Neurology
Stroke and TIA, seizures, headache, weakness and neurodegenerative disease. AMC focuses on time-critical stroke care, headache red flags and driving advice after seizures.
High-yield points
Ischaemic stroke: thrombolysis up to 4.5 hours from onset; endovascular clot retrieval for large vessel occlusion, up to 24 hours in selected patients with imaging selection.
TIA: urgent assessment (same day) and imaging of brain and carotids; start antiplatelet therapy once haemorrhage is excluded.
Headache red flags: thunderclap onset, new headache over 50, fever/neck stiffness, focal signs, papilloedema, immunosuppression, pregnancy.
Suspected SAH: non-contrast CT; if negative and more than 6 hours from onset, lumbar puncture for xanthochromia.
Status epilepticus: benzodiazepine first (IV/IM midazolam or IV diazepam), repeat once, then a second-line agent such as levetiracetam, valproate or phenytoin.
Guillain-Barre syndrome: ascending weakness with areflexia; monitor forced vital capacity for respiratory failure.
Giant cell arteritis causes headache with jaw claudication and can cause blindness; start steroids before biopsy.
After a seizure, give driving advice and document it; Austroads standards set non-driving periods.
India vs Australia
Where the answer the AMC marks correct differs from what’s usually taught in Indian MBBS.
| Aspect | India (MBBS)What you learn in MBBS | Australia (AMC)What the exam marks as correct |
|---|---|---|
| Acute stroke care | Thrombolysis mostly in tertiary centres; access is limited. | Stroke units and telestroke for rural hospitals. Thrombolysis within 4.5 hours; endovascular clot retrieval for large vessel occlusion. |
| Driving after seizure or stroke | Rarely a formal part of management. | Austroads 'Assessing Fitness to Drive' sets standards. The patient must notify the licensing authority; the doctor advises and documents. |
| New-onset seizures | Neurocysticercosis is a common cause. | Neurocysticercosis is rare; think of it mainly in migrants. Standard epilepsy workup otherwise. |
| Multiple sclerosis | Relatively uncommon. | More common, and prevalence rises with distance from the equator (highest in Tasmania). |
Acute stroke care
India (MBBS)
Thrombolysis mostly in tertiary centres; access is limited.
Australia (AMC): what the exam expects
Stroke units and telestroke for rural hospitals. Thrombolysis within 4.5 hours; endovascular clot retrieval for large vessel occlusion.
Driving after seizure or stroke
India (MBBS)
Rarely a formal part of management.
Australia (AMC): what the exam expects
Austroads 'Assessing Fitness to Drive' sets standards. The patient must notify the licensing authority; the doctor advises and documents.
New-onset seizures
India (MBBS)
Neurocysticercosis is a common cause.
Australia (AMC): what the exam expects
Neurocysticercosis is rare; think of it mainly in migrants. Standard epilepsy workup otherwise.
Multiple sclerosis
India (MBBS)
Relatively uncommon.
Australia (AMC): what the exam expects
More common, and prevalence rises with distance from the equator (highest in Tasmania).
The Australian context
Stroke care in Australia is organised around stroke units and telestroke networks for rural hospitals. The patient, not the doctor, has the legal duty to tell the licensing authority about a condition affecting driving, but the doctor must advise them and document it (see Austroads 'Assessing Fitness to Drive').