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  • Question 1 - You see a 50-year-old man in morning surgery after discharge from hospital following...

    Incorrect

    • You see a 50-year-old man in morning surgery after discharge from hospital following fitting of an implantable cardioverter defibrillator (ICD).

      He had several episodes of sustained ventricular tachycardia requiring hospital admission before having the defibrillator implanted. He needs a medical certificate for work as he is a travelling salesman and has to drive for his work.

      How long should he refrain from driving a car following the fitting of an implantable defibrillator?

      Your Answer: 1 month

      Correct Answer: 2 months

      Explanation:

      Driving Restrictions for Patients with ICDs

      Patients who have received an implantable cardioverter-defibrillator (ICD) for sustained ventricular arrhythmias should be aware of driving restrictions. For the first six months after the initial implant, patients should not drive. Additionally, after any shock therapy or symptomatic anti-tachycardia pacing, patients should refrain from driving for an additional six months. It is important for patients to follow these guidelines to ensure their safety and the safety of others on the road.

    • This question is part of the following fields:

      • Consulting In General Practice
      43.9
      Seconds
  • Question 2 - A 32-year-old woman presents to the clinic seeking advice on quitting smoking as...

    Correct

    • A 32-year-old woman presents to the clinic seeking advice on quitting smoking as she is planning to start a family. Despite several attempts to quit on her own, she has been unsuccessful. She is hesitant to attend a smoking cessation program and asks about medical options to aid in quitting. What would be the most suitable management to suggest, considering she has not tried any medications before?

      Your Answer: Nicotine replacement therapy (NRT) alone

      Explanation:

      Smoking Cessation Options for a Woman Trying to Conceive

      Nicotine replacement therapy (NRT) is the recommended option for a woman trying to conceive who is struggling to quit smoking. While it is ideal for her to delay conception until she has successfully quit smoking and ceased NRT, the benefits of NRT outweigh the risks of smoking and NRT. It is important for her to also receive behavioral support through a Stop Smoking Service. E-cigarettes are not currently recommended due to lack of evidence on their safety and effectiveness. Bupropion and varenicline are contraindicated in pregnancy and should not be prescribed. While attending a Stop Smoking Service is preferred, medical treatments such as NRT can be prescribed in primary care.

    • This question is part of the following fields:

      • Smoking, Alcohol And Substance Misuse
      61
      Seconds
  • Question 3 - You are visiting a local nursing home to see a new resident who...

    Correct

    • You are visiting a local nursing home to see a new resident who is complaining of an itchy rash when you get an urgent call to see a 78-year-old lady who has collapsed in the dining room.

      The relief staff at the home tell you that she is a diabetic and has had a stroke some years ago, but they do not know much else about her.

      On examination, she is lying in the recovery position on the floor and her BP is 115/70 mmHg, pulse 95 she is bathed in sweat and is unresponsive. She has adequate air entry on auscultation of the chest and there is no danger in the immediate vicinity. Trained nursing staff are at hand to help you with her management and take any further action.

      What would be your first action in this situation?

      Your Answer: Check her finger prick glucose

      Explanation:

      Managing Hypoglycaemia in Nursing Homes

      Hypoglycaemia is a common occurrence in nursing homes and can lead to significant neurological impairment if not managed promptly. When a patient is suspected of having hypoglycaemia, the first step is to check their finger prick glucose level. This should be done after ensuring their airway, breathing, and circulation are stable.

      Early intervention with a glucagon injection can prevent further complications. It is important to note that nursing home ‘strokes’ are a common cause of admissions to emergency departments. Therefore, prompt management of hypoglycaemia can potentially avoid such admissions.

      If the patient is unconscious, they should be placed in the recovery position until medical help arrives. By following these steps, nursing home staff can effectively manage hypoglycaemia and prevent further complications.

    • This question is part of the following fields:

      • Older Adults
      71.1
      Seconds
  • Question 4 - A 55 year old man comes to the clinic with complaints of tingling...

    Incorrect

    • A 55 year old man comes to the clinic with complaints of tingling sensations in his left thumb and first finger. He reports difficulty in gripping objects and unintentionally dropping them. Upon examination, there is noticeable muscle wasting in the thenar eminence. What clinical sign would indicate a diagnosis other than carpal tunnel syndrome?

      Your Answer: Positive Tinnels test

      Correct Answer: Positive Hoffmans sign

      Explanation:

      Degenerative cervical myelopathy (DCM) is often misdiagnosed as carpal tunnel syndrome (CTS) in patients who undergo surgery for the former. This highlights the importance of considering DCM as a differential diagnosis in patients suspected to have CTS.

      CTS is a peripheral nervous system disorder that results from compression of the median nerve at the wrist within the carpal tunnel. It affects only the aspects of the hand innervated by the median nerve, including sensation and motor function. Symptoms typically include intermittent pain or parasthesiae, and motor signs are less commonly seen.

      Tests such as Tinels and Phalens can be positive in CTS, but they are not always reliable. In contrast, examination features in focal central nervous system disorders like DCM have low sensitivity but high specificity. DCM affects the sensory, motor, and autonomic nervous systems from the neck downwards, and motor signs are typically upper motor neuron signs such as increased tone, hyper-reflexia, and pyramidal weakness.

      Detecting early DCM can be challenging, as the neurological signs are often subtle initially but likely to worsen over time. Therefore, a high index of suspicion, comprehensive neurological examination, and monitoring for progression are required.

      Degenerative cervical myelopathy (DCM) is a condition that has several risk factors, including smoking, genetics, and certain occupations that expose individuals to high axial loading. The symptoms of DCM can vary in severity and may include pain, loss of motor function, loss of sensory function, and loss of autonomic function. Early symptoms may be subtle and difficult to detect, but as the condition progresses, symptoms may worsen or new symptoms may appear. An MRI of the cervical spine is the gold standard test for diagnosing cervical myelopathy. All patients with DCM should be urgently referred to specialist spinal services for assessment and treatment. Decompressive surgery is currently the only effective treatment for DCM, and early treatment offers the best chance of a full recovery. Physiotherapy should only be initiated by specialist services to prevent further spinal cord damage.

    • This question is part of the following fields:

      • Neurology
      33.8
      Seconds
  • Question 5 - A 16-year-old male presents for follow-up. He has a medical history of acne...

    Incorrect

    • A 16-year-old male presents for follow-up. He has a medical history of acne and is currently taking oral lymecycline. Despite treatment, there has been no improvement and upon examination, scarring is evident on his face. What is the most appropriate course of action?

      Your Answer: Oral doxycycline

      Correct Answer: Referral for oral isotretinoin

      Explanation:

      Referral for oral retinoin is recommended for patients with scarring.

