Choose how you want to revise

Select Questions

Revise with my preferences. Choose your difficulty or recap questions you've found hard.

Mock tests

Test myself against recent exam themes and ones curated by BMJ’s editorial team of doctors.

Group Learning

Play under a username and join friends or others for 10 questions. Move up of the daily leaderboard.

On the go

Download the app for offline access. Make revision easily fit into your schedule.

Select the best subscription for your exam date

Join 200,000+ OnExamination users who have successfully become medical professionals

Revise with quality questions and detailed explanations



Demo Question

 

A 74-year-old man with bronchial carcinoma comes to the clinic for review. He is seeing the oncologists soon for radiotherapy, but is concerned as his walking has deteriorated markedly over the past three weeks, with poor co-ordination, and frequent falls. Examination in the clinic reveals an ataxic gait with bilateral cerebellar signs on upper limb assessment.

Which of the following autoantibodies is most likely to be found in this patient?

 Anti-amphiphysin

 Anti-GABA (B)

 Anti-Hu

 Anti-mGluR1

 Anti-VGCC




Key Learning Point

 

Cerebellar degeneration is a well recognised paraneoplastic syndrome, and is associated with number of malignancies.



Explanation


The answer is Anti-Hu. Anti-Hu, anti-Yo, anti-Ri and anti-Tr antibodies are all associated with paraneoplastic cerebellar degeneration. Anti-Hu and Ri antibodies are associated with small cell lung cancer, Yo antibodies are associated with breast and gynaecological cancers, and Tr antibodies are associated with Hodgkin's lymphoma. Treatment of the underlying tumour reduces autoantibody formation, and may improve symptoms.

Anti-amphiphysin antibodies are associated with stiff person syndrome and encephalomyelitis, and are associated with breast and lung cancer. Anti-GABA (B) antibodies are seen in small cell lung cancer and are associated with seizures and limbic encephalitis. Anti-mGluR1 antibodies are seen in Hodgkin's lymphoma and are associated with cerebellar degeneration. Anti-VGCC antibodies are of course related to the Lambert-Eaton myasthenic syndrome.

 

Smart features to maximise your revision efforts

Daily questions

Keep on track. Set a time that suits you, we will send you a personalised revision question every day.

Revision plans

Turn weaknesses into strengths. Focus on the specialities that will give you the biggest learnings.

Feedback & peer comparison

Indicates how likely you are to pass. Detailed performance graphs show how you’re currently performing and benchmark you against your peers.

Save time and focus on the most important questions

High Impact Questions

Maximise your revision time. High Impact Questions instantly delivers you the most important questions, ranked by our clinical tutors and your peers.