Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CBR neurology > clinical neurology soal 37-70 > Flashcards

clinical neurology soal 37-70 Flashcards

36
Q

Which of the following is not a characteristic of Adie’s syndrome?
A. degeneration of the ciliary ganglia and postganglionic parasympathetics
B. more common in women than in men
C. no reaction to 0.1% pilocarpine solution
D. paralysis of segments of the pupillary sphincter
E. Pupil responds better to near than to light.

A

C. no reaction to 0.1% pilocarpine solutionV&A p. 297. An Adie’s pupil is unusually sensitive to 0.1% pilocarpine (dener- ation hypersensitivity).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q 
Characteristics of  infantile seizures include 
I.  lip smacking 
11.  hypsarrythmia 
111.  generalized tonic-clonic activity 
IV.  myoclonic head jerks 
A.  I.  11,  111 
B.  I,  111 
C.  11,  IV 
D.  IV 
E.  all of  the  above
A

C. II, IV V&A p. 352. Infantile seizures or spasms usually begin before 6 months of age and are characterized by sudden flexor or extensor spasms of the head, trunk. and limbs and an electroencephalogram (EEG) picture of bilateral high- voltage, slow-wave activity (hypsarrythmia). Lip smacking and generalized onic-clonic activity are not features.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Muscles of the trunk and lower extremities are more frequently involved than the extraocular muscles
A. myasthenia gravis
B. myasthenic syndrome of Eaton-Lambert
C. both
D. neither

A

B. myasthenic syndrome of Eaton-Lambert For questions 39-42 see V&A pp. 1547-1548. These are all features of the Eaton-Lambert syndrome.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Poor response to anticholinesterase drugs
A. myasthenia gravis
B. myasthenic syndrome of Eaton-Lambert
C. both
D. neither

A

B. myasthenic syndrome of Eaton-Lambert

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

An incrementing response (marked increase in the amplitude of the action potential with,,fast rates of nerve stimulation) is typical.
A. myasthenia gravis
B. myasthenic syndrome of Eaton-Lambert
C. both
D. neither

A

B. myasthenic syndrome of Eaton-Lambert

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

associated with antibodies to the presynaptic voltage-dependent calcium channel
A. myasthenia gravis
B. myasthenic syndrome of Eaton-Lambert
C. both
D. neither

A

B. myasthenic syndrome of Eaton-Lambert

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q 
The  dorsal scapular nerve innervates the 
I.  supraspinatus 
11.  rhomboids 
111.  subscapularis 
IV.  levator  scapulae 
A.  I,  11,111 
B.  I, 111 
C  11,  IV 
D.  IV 
E.  all of  the  above
A

C. 11. rhomboids , IV. levator scapulae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

teres major

A.  axillary nerve 
B.  dorsal scapular nerve 
C.  subscapular  nerve 
D.  suprascapular nerve 
E.  none of  the  above
A

C. subscapular nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

teres minor

A.  axillary nerve 
B.  dorsal scapular nerve 
C.  subscapular  nerve 
D.  suprascapular nerve 
E.  none of  the  above
A

A. axillary nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q 
subscapularis 
A.  axillary nerve 
B.  dorsal scapular nerve 
C.  subscapular  nerve 
D.  suprascapular nerve 
E.  none of  the  above
A

C. subscapular nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q 
levator  scapulae 
A.  axillary nerve 
B.  dorsal scapular nerve 
C.  subscapular  nerve 
D.  suprascapular nerve 
E.  none of  the  above
A

B. dorsal scapular nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q 
supraspinatus 
A.  axillary nerve 
B.  dorsal scapular nerve 
C.  subscapular  nerve 
D.  suprascapular nerve 
E.  none of  the  above
A

D. suprascapular nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q 
infraspinatus 
A.  axillary nerve 
B.  dorsal scapular nerve 
C.  subscapular  nerve 
D.  suprascapular nerve 
E.  none of  the  above
A

