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CBR neurology > clinical neurology 161-190 > Flashcards

clinical neurology 161-190 Flashcards

160
Q 
status epilepticus
A. adrenocorticotropic hormone (ACTH)
B. ethosuximide
C. lorazepam
D. Tegretol
E. valproic acid
A

C. lorazepam

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161
Q 
absence seizures
A. adrenocorticotropic hormone (ACTH)
B. ethosuximide
C. lorazepam
D. Tegretol
E. valproic acid
A

B. ethosuximide

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162
Q 
complex partial seizures
A. adrenocorticotropic hormone (ACTH)
B. ethosuximide
C. lorazepam
D. Tegretol
E. valproic acid
A

D . Tegretol
or
E. valproic acid

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163
Q 
infantile seizures
A. adrenocorticotropic hormone (ACTH)
B. ethosuximide
C. lorazepam
D. Tegretol
E. valproic acid
A

A. adrenocorticotropic hormone (ACTH)

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164
Q 
atypical petit ma1 syndrome of Lennox-Gastaut
A. adrenocorticotropic hormone (ACTH)
B. ethosuximide
C. lorazepam
D. Tegretol
E. valproic acid
A

E. valproic acid

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165
Q

Each of the following is true of polymyositis associated with carcinoma except
A. Carcinoma affects 9% of patients with polymyositis.
B. It is most commonly associated with lung and prostate cancer in men.
C. It is usually painful.
D. Muscle biopsies show no evidence of tumor cells
.E. Proximal muscles are initially affected more than distal ones.

A

C. It is usually painful.
V&A pp. 1484-1487. Pain with polymyositis occurs in only 15% of patientsand often suggests an additional disorder (e.g., rheumatoid arthritis).

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166
Q

Which of the following is least suggestive of cluster headaches?
A. associated with lacrimation and rhinorrhea
B. bilateral location
C. daily occurrence for 2 months
D. male predominance
E. orbital location

A

B. bilateral location
V&A p. 189. Cluster headaches typically are recurrent for 6 to 12 weeks in aunilateral orbital location. The male to female ratio is 4.5:l to 6.7:l.Lacrimation, rhinorrhea, flushing of the face, and other such parasympathetic-type responses often accompany the headache.

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167
Q 
Organophosphate poisoning is characterized by all of the following except
A. bronchial spasms
B. dry mouth
C. miosis
D. sweating
E. vomiting
A

B. dry mouth

V&A p. 1281. The anticholinesterase effect of organophosphate poisoningresults in increased salivation.

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168
Q 
One of the cerebral biochemical defects in Huntington's disease is
A. decreased dopamine
B. decreased GABA. 
C.decreased norepinephrine
D. decreased somatostatin
E. increased acetylcholine
A

B. decreased GABA.
V&A p. 1125. Decreased glutamic acid decarboxylase (hence y-aminobutyricacid [GABA]) and choline acetyltransferase (hence acetylcholine) have beenfound in the striatum and lateral pallidum in Huntington’s disease. Alsoreported has been increased norepinephrine and somatostatin in the striaturn.An excess of dopamine or an increased sensitivity of striatal dopaminereceptors has been postulated in the pathogenesis of Huntington’s disease.

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169
Q

Prosopagnosia is associated with lesions of the
A. anterior corpus callosum
B. bilateral anterorinferior temporal lobes
C. bilateral medial temporo-occipital lobes
D. occipital poles
E. posterior corpus callosum

A

C. bilateral medial temporo-occipital lobes
V&A pp. 490-492. Prosopagnosia refers to the inability to identify a familiarface while retaining the ability to identify its features.

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170
Q 
A lesion of the supplementary motor cortex produces
A. echolalia
B. palilalia
C. poverty of spontaneous speech
D. receptive aphasia
E. no speech abnormalities
A

C. poverty of spontaneous speech

Carp p. 424.

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171
Q

Lesions of b e peroneal nerve produce weakness of the
A. abductor hallucis and gastrocnemius
B. extensor digitorum longus and brevis and abductor hallucis
C. gastrocnemius and flexor hallucis longus
D. tibialis anterior and extensor digitorum longus and brevis
E. tibialis anterior and flexor digitorum brevis

A

D. tibialis anterior and extensor digitorum longus and brevis

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172
Q 
Which of the following is not characteristic of Tay-Sachs disease?
A. abnormal startle response
B. autosomal recessive inheritance
C cherry-red spots in the retina
D. deficiency of sphingomyelinase
E. macrocephaly
A

D. deficiency of sphingomyelinase

V&A p. 996.*~eficienco~f hexoarninidase A characterizes Tay-Sachs disease.

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173
Q 
Which of the following deficits is least characteristic of Alzheimer's disease?
A. corticospinal tract dysfunction
B. dysnomia
C. Korsakoff s amnesic state
D. personality change
E. spatial disorientation
A

A. corticospinal tract dysfunction
V&A pp. 1110-1111. Corticospinal and corticosensory functions, visual acuity,and visual fields are relatively preserved throughout the course ofAlzheimer’s disease.

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174
Q

Each of the following is true of Guillain-Barr syndrome except
A. Disturbances of autonomic function are common.
B. High-dose steroids form the mainstay of therapy.
C. Hypo- or areflexia is characteristic
D. The mortality rate is 3%.
E. The peak severity is 10 to 14 days after onset in 80% of cases.

A

B.High-dose steroids form the mainstay of therapy
V&A pp. 1380-1387. Neither conventional dose nor high-dose steroids havebeen shown to be helpful in the treatment of Guillain-BarrC syndrome.

