Chap 6

Question 1

Which statement is true about confusion

Answer 1

Polypharmacy is a major contributor to confusion in an older adult

Question 2

Which of the following medications will help decrease edema in the labyrinth of the ear

Answer 2

Diamond

Question 3

The hallmark of an absence seizure

Answer 3

A blank stare

Question 4

How often should the drug levels of a seizure medication be monitored when the seizure medication has controlled the seizure and the drug levels are adequate

Answer 4

Every 6 months

Question 5

Which of the following persons fits the description of a patient with MS

Answer 5

A 25 year old female

Question 6

Which of the following is a specific test to MS

Answer 6

There is no specific test for MS

Question 7

Which drug for Alzheimer’s should be administered at the beginning at the time of diagnosis?

Answer 7

Cholinesterase inhibitors

Question 8

Which hematoma occurs along the temporal cranial wall and Results from tears in the Middle meningeal artery

Answer 8

Epidural hematoma

Question 9

Which cranial nerve in the cerebral vascular accident patient is Affected when the patient has difficulty chewing

Answer 9

CN V

Question 10

Which statement best describes a carotid bruit

Answer 10

The higher the pitch of the bruit, the greater degree of stenosis.

Question 11

Which patient is more likely to have a cluster headache

Answer 11

A 45 year old male awakened at night

Question 12

Inattention and sleep wake cycle disturbances are hallmark signs of

Answer 12

Delirium

Question 13

13.	Which type of meningitis is more benign, self-limiting, and caused primarily by a virus?
a.
Purulent meningitis
b.
Chronic meningitis
c.
Aseptic meningitis
d.
Herpes meningitis

Answer 13

c.

Aseptic meningitis

Question 14

14.	Which is the most sensitive neuroimaging test to evaluate patients with encephalitis?
a.
MRI
b.
CT
c.
Electroencephalogram (EEG)
d.
An initial lumbar puncture

Answer 14

a.

MRI

Question 15

15. What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster?
    a.
    A stabbing pain on one small area of the body
    b.
    A vesicular skin lesion on one side of the body
    c.
    A pain that is worse upon awakening
    d.
    A lesion on the exterior ear canal

Answer 15

b.

A vesicular skin lesion on one side of the body

Question 16

16. Gabby, aged 22, has Bell’s palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her?
    a.
    “Most patients have complete recovery in 3 to 6 months.”
    b.
    “Unfortunately, you’ll probably have a small amount of residual damage.”
    c.
    “Don’t worry, I’ll take care of everything.”
    d.
    “You may have a few more episodes over the course of your lifetime but no permanent damage.”

Answer 16

a.

“Most patients have complete recovery in 3 to 6 months.”

Question 17

17. Sam, aged 65, is started on L-dopa for his Parkinson’s disease (PD). He asks why this is necessary. You tell him:
    a.
    “L-dopa is neuroprotective.”
    b.
    “The primary goal of therapy is to replace depleted stores of dopamine.”
    c.
    “This is the only drug that can provide symptomatic benefit.”
    d.
    “This is the initial monotherapy drug.”

Answer 17

“The primary goal of therapy is to replace depleted stores of dopamine.”

Question 18

18.	Which of the following signs is seen in a patient with more advanced PD?
a.
Resting tremor
b.
Bradykinesia
c.
Rigidity
d.
Postural instability

Answer 18

Postural instability

Question 19

\_\_\_\_	19.	Which of the following is the most commonly experienced symptom of migraine?
a.
Light sensitivity
b.
Pulsatile pain
c.
Sound sensitivity
d.
Experiencing an aura

Answer 19

Pulsation pain

Question 20

____ 20. Which of the following characteristics differentiates peripheral vertigo from central vertigo?
a.
The duration of central vertigo is shorter than that of peripheral vertigo.
b.
There is an auditory-associated symptom with peripheral vertigo and a visual-associated symptom with central vertigo.
c.
Central vertigo is positional, and peripheral vertigo is not.
d.
The onset of central vertigo is more sudden than that of peripheral vertigo.

Answer 20

b.

There is an auditory-associated symptom with peripheral vertigo and a visual-associated symptom with central vertigo.

