AMC MCQ Neurology and Mental Health 2

Question 1

A 68-year-old presents with sudden right-sided weakness and expressive aphasia that resolves completely within 45 minutes. CT brain is normal. What is the most appropriate immediate management?

Accepted Answer

Commence aspirin and arrange urgent specialist assessment

Answer

Reassure and discharge as symptoms resolved

Answer

Commence warfarin immediately

Answer

Repeat CT in 24 hours only

Question 2

A 24-year-old woman reports recurrent episodes of intense fear, palpitations, sweating and a sense of impending doom lasting about 10 minutes, with no medical cause found. What is the most likely diagnosis?

Accepted Answer

Panic disorder

Answer

Generalised anxiety disorder

Answer

Phaeochromocytoma

Answer

Hyperthyroidism

Question 3

A patient with Parkinson's disease develops worsening tremor and rigidity after being started on a new medication for nausea. Which drug is the most likely cause?

Accepted Answer

Metoclopramide

Answer

Ondansetron

Answer

Domperidone

Answer

Cyclizine

Question 4

A 30-year-old man with schizophrenia on haloperidol develops fever, muscle rigidity, autonomic instability and a markedly raised creatine kinase. What is the diagnosis?

Accepted Answer

Neuroleptic malignant syndrome

Answer

Serotonin syndrome

Answer

Malignant hyperthermia

Answer

Acute dystonia

Question 5

A 55-year-old presents with the 'worst headache of my life' that began suddenly. CT brain is normal at 12 hours. What is the next most appropriate investigation?

Accepted Answer

Lumbar puncture looking for xanthochromia

Answer

Reassure and discharge

Answer

MRI of the lumbar spine

Answer

EEG

Question 6

A 40-year-old woman reports two weeks of persistent low mood, anhedonia, early morning waking, poor appetite and thoughts that life is not worth living. What is the most appropriate first action?

Accepted Answer

Assess suicide risk in detail

Answer

Prescribe a hypnotic and review in a month

Answer

Refer for dietary advice

Answer

Recommend increased exercise only

Question 7

A 70-year-old man has a resting tremor, bradykinesia and cogwheel rigidity that began on one side. What is the most likely diagnosis?

Accepted Answer

Idiopathic Parkinson's disease

Answer

Essential tremor

Answer

Cerebellar tremor

Answer

Benign physiological tremor