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175
Q

The second-order neuron in the sympathetic pathway to the pupil arises fromth
tA. ciliary ganglion to the iris
B. Edinger-Westphal nucleus to the ciliary ganglion
C. hypothalamus to the lateral horn cells at C8 to T3
D. lateral horn cells at C8 to T3 to the superior cervical ganglion
E. superior cervical ganglion to the iris

A

D. lateral horn cells at C8 to T3 to the superior cervical ganglion
V&A pp. 294-295. The pathway from the lateral horn cells at C8 to T3 to thesuperior cervical ganglion constitutes the second-order neuron (preganglionic).Response C constitutes the first-order neuron (central), andresponse E constitutes the third-order neuron (postganglionic) in the sympatheticinnervation of the pupil.

176
Q 
The treatment of choice for toxoplasmosis is
A. penicillin
B. praziquantel
C. pyrimethamine and sulfadiazine
D. rifampin and nafcillin
E. thiabendazole
A

C. pyrimethamine and sulfadiazine

177
Q

Which of the following is true of subacute sclerosing panencephalitis (SSPE)?
A. Intracytoplasmic but not intranuclear inclusions are found.
B. It is more common in patients 4 8 years of age.
C. Lesions are confined to the white matter.
D. The EEG shows characteristic periodic 2 to 3 per second waves.
E. The CSF protein is normal.

A

D. The EEG shows characteristic periodic 2 to 3 per second waves.
V&A pp. 810-811. Subacute sclerosing panencephalitis (SSPE), characterizedby a progressive mental decline with seizures, myoclonus, and ataxia, mainlyaffects children and adolescents. The lesions are found in the cerebral cortexand white matter. Eosinophilic inclusions are found in the cytoplasm andnuclei of neurons and glial cells. Elevated gamma globulin in the CSF istypical.

178
Q

The treatment of choice for optic neuritis is
A. intrathecal prednisolone
B. intravenous methylprednisolone followed by oral prednisone
C. oral prednisone only
D. oral prednisone followed by intravenous methylprednisolone
E. plasmapheresis

A

B. intravenous methylprednisolone followed by oral prednisone
V&A pp. 973-974. Treatment with oral prednisone alone actually increasedthe risk of new episodes of optic neuritis in a large randomized controlledstudy of optic neuritis treatment. Intravenous methylprednisolone therapyfollowed by oral prednisone speeds recovery of visual loss.

179
Q 
Schilder's disease most closely resembles
A. Duchenne muscular dytrophy
B. Krabbe's disease
C. multiple sclerosis
D. trisomy 13
E. tuberous sclerosis
A

C. multiple sclerosis
V&A p. 967. Schilder’s disease is a demyelinating illness of children and youngadults that has several features in common with chronic relapsing MS.

180
Q

The cricothyroid muscle is innervated by the
A. external branch of the superior laryngeal nerve
B. internal laryngeal branch of the superior laryngeal nerve
C ninth cranial nerve
D. recurrent laryngeal nerve
E. seventh cranial nerve

A

A. external branch of the superior laryngeal nerve
Moore p. 1045. The cricothyroid, supplied by the external laryngeal nerve, isthe only intrinsic laryngeal muscle not supplied by the recurrent laryngealnerve.

181
Q

Korsakoffs syndrome is best characterized by (a)
A. defect in learning and loss of past memories
B. global confusional state
C. manic-depressive state
D. paranoid ideation
E. stupor or coma

A

A. defect in learning and loss of past memories
V&A p. 1206. In Korsakoffs psychosis, retentive memory is impaired out ofproportion to other cognitive functions in an otherwise alert patient.

182
Q 
Werdnig-Hoffmann disease is notable for all of the following except
A. areflexia
B. autosomal recessive inheritance
C. hypotonia
D. involvement of chromosome 5q
E. mental retardation
A

E.mental retardation

V&A pp. 1159-1161. Mental retardation is not a feature of the spinal muscularatrophy of infancy and childhood.

183
Q 
Tricyclic antidepressants
I. block norepinephrine uptake
II. block oxidative deamination of monoamines
III. block serotonin uptake
IV. Bind to GABA receptors
A. I. II, III
B. I, III
C II, IV
D. IV
E. all of the above
A

B. i. block norepinephrine uptake, III. block serotonin uptake

184
Q 
lower extremity spasticity
A. amyotrophic lateral sclerosis (ALS)
B. cervical spondylosis
C. both
D. neither
A

C. both

185
Q 
hyporeflexia
A. amyotrophic lateral sclerosis (ALS)
B. cervical spondylosis
C. both
D. neither
A

D. neither

186
Q 
hyperreflexia
A. amyotrophic lateral sclerosis (ALS)
B. cervical spondylosis
C. both
D. neither
A

C. both

187
Q 
absence or paucity of sensory symptoms
A. amyotrophic lateral sclerosis (ALS)
B. cervical spondylosis
C. both
D. neither
A

A. amyotrophic lateral sclerosis (ALS)

188
Q 
atrophy of the hand muscles
A. amyotrophic lateral sclerosis (ALS)
B. cervical spondylosis
C. both
D. neither
A

C. both
For questions 185-189 see V&A pp. 1155-1157, 1325. Despite the muscleweakness and atrophy seen in ALS, hyperreflexia and mild lower extremityspasticity are characteristic.

189
Q 
antineutrophil cytoplasmic antibodies
A. Cogan's syndrome
B. polyarteritis nodosa
C. systemic lupus erythematosus
D. Takayasu's syndrome
E. temporal arteritis
F. Wegener's granulomatosis
A

F. Wegener’s granulomatosis

CBR neurology (7 decks)

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