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NEUROLOGY TEST > chapter 24-25-26 > Flashcards

chapter 24-25-26 Flashcards

1
Q

Which of the following is not a typical clinical feature of tardive dyskinesia?
A. Repetitive stereotypic movements of the mouth
B. Inability to voluntarily suppress the movements
C. Facial movements are mainly of the lower face
D. Gait is usually normal

A

b

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2
Q

Which of the following features are true of primary writing tremor?
A. Action tremor particularly exacerbated by writing
B. Tremor with writing associated with dystonic posturing
C. Tremor which affects only writing and not other tasks and movements
D. Unusually loose grip on a pen

A

c

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3
Q

A patient reports tremor when eating and writing, but has no tremor at rest. Muscle tone is not
increased, and there is no alteration in station or gait. Which is the most likely diagnosis?
A. Essential tremor
B. Parkinson’s disease
C. Orthostatic tremor
D. Tardive dyskinesia

A

a

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4
Q 
Which of the following is not a feature of early Parkinsonism?
A. Rigidity
B. Bradykinesia
C. Resting tremor
D. Motor fluctuations
A

d

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5
Q

Which of the following best described the speech difficulty in patients with Parkinson’s disease?
A. Palilalia
B. Slurred speech with decreased volume
C. Stuttering speech with defective prosody and inappropriate pauses
D. Fluent sounding speech devoid of content

A

b

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6
Q

A young adult patient presents with dystonia and is found on examination to have supranuclear
ophthalmoplegia. Laboratory studies indicate a lactic acidosis. Which is the most likely
diagnosis?
A. Leigh’s disease
B. SCA
C. Lesch-Nyhan syndrome
D. Ataxia telangiectasia

A

a

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7
Q

Which of the following statements about Parkinson’s disease are true?
1. Observation of Keyser-Fleischer rings on the cornea confirm the diagnosis
2. Handwriting becomes smaller and slower
3. Marked voice changes are common early in the course
4. Motor findings are commonly asymmetric early in the course
Select: A = 1, 2, 3. B = 1, 3. C = 2, 4. D = 4 only. E = All

A

c

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8
Q

Which of the following features would be expected in patients with progressive supranuclear
palsy?
1. Lewy bodies
2. Motor neuron degeneration
3. Prominent tremor
4. Eyelid apraxia
Select: A = 1, 2, 3. B = 1, 3. C = 2, 4. D = 4 only. E = All

A

d

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9
Q

Which of the following helps to differentiate corticobasal degeneration from other causes of
rigidity and bradykinesia?
1. Alien limb syndrome
2. Motor neuron degeneration
3. Limb apraxia
4. Absence of ataxia
Select: A = 1, 2, 3. B = 1, 3. C = 2, 4. D = 4 only. E = All

A

b

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10
Q

Which of the following conditions shows Lewy bodies on pathological examination?
1. Dementia with Lewy bodies
2. Parkinson’s disease
3. Shy-Drager syndrome
4. Olivopontocerebellar degeneration
Select: A = 1, 2, 3. B = 1, 3. C = 2, 4. D = 4 only. E = All

A

e

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11
Q

Ataxia characterized by increased body sway and disequilibrium with a broad stance and broad
gait suggests which localization of the lesion?
A. Cerebral cortex
B. Basal ganglia
C. Cerebellum
D. Spinal cord

A

c

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12
Q 
Ataxia which markedly worsens following eye closure is typical of which location?
A. Basal ganglia
B. Cerebellum
C. Spinal cord
D. Sensory nerves
A

d

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13
Q

Which of the following causes of akinetic-rigid syndrome can differentiate PSP from Parkinson’s
disease?
A. Neck posture is flexed in PSP rather than extended as in PD
B. Neck posture is extended in PSP rather than flexed as in PD
C. Early loss of postural reflexes is seen in PD rather than PSP
D. Cognitive dysfunction is seen in PD but not PSP

A

b

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14
Q

A young woman presents with a broad-based gait with a bouncing character. Clonus is easily
elicited in the legs. The symptoms have been progressive over months and are associated with
headache and mild cognitive difficulty. Which is the most likely diagnosis?
A. Multiple sclerosis
B. Spinocerebellar atrophy
C. Hydrocephalus
D. Alcoholic cerebellar degeneration

A

c

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15
Q 
Which of the following features suggest Parkinson's disease rather than symptomatic
parkinsonism?
A. Narrow based gait
B. Shuffling gait
C. Freezing
D. Hesitation to initiate gait
A

a

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16
Q

The following questions present important clinical presentations regarding the level of the lesion
in a patient with spastic hemiparesis. For each clinical vignette, select the most likely localization
of the lesion.
A. Cerebral cortex
B. Pons
C. Medulla
D. Spinal cord
A patient presents with spastic left hemiparesis and is found on examination to have right facial
weakness involving the lower face.