      Acne vulgaris is a common skin condition that usually affects teenagers and is characterized by the obstruction of hair follicles with keratin plugs, resulting in comedones, inflammation, and pustules. The severity of acne can be classified as mild, moderate, or severe, depending on the number and type of lesions present. Treatment for acne typically involves a step-up approach, starting with single topical therapy and progressing to combination therapy or oral antibiotics if necessary. Tetracyclines are commonly used but should be avoided in certain populations, and a topical retinoid or benzoyl peroxide should always be co-prescribed to reduce the risk of antibiotic resistance. Combined oral contraceptives can also be used in women, and oral isotretinoin is reserved for severe cases under specialist supervision. Dietary modification has no role in the management of acne.

    • This question is part of the following fields:

      • Dermatology
      35.6
      Seconds
  • Question 6 - A 28-year-old man presents with macroscopic haematuria and is found to have a...

    Incorrect

    • A 28-year-old man presents with macroscopic haematuria and is found to have a serum creatinine level of 160 µmol/l (60-120 µmol/l).
      Select from the list the single feature that would be most suggestive of a diagnosis of nephritic syndrome rather than nephrotic syndrome.

      Your Answer: Hyperlipidaemia

      Correct Answer: Oliguria

      Explanation:

      Understanding Nephrotic and Nephritic Syndrome: Symptoms and Causes

      Nephrotic syndrome is characterized by proteinuria, hypoalbuminaemia, oedema, and hyperlipidaemia, while nephritic syndrome is defined by acute kidney injury, hypertension, oliguria, and urinary sediment. Both syndromes can be caused by various renal diseases and are a constellation of several symptoms.

      In nephritic syndrome, increased cellularity within the glomeruli and a leucocytic infiltrate cause an inflammatory reaction that injures capillary walls, leading to red cells in urine and decreased glomerular filtration rate. Hypertension is likely due to fluid retention and increased renin release. Examples of conditions causing nephritic syndrome include diffuse proliferative glomerulonephritis, IgA nephropathy, and lupus nephritis.

      Acute nephritic syndrome is the most serious and requires immediate referral to secondary care, while patients with nephrotic syndrome will also be referred but usually do not require acute admission.

    • This question is part of the following fields:

      • Kidney And Urology
      30.8
      Seconds
  • Question 7 - A 30-year-old woman visits the clinic with a complaint of back pain and...

    Incorrect

    • A 30-year-old woman visits the clinic with a complaint of back pain and stiffness in the morning that has been worsening for the past 2 years. She reports that the pain improves with exercise. She also mentions having experienced an episode of anterior uveitis (iritis) recently. Upon investigation, it is found that she is negative for rheumatoid factor but positive for human leukocyte antigen B27 (HLA-B27). What is the most probable diagnosis?

      Your Answer: Psoriatic arthritis

      Correct Answer: Ankylosing spondylitis (AS)

      Explanation:

      Understanding Different Types of Spondyloarthropathy

      Spondyloarthropathy is a group of inflammatory diseases that affect the joints and spine. Among the different types of spondyloarthropathy, ankylosing spondylitis (AS) is the most common. It typically affects people under 30 years old and is characterized by inflammatory back pain that causes stiffness and wakes patients up in the early morning hours. AS is strongly associated with the HLA-B27 gene, and about 20-30% of patients also experience acute anterior uveitis.

      Enteropathic spondyloarthropathy is another type of spondyloarthropathy that is linked to inflammatory bowel disease. However, there is no evidence of this in the patient’s history. Like AS, enteropathic spondyloarthropathy is also associated with HLA-B27.

      Mechanical back pain, on the other hand, is not an inflammatory condition. It usually starts suddenly and varies in severity depending on posture and movement. In contrast, the patient’s pain has developed gradually over a year.

      Psoriatic arthritis is another type of spondyloarthropathy that is associated with psoriasis of the skin and/or nails. However, there is no mention of this in the patient’s history. Psoriatic arthritis can affect any joint but mostly affects the knees, ankles, hands, and feet. It is also linked to HLA-B27.

      Reactive arthritis is characterized by asymmetrical aseptic arthritis, urethritis, and conjunctivitis. It usually occurs after a sexually transmitted infection or gastrointestinal illness. However, there is no indication of this in the patient’s history or examination.

      In summary, understanding the different types of spondyloarthropathy can help healthcare professionals make an accurate diagnosis and provide appropriate treatment.

    • This question is part of the following fields:

      • Musculoskeletal Health
      30.2
      Seconds
  • Question 8 - The following patients all attend for a medication review in your afternoon clinic....

    Incorrect

    • The following patients all attend for a medication review in your afternoon clinic. They all have atrial fibrillation (AF) and are taking multiple medications.

      Which patient should discontinue anticoagulation?

      Your Answer: A 65-year-old woman who has undergone catheter ablation

      Correct Answer: An 80-year-old man who has undergone left atrial appendage closure, surgically preventing clots from entering the bloodstream

      Explanation:

      Even after undergoing catheter ablation for atrial fibrillation, patients must continue taking anticoagulants for an extended period based on their CHA2DS2-VASc score.

      Atrial fibrillation (AF) is a heart condition that requires prompt management. The management of AF depends on the patient’s haemodynamic stability and the duration of the AF. For haemodynamically unstable patients, electrical cardioversion is recommended. For haemodynamically stable patients, rate control is the first-line treatment strategy, except in certain cases. Medications such as beta-blockers, calcium channel blockers, and digoxin are commonly used to control the heart rate. Rhythm control is another treatment option that involves the use of medications such as beta-blockers, dronedarone, and amiodarone. Catheter ablation is recommended for patients who have not responded to or wish to avoid antiarrhythmic medication. The procedure involves the use of radiofrequency or cryotherapy to ablate the faulty electrical pathways that cause AF. Anticoagulation is necessary before and during the procedure to reduce the risk of stroke. The success rate of catheter ablation varies, with around 50% of patients experiencing an early recurrence of AF within three months. However, after three years, around 55% of patients who have undergone a single procedure remain in sinus rhythm.

    • This question is part of the following fields:

      • Cardiovascular Health
      54.2
      Seconds
  • Question 9 - A 19-year-old female is brought to the hospital from her dormitory at college...

    Incorrect

    • A 19-year-old female is brought to the hospital from her dormitory at college with suspected meningitis. She complained of a severe headache, fever, and vomiting that had been getting worse for the past two days. After a lumbar puncture, it was confirmed that she has a positive culture for Neisseria meningitidis.

      What antibiotic should be prescribed for her college roommates?

