MEDSURG2: 1st Shifting

Question 1

A lesion in this region usually will present with normal reflexes?

Answer 1

Myoneural junction

Question 2

In taking a neurological history, the following aspects should also be carefully taken into account?
A. onset of illness
B. family history
C. medical history
D. all of the above

Answer 2

D. all of the above

Question 3

The following pertains to a lower motor neuron lesion EXCEPT?
A. presence of hyperreflexia
B. absence of pathologic reflexes
C. hypotonicity
D. presence of fasciculations

Answer 3

Presence of hyperreflexia

Question 4

A stroke patient presented with dysdiachokinesia and intention tremors on the left upper extremity. Where is the location of the lesion?

Answer 4

Left cerebellar hemisphere

Question 5

The following is an important component in the assessment of the second cranial nerve (CN II)?

Answer 5

Testing for visual acuity

Question 6

A mass lesion located in the vermis will most likely present with which cerebellar sign?

Answer 6

Truncal ataxia

Question 7

Flexion of both lower extremities on passive flexion of neck refers to?

Answer 7

(+) Brudzinski

Question 8

Which brain lesion has an acute onset and rapid course?

Answer 8

Vascular lesion

Question 9

Anisocoria refers to?

Answer 9

Presence of unequal pupils

Question 10

Tapping of the Achilles tendon will elicit what response?

Answer 10

Plantarflexion

Question 11

The afferent limb and efferent limb of the reflex arc are located in the?

Answer 11

Spinal nerve

Question 12

Hyperreflexia may be caused by a dysfunction in which neural structures?

Answer 12

Corticospinal tract

Question 13

A lesion in the level of the pons will affect which reflex?

Answer 13

Corneal reflex

Question 14

Crossed motor/sensory syndrome is characteristic of lesions in the?

Answer 14

Brainstem

Question 15

Big toe extension elicited by squeezing the gastrocnemius maximally is referred to as?

Answer 15

Gordon sign

Question 16

The presence of a pathological pupillary dilatation is indicative of a problem in the?

Answer 16

Oculomotor nerve

Question 17

Which among the following is not considered a focal neurologic deficit?
A. aphasia
B. dizziness
C. seizures
D. hemiparesis

Answer 17

B. dizziness

Question 18

Rigidity and rest tremor are often seen in lesions of the?

Answer 18

Basal ganglia

Question 19

The following are tests used to confirm the presence of visual or visual field defects EXCEPT?
A. perimetry
B. visual evoke potential
C. Electronystagmography
D. tangent screen

Answer 19

C. Electronystagmography

Question 20

Proximal symmetrical weakness is characteristic of a lesion affecting the?

Answer 20

muscle

Question 21

In the presence of hypereflexia, the usual grade or score given to the deep tendon reflex is?

Answer 21

3

Question 22

focal deficits with the area responsible for it’s presentation: Contralateral hemiparesis, contralateral hemisensory deficit and contralateral Babinski

Answer 22

Cerebral hemisphere dysfunction

Question 23

focal deficits with the area responsible for it’s presentation: Presents with purely motor manifestation in a diurnal pattern usually involving cranially and spinally innervated muscles, with intact reflexes.

Answer 23

Neuromuscular Junction / Myoneural Junction

Question 24

focal deficits with the area responsible for it’s presentation: Ipsilateral cranial nerve deficits accompanied by contralateral hemiparesis with Babinski

Answer 24

Brainstem dysfunction

Question 25

focal deficits with the area responsible for it’s presentation: truncal ataxia

Answer 25

Cerebellar dysfunction

Question 26

Which among these complaints is a red flag of headache?
a. Unilateral pain surrounding the eye accompanied by lacrimation
b. Episodic non progressive headaches
c. Bi-temporal band-like headaches
d. Headache that wakes the patient during sleep

Answer 26

Headache that wakes patient from sleep

Question 27

The most prevalent cause of primary headache is

Answer 27

Tension headache

Question 28

All are pain sensitive structures, EXCEPT
a. Arteries at the base of the brain
b. Cranial venous sinuses
c. Pia and arachnoid
d. All extra-cranial structures

Answer 28

Pia and Arachnoid

Question 29

These are the possible mechanisms of development of headaches, EXCEPT
a. Direct pressure on cranial or cervical nerves
b. Inflammation in the brain parenchyma
c. Traction on major intracranial vessels
d. Distention, dilation of intracranial arteries

Answer 29

Inflammation in the brain parenchyma

Question 30

A 27-year-old female started having recurrent headaches since senior high school, usually occurring 1-2 times per month, described as unilateral, throbbing headache, accompanied by nausea and photophobia. Her attacks would usually last two to four hours but would feel tired after. This would be alleviated by intake of analgesics and sleep. What will be your initial impression?
a. Classic migraine
b. Common migraine
c. Cluster headache
d. Tension headache

Answer 30

Common Migraine

Question 31

On further interview, she mentioned that she would see flashes of light a few minutes before the onset of her headaches this is known as?
a. Aura
b. Osmophobia
c. Photophobia
d. Transient blindness

Answer 31

Aura

Question 32

The proposed theory for this presentation of aura is?
a. Cortical spreading depression
b. Vasodilation
c. Neurogenic inflammation
d. All of the above

Answer 32

a. Cortical spreading depression

Question 33

Which among the following pharmacologic agents is useful in acute treatment of migraine?
a. Ergotamine
b. Flunarizine
c. Mefenamic acid
d. Sumatriptan

Answer 33

d. Sumatriptan

Question 34

What will be your differential diagnosis for a patient presenting with acute headache with increased intracranial pressure?

Answer 34

Subarachnoid hemorrhage

Question 35

TRUE of migraine prophylaxis indications, EXCEPT?

Answer 35

Attacks lasting less than 24 hours