A 50-year old man has significant tics, but his language, memory and insight are only mildly to moderately impaired. He also has prominent depression and a butterfly pattern in the caudate nucleus on computed tomography (CT) scan.
Which is the most likely form of dementia in this patient?
A 55-year-old male patient is admitted with a seizure and reduced conscious level. He had been generally unwell with a fever and headaches over the previous 48 h. Computed tomography (CT) brain scan was normal. Lumbar puncture reveals: protein 0.8 g/l, glucose 3.5 mmol/l (serum glucose 5 mmol/l), WCC (white cell count) 80/mm3, 90% lymphocytes.
Which of the following is the most likely diagnosis?
In which condition is a stiff neck not present in a toddler?
A 68-year-old man in-patient on the gastroenterology ward is noted by the consultant on the ward round to have features which raise suspicion of Parkinson’s disease. The consultant proceeds to examine the patient and finds that he exhibits all three symptoms that are commonly associated with the symptomatic triad of Parkinson’s disease.
What are the three symptoms that are most commonly associated with the symptomatic triad of Parkinson’s disease?
A 21-year-old woman attends the antenatal clinic, six weeks pregnant with an unplanned pregnancy. She has a history of grand mal epilepsy for two years and is currently taking carbamazepine. She has not had any seizures for the past six months and wishes to continue with the pregnancy if it is safe for her and the baby. She is concerned about the effects of her anticonvulsant therapy on the fetus and seeks advice on how to proceed. What is the most suitable management plan for this patient?
A 15-year-old boy is brought to his GP by his mother due to complaints of bilateral leg weakness and difficulty walking, which has been progressively worsening over the past few years. The patient’s father, who passed away from a heart attack four years ago, also had similar issues with his legs. During the examination, the patient was found to have pes cavus, bilateral foot drop, and a stamping gait. Additionally, he had bilateral areflexia and flexor plantar responses, as well as glove-and-stocking sensory loss to the ankle. What is the most likely diagnosis?
A 25-year-old male patient complains of recurring headaches on the left side accompanied by lacrimation, ptosis, and miosis on the same side. The duration of each episode is less than two hours. What is the probable diagnosis?
A 22-year-old student is admitted to hospital with symptoms of fever, headache, photophobia and vomiting. The general practitioner administers 1.2 g of intramuscular benzylpenicillin before transferring the patient to the hospital. On examination, the patient’s temperature is 38.0 °C, pulse 100 bpm and blood pressure 150/80 mmHg. No rash is visible, but there is mild neck stiffness. A CT scan of the brain is performed and shows no abnormalities. A lumbar puncture is also performed, and the results are as follows:
– Opening pressure: 20 cm H2O
– Appearance: Clear
– Red cell count: 25/mcl
– Lymphocytes: 125/mcl
– Polymorphs: 5/mcl
– Glucose: 4.5 mmol/l (blood glucose 5.5 mmol/l)
– Protein: 0.5 g/l
– Gram stain: No organisms seen
– Culture: No growth
What diagnosis is consistent with these findings?
A 50-year-old homeless individual is brought to the emergency department after being found vomiting. Upon examination, the patient appears confused and disoriented, with unkempt appearance and slurred speech. However, the patient has a Glasgow Coma Scale score of 14. Vital signs include a pulse of 108 bpm, oxygen saturation of 94% on air, and blood pressure of 124/78 mmHg. Cardiovascular and respiratory exams are normal, with mild epigastric tenderness on abdominal exam. The patient has a broad-based gait and bilateral nystagmus with weakness of abduction of the eyes. Reflexes, power, and tone are generally normal with flexor plantar responses. What is the likely diagnosis?
What is the best preventative treatment for a 33-year-old woman who experiences frequent migraine episodes?