The lifts at BioTech's main office have begun to malfunction. BioTech engages LiftFix Ltd to repair

and service the lifts, solely on the ground that LiftFix claimed they could repair and service the lifts

for 50 per cent of the cost of any of their rivals. The contract between BioTech and LiftFix states that

LiftFix are to be regarded as independent contractors. LiftFix repairs are negligently performed and,

as a result, one of the lift cables snaps and the lift plummets to the bottom of the lift shaft, killing its

occupant, Damian. After investigating further, BioTech discovers that LiftFix has been sued on

several occasions for negligence. Discuss the above case on the ground of whether liability should be imposed or not.

Question 1

I am a neurologist and would like to know:

What precautions I should take with regard to the cardiovascular

system, before and after prescribing mexiletine for cases of

myotonia.

Whether there is a group of patients who should not receive this drug.

Question 2

Can myasthenia gravis be unilateral and, if so, how often?

Question 3

Can the creatine phosphokinase (CPK) level in the blood, or the presence

of certain auto-antibodies, help to differentiate muscle dystrophies from

myositis?

Question 4

Can percussion myotonia occur with motor neurone disease? If so, please

explain the mechanism and cause-effect for this.

Question 5

Can benign intracranial hypertension be diagnosed on the basis of

persistent headache and CT-brain scan findings of slit ventricles with

no papilloedema and preserved spontaneous venous pulsations on

ophthalmoscopy? And do you recommend cerebrospinal fluid (CSF)

pressure measurement as a routine investigation in the diagnosis of this

type of disorder?

Question 6

In my experience in the treatment of stroke patients, the combination

of atenolol 50 mg, hydrochlorothiazide 25 mg and amlodipine 10 mg is

very effective in the treatment of resistant hypertension. Can you tell

me whether this combination of antihypertensives is contraindicated in

diabetic patients?

Question 7

Can diabetic mononeuropathy of the third cranial nerve cause ipsilateral

pain of the face and tenderness (but not redness) of the affected eye? Can

these symptoms be explained by Tolosa-Hunt syndrome?

Question 8

1. For how long should adrenocorticotrophic hormone (ACTH) be given

to patients after stoppage of myoclonic seizures in West's syndrome?

2. If seizures recur after stoppage, should ACTH be re-administered?

Question 9

In acute attacks of multiple sclerosis (MS), where methylprednisolone is

not available, can pulse steroid therapy be given with a one-off dose of

200 mg dexamethasone?

Question 10

Does temporal arteritis headache or other pain respond to non-steroidal

anti-inflammatory drugs