Neurology and Psychiatry
Neurology and Psychiatry tests focal deficits, headache, seizures, delirium, mood disorders, psychosis, and suicide risk. The exam expects both neurological localisation and mental state assessment.
Core rules
- Stroke: sudden focal deficit; check glucose, activate stroke pathway, and image urgently; thrombolysis is time-dependent.
- Headache red flags: thunderclap onset, fever with neck stiffness, focal signs, papilloedema, age over 50 with new headache.
- Delirium is acute fluctuating attention with altered consciousness; find and treat the cause, avoid benzodiazepines unless withdrawal.
- Depression screening asks about low mood and anhedonia; assess suicide risk directly.
- Psychosis requires exclusion of organic causes and drug effects before antipsychotic treatment.
Worked example
A 70-year-old has sudden right arm weakness and expressive aphasia. The reasoning: left middle cerebral artery stroke. Check glucose, record onset time, obtain urgent brain imaging, and assess thrombolysis or thrombectomy eligibility. Do not lower blood pressure aggressively unless extreme.
Traps
Do not miss hypoglycaemia mimicking stroke; do not attribute acute confusion to dementia; do not sedate delirium without treating the cause.