EMQ's

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Question 1 of 1

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485634

240

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For the following descriptions choose the most likely diagnosis

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Explanation

Binswanger's: Subcortical leukoencephalopathy; a form of small vessel vascular dementia due to involvement of white matter Kluver Bucy Syndrome: Bilateral lesions of the anterior temporal lobe

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A 55 yr old female presents with dysarthria and hypokinesia.
A 35 yr old I.V drug user presents with forgetfulness, poor concentration, apathy and withdrawal
59 yr old man with chronic hypertension presents with gradually deteriorating memory. MRI reveals white matter demylination in the periventricular area
A 65 yr old man with severe head injury shows hyperorality, inappropriate sexuality and hypermetamorphosis

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HIV Dementia
Kluver Bucy Syndrome
Binswanger's Disease
Parkinson's

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For the following descriptions match the definition

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Speech consists of paraphasias devoid of meaning and comprehension is also impaired
This aphasia is most associated with depression, right hemiparesis and hemisensory loss
Comprehension is intact but speech is fluent with paraphasias and neologisms. Repetition is also impaired
Repetition is intact but speech is non-fluent
Repetition is intact but speech is fluent
Repetition and comprehension are intact but has severe reading problems

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Transcortical Motor
Wernicke's aphasia
Broca's Aphasia
Alexia
Transcortical Sensory
Conduction Aphasia

485891

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Match the following descriptions with the appropriate choice

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Explanation

Alpha: 8-12 Hz, present on closing eyes and pathologic in coma Delta Waves up to 3 Hz • normal in slow wave sleep • babies Pathologic • subcortical lesions • diffuse lesions • metabolic encephalopathy • hydrocephalus • deep midline lesions K Complexes 12-14 Hz

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These waves attenuate on opening the eyes
Present in young children and in deep sleep
Brief bursts of slow waves during REM sleep
Present when the body is at rest, but is “suppressed” or “blocked” when the person performs a motor action
Occur with saccadic eye movements during visual scanning, disappearing when eyes are closed and in sleep
Arising from the hippocampus and manifested during some short-term memory tasks

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Alpha
Lambda Waves
Delta
K Complexes
Mu Rhythm
Theta Waves

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Match the following disorders with symptoms

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Match the text
impairment of consciousness, ataxia, and ophthalmoplegia
anterograde and retrograde amnesia
The most frequent presenting symptom is gait ataxia, followed by lower limb weakness and clumsiness. Lower limb reflexes are usually absent.
Déjà Vu, Jamas Vu, visual and olfactory hallucinations
Dull, continuous headache in the temporal region
Hallucinations and paranoia with intact affect and personality

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Temporal Lobe Epilepsy
Friedreich Ataxia
Korsakoff
Temporal arteritis
Wernicke’s
Partial complex seizures

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660

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Match the following with the appropriate structures

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Explanation

The Nucleus basalis of Meynert (NBM) recently been identified as the primary source of acetylcholine (ACh) in the cerebral cortex.

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Neurons rich in dopamine project from this area to the nigrostriatal pathway
Playing a role in reward, motivation and drug addiction
Major cholinergic site involved in pathogeneisis of alzheimers dementia
Noradrenergic neurones
Part of brain involved in visual processing
Involved in feeding, sexual behaviour and lactation
Lesions cause pure word deafness
Lesions cause alexia and agraphia
Sleep
Serotonin neurons involved in reward seeking behaviours
Integrative center for emotions, emotional behavior, and motivation

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Nucleus Accumbens
Nucleus basalis
Amygdala
Dorsal Raphe Nucleus
Reticular System
Lateral geniculate nucleus
Heschl's gyrus
Ventral Tegmental Area
Ventromedial Hypothalamus
Angular Gyrus
Locus Coeruleus

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Match the following conditions with their localisation

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Associated with laughing seizures
Patient presents with swinging movements of left arm and leg
Patient with significant change in personality with childlike behaviour and disinhibition
Patient with hypertension has a stroke. He develops an intense pain on the left side of the body
The patient shows an impaired finger nose test

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Inferior olivary nucleus
Right sub thalamic nucleus
Thalamus
Orbitofrontal cortex
Hypothalamus

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Match the following correct structure types

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Chlorpromazine
Haloperidone
Olanzapine
Clozapine
Quetiapine

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Phenothiazine
Dibenzodiazapine
Butyrophenone
Thienobenzodiazapine
Same class as clozapine

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What are the mechanisms of actions of the following antipsychotics?