      Your Answer: Benzylpenicillin

      Correct Answer: Ciprofloxacin

      Explanation:

      Prophylaxis for contacts of patients with meningococcal meningitis typically involves the use of oral ciprofloxacin or rifampicin. Amoxicillin is primarily used in the treatment of meningitis in young children who are at a higher risk for listeria meningitis. In emergency situations, benzylpenicillin is the preferred treatment for meningitis, but it is not used for prophylaxis. Cephalosporins, such as cefalexin, are typically used in the treatment of bacterial meningitis rather than for prophylaxis.

      When suspected bacterial meningitis is being investigated and managed, it is important to prioritize timely antibiotic treatment to avoid negative consequences. Patients should be urgently transferred to the hospital, and if meningococcal disease is suspected in a prehospital setting, intramuscular benzylpenicillin may be given. An ABC approach should be taken initially, and senior review is necessary if any warning signs are present. A key decision is when to attempt a lumbar puncture, which should be delayed in certain circumstances. Management of patients without indication for delayed LP includes IV antibiotics, with cefotaxime or ceftriaxone recommended for patients aged 3 months to 50 years. Additional tests that may be helpful include blood gases and throat swab for meningococcal culture. Prophylaxis needs to be offered to households and close contacts of patients affected with meningococcal meningitis, and meningococcal vaccination should be offered to close contacts when serotype results are available.

    • This question is part of the following fields:

      • Infectious Disease And Travel Health
      28.3
      Seconds
  • Question 10 - A 17-year-old male presents with worries about delayed pubertal development, despite being 1.75m...

    Incorrect

    • A 17-year-old male presents with worries about delayed pubertal development, despite being 1.75m tall. He has minimal pubic hair and decreased testicular size. The following laboratory results are obtained:

      Testosterone 7.2 nmol/l (9 - 30)
      LH 3.5 mu/l (3 - 10)
      FSH 5.9 mu/l (3 - 10)

      What is the probable diagnosis?

      Your Answer: Testicular feminisation syndrome

      Correct Answer: Kallman's syndrome

      Explanation:

      Kallmann’s syndrome is a condition that can cause delayed puberty due to hypogonadotropic hypogonadism. It is often inherited as an X-linked recessive trait and is believed to be caused by a failure of GnRH-secreting neurons to migrate to the hypothalamus. One of the key indicators of Kallmann’s syndrome is anosmia, or a lack of smell, in boys with delayed puberty. Other features may include hypogonadism, cryptorchidism, low sex hormone levels, and normal or above-average height. Some patients may also have cleft lip/palate and visual/hearing defects.

      Management of Kallmann’s syndrome typically involves testosterone supplementation. Gonadotrophin supplementation may also be used to stimulate sperm production if fertility is desired later in life. It is important for individuals with Kallmann’s syndrome to receive appropriate medical care and monitoring to manage their symptoms and ensure optimal health outcomes.

    • This question is part of the following fields:

      • Metabolic Problems And Endocrinology
      99.5
      Seconds
  • Question 11 - One of your elderly patients with chronic kidney disease stage 4 has undergone...

    Incorrect

    • One of your elderly patients with chronic kidney disease stage 4 has undergone his annual blood tests:

      Hb 9.4 g/dl
      Platelets 166 * 109/l
      WBC 6.7 * 109/l

      He is currently receiving treatment from the renal team and has been prescribed erythropoietin. What is the target haemoglobin level for this patient?

      Your Answer: 9-11 g/dl

      Correct Answer: 10-12 g/dl

      Explanation:

      The target for haemoglobin levels in CKD patients with anaemia should be between 10-12 g/dl.

      Anaemia in Chronic Kidney Disease

      Patients with chronic kidney disease (CKD) may develop anaemia due to various factors, with reduced erythropoietin levels being the most significant. This type of anaemia is usually normochromic normocytic and becomes apparent when the GFR is less than 35 ml/min. Other causes of anaemia should be considered if the GFR is greater than 60 ml/min. Anaemia in CKD can lead to the development of left ventricular hypertrophy, which is associated with a three-fold increase in mortality in renal patients.

      There are several causes of anaemia in renal failure, including reduced erythropoietin levels, reduced erythropoiesis due to toxic effects of uraemia on bone marrow, reduced absorption of iron, anorexia/nausea due to uraemia, reduced red cell survival (especially in haemodialysis), blood loss due to capillary fragility and poor platelet function, and stress ulceration leading to chronic blood loss.

      To manage anaemia in CKD, the 2011 NICE guidelines suggest a target haemoglobin of 10-12 g/dl. Determination and optimisation of iron status should be carried out before the administration of erythropoiesis-stimulating agents (ESA). Oral iron should be offered for patients who are not on ESAs or haemodialysis. If target Hb levels are not reached within three months, patients should be switched to IV iron. Patients on ESAs or haemodialysis generally require IV iron. ESAs such as erythropoietin and darbepoetin should be used in those who are likely to benefit in terms of quality of life and physical function.

    • This question is part of the following fields:

      • Kidney And Urology
      31.3
      Seconds
  • Question 12 - A 12-month-old girl comes in with a unilateral purulent nasal discharge and worsening...

    Incorrect

    • A 12-month-old girl comes in with a unilateral purulent nasal discharge and worsening bad breath over the past few days. However, she doesn't exhibit any systemic symptoms. What is the probable diagnosis?

      Your Answer: Nasal foreign body

      Correct Answer: Allergic rhinitis

      Explanation:

      Unilateral Discharge in Children: A Possible Sign of Foreign Body

      The occurrence of unilateral discharge in an otherwise healthy child may indicate the presence of a foreign body, especially in this age group. It is important to consider the child’s history to determine the possible cause of the discharge. If a foreign body is suspected, prompt removal is necessary to prevent further complications. Fortunately, removal of the foreign body is usually curative and can alleviate the symptoms.

    • This question is part of the following fields:

      • Children And Young People
      33.2
      Seconds
  • Question 13 - What is the recommended course of action in the management of an adult...

    Incorrect

    • What is the recommended course of action in the management of an adult with asthma who is on low dose inhaled corticosteroid (ICS) but doesn't show improvement after the introduction of a long acting beta agonist (LABA)?

      Your Answer: Stop inhaled steroid and start long acting muscarinic antagonist (LAMA)

      Correct Answer: Stop long-acting beta-2 agonist (LABA) and increase dose ICS

      Explanation:

      BTS Guidance on Low Dose ICS and LABA Treatment

      According to the 2016 BTS guidance, if a patient taking a low dose ICS doesn’t respond to the addition of a LABA, the LABA should be discontinued. Instead, healthcare providers should consider increasing the dose of ICS. It is important to note that options suggesting only an increase in ICS dose without stopping the LABA are incorrect.