D. suprascapular nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q 
rhomboids
 A.  axillary nerve 
B.  dorsal scapular nerve 
C.  subscapular  nerve 
D.  suprascapular nerve 
E.  none of  the  above
A

B. dorsal scapular nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

The motor unit potential in myopathy is of
A. decreased voltage and decreased duration
B. decreased voltage and increased duration
C. decreased voltage and normal duration
D. normal voltage and decreased duration
E. normal voltage and increased duration

A

A. decreased voltage and decreased duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Which is true of myotonic dystrophy?
A. Frontal balding occurs only in men.
B. Lens abnormalities are rare.
C The congenital form is inherited only from the maternal line.
D. The inheritance is autosomal recessive.
E. Weakness always predates the myotonia.

A

C The congenital form is inherited only from the maternal line. V&A pp. 1503-1504. Frontal balding occurs in both men and women afflicted with myotonic dystrophy. Lens opacities are found by slit lamp in 90% of patients. The inheritance is autosomal dominant, and the defective gene segregates on chromosone 19. Myotonia may precede weakness by several years. Answer C is correct.

52
Q 
Subacute  combined degeneration of  the  spinal  cord is  caused  by a  deficiency of 
A.  cobalamin 
B.  folic acid 
C.  nicotinic  acid 
D.  pyridoxine 
E.  thiamine
A

A. cobalamin V&A p. 1218. Subacute combined deficiency of the cord occurs from failure totransfer cobalamin (vitamin BIZ) across the interstitial mucosa because of lackof intrinsic factor.

53
Q 
The  marker linked  to the  Huntington  gene is  localized  to the  short  arm  of chromosome
A.  4 
B.  11 
C.  17 
D.  22 
E.  none of  the  above
A

A.4

54
Q

Alexia without agraphia is most likely to occur with a lesion involving the
A. left geniculocalcarine tract and corpus callosum
B. left geniculocalcarine tract and Wernicke’s area
C. left geniculocalcarine tract, corpus callosum, and Wernicke’s area
D. right geniculocalcarine tract and corpus callosum
E. right geniculocalcarine tract and Wernicke’s area

A

A. left geniculocalcarine tract and corpus callosum V&A pp. 494,511. The lesion described in A would render the patient blind in the right half of the visual field. Visual information reaches only the right occipital lobe but cannot be transferred to Wernicke’s area across the callo- sum. Thus the ability to read aloud and to understand the written word is lost, but the ability to understand the spoken language, speak, write, dictate, and converse is retained.

55
Q

Deviation of the eyes to the right is most likely to occur with occlusion of the A. calcarine artery bilaterally
B. calcarine artery on the contralateral side
C. contralateral paramedian branch of the basilar artery
D. ipsilateral superior cerebellar artery
E. superior division of the contralateral middle cerebral artery

A

C. contralateral paramedian branch of the basilar artery V&A p. 849. Deviation of the eyes away from the lesion occurs in brainstem syndromes, for example, the medial midpontine syndrome (occlusion of the paramedian branch of the midbasilar artery). Answers B, D, and E would cause deviation of the eyes to the left.

56
Q 
Which of  the  following antiepileptic drugs has the  shortest half-life? 
A.  carbamazepine 
B.  ethosuximide 
C.  phenobarbital 
D.  phenytoin 
E.  valproate
A

E. valproate Of the antiepileptic drugs listed, phenobarbital has the longest half-life of 96 k 12 hours, followed by ethosuximide, 40 k 6 hours; phenytoin 24 k 12 hours; carbamazepine 12 k 4 hours; and valproate 8 f 2 hours.

57
Q 
weakness and atrophy  of  the  hands 
A.  amyotrophic lateral  sclerosis 
B.  syringomyelia 
C.  both 
D.  neither
A

C. both
Despite the atrophy of the hands and forearms in amyotrophic lateral sclerosis (ALS), diffuse hyperreflexia is seen, with absence of sensory change.

58
Q 
hypo- or areflexia
A.  amyotrophic lateral  sclerosis 
B.  syringomyelia
C.  both
D.  neither
A

B . syringomyelia
Despite the atrophy of the hands and forearms in amyotrophic lateral sclerosis (ALS), diffuse hyperreflexia is seen, with absence of sensory change.

59
Q 
absence of  sensory changes 
A.  amyotrophic lateral  sclerosis 
B.  syringomyelia 
C.  both 
D.  neither
A

A amyotrophic lateral sclerosis
Despite the atrophy of the hands and forearms in amyotrophic lateral sclerosis (ALS), diffuse hyperreflexia is seen, with absence of sensory change.

60
Q

Biochemical studies of neurons from a seizure focus have shown all of the ollowing except
A. increased levels of extracellular potassium in glial scars near seizure foci .
B. decreased rate of binding and removing acetylcholine in the foci .
C. deficiency of y-aminobutyric acid (GABA)
D. decreased glycine levels .
E. decreased taurine levels

A

D. decreased glycine levels .

V&A p. 345. Increased glycine levels have been found in neurons in seizure foci.

61
Q

The most reliable indicator of an intracellular cobalamin (vitamin B12deficiency is
A. low vitamin B12 on a microbiologic assay
B. low vitamin B12 on a radioisotope dilution assay
C. low vitamin Biz on a Schilling test
D. the finding of hypersegmented polymorphonuclear neutrophil leukocytes (PMN) in bone marrow smears
E. the finding of increased serum concentration of methylmalonic acid and homocysteine

A

E. the finding of increased serum concentration of methylmalonic acid and homocysteine
V&A p. 1222. Although microbiologic assay is the most accurate way to mea- sure serum cobalamin levels, the serum level is not a measure of total body cobalamin. High serum concentrations of cobalamin metabolites (methyl- malonic acid and homocysteine) are the most reliable indicators of an intra- cellular cobalamin deficiency.

62
Q

Each of the following is true of radiation myelopathy (delayed progressive type) except
A. Absence of pain is typical early in the course.
B. It occurs 12 to 15 months after radiation.
C. Magnetic resonance imaging (MRI) shows abnormal signal intensity; decreased on TI and increased on T2.
D. Sensory changes usually develop after motor changes.
E. The most severe parenchymal changes are typical of infarction.

A

D. Sensory changes usually develop after motor changes.

V&A p. 1302. In radiation myelopathy, sensory changes usually precede theweakness.

63
Q 
Fasciculation potentials indicate 
A.  motor nerve fiber irritability 
B.  motor nerve fiber destruction 
C  motor unit denervation 
D.  muscle atrophy 
E.  reinnervation  of  muscle units
A

A. motor nerve fiber irritability

64
Q 
di- or triphasic pattern 
A.  fasciculation potential 
B.  fibrillation  potential 
C.  both 
D.  neither
A

B. fibrillation potential

65
Q 
5  to 15 ms in  duration 
A.  fasciculation potential 
B.  fibrillation  potential 
C.  both 
D.  neither
A

A. fasciculation potential

66
Q 
may  take  the  form of  positive sharp waves 
A.  fasciculation potential
B.  fibrillation  potential 
C.  both 
D.  neither
A

B. fibrillation potential

67
Q 
seen in  poliomyelitis 
A.  fasciculation potential 
B.  fibrillation  potential 
C.  both 
D.  neither
A

C. both

68
Q 
usually develops 24  to 36 hours after the  death of  an axon 
A.  fasciculation potential 
B.  fibrillation  potential 
C.  both 
D.  neither
A

D. neither

69
Q 
may  be visible  through  the  skin 
A.  fasciculation potential
B.  fibrillation  potential 
C.  both 
D.  neither
A

A. fasciculation potential
For questions 65-70 see V&A pp. 1361-1362. Fibrillation potentials last from 1 to 5 ms, may take the form of positive sharp waves, and are seen 10 to 25 days after the death of an axon. Fasciculation potentials have three to five phases. Both can be seen in poliomyelitis.

CBR neurology (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions