MEDSURG2: 1st Shifting Flashcards
A lesion in this region usually will present with normal reflexes?
Myoneural junction
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
D. all of the above
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
Presence of hyperreflexia
A stroke patient presented with dysdiachokinesia and intention tremors on the left upper extremity. Where is the location of the lesion?
Left cerebellar hemisphere
The following is an important component in the assessment of the second cranial nerve (CN II)?
Testing for visual acuity
A mass lesion located in the vermis will most likely present with which cerebellar sign?
Truncal ataxia
Flexion of both lower extremities on passive flexion of neck refers to?
(+) Brudzinski
Which brain lesion has an acute onset and rapid course?
Vascular lesion
Anisocoria refers to?
Presence of unequal pupils
Tapping of the Achilles tendon will elicit what response?
Plantarflexion
The afferent limb and efferent limb of the reflex arc are located in the?
Spinal nerve
Hyperreflexia may be caused by a dysfunction in which neural structures?
Corticospinal tract
A lesion in the level of the pons will affect which reflex?
Corneal reflex
Crossed motor/sensory syndrome is characteristic of lesions in the?
Brainstem
Big toe extension elicited by squeezing the gastrocnemius maximally is referred to as?
Gordon sign
The presence of a pathological pupillary dilatation is indicative of a problem in the?
Oculomotor nerve
Which among the following is not considered a focal neurologic deficit?
A. aphasia
B. dizziness
C. seizures
D. hemiparesis
B. dizziness
Rigidity and rest tremor are often seen in lesions of the?
Basal ganglia
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
C. Electronystagmography
Proximal symmetrical weakness is characteristic of a lesion affecting the?
muscle
In the presence of hypereflexia, the usual grade or score given to the deep tendon reflex is?
3
focal deficits with the area responsible for it’s presentation: Contralateral hemiparesis, contralateral hemisensory deficit and contralateral Babinski
Cerebral hemisphere dysfunction
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.
Neuromuscular Junction / Myoneural Junction
focal deficits with the area responsible for it’s presentation: Ipsilateral cranial nerve deficits accompanied by contralateral hemiparesis with Babinski
Brainstem dysfunction
focal deficits with the area responsible for it’s presentation: truncal ataxia
Cerebellar dysfunction
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
Headache that wakes patient from sleep
The most prevalent cause of primary headache is
Tension headache
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
Pia and Arachnoid
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
Inflammation in the brain parenchyma
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
Common Migraine
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
Aura
The proposed theory for this presentation of aura is?
a. Cortical spreading depression
b. Vasodilation
c. Neurogenic inflammation
d. All of the above
a. Cortical spreading depression
Which among the following pharmacologic agents is useful in acute treatment of migraine?
a. Ergotamine
b. Flunarizine
c. Mefenamic acid
d. Sumatriptan
d. Sumatriptan
What will be your differential diagnosis for a patient presenting with acute headache with increased intracranial pressure?
Subarachnoid hemorrhage
TRUE of migraine prophylaxis indications, EXCEPT?
Attacks lasting less than 24 hours