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Haloperidol
Amisulpiride
Risperidone
Olanzapine
Ziprasidone
Aripiprazole
Paliperidone

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Dose related antagonist at presynaptic D4 receptors (less than 300 mg I day) and post-synaptic D2 receptors (more than 300 mg I day)
5HT2:D2 antagonist and Alpha1 blockade (first dose hypotensive effect). High prolactin elevation due to D2
Partial agonist at D2 receptors, 5HT2A antagonist and partial agonist at SHT1A receptors
5HT2:D2 antagonist and agonist activity at SHT1A with monoamine reuptake inhibition
5HT2:D2 antagonist, H1 blockade (sedative effect)
D2 and 5HT2A antagonist. Does not undergo hepatic metabolism
D2 Blocker (similar to all other typical antipsychotics)

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most appropriate investigation:

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Explanation

The case suggests neurosyphilis and CSF VDRL is an essential tool for diagnosis SPECT for HD can show caudate and putamen hypometabolism. (SPECT) is a functional nuclear imaging technique performed to evaluate regional cerebral perfusion. MRI-Sella Turcica It is useful to rule out prolactinoma MRI- T2 weighted image Multiple Sclerosis is the key diagnosis here. MRI T2 weighted images will show hyperintense lesions which are plaques.

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60 yr old man presents with first episode psychosis, auditory hallucinations, and visual difficulties with light reflex absent on examination.
30 yr old man presents with dysphoria, ataxia and involuntary movements of the upper and lower limbs.
40 yr old female who has been on a risperidone depot for 10 yrs complaining of galactorrhoea, headache and homonymous hemianopia.
35 yr old female presents with 2 wk history of depression and deteriorating vision in her left eye with diplopia on lateral gaze.

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SPECT
CSF VDRL
MRI
MRI - T2 weighted

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For the following select the most appropriate investigation

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Explanation

MRI visualisation of pulvinar nuclei in variant CJD. High intensity signal bilaterally in the pulvinar nuclei of the Thalamus is considered a useful sign in Variant CJD. Differentiating Alzheimer's from Lewy Body pooled sensitivity of DaTSCAN in differentiating DLB versus no DLB was 86.5% Raclopride is a ligand to explore D2/D3 binding. Sulpride and Amisulpride are medications that are D2/D3 antagonists.

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Subarachnoid haemorrhage
MS
Variant CJD
Differentiating Alzheimer's from Lewy Body
Explore D2/D3 receptor binding

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Dopamine transporter scan
Raclopride SPECT scan
CT
MRI
FLAIR

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Match the tests with their utility

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MMSE
CAMCOG
Ravens Progressive Matrices
NART
Wisconsin card sorting test
Stroop test
Stanford Binet
MMPI
Rorschach inkblot test
Paired associate learning test
Trail making test

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Verbal memory
Intelligence test
Frontal lobe executive function
Frontal lobe test of attentional conflict
pre-morbid IQ
Cognitive screening
Personality test
Culture free intelligence test
Cognitive screening
Protective test for personality assessment
Test of visuospacial and perceptuomotor speed

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OBSERVER RATING SCALES

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CAMCOG
BPRS
MAS
MADRS
HAM-A
Y-BOCS

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Schizophrenia
Mania
Depression
OCD
Anxiety
Dementia

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Match the following pairs

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Match the text
Altruistic suicide
Anomic suicide
Egoistic suicide
Acute anomie
Chronic Anomie

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An Iranian man who migrated to Australia recently presents to his GP with panic attacks
A man becomes bankrupt and overdoses on his medications rather than face his family
A Japanese soldier in WW2 was expected to commit suicide if captured
An homeless indigenous man is brought to hospital after an attempted hanging
A 45 year old man has major depression after being unemployed for 2 years

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Match the contributions of the following historical figures