      This guidance emphasizes the importance of individualized treatment plans for patients with respiratory conditions. By carefully monitoring patient response to medication and adjusting treatment as needed, healthcare providers can help improve patient outcomes and quality of life. Proper medication management can also help reduce the risk of adverse effects and complications associated with respiratory conditions.

    • This question is part of the following fields:

      • Respiratory Health
      46.5
      Seconds
  • Question 14 - A 27-year-old female with epilepsy controlled on topiramate is seeking advice on contraception...

    Incorrect

    • A 27-year-old female with epilepsy controlled on topiramate is seeking advice on contraception options that will not interfere with her medication. She desires a reliable method due to concerns about teratogenicity. What type of contraception would be suitable to recommend while taking an enzyme-inducing medication?

      Your Answer: Barrier methods for example, condoms

      Correct Answer: Injectable progesterone (Depo- provera)

      Explanation:

      According to the guidelines of the Faculty of Sexual and Reproductive Health and the BNF, the recommended contraceptive method in this case is injectable progesterone. This method is not affected by drug interactions. However, as topiramate is an enzyme inducer, it can reduce the effectiveness of oestrogens and progesterone, which are components of combined contraceptive pills. Therefore, if a combined contraceptive pill is to be used, it should contain at least 50 micrograms of ethinyl estradiol. Barrier methods alone are not reliable and should not be used as the sole form of contraception. Progesterone-only pills and implants are not suitable due to the enhanced first pass metabolism of progesterone, which can result in decreased contraceptive efficacy.

      Contraception for Women with Epilepsy

      Women with epilepsy need to consider several factors when choosing a contraceptive method. The effectiveness of anti-epileptic medication can be affected by the contraceptive, and vice versa. Additionally, if a woman becomes pregnant while taking anti-epileptic medication, there is a risk of teratogenic effects on the fetus. To address these concerns, the Faculty of Sexual & Reproductive Healthcare (FSRH) recommends the consistent use of condoms in addition to other forms of contraception.

      For women taking certain anti-epileptic medications such as phenytoin, carbamazepine, barbiturates, primidone, topiramate, and oxcarbazepine, the FSRH recommends using the combined oral contraceptive pill (COCP) or progestogen-only pill (POP) with a UK Medical Eligibility Criteria (UKMEC) rating of 3. The implant has a UKMEC rating of 2, while the Depo-Provera injection, intrauterine device (IUD), and intrauterine system (IUS) have a UKMEC rating of 1.

      For women taking lamotrigine, the FSRH recommends using the COCP with a UKMEC rating of 3 or the POP, implant, Depo-Provera injection, IUD, or IUS with a UKMEC rating of 1. If a COCP is chosen, it should contain a minimum of 30 µg of ethinylestradiol.

      In summary, women with epilepsy should carefully consider the potential interactions between their anti-epileptic medication and their chosen contraceptive method. Using condoms consistently in addition to other forms of contraception can help reduce the risk of unintended pregnancy and potential teratogenic effects on the fetus.

    • This question is part of the following fields:

      • Maternity And Reproductive Health
      39.8
      Seconds
  • Question 15 - A 50-year-old man who you have treated for obesity comes for review. Despite...

    Incorrect

    • A 50-year-old man who you have treated for obesity comes for review. Despite ongoing lifestyle interventions and trials of orlistat and sibutramine he has failed to lose a significant amount of weight. He is currently taking lisinopril for hypertension but a recent fasting glucose was normal. For this patient, what is the cut-off body mass index (BMI) that would trigger a referral for consideration of bariatric surgery?

      Your Answer: BMI > 40 kg/m^2

      Correct Answer: BMI > 35 kg/m^2

      Explanation:

      Bariatric Surgery for Obesity Management

      Bariatric surgery has become a significant option in managing obesity over the past decade. For obese patients who fail to lose weight with lifestyle and drug interventions, the risks and expenses of long-term obesity outweigh those of surgery. The NICE guidelines recommend that very obese patients with a BMI of 40-50 kg/m^2 or higher, particularly those with other conditions such as type 2 diabetes mellitus and hypertension, should be referred early for bariatric surgery rather than it being a last resort.

      There are three types of bariatric surgery: primarily restrictive operations, primarily malabsorptive operations, and mixed operations. Laparoscopic-adjustable gastric banding (LAGB) is the first-line intervention for patients with a BMI of 30-39 kg/m^2. It produces less weight loss than malabsorptive or mixed procedures but has fewer complications. Sleeve gastrectomy reduces the stomach to about 15% of its original size, while the intragastric balloon can be left in the stomach for a maximum of six months. Biliopancreatic diversion with duodenal switch is usually reserved for very obese patients with a BMI of over 60 kg/m^2. Roux-en-Y gastric bypass surgery is both restrictive and malabsorptive in action.

    • This question is part of the following fields:

      • Gastroenterology
      55.5
      Seconds
  • Question 16 - You encounter a 30-year-old mother of two who is experiencing recurrent Meniere's disease....

    Correct

    • You encounter a 30-year-old mother of two who is experiencing recurrent Meniere's disease. She has been suffering from tinnitus and mild hearing loss on the right side for nearly 2 years. Every 2 months, she has an episode of vertigo accompanied by nausea and vomiting, which lasts up to 7 days and causes her significant distress. While under the care of the ENT team, she is curious about any available treatments to prevent Meniere's disease attacks.

      What would be your initial recommendation?

      Your Answer: Betahistine

      Explanation:

      To prevent recurrent attacks of Meniere’s disease, doctors often prescribe betahistine. While prochlorperazine and promethazine teoclate can be used to treat acute attacks, they are not effective in preventing them. Betahistine, taken at an initial dose of 16 mg three times a day, can help reduce the frequency and severity of symptoms such as hearing loss, tinnitus, and vertigo. Diuretics are not recommended for treating Meniere’s disease in primary care. Although some other drugs, such as corticosteroids, have been used historically to treat Meniere’s disease, there is limited evidence to support their use and they should only be used under the supervision of an ENT specialist.

      Meniere’s disease is a condition that affects the inner ear and its cause is unknown. It is more commonly seen in middle-aged adults but can occur at any age and affects both men and women equally. The condition is characterized by the excessive pressure and progressive dilation of the endolymphatic system. The main symptoms of Meniere’s disease are recurrent episodes of vertigo, tinnitus, and sensorineural hearing loss. Vertigo is usually the most prominent symptom, but patients may also experience a sensation of aural fullness or pressure, nystagmus, and a positive Romberg test. These episodes can last from minutes to hours and are typically unilateral, but bilateral symptoms may develop over time.

