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CBR neurology > clinical neurology soal 131-160 > Flashcards

clinical neurology soal 131-160 Flashcards

130
Q 
Stage 2 sleep is characterized by
A. K complexes
B. delta waves
C. desynchronization of the EEG
D. REM sleep
E. somnambulism
A

A. K complexes
V&A p. 405. Delta waves are prevalent in stage 3 and 4 sleep. Desynchronizationof the EEG occurs in REM sleep, and somnambulism occurs almostexclusively i l stage 4 sleep.

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131
Q 
The protein dystrophin is absent.
A. Becker's muscular dystrophy
B. Duchenne's muscular dystrophy
C. Emery-Dreifuss muscular dystrophy
D. Landouzy-Dejerine (fascioscapulohumera1) dystrophy
E. myotonic dystrophy
A

B. Duchenne’s muscular dystrophy

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132
Q

The protein dystrophin is structurally abnormal.
A. Becker’s muscular dystrophy
B. Duchenne’s muscular dystrophy
C. Emery-Dreifuss muscular dystrophy
D. Landouzy-Dejerine (fascioscapulohumera1) dystrophy
E. myotonic dystrophy

A

A. Becker’s muscular dystrophy

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133
Q

the most common adult form of muscular dystrophy
A. Becker’s muscular dystrophy
B. Duchenne’s muscular dystrophy
C. Emery-Dreifuss muscular dystrophy
D. Landouzy-Dejerine (fascioscapulohumera1) dystrophy
E. myotonic dystrophy

A

E. myotonic dystrophy

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134
Q

Prominent pseudohypertrophy of the calves is seen in Becker and in this type
A. Becker’s muscular dystrophy
B. Duchenne’s muscular dystrophy
C. Emery-Dreifuss muscular dystrophy
D. Landouzy-Dejerine (fascioscapulohumera1) dystrophy
E. myotonic dystrophy

A

B.Duchenne’s muscular dystrophy

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135
Q

Contractures of the elbow flexors and neck extensors occur early
A. Becker’s muscular dystrophy
B. Duchenne’s muscular dystrophy
C. Emery-Dreifuss muscular dystrophy
D. Landouzy-Dejerine (fascioscapulohumera1) dystrophy
E. myotonic dystrophy

A

C. Emery-Dreifuss muscular dystrophy

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136
Q 
Abnormal gene is on chromosome 4
A. Becker's muscular dystrophy
B. Duchenne's muscular dystrophy
C. Emery-Dreifuss muscular dystrophy
D. Landouzy-Dejerine (fascioscapulohumera1) dystrophy
E. myotonic dystrophy
A

D. Landouzy-Dejerine (fascioscapulohumera1) dystrophy

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137
Q

Lens opacities are found in 90% of patients
A. Becker’s muscular dystrophy
B. Duchenne’s muscular dystrophy
C. Emery-Dreifuss muscular dystrophy
D. Landouzy-Dejerine (fascioscapulohumera1) dystrophy
E. myotonic dystrophy

A

E. myotonic dystrophy

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138
Q

occasionally associated with congenital absence of an involved muscle
A. Becker’s muscular dystrophy
B. Duchenne’s muscular dystrophy
C. Emery-Dreifuss muscular dystrophy
D. Landouzy-Dejerine (fascioscapulohumera1) dystrophy
E. myotonic dystrophy

A

D. Landouzy-Dejerine (fascioscapulohumera1) dystrophy

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139
Q

Masseter atrophy, ptosis, and frontal baldness are characteristic.
A. Becker’s muscular dystrophy
B. Duchenne’s muscular dystrophy
C. Emery-Dreifuss muscular dystrophy
D. Landouzy-Dejerine (fascioscapulohumera1) dystrophy
E. myotonic dystrophy

A

E. myotonic dystrophy

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140
Q 
Abnormal gene is on chromosome 19.
A. Becker's muscular dystrophy
B. Duchenne's muscular dystrophy
C. Emery-Dreifuss muscular dystrophy
D. Landouzy-Dejerine (fascioscapulohumera1) dystrophy
E. myotonic dystrophy
A