Question 21

21.	Carotid endarterectomy should be considered only for symptomatic patients with greater than what percentage of stenosis?
a.
Greater than 25%
b.
Greater than 50%
c.
Greater than 75%
d.
Only for 100% occlusion

Answer 21

> 50%

Question 22

\_\_\_\_	22.	What antiplatelet agent is most widely used for secondary prevention of stroke?
a.
Aspirin
b.
Ticlopidine
c.
Clopidogrel
d.
Aspirin and clopidogrel

Answer 22

Aspirin

Question 23

\_\_\_\_	23.	Which adjunctive diagnostic test should be used in the work-up of a patient with suspected Creutzfeldt-Jakob disease or transient epileptic amnesia?
a.
MRI
b.
CT
c.
Cerebrospinal fluid analysis
d.
EEG

Answer 23

EEG

Question 24

24.	Which herbal preparation may cause delirium and should be avoided in an elderly patient?
a.
Sam-e
b.
Saint John’s Wort
c.
Melatonin
d.
Saw Palmetto

Answer 24

Saint Johns Wort

Question 25

____ 25. Which of the following activities is part of the functional activities questionnaire?
a.
Asking the patient to unravel a Rubik’s cube
b.
Determining if the patient can drive on the highway
c.
Asking the patient about a news event from the current week
d.
Seeing if the patient can keep his or her home clean

Answer 25

Asking the patient about a news event from the current week

Question 26

\_\_\_\_	26.	About 90% of all headaches are?
a.
Tension
b.
Migraine
c.
Cluster
d.
Without pathological cause

Answer 26

Without pathological cause

Question 27

27. Which statement is true regarding driving and patients with a seizure disorder?
    a.
    Once diagnosed with a seizure disorder, patients must never drive again.
    b.
    After being seizure free for 6 months, patients may drive.
    c.
    Each state has different laws governing driving for individuals with a seizure disorder.
    d.
    These persons may drive but never alone.

Answer 27

Each state has different laws governing driving for individuals with a seizure disorder.

Question 28

\_\_\_\_	28.	Julie has relapsing-remitting muscular sclerosis. She has not had a good response to interferon. Which medication might help given intravenously once a month?
a.
Glatiramer acetate
b.
Natalizumab
c.
Fingolimod
d.
Glucocorticoids

Answer 28

Natalizumab

Question 29

\_\_\_\_	29.	The ‘freezing phenomenon’ is a cardinal feature of?
a.
Parkinson’s disease
b.
Alzheimer’s disease
c.
A CVA
d.
Bell’s palsy

Answer 29

Parkinson’s disease

Question 30

30.	A ratchet-like rhythmic contraction, especially in the hand, during passive stretching is known as?
a.
Spinothalamic dysfunction
b.
Ratcheting
c.
Cogwheeling
d.
Hand tremors

Answer 30

Cogwheeling

Question 31

\_\_\_\_	31.	Clinical features of insidious onset, slow progression, and a lack of other findings to explain the symptoms are fairly diagnostic of which condition?
a.
Guillain-Barré syndrome
b.
Parkinson’s disease
c.
Alzheimer’s disease
d.
Huntington’s disease

____

Answer 31

Parkinson’s disease

Question 32

32.	Which condition is characterized by the impaired ability to learn new information along with either a cognitive disturbance in language, function, or perception?
a.
Guillain-Barré syndrome
b.
Parkinson’s disease
c.
Alzheimer’s disease
d.
Delirium

Answer 32

Alzheimer’s disease

Question 33

33.	A score of 20 to 25 on this test indicates early-stage Alzheimer’s disease:
a.
SLUMS
b.
MoCA
c.
FAST
d.
MMSE

Answer 33

MMSE

Question 34

\_\_\_\_	34.	Intravenous thrombolytic therapy following an ischemic CVA should be given within how many hours of symptom onset?
a.
1 hour
b.
3 hours
c.
6 hours
d.
12 hours

Answer 34

3 hours

Question 35

\_\_\_\_	35.	When administered at the beginning of an attack, oxygen therapy may help this kind of headache?
a.
Tension
b.
Migraine
c.
Cluster
d.
Stress

Answer 35

Cluster