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

A resolving focal deficit is a transient ischaemic attack, requiring antiplatelet therapy and urgent assessment to prevent stroke.

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

Recurrent discrete episodes of intense fear peaking within minutes, with no organic cause, characterise panic disorder.

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

Metoclopramide is a central dopamine antagonist that crosses the blood-brain barrier and worsens parkinsonism.

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

Fever, rigidity, autonomic instability and raised CK in a patient on antipsychotics indicate neuroleptic malignant syndrome.

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

A thunderclap headache with a normal CT requires lumbar puncture to detect xanthochromia from subarachnoid haemorrhage.

AMC MCQ Practice Test

AMC MCQ Practice Test

AMC MCQ Neurology and Mental Health 2