E. myotonic dystrophy
For questions 132-141 see V&A pp. 1494-1500, 1503-1504. Duchenne andBecker muscular dystrophies are X-linked recessive disorders characterized bythe absence of the gene product dytrophin in the former and the presence of astructurally abnormal form of the product in the latter. Weakness and pseudohypertrophyof certain muscles (notably the calf) occur. The onset is later andthe course more benign in the Becker type. Myotonic dystrophy is the mostcommon adult form of muscular dystrophy and is characterized by an autosomaldominant inheritance, with the defective gene localized to chromosome 19q.Features include dystrophic changes in nonmuscular tissues (e.g., lens opacities)and a characteristic facies. Landouzy-Dejerine dystrophy is usually transmittedby autosomal dominant inheritance, and the abnormal gene has been localizedto chromosome 4. Congenital absence of a pectoral, brachioradialis, or bicepsfemoris muscle occasionally occurs. Characteristics of Emery-Dreifuss dystrophy,a benign X-linked dystrophy, include contractures of the elbow flexors,neck extensors, and posterior calf muscles.

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141
Q 
Monoplegia without muscular atrophy is most often secondary to a lesion in the
A. brainstem
B. cortex
C. internal capsule
D. peripheral nerve
E. spinal cord
A

B. cortex

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142
Q 
The transmissable agent of Creutzfeldt-Jakob disease is inactivated by
I. formalin
II. autoclaving at 132°C under pressure for 1 hour
III. alcohol
IV. immersion for 1 hour in bleach
A. I, II,III
B. I. III
C II, IV
D. IV
E. all of the above
A

C. autoclaving at 132°C under pressure for 1 hour, immersion for 1 hour in bleach

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143
Q 
The most common finding on audiography in patients with acoustic neuromas is
A. flat loss
B. high-frequency loss
C. low tone loss
D. normal audiogram
E. trough-shaped loss
A

B. high-frequency loss

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144
Q 
Median sensory responses from the index and middle finger are low in amplitude,but motor conduction velocities of the hand muscles are normal.
A. lateral cord lesion
B. lower trunk lesion
C medial cord lesion
D. middle trunk lesion
E. upper trunk lesion
A

D. middle trunk lesion

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145
Q 
Ulnar sensory response from the little finger is abnormal; electromyographicexam of the extensor indicis proprius and abductor pollicis longus is abnormal.
A. lateral cord lesion
B. lower trunk lesion
C medial cord lesion
D. middle trunk lesion
E. upper trunk lesion
A

B. lower trunk lesion

146
Q 
Ulnar sensory response from the little finger is abnormal; normal responsesare seen from the extensor indicis proprius.
A. lateral cord lesion
B. lower trunk lesion
C medial cord lesion
D. middle trunk lesion
E. upper trunk lesion
A

C. medial cord lesion

147
Q 
Action potentials from the deltoid and biceps are of low amplitude.
A. lateral cord lesion
B. lower trunk lesion
C medial cord lesion
D. middle trunk lesion
E. upper trunk lesion
A

E. upper trunk lesion

148
Q 
Abnormal median sensory responses and denervation are seen in the biceps andflexor carpi radialis; normal response is seen from the abductor pollicis brevis.
A. lateral cord lesion
B. lower trunk lesion
C medial cord lesion
D. middle trunk lesion
E. upper trunk lesion
A

A. lateral cord lesion
For questions 145-149 see Y4 p. 237. Although lower trunk lesions resemblemedial cord lesions, abnormalities of radially innervated C8 muscles areseen with the former, but not with the latter. Low-amplitude action potentials in the deltoid and biceps are seen in upper trunk lesions. Mediansensory responses from the index and middle finger are abnormal, andmotor conduction velocities of the hand muscles are normal in middle trunklesions. Lateral cord lesions cause weakness of the muscles supplied by themusculocutaneous nerve and the lateral root of the median nerve (innervatesthe forearm muscles). The intrinsic hand muscles innervated by themedial root of the median nerve are spared.

149
Q 
Persons migrating from a zone with high risk of multiple sclerosis (MS) to oneof low risk after age 15 show a risk of developing MS that is
A. equal to that of the high-risk zone
B. equal to that of the low-risk zone
C. intermediate between the two zones
D. lower than that of the low-risk zone
E. unpredictable
A

A.equal to that of the high-risk zone
V&A pp. 957-958. Several studies indicate that a person migrating from ahigh-risk to a low-risk zone of MS before age 15 will develop a risk that issimilar to the low-risk zone. If the migration takes place after age 15, the riskis similar to that of natives of the high-risk zone.

150
Q 
Eye findings in botulinism include
I. ptosis
II. strabismus
III. diplopia
IV. unreactive pupils
A. I, II,III
B. I, III
C. II, IV
D. IV
E. all of the above
A

E. . all of the above

151
Q 
Repetition is least likely to be affected by a
A. Broca's aphasia
B. conduction aphasia
C. global aphasia
D. transcortical sensory aphasia
E. Wernicke's aphasia
A

D. transcortical sensory aphasia

V&A pp. 506. 512-513. Transcortical motor and sensory aphasias are manifestedby preserved repetition.

152
Q 
Which stage of sleep is prominent on EEG at the onset of narcoleptic sleepattacks?
A. stage 1
B. stage 2
C. stage 3
D. stage 4
E. REM
A

E. REM

153
Q 
The most common cause of viral meningitis is
A. enterovirus
B. human immunodeficiency virus (HIV)
C. leptospirosis
D. lymphocytic choriomeningitis
E. mumps
A

A. enterovirus

154
Q 
Successive involvement of all cranial nerves on one side has been reported in
A. meningitis
B. sarcoidosis
C. tumors of the brainstem
D. tumors of the cavernous sinus
E. tumors of the clivus
A

E.tumors of the clivus

V&A p. 723. Garcin’s (hemibasal) syndrome has been reported with chondromasor chondrosarcomas of the clivus.

155
Q

Each of the following is true of Meniere’s disease except
A. Distention of the endolymphatic duct occurs.
B. Hearing loss is usually unilateral.
C. High tone loss occurs early in the disease.
D. Horizontal nystagmus occurs during an acute attack
E. Low-pitched tinnitus is typical.

A

C. High tone loss occurs early in the disease
V&A pp. 319-320. Early in Meniere’s disease deafness affects mainly the lowtones and fluctuates in severity. Later in the disease high tones are affected.

156
Q

Each of the following is true of Eaton-Lambert syndrome except 1
A. Autonqnic disturbances are seen
.B. Fasciculations are not seen. I
C. It has been associated with carcinoma of the stomach and colon.
D. Temporary increase in muscle power may occur during the first fewcontractions.
E. Women are more frequently affected than men.

A

E. Women are more frequently affected than men.

Men are more often affected than women (5:l).

157
Q

Type I (red) muscle fibers differ from type II (white) fibers in all of thefollowing ways except that
A. theyare more fatiguable
B. fire more tonically
C. have a slower contraction and relaxation rates
D. have more mitochondria
E. have more oxidative enzymes

A

A. theyare more fatiguable
V&A p. 1465. Type I (red) muscle fibers are richer in oxidative enzymes,poorer in glycolytic enzymes, contain more mitochondria and myoglobin,fire more tonically, have slower rates of contraction and relaxation, and areless fatiguable than type I1 (white) fibers.

158
Q 
Historically, one of the treatment modalities of Parkinson's disease wassurgical ligation of the
A. anterior cerebral artery
B. anterior choroidal artery
C. middle cerebral artery
D. posterior communicating artery
E. recurrent artery of Huebner
A

B. anterior choroidal artery

159
Q

Which of the following is not characteristic of diabetic mononeuritis multiplex?
A. Lower extremities are more commonly affected than upper extremities.
B. painful neuropathy
C. Proximal extremities are more commonly affected than distalextremities.
D. Recovery is usual.
E. symmetric neuropathy

A

E. symmetric neuropathy
V&A p. 1397. Mononeuropathy multiplex of diabetes is classically asymmetric.In practice, however, a confluence of multiple mononeuropathies may leadto a symmetric picture.

CBR neurology (7 decks)

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