A

b

17
Q

The following questions present important clinical presentations regarding the level of the lesion
in a patient with spastic hemiparesis. For each clinical vignette, select the most likely localization
of the lesion.
A. Cerebral cortex
B. Pons
C. Medulla
D. Spinal cord

A patient with spastic left hemiparesis is round on examination to have weakness of right
shoulder shrug.

A

c

18
Q

The following questions present important clinical presentations regarding the level of the lesion
in a patient with spastic hemiparesis. For each clinical vignette, select the most likely localization
of the lesion.
A. Cerebral cortex
B. Pons
C. Medulla
D. Spinal cord

A patient presents with spastic left hemiparesis without any race involvement. Sensory
examination shows sensory deficit for pain on the right side of the body.

A

d

19
Q

A patient presents with broad-based gait with short, shuffling steps. The posture is upright. Arm
swing is exaggerated although there is loss of the normal truncal swing of gait. Which is the most
likely diagnosis?
A. Frontal lobe ataxia
B. Parkinsonism
C. Cerebellar ataxia
D. Conversion reaction

A

a

20
Q

Gower’s sign is most likely seen in patients with which disorder?
A. Spastic hemiparesis from cerebral infarction
B. Cervical myelopathy
C. Multiple sclerosis
D. Duchenne muscular dystrophy

A

d

21
Q

Which clinical findings suggest L5 radiculopathy?
1. Weakness of extensor hallucis longus
2. Weakness of flexion of the big toe
3. Loss of sensanon on the dorsum of the foot
4. Decreased ankle reflex
Select: A = 1,2,3. B = 1.3. C = 2.4. D = 4 only. E = All

A

b

22
Q

What is the most likely diagnostic consideration in a patient with arm nam plus weakness of the
finger and wrist flexors and mtcrossei?
A. C8 radiculopathy from cervical spondylosis
B. Radiation plexitis
C. Mononeuropathy multiplex
D.Tumor infiltration of the brachial plexus

A

d

23
Q

Subcortical cause for hemiparesis is suggested by which of the following clinical findings’7
1. Aphakia
2. Approximately equal weakness of arm and leg
3. Neglect
4. Pure motor deficit, i.e.. no sensory loss
Select: A = I, 2. 3. B = 1, 3. C - 2. 4. D = 4 only. E = All

A

c

24
Q

Deficits which appear peripheral but which cannot be explained by one anatomical localization
could be explained by which of the following?
1. Multiple sclerosis
2. Vasculitis
3. Brain metastases
4. Mononeuropathy multiplex
Select: A = 1.2, 3.B = 1. 3. C = 2. 4. D = 4 only. E - All

A

d

25
Q

All of the following features suggest a central rather than peripheral etiology for arm weakness
except which?
A. Finger coordination affected more than strength
B. Increased ami tendon reflexes
C. Pronator drift
D. Absence of sensory deficit

A

d

26
Q

Left hemiparesis from a cortical lesion, such as MCA CVA, would be expected to produce all of
the following findings, except:
A. Deltoid weakness more prominent than hand intrinsic muscle weakness
B. Deficits in visuo-spatiai orientation
C. Depression
D. Left hemianopia
E. Neglect

A

a

27
Q

A patient presents with acute onset of right leg weakness and is found on examination to have
weakness of the proximal right arm. Which is the most likely diagnosis?
A. Multiple sclerosis
B. Anterior cerebral artery inlarction
C. Parasagittal meningioma
D. Encephalitis

A

d

28
Q

A patient presents with sudden onset of bilateral leg weakness along with bladder incontinence.
There is no pain and arm function is normal except for some deltoid and biceps weakness. Re
Hexes are hyperactive in the legs with upgoing plantar responses. Which is the most likely
diagnosis?
A. Anterior cerebral artery mfarcticn
B. Cervical spondylitic myelopathy
C. menor spinal artery syndrome
D. Basilar artery thrombosis

A

a

29
Q

An 8-year-old female presents with episodes of unilateial weakness and stiffness which partially
resolve. Multiple episodes affecting either side result in accumulation of corticospinal deficit.
MR1 and MRA are normal. Which is the most likely diagnosis?
A. Multiple sclerosis
B. Alternating hemiplegia of childhood
C. Vasculitis
D. Cardiogenic emboli from PFO
E. Conversion reaction

A

b

30
Q

Which of the following are most likely to produce the spinal hemisection (Brown-Sequard)
syndrome?
1. Intradural rumor
2. Cervical disc disease
3. Trauma
4. Extradural tumor
Select: A = 1, 2, 3. B = 1, 3. C = 2, 4. D =4 only. E = All

A

b

NEUROLOGY TEST (21 decks)

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