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Explanation

- The sick role was defined by Parsons (1951) as the role given by society to a sick individual, and was considered to carry rights or privileges and obligations. - Illness behaviour is a set of stages describing the behaviour adopted by sick individuals (Mechanic, 1978). It describes the way in which individuals respond to somatic symptoms and signs and the Social roles of doctors and illness conditions under which they come to view them as abnormal. - From his study of the large St Elizabeth’s Hospital in Washington, DC, Goffman (1961) was one of the first to suggest that institutions may be harmful (Binary living, batch living, role stripping, patient/inmate role)

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Introduced the term ‘anomie’
Asylums were institutions to carry out social exclusion
The Sick Role
Illness Behaviour
The total institution

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Michael Foucault
Mechanic
Irving Goffman
Parsons
Emile Durkheim

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Match the disorders of general behaviour

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Stupor
Depressive retardation
Obsessional slowness
Hyperkinesis
Somnambulism

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Secondary to repeated doubts and compulsive rituals
In its extreme form mimics stupor
Mutism, immobility, periods of excitement
Overactivity, distractibility, impulsivity, excitability
Complex sequence of behaviours is carried out by a person who rises from sleep

EMQ's

Question 1 of 1

Time Left

For the following descriptions choose the most likely diagnosis

Match the text (click and drag)

(0/0)

Explanation

A 55 yr old female presents with dysarthria and hypokinesia.

A 35 yr old I.V drug user presents with forgetfulness, poor concentration, apathy and withdrawal

59 yr old man with chronic hypertension presents with gradually deteriorating memory. MRI reveals white matter demylination in the periventricular area

A 65 yr old man with severe head injury shows hyperorality, inappropriate sexuality and hypermetamorphosis

HIV Dementia

Kluver Bucy Syndrome

Binswanger's Disease

Parkinson's

For the following descriptions match the definition

Match the text (click and drag)

(0/0)

Speech consists of paraphasias devoid of meaning and comprehension is also impaired

This aphasia is most associated with depression, right hemiparesis and hemisensory loss

Comprehension is intact but speech is fluent with paraphasias and neologisms. Repetition is also impaired

Repetition is intact but speech is non-fluent

Repetition is intact but speech is fluent

Repetition and comprehension are intact but has severe reading problems

Transcortical Motor

Wernicke's aphasia

Broca's Aphasia

Alexia

Transcortical Sensory

Conduction Aphasia

Match the following descriptions with the appropriate choice

Match the text (click and drag)

(0/0)

Explanation

These waves attenuate on opening the eyes

Present in young children and in deep sleep

Brief bursts of slow waves during REM sleep

Present when the body is at rest, but is “suppressed” or “blocked” when the person performs a motor action

Occur with saccadic eye movements during visual scanning, disappearing when eyes are closed and in sleep

Arising from the hippocampus and manifested during some short-term memory tasks

Alpha

Lambda Waves

Delta

K Complexes

Mu Rhythm

Theta Waves

Match the following disorders with symptoms

Match the text (click and drag)

(0/0)

impairment of consciousness, ataxia, and ophthalmoplegia

anterograde and retrograde amnesia

The most frequent presenting symptom is gait ataxia, followed by lower limb weakness and clumsiness. Lower limb reflexes are usually absent.

Déjà Vu, Jamas Vu, visual and olfactory hallucinations

Dull, continuous headache in the temporal region

Hallucinations and paranoia with intact affect and personality

Temporal Lobe Epilepsy

Friedreich Ataxia

Korsakoff

Temporal arteritis

Wernicke’s

Partial complex seizures

Match the following with the appropriate structures

Match the text (click and drag)

(0/0)

Explanation

Neurons rich in dopamine project from this area to the nigrostriatal pathway

Playing a role in reward, motivation and drug addiction

Major cholinergic site involved in pathogeneisis of alzheimers dementia

Noradrenergic neurones

Part of brain involved in visual processing

Involved in feeding, sexual behaviour and lactation

Lesions cause pure word deafness

Lesions cause alexia and agraphia

Sleep

Serotonin neurons involved in reward seeking behaviours

Integrative center for emotions, emotional behavior, and motivation

Nucleus Accumbens

Nucleus basalis

Amygdala

Dorsal Raphe Nucleus