      The natural history of Meniere’s disease is that symptoms usually resolve in the majority of patients after 5-10 years. However, most patients will be left with some degree of hearing loss, and psychological distress is common. ENT assessment is required to confirm the diagnosis, and patients should inform the DVLA as the current advice is to cease driving until satisfactory control of symptoms is achieved. Acute attacks can be managed with buccal or intramuscular prochlorperazine, and admission to the hospital may be required. Prevention strategies include the use of betahistine and vestibular rehabilitation exercises, which may be beneficial.

    • This question is part of the following fields:

      • Ear, Nose And Throat, Speech And Hearing
      43.2
      Seconds
  • Question 17 - A 17-year-old girl presents to you today. She is currently in a relationship...

    Incorrect

    • A 17-year-old girl presents to you today. She is currently in a relationship and has started having sexual intercourse while using condoms as contraception. She expresses her desire to switch to hormonal contraception and has chosen the combined contraceptive pill, Rigevidon, as she has no contraindications. During the consultation, you discover that she is on day 4 of her menstrual cycle. What guidance do you provide her regarding commencing the pill at this stage of her cycle?

      Your Answer: Start pill - use additional contraception for 7 days

      Correct Answer: Start pill - there is no need for additional contraception

      Explanation:

      To avoid the need for additional barrier contraception, the woman should begin taking the pill immediately as she is currently menstruating and therefore not at risk of pregnancy. The combined contraceptive pill, except for Qlaira and Zoely, can be started within the first five days of a menstrual cycle without requiring further contraception. If started on day six or later, seven days of barrier contraception or abstinence is recommended. Waiting until day eight or the next menstrual period is unnecessary as the starting rules remain the same.

      Pros and Cons of the Combined Oral Contraceptive Pill

      The combined oral contraceptive pill is a highly effective method of birth control with a failure rate of less than one per 100 woman years. It is a convenient option that doesn’t interfere with sexual activity and its contraceptive effects are reversible upon stopping. Additionally, it can make periods regular, lighter, and less painful, and may reduce the risk of ovarian, endometrial, and colorectal cancer. It may also protect against pelvic inflammatory disease, ovarian cysts, benign breast disease, and acne vulgaris.

      However, there are also some disadvantages to consider. One of the main drawbacks is that people may forget to take it, which can reduce its effectiveness. It also offers no protection against sexually transmitted infections, so additional precautions may be necessary. There is an increased risk of venous thromboembolic disease, breast and cervical cancer, stroke, and ischaemic heart disease, especially in smokers. Temporary side effects such as headache, nausea, and breast tenderness may also be experienced.

      Despite some reports of weight gain, a Cochrane review did not find a causal relationship between the combined oral contraceptive pill and weight gain. Overall, the combined oral contraceptive pill can be a safe and effective option for birth control, but it is important to weigh the pros and cons and discuss any concerns with a healthcare provider.

    • This question is part of the following fields:

      • Gynaecology And Breast
      61.3
      Seconds
  • Question 18 - A 35-year-old woman patient of yours has epilepsy. Her epilepsy is under reasonable...

    Incorrect

    • A 35-year-old woman patient of yours has epilepsy. Her epilepsy is under reasonable control but she still has occasional seizures - mainly during the night but occasionally during the day. You notice that she has driven herself to your surgery for an appointment.

      What should be your first step?

      Your Answer: Explain to her the rules about driving and epilepsy

      Correct Answer: Cancel the appointment and tell her to go home

      Explanation:

      Explaining Driving Rules for Epilepsy

      The first step in addressing a loved one’s epilepsy and driving is to explain the rules regarding driving and epilepsy. It is important to ensure that she is aware of the regulations and the potential risks involved. If she decides to continue driving despite being informed of the rules, it is necessary to take further action.

      One option is to inform the DVLA of the situation. This will help to ensure that the appropriate measures are taken to protect both the driver and other road users. Additionally, it may be necessary to warn the individual that the police may need to be notified for her own safety and the safety of others. By taking these steps, you can help to ensure that your loved one is safe and that the rules regarding driving and epilepsy are being followed.

    • This question is part of the following fields:

      • Improving Quality, Safety And Prescribing
      50.7
      Seconds
  • Question 19 - As an ST1 doctor at the local genitourinary medicine clinic, you encounter a...

    Incorrect

    • As an ST1 doctor at the local genitourinary medicine clinic, you encounter a 17-year-old female patient who has tested positive for Chlamydia. However, when she is asked about her previous or current partner, she refuses to provide any details. What would be the most suitable course of action in this situation?

      Your Answer: Treat her but tell her she risk infertility through re-infection if her partner is not treated

      Correct Answer: Treat her and explore the reasons why she doesn't want to tell her previous or current partner

      Explanation:

      In this scenario, it is important to prioritize confidentiality and empathy.

      It is crucial to treat the patient with respect and care, regardless of whether she is willing to disclose the names of her previous partners. Refusing to treat her or threatening to disclose her information to her parents is unethical and unacceptable.

      Instead, it is important to have an open and non-judgmental conversation with the patient to understand her concerns and reasons for not disclosing her partners. This approach may help to build trust and alleviate her fears.

      On the other hand, simply providing her with a tablet of azithromycin to give to her partner is not a recommended solution. This approach doesn’t address the underlying issues and may not effectively prevent the spread of the infection.

    • This question is part of the following fields:

      • Sexual Health
      47.6
      Seconds
  • Question 20 - A 65-year-old female presents to the rapid access transient ischaemic attack clinic with...

    Correct

    • A 65-year-old female presents to the rapid access transient ischaemic attack clinic with a history of transient loss of vision in the right eye over the past three weeks. Upon examination, a carotid ultrasound reveals a 48% stenosis of her right carotid artery and an ECG shows sinus rhythm. The patient was initiated on aspirin 300 mg od by her GP after the first episode. What is the optimal course of action for managing this patient?

      Your Answer: Clopidogrel

      Explanation:

      According to NICE Clinical Knowledge Summaries, patients diagnosed with ischaemic stroke or TIA without paroxysmal or permanent atrial fibrillation should be prescribed antiplatelet therapy for long-term vascular prevention. The standard treatment is clopidogrel 75 mg daily, which is licensed for use in ischaemic stroke and can be used off-label for TIA. If clopidogrel and aspirin are contraindicated or cannot be tolerated, modified-release dipyridamole 200 mg twice daily may be used. Aspirin 75 mg daily can be used if both clopidogrel and modified-release dipyridamole are contraindicated or cannot be tolerated. If clopidogrel cannot be tolerated, aspirin 75 mg daily with modified-release dipyridamole 200 mg twice daily may be used. The 2012 Royal College of Physicians National clinical guidelines for stroke now recommend using clopidogrel following a TIA, which aligns with current stroke guidance.

