Chapter 12 Single best answer questions

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. You are a medical student in urology clinic. A 72 year old man has been referred by his GP due to his increasing symptoms of urinary incontinence. You assist him into the room as he is very unsteady on his feet, with a shuffling gait. He is accompanied by his wife, who gives the history as he has become "very forgetful" recently.
He is referred for a head CT scan. What would you expect this to show?

Multiple small areas of ischaemia correct incorrect

Dilated ventricles correct incorrect

Caudate nucleus atrophy correct incorrect

Normal CT correct incorrect

Global atrophy correct incorrect

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. You confirm the diagnosis.
What would be the most appropriate treatment?

Acetylcholinesterase inhibitors correct incorrect

Levodopa correct incorrect

Diuretics correct incorrect

Ventriculoperitoneal shunt correct incorrect

No specific treatment is yet available correct incorrect

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. A 58 year old man, known to be HIV positive, is followed up in clinic. The previous entry in the notes reports him to have been very withdrawn at his last attendance. His friend reports that he has deteriorated, with notable memory impairment, apathy, and poor coordination.
Which of the following is NOT true regarding this form of dementia?

It affects less than 10% of people taking antiretrovirals correct incorrect

It is a subcortical dementia correct incorrect

There is early withdrawal and apathy correct incorrect

It is characterized by neurological features including seizures correct incorrect

MRI characteristically shows global atrophy and diffuse grey matter signal changes correct incorrect

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. It is 5 o'clock in the morning and you are asked to see an 87 year old lady who was admitted earlier in the night with a fractured neck of femur following a fall. Physical examination was otherwise normal. She has a 3 year history of gradually increasing memory impairment. You arrive at the ward to find her shouting for her husband who passed away last year. You note that she is on galantamine.
What is the most appropriate immediate management of this patient?

Prescribe a small dose of lorazepam (e.g. 0.5mg) to reduce her distress and make it safer to assess her. correct incorrect

Physical examination, urine dipstick, blood glucose and chest X-ray correct incorrect

Increase the dose of galantamine correct incorrect

Commence broad-spectrum antibiotics to treat possible infection. correct incorrect

Move her to a side room to prevent further disturbance. correct incorrect

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. A 63 year old lady who was previously fit and well suffers an ischaemic stroke and is left with some left-sided weakness. She is able to mobilize with a frame and carry out most of her ADLs independently. There is no evidence of cognitive impairment and she has no past psychiatric history.
Which of the following disorders is most likely in the year following the stroke?

Hypomania correct incorrect

Agoraphobia correct incorrect

Depression correct incorrect

Social phobia correct incorrect

Alcohol dependency correct incorrect

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. A 42 year old woman attends the GP practice. Her husband has just been diagnosed with Huntington's chorea aged 40, and she wants some advice and information, since they have a son and she is concerned that he may have inherited the disorder.
Which of the following statements is TRUE?

You are unable to offer this lady any information as you have a duty of confidentiality to her husband correct incorrect

Her son has a 25% chance of inheriting the disorder correct incorrect

If her son does have Huntington's disease, he is likely to become symptomatic at a younger age than his father correct incorrect

Although there is no cure, levodopa may temporarily alleviate symptoms correct incorrect

Genetic testing is not available correct incorrect