chapter 13-14-15 Flashcards
Which of the following can be causes of mechanical dysphagia? A. Esophageal stricture B. Gastroesophageal reflux C. Aortic aneurysm D. Macroglossia E. All of the above
E
Which of the following is most prominent in patients with myotonic dystrophy? A. Aspiration B. Spastic dysphonia C. Neuromuscular dysphagia D. Mechanical dysphagia
C
A 64-year-old man presents with diplopia, unilateral ptosis, and dysphagia. Which of the following is the most likely diagnosis? A. Myotonic dystrophy B. Myasthenia gravis C. Brainstem infarction D. Paraneoplastic syndrome
B
A 54-year-old female presents with dysphagia associated with hemiataxia and a small pupil on
the same side. Which is the most likely diagnosis?
A. Brainstem tumor
B. Multiple sclerosis
C. Diabetic cranial neuropathy
D. Stroke
D
Which of the following statements regarding stroke and dysphagia is true?
A. Dysphagia following stroke indicates a brainstem localization of the lesion
B. Aspiration is uncommon in patients with stroke
C. Dysphagia to the point of requiring tube feeding rarely shows subsequent improvement
D. Dysphagia can be the sole manifestation of stroke
D
Which of the following statements is true regarding dysphagia in multiple sclerosis?
A. Dysphagia is uncommon in MS because this is a disease of myelin rather than neurons
B. Dysphagia is common in patients with brainstem dysfunction from MS
C. Dysphagia in MS usually develops early in the course of the disease
D. Dysphagia in MS is usually due to dysfunction of the esophageal phase
B
A 60-year-old female presents with slowly progressive dysphagia and dysarthria with no other
signs of weakness or ataxia. Reflexes are brisk and the plantar responses are upgoing. Which is
the most likely diagnosis?
A. ALS
B. Brainstem tumor
C. Multiple sclerosis
D. Central pontine mvelinolvsis
A
The following questions present a clinical manifestation of dysphagia. For each, select the
localization of the dysfunction from the following list.
A. Oropharyngeal dysfunction
B. Esophageal dysfunction
C. Mechanical obstruction
D. Zencer’s diverticulum
Difficulty with solids but not liquids.
C
The following questions present a clinical manifestation of dysphagia. For each, select the
localization of the dysfunction from the following list.
A. Oropharyngeal dysfunction
B. Esophageal dysfunction
C. Mechanical obstruction
D. Zencer’s diverticulum
Difficulty initiating swallowing.
A
The following questions present a clinical manifestation of dysphagia. For each, select the
localization of the dysfunction from the following list.
A. Oropharyngeal dysfunction
B. Esophageal dysfunction
C. Mechanical obstruction
D. Zencer’s diverticulum
Retrosternal “hanging up” sensation.
B
A 36-year-old man complains of intermittent monocular visual loss. On questioning, he notes
halos around lights, but has no eye pain. Which is the most likely diagnosis?
A. Optic neuritis
B. Amaurosis fugax
C. Glaucoma
D. Migraine
C
Which of the following statements are true regarding junctional scotoma?
A. Visual field defects are identical in me two eyes
B. Most common cause is migraine
C. Is seldom symptomatic
D. The cause is usually a lesion at or near the chiasm
E. All are true
D
A patient with a history of optic neuritis notes that with fever, the vision in the affected eye
deteriorates. What is the most likely clinical explanation?
A. The illness produces recurrent episodes of optic neuritis.
B. The fever produces exacerbation of the pre-existing demyelinating damage
C. The fever and the exacerbation of visual loss are coincidental.
D. The patient’s observations are psychosomatic.
B
A 70-year-old man presents with the sudden onset of monocular visual loss. The defect is central with peripheral vision spared. Examination shows retinal hemorrhages in the affected eye. Which is the most likely diagnosis? A. Optic neuritis B. Acute glaucoma C. Central retinal artery occlusion D. Central retinal vein occlusion E. None of the above
D
Which of the following statements is true regarding drv.sen of the optic nerve?
A. Patienta seldom have detectable visual field loss
B. Arcuate visual field defects and enlargement of the blind spot are common
C. Drusen is due to myelination of optic nerve axons within the eye
D. Loss of central vision with drusen is always benign
B