ESSAYS
1. A 40 years old male presented with twitching of right
upper limb followed by tonic clonic convulsions. On examination patient has tongue bite and post
ictal confusion and headache. Answer the following: (2+3+2+3)
- What is your diagnosis
- Classify seizures
- Where is the probable lesion
- How will you manage this patient
2. 30 years old man comes to casualty with high fever,
chills and rigors, vomiting and
headache and altered sensorium for two days. On examination
the patient is febrile,
irritable and presence of signs of meningeal irritation. CSF
shows predominant
polymorphs with increased protein and decreased sugar.
Answer the following:
- What is your diagnosis.
- What are the other investigations you want to do.
- How you are going to treat this patient.
- What are the complications. (2+3+3+2=10)
3. A 32 years old female was admitted to the causality with
history of altered sensorium,
fever, headache and vomiting. On examination, neck
stiffness, drowsiness and irritability
- What are the differential diagnosis.
- What are the complications
- Discuss the investigations (3+3+4=10)
4. A 70 years old male having hyperlipidemia presents with
inability to move his left hand and leg for one day duration. He felt that his left hand was weak in the morning and in the evening he developed weakness of left leg. On examination vitals signs were stable. No
wasting of muscles, spasticity of the left upper and lower limb. Power grade IV on the left side. Brisk deep tendon reflex on the left side and up going plantar on the left side. Other systems were normal. Answer the following:
- What is your probable diagnosis.
- Where is the lesion.
- How will you confirm the diagnosis.
- How will you treat this condition. (2+2+3+3=10)
5. A 70 years old man presents with a history of slowness of
movement and tremors of the left hand. On examination patient has mask like facies,
coarse tremors of the left hand and rigidity. Answer the following:
- What is your probable diagnosis
- What are the likely causes for this condition
- Where is the lesion.
- How will you treat this condition (2+2+3+3=10)
6. A 50 years old man with history of type 2 diabetes
mellitus and primary hypertension
presented with sudden onset weakness right half of the body
and alteration of sensorium. He reported within 2 hours of onset. Answer the following:
- What is your probable diagnosis
- What investigations will you do on admission
- How will you manage this patient
- What are the complications
7. A 30 years lady presents with tingling and numbness of
legs and fatigue. On examination she has severe pallor. On examination of CNS, patient is
found to have absent ankle jerk and up going plantar bilaterally. Answer the following
- What is your probable diagnosis.
- What are the probable causes for this condition.
- How will you confirm the diagnosis.
- How will you treat this condition (2+3+2+3=10)
SHORT NOTES
- Trigger factors for seizures
- How do you investigate a suspected case of epilepsy
- Mention four new antiepileptic drugs
- Indications of carbamazepine
- Migraine
- Crossed hemiplegia
- Differences between spasticity and rigidity
- Components of Babinski’s sign
- Causes of syncope
- Mention 4 causes for flapping tremor
- Clinical features of cerebellar ataxia
- Clinical features of meningitis
- CSF findings in bacterial meningitis
- CSF findings in tuberculous meningitis
- CSF findings in viral meningitis
- Investigations for tubercular meningitis
- Treatment of pyogenic meningitis
- Treatable causes of dementia
- Features of Horner’s syndrome
- Mention brain stem reflexes
- Treatment of parkinsonism
- Brain natriuretic peptide
