MCQS 380-382:A 64 year white man presented with progressive (over 4 months) gait disturbance and a more recent history of psychosis

Question:380
Correct Answer: F

Explanation:
Children with infrequent episodic disease should usually take an inhaled bronchodilator such as salbutamol `as necessary'. Those with frequent episodic symptoms should receive preventive therapy with regular sodium cromoglycate or nedocromil sodium, together with a bronchodilator as needed for break-through symptoms. Those with persistent asthma, characterised by daily symptoms, should receive regular inhaled corticosteroids together with intermittent bronchodilators as needed.

 

Question:381
Correct Answer: E

Explanation:
The clinical problem of hydrocephalus without associated increased cerebrospinal fluid (CSF) pressure in adults (usually elderly) has been called normal pressure hydrocephalus (NPH) syndrome. Treatment with shunting procedures can improve the clinical symptoms of gait disturbance, memory deficit and bladder incontinence in patients with NPH Nevertheless, in certain patients, treatment fails without recognizable shunt problems. A nuclear cisternogram typically demonstrates absent or delayed passage of tracer over convexities and ventricular reflux of tracer with persistence

 

Question:382
Correct Answer: E

Explanation:
Laurence-Moon-Bardet-Biedl Syndrome Mode of Transmission: Autosomal recessive Classical Presentation:Obesity Mental retardation (~75% of cases)Polydactyly and/or syndactyly Genital hypoplasia and/or hypogonadism (most males and about half of the females)Retinitis pigmentosa (~70% of cases after the age of 2 years)Minimal Diagnostic Criteria: Cone rod dystrophy Postaxial polydactyly of any one limb and/or brachy-syndactyly of the toes,and one of the following:a) obesity b) mental retardation c) renal involvement d) hypogonadism Renal Manifestations: Renal hypoplasia Tubule-interstitial nephritis Caliectasis Differential Diagnosis: Biemond's syndrome (includes congenital coloboma of the iris, no renal abnormalities) Carpenter's syndrome (includes preaxial polydactyly, no renal abnormalities) Apert's syndrome (acrocephalosyndactyly, polycystic kidney, hydronephrosis)


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