      A transient ischaemic attack (TIA) is a brief period of neurological deficit caused by a vascular issue, lasting less than an hour. The original definition of a TIA was based on time, but it is now recognized that even short periods of ischaemia can result in pathological changes to the brain. Therefore, a new ’tissue-based’ definition is now used. The clinical features of a TIA are similar to those of a stroke, but the symptoms resolve within an hour. Possible features include unilateral weakness or sensory loss, aphasia or dysarthria, ataxia, vertigo, or loss of balance, visual problems, sudden transient loss of vision in one eye (amaurosis fugax), diplopia, and homonymous hemianopia.

      NICE recommends immediate antithrombotic therapy, giving aspirin 300 mg immediately unless the patient has a bleeding disorder or is taking an anticoagulant. If aspirin is contraindicated, management should be discussed urgently with the specialist team. Specialist review is necessary if the patient has had more than one TIA or has a suspected cardioembolic source or severe carotid stenosis. Urgent assessment within 24 hours by a specialist stroke physician is required if the patient has had a suspected TIA in the last 7 days. Referral for specialist assessment should be made as soon as possible within 7 days if the patient has had a suspected TIA more than a week previously. The person should be advised not to drive until they have been seen by a specialist.

      Neuroimaging should be done on the same day as specialist assessment if possible. MRI is preferred to determine the territory of ischaemia or to detect haemorrhage or alternative pathologies. Carotid imaging is necessary as atherosclerosis in the carotid artery may be a source of emboli in some patients. All patients should have an urgent carotid doppler unless they are not a candidate for carotid endarterectomy.

      Antithrombotic therapy is recommended, with clopidogrel being the first-line treatment. Aspirin + dipyridamole should be given to patients who cannot tolerate clopidogrel. Carotid artery endarterectomy should only be considered if the patient has suffered a stroke or TIA in the carotid territory and is not severely disabled. It should only be recommended if carotid stenosis is greater

    • This question is part of the following fields:

      • Cardiovascular Health
      43.2
      Seconds
  • Question 21 - You have a practice nurse who performs spirometry for diagnosis of Chronic obstructive...

    Incorrect

    • You have a practice nurse who performs spirometry for diagnosis of Chronic obstructive pulmonary disease (COPD) in the practice. She is updating the practice team about how to perform and interpret spirometry correctly.

      What is the appropriate number and quality of spirometry readings needed for precise evaluation of patients with respiratory conditions?

      Your Answer: Three readings should be obtained where two of them are within 10% of each other

      Correct Answer: Patients should keep having attempts at blowing until two sets of readings within 10% of each other are recorded

      Explanation:

      Spirometry Procedure for Health Care Providers

      To perform spirometry, a clean, disposable, one-way mouthpiece should be attached to the spirometer. The patient should be instructed to take a deep breath until their lungs feel full and then hold their breath long enough to seal their lips tightly around the mouthpiece. The patient should then blast the air out as forcibly and fast as possible until there is no more air left to expel, while the operator verbally encourages them to keep blowing and maintain a good mouth seal.

      It is important to watch the patient to ensure a good mouth seal is achieved and to check that an adequate trace has been achieved. The procedure can be repeated at least twice until three acceptable and repeatable blows are obtained, with a maximum of 8 efforts. Finally, there should be three readings, of which the best two are within 150 mL or 5% of each other. By following these steps, health care providers can accurately measure a patient’s lung function using spirometry.

    • This question is part of the following fields:

      • Respiratory Health
      49.9
      Seconds
  • Question 22 - A 30-year-old female is worried about the unsightly appearance of her toenails. She...

    Incorrect

    • A 30-year-old female is worried about the unsightly appearance of her toenails. She has noticed a whitish discoloration that extends up the nail bed in several toes on both feet. After confirming a dermatophyte infection, she has been diligently cutting her nails and applying topical amorolifine, but with no improvement. What is the best course of treatment?

      Your Answer: Topical fluconazole

      Correct Answer: Topical terbinafine

      Explanation:

      Treatment for Fungal Nail Infection

      If an adult has a confirmed fungal nail infection and self-care measures or topical treatment are not successful or appropriate, treatment with an oral antifungal agent should be offered. The first-line recommendation is Terbinafine because it is effective against both dermatophytes and Candida species. On the other hand, the ‘-azoles’ such as fluconazole do not have as much efficacy against dermatophytes. Proper diagnosis and treatment can help prevent the spread of infection and improve the appearance of the affected nail.

    • This question is part of the following fields:

      • Dermatology
      27.5
      Seconds
  • Question 23 - Primary biliary cirrhosis is most characteristically associated with: ...

    Correct

    • Primary biliary cirrhosis is most characteristically associated with:

      Your Answer: Anti-mitochondrial antibodies

      Explanation:

      The M rule for primary biliary cholangitis includes the presence of IgM and anti-Mitochondrial antibodies, specifically the M2 subtype, in middle-aged women.

      Primary biliary cholangitis is a chronic liver disorder that affects middle-aged women. It is thought to be an autoimmune condition that damages interlobular bile ducts, causing progressive cholestasis and potentially leading to cirrhosis. The classic presentation is itching in a middle-aged woman. It is associated with Sjogren’s syndrome, rheumatoid arthritis, systemic sclerosis, and thyroid disease. Diagnosis involves immunology and imaging tests. Management includes ursodeoxycholic acid, cholestyramine for pruritus, and liver transplantation in severe cases. Complications include cirrhosis, osteomalacia and osteoporosis, and an increased risk of hepatocellular carcinoma.

    • This question is part of the following fields:

      • Gastroenterology
      16.7
      Seconds
  • Question 24 - A 25-year-old university student comes to your clinic with a complaint of back...

    Incorrect

    • A 25-year-old university student comes to your clinic with a complaint of back pain that has been bothering her for the past six months. She denies any bladder or bowel dysfunction. She reports experiencing severe pain in her left shoulder that radiates down her left arm whenever she drinks alcohol.

      Upon examination, there is no kyphosis or scoliosis, and palpation of the spine and lumbar area is unremarkable. Sensation in her legs is normal, and her reflexes are intact.

      What condition is indicated by the symptom of pain during or after alcohol consumption?

      Your Answer: Non-Hodgkin's lymphoma

      Correct Answer: Hodgkin's lymphoma

      Explanation:

      Alcohol-Associated Pain in Hodgkin’s Lymphoma

      Pain during or after drinking alcohol has been linked to Hodgkin’s lymphoma since the 1950s. This pain typically occurs in affected lymph nodes and can be sharp or dull, with a radiating distribution. While it only occurs in 2-3% of people with HL, it is considered pathognomonic due to its high specificity. Alcohol-associated pain has also been noted in other conditions such as TB lymphadenitis, cervical carcinoma, and bronchial adenocarcinoma. In some cases, HL may present with nonspecific back pain. If a patient reports alcohol-associated pain, a full history and examination should be conducted to look for other symptoms of HL, including lymphadenopathy and hepatosplenomegaly.

    • This question is part of the following fields:

      • Haematology
      77.5
      Seconds
  • Question 25 - A father brings his 3-year-old son to the after-hours clinic. He reports that...

    Incorrect

    • A father brings his 3-year-old son to the after-hours clinic. He reports that his son has been unwell for the past 2 days with a fever and flushed cheeks. Today, he has developed a rash all over his body, starting from his chest and stomach. The child is eating less than usual but has had enough wet and soiled nappies. During examination, the child's temperature is 37.8°C, and all other observations are normal. The child has a widespread blanching, pink rash all over his body, feeling like sandpaper to touch. Additionally, his tongue appears red and bumpy. What is the most probable causative organism?

      Your Answer: Parvovirus B19

      Correct Answer: Group A streptococcus

      Explanation:

      The symptoms presented by this young lady are indicative of scarlet fever, which is caused by Group A beta-haemolytic streptococcus. These symptoms include a rash that feels like sandpaper and a tongue that looks like a strawberry.

      Fifth disease, also known as slapped cheek, is caused by Parvovirus B19. Symptoms include a fever, runny nose, and headache, followed by a rash on the face that looks like a slap mark.

      The common cold is primarily caused by Rhinovirus.

      Group B streptococcus is a significant cause of bacterial infections in newborns, which can result in septicaemia, pneumonia, meningitis, and potentially fatal or long-term consequences.

      The table summarizes the main characteristics of childhood infections including Chickenpox, measles, mumps, rubella, erythema infectiosum, scarlet fever, and hand, foot and mouth disease. Each infection has its own set of symptoms such as fever, rash, and lymphadenopathy. Some infections have specific identifying features such as Koplik spots in measles and a ‘slapped-cheek’ rash in erythema infectiosum. Hand, foot and mouth disease is caused by the coxsackie A16 virus and presents with vesicles in the mouth and on the palms and soles of the feet.

    • This question is part of the following fields:

      • Children And Young People
      60.2
      Seconds
  • Question 26 - A 28-year-old woman with type 1 diabetes mellitus for 12 years has persistent...

    Correct

    • A 28-year-old woman with type 1 diabetes mellitus for 12 years has persistent microalbuminuria.
      She is taking twice daily premixed insulin.
      On examination:
      Blood pressure 128/80 mmHg -
      HbA1c <48 mmol/mol (20-46)
      <6.5% (3.8-6.4)
      What would be the next most suitable treatment option for this patient?

      Your Answer: Avoid excessive exercise

      Explanation:

      Management of Microalbuminuria in Type 1 Diabetes

      This patient with Type 1 diabetes has persistent microalbuminuria, putting them at risk of developing albuminuria and end-stage renal disease. Studies have shown that angiotensin-converting enzyme (ACE) inhibitors can reduce the progression to albuminuria in hypertensive patients and also decrease microalbuminuria in normotensive Type 1 diabetics. However, since the patient’s HbA1c is satisfactory, there is no need to alter their current therapy. Metformin is not recommended for this type of patient, and there is no known benefit to dietary restriction or avoiding exercise in those with microalbuminuria. By managing microalbuminuria in Type 1 diabetes, patients can reduce their risk of developing more severe kidney disease.

    • This question is part of the following fields:

      • Metabolic Problems And Endocrinology
      40.1
      Seconds
  • Question 27 - A 5-year-old boy is brought into the minor injury unit by his mother...

    Incorrect

    • A 5-year-old boy is brought into the minor injury unit by his mother after suddenly developing a cough and wheeze. His symptoms seem to have started suddenly at a birthday party. On examination, he is irritable, afebrile, with a raised respiratory rate and cough. He has a wheeze heard on the right side and breath sounds are more prominent on the left.
      What is the most likely diagnosis?

      Your Answer: Bronchopneumonia

      Correct Answer: Inhaled foreign body

      Explanation:

      Foreign Body Aspiration, Peanut Allergy, and Spontaneous Pneumothorax: Symptoms and Signs

      Unilateral wheeze in a child should always prompt the search for an inhaled foreign body, especially if symptoms started acutely in an otherwise healthy child. Large foreign bodies can cause complete airway obstruction and are rapidly fatal, while smaller ones, like peanuts, usually lodge in the right main bronchus and cause hyperinflation of the unaffected side, reduced air entry on the affected side, and a unilateral monophonic wheeze. Symptoms of foreign body aspiration may not always include the classic triad of coughing, wheezing, and decreased breathing sounds, and patients with chronic symptoms may have been misdiagnosed as having asthma or bronchitis. Peanut allergy symptoms can include itching, urticaria, facial swelling, bronchospasm, vomiting, diarrhea, abdominal pain, and collapse with anaphylactic shock. Spontaneous pneumothorax presents with sudden onset of pain and dyspnea, hyper-resonance, and reduced breath sounds on the affected side. It is important to recognize the symptoms and signs of these conditions to ensure prompt and appropriate treatment.

    • This question is part of the following fields:

      • Children And Young People
      443.1
      Seconds
  • Question 28 - A 68-year-old teacher suddenly lost her memory after walking her dog. Her husband...

    Correct

    • A 68-year-old teacher suddenly lost her memory after walking her dog. Her husband noticed that she still knew the names of close friends, but she was disorientated in time and place, and seemed perplexed. She could follow complex commands, but was unable to recall something she had been told 5 minutes before. The episode resolved after 10 hours, although she did not remember the event. She has a history of migraine, but the episode of memory loss was not associated with headache.
      What is the most probable clinical diagnosis for this patient?

      Your Answer: Transient global amnesia

      Explanation:

      Transient Global Amnesia: Symptoms, Causes, and Differential Diagnosis

      Transient Global Amnesia (TGA) is a sudden onset condition that profoundly impairs anterograde memory. Patients are disoriented in time and place, but not in person. Retrograde memory is variably disturbed, lasting for hours to years. Patients recognize their memory deficits and repeatedly ask questions to orient themselves. Immediate and procedural memory are preserved, and patients can perform complex tasks. The attack resolves gradually, with subjective recovery occurring in two-thirds of patients within 2-12 hours. Precipitating events include strenuous exercise, intense emotion, and medical procedures. Differential diagnosis includes migraine, transient epileptic amnesia, and transient ischemic attack (TIA).

    • This question is part of the following fields:

      • Neurology
      152
      Seconds
  • Question 29 - A 75-year-old man with a history of osteoarthritis and high blood pressure presents...

    Incorrect

    • A 75-year-old man with a history of osteoarthritis and high blood pressure presents to the GP for a follow-up on recent test results. He follows a vegetarian diet and enjoys gardening. On examination, he has joint deformities in his fingers but is otherwise unremarkable. His DEXA scan T-score was -2.5. The table below shows his blood test results.

      Calcium 2.0 mmol/L (2.1-2.6)
      Phosphate 1.2 mmol/L (0.8-1.4)
      Magnesium 0.9 mmol/L (0.7-1.0)
      Thyroid stimulating hormone (TSH) 2.5 mU/L (0.5-5.5)
      Free thyroxine (T4) 14 pmol/L (9.0 - 18)
      Amylase 250 U/L (70 - 300)
      Uric acid 0.22 mmol/L (0.18 - 0.48)
      Creatine kinase 150 U/L (35 - 250)

      What is the initial treatment that should be started?

      Your Answer: Dietary and lifestyle advice

      Correct Answer: Calcium replacement

      Explanation:

      Before administering bisphosphonates, it is important to correct hypocalcemia/vitamin D deficiency. Therefore, calcium replacement is the correct choice for this patient. If dietary intake is inadequate, calcium should be prescribed when starting bisphosphonate treatment for osteoporosis. As this patient is vegan and hypocalcemic, it is likely that her dietary intake is insufficient, making calcium replacement necessary.

      While alendronate is a suitable first-line bisphosphonate, it cannot be initiated until the patient’s hypocalcemia is corrected.

      Dietary and lifestyle advice alone is not appropriate for this patient, as she requires correction of her hypocalcemia and osteopenia. However, such advice may be given in conjunction with pharmacological measures.

      Pamidronate is an intravenous bisphosphonate that may be used by a specialist if first-line bisphosphonates are not tolerated or contraindicated.

      Bisphosphonates: Uses, Adverse Effects, and Patient Counselling

      Bisphosphonates are drugs that mimic the action of pyrophosphate, a molecule that helps prevent bone demineralization. They work by inhibiting osteoclasts, the cells responsible for breaking down bone tissue. Bisphosphonates are commonly used to prevent and treat osteoporosis, hypercalcemia, Paget’s disease, and pain from bone metastases.

      However, bisphosphonates can cause adverse effects such as oesophageal reactions, osteonecrosis of the jaw, and an increased risk of atypical stress fractures of the proximal femoral shaft in patients taking alendronate. Patients may also experience an acute phase response, which includes fever, myalgia, and arthralgia following administration. Hypocalcemia may also occur due to reduced calcium efflux from bone, but this is usually clinically unimportant.

      To minimize the risk of adverse effects, patients taking oral bisphosphonates should swallow the tablets whole with plenty of water while sitting or standing. They should take the medication on an empty stomach at least 30 minutes before breakfast or another oral medication and remain upright for at least 30 minutes after taking the tablet. Hypocalcemia and vitamin D deficiency should be corrected before starting bisphosphonate treatment. However, calcium supplements should only be prescribed if dietary intake is inadequate when starting bisphosphonate treatment for osteoporosis. Vitamin D supplements are usually given.

      The duration of bisphosphonate treatment varies depending on the level of risk. Some experts recommend stopping bisphosphonates after five years if the patient is under 75 years old, has a femoral neck T-score of more than -2.5, and is at low risk according to FRAX/NOGG.

    • This question is part of the following fields:

      • Musculoskeletal Health
      54.1
      Seconds
  • Question 30 - A 65-year-old woman presents due to a 6-month history of cognitive decline. On...

    Correct

    • A 65-year-old woman presents due to a 6-month history of cognitive decline. On examination, the General Practitioner notices she has a resting tremor and shuffling gait.
      What is the most likely diagnosis?

      Your Answer: Lewy body dementia

      Explanation:

      Differentiating Lewy Body Dementia from Other Dementia-Related Disorders

      Lewy body dementia (LBD) is a type of dementia that is often misdiagnosed due to its similarity to other dementia-related disorders. One key feature that sets LBD apart is the presence of Parkinsonian symptoms, such as tremors and rigidity. In fact, LBD is diagnosed when a patient develops symptoms of dementia either before or at the same time as Parkinsonian symptoms. Other characteristic features of LBD include fluctuations in cognition and alertness, visual hallucinations, hypersensitivity to neuroleptic medication, and repeated falls.

      It is important to differentiate LBD from other disorders, such as Alzheimer’s disease, Creutzfeldt-Jakob disease, frontotemporal dementia, and Huntington’s disease. Alzheimer’s disease would not give you Parkinsonian symptoms, while Creutzfeldt-Jakob disease is a rapidly progressing physical and cognitive decline that doesn’t feature Parkinsonian symptoms. Frontotemporal dementia would not give you Parkinsonian symptoms either, and typically presents with prominent changes in personality and social behavior. Huntington’s disease initially presents with chorea, personality changes, and neuropsychiatric symptoms, followed later by dementia, but doesn’t feature Parkinsonian symptoms. By understanding the unique features of LBD and how it differs from other disorders, healthcare professionals can provide more accurate diagnoses and appropriate treatment plans for their patients.

    • This question is part of the following fields:

      • Mental Health
      41.9
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Consulting In General Practice (0/1) 0%
Smoking, Alcohol And Substance Misuse (1/1) 100%
Older Adults (1/1) 100%
Neurology (1/2) 50%
Dermatology (0/2) 0%
Kidney And Urology (0/2) 0%
Musculoskeletal Health (0/2) 0%
Cardiovascular Health (1/2) 50%
Infectious Disease And Travel Health (0/1) 0%
Metabolic Problems And Endocrinology (1/2) 50%
Children And Young People (0/3) 0%
Respiratory Health (0/2) 0%
Maternity And Reproductive Health (0/1) 0%
Gastroenterology (1/2) 50%
Ear, Nose And Throat, Speech And Hearing (1/1) 100%
Gynaecology And Breast (0/1) 0%
Improving Quality, Safety And Prescribing (0/1) 0%
Sexual Health (0/1) 0%
Haematology (0/1) 0%
Mental Health (1/1) 100%
Passmed