MEDSURG2: 2nd Shifting Flashcards
.TRUE OR FALSE: The loss of dopamine-producing neurons in the substantia nigra results in an imbalance between dopamine, an excitatory neurotransmitter, and the inhibitory neurotransmitter acetylcholine.
False
What is the drug of choice in the treatment of Parkinson’s Disease?
Levodopa OR levodopa carbidopa
TRUE OR FALSE: The Male to Female Ratio of the prevalence of Parkinson’s disease is 3 is to 1.
False
Which of the following brain structures have been implicated in some movement disorders ?
A. substantia nigra
B. corpus callosum
C. pineal gland
D. internal capsule
A. substantia nigra
Give three cardinal features of Parkinson’s Disease
Any 3 of the following:
Resting tremors
Bradykinesia
Rigidity
Postural instability
Which among the following is NOT a cardinal feature of Parkinson’s Disease?
A. Rigidity
B. Postural instability
C. Chorea
D. Tremor
C. Chorea
TRUE OR FALSE: Increased iron levels, lack of compensatory rