Neurology Neurology I Questions

Neurology Neurology I Questions

SELF-ASSESSMENT/CPD Self-assessment/CPD in association with This self-assessment section is brought to you in association with Elsevier’s ExamPrep ...

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SELF-ASSESSMENT/CPD

Self-assessment/CPD

in association with

This self-assessment section is brought to you in association with Elsevier’s ExamPrep (www.elsevierexamprep.co.uk/individual). Every month we will feature MRCP (UK) style questions based on the chapter’s topic. Answers are provided online only at www.medicinejournal.co.uk/content/cpd

Questions

Select the ONE single best answer from the five alternatives:

Question 1 A 33-year-old woman was referred with a 3-week history of sensory disturbance in the trunk, right arm and leg and left arm weakness. Twelve months previously, she had noticed numbness of the right side of her face that had resolved over a period of 4 weeks. She had undergone a right knee replacement 3 months previously. On examination, visual acuity was decreased in the left eye. There was weakness of the left arm (MRC grade 4/5 in a pyramidal distribution). There was no objective sensory loss in the legs. A CT scan of the head without contrast enhancement was reported as normal. What is the most appropriate next imaging investigation?

Question 3 A 25-year-old man presented with muscle cramps, which prevented him from playing football. He had always experienced muscle pain during the initial period of exercise but found that his symptoms passed off with continued graduated exertion. He was otherwise fit and well and there was no relevant family history. General examination was normal and neurologically he had no evidence of muscle weakness. Baseline investigations, including muscle enzymes and electromyography, were normal. An ischaemic forearm test was performed, which demonstrated no rise in venous lactate after cessation of exercise. What is the most likely diagnosis?

A

contrast-enhanced CT scan of brain

A

Gaucher’s disease

B

CT cerebral angiography

B

hypokalaemic periodic paralysis

C

CT cerebral venography

C

McArdle’s disease

D

MR scan of brain

D

Pompe’s disease

E

repeat unenhanced CT scan of head after 2 weeks

E

Von Gierke’s disease

Question 2 A 52-year-old man had a 7-hour history of right-sided weakness and dysphasia. Six months previously, he had sustained an inferior wall myocardial infarction and had required subsequent insertion of a permanent pacemaker. On examination, there was a right hemiparesis. What is the most appropriate initial imaging investigation? A

contrast-enhanced CT scan of head

B

Doppler ultrasound of carotid arteries

C

echocardiogram

D

MR scan of brain

E

unenhanced CT scan of head

For the answers, please visit

www.medicinejournal.co.uk/content/cpd For exclusive offers on ExamPrep, go to

www.elsevierexamprep.co.uk/ individual

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