MRCP Part 1 Neurology and Psychiatry 2

Question 1

A 78-year-old man presents with visual hallucinations, fluctuating cognition, and parkinsonism that preceded dementia onset. What is the most likely diagnosis?

Accepted Answer

Dementia with Lewy bodies

Answer

Alzheimer's disease

Answer

Vascular dementia

Answer

Frontotemporal dementia

Question 2

A 40-year-old man presents with bilateral lower limb weakness that ascended over 5 days following a respiratory infection. Reflexes are absent and CSF shows raised protein with normal cell count. What is the diagnosis?

Accepted Answer

Guillain-Barre syndrome

Answer

Multiple sclerosis

Answer

Myasthenia gravis

Answer

Motor neurone disease

Question 3

Which cranial nerve is most commonly affected in raised intracranial pressure, causing a false localising sign?

Accepted Answer

Abducens nerve (CN VI)

Answer

Oculomotor nerve (CN III)

Answer

Trochlear nerve (CN IV)

Answer

Facial nerve (CN VII)

Question 4

A patient presents to A&E having taken 40 paracetamol tablets 4 hours ago. The plasma paracetamol level is above the treatment line on the nomogram. What is the antidote?

Accepted Answer

N-acetylcysteine (NAC)

Answer

Flumazenil

Answer

Naloxone

Answer

Activated charcoal

Question 5

A 55-year-old man presents with progressive weakness affecting both upper and lower motor neurones but with no sensory involvement. Fasciculations are noted in multiple limbs. What is the most likely diagnosis?

Accepted Answer

Motor neurone disease (amyotrophic lateral sclerosis)

Answer

Multiple sclerosis

Answer

Guillain-Barre syndrome

Answer

Cervical myelopathy

Question 6

A 22-year-old university student presents with low mood, anhedonia, poor concentration, early morning wakening, and weight loss for 3 months. She expresses passive suicidal ideation. According to NICE, what severity of depression is this?

Accepted Answer

Moderate to severe depression

Answer

Mild depression

Answer

Subthreshold depressive symptoms

Answer

Psychotic depression