neuritis

11

Patients with MS can present with non specific symptoms. How do 75% present?

significant lethargy

12

what can you get in neck flexion in MS?

paraesthesia in limbs (Lhermittes syndrome)

13

what is paraesthesia?

abnormal sensation such as tingling, tickling or burning of a person's skin with no apparent physical cause

14

Progressive degenerative disesase of brain. Accounts for majority of dementia in the UK?

alzheimers disease

15

what is thought to cause the inherited form?

mutations in amyloid precursor protein

16

what is apoE4?

class of proteins involved in the metabolism of fats in the body

17

macroscopic changes in alzheimers>

macroscopic: widespread cerebral atrophy, particularly involving the cortex and hippocampus

18

microscopic changes in alzheimers?

cortical plaques due to deposition of type A-Beta-amyloid protein and intraneuronal neurofibrillary tangles caused by abnormal aggregation of the tau protein

19

biochemically, what is there a deficit of in alzheimers?

acetylcholine

20

paired helical filaments are partly made from a protein called tau?

neurofibrillary tangles

21

There is a deficit of acetylcholine in amlzheimers. NICE now recommend the three acetylcholinesterase inhibitors. what are they?

donepezil, galantamine and rivastigmine

22

if intolerant of first l in drugs, what can be given second line ?

memantine (clementine)

23

DVLA advice post multiple TIAs: cannot drive for

3 months

24

if you have a seizure/fit, what must you do?

inform the DVLA

25

for patients with established epilepsy or those with multiple unprovoked seizures:
→ may qualify for a driving licence if they have been free from any seizure for?

12 months
if there have been no seizures for 5 years (with medication if necessary)

26

single episode syncope, explained and treated. restriction on driving?

4 weeks

27

single episode syncope, unexplained?

6 months off driving

28

stroke or TIA. If not residual neurological deficit. how long do you need to take off driving and do you need to inform DVLA?

1 month off driving. may not need to inform DVLA

29

craniotomy e.g. For meningioma. How long off driving

1 year

30

chronic neurological disorders e.g. multiple sclerosis, motor neuron disease: DVLA should be informed, what form is filled out?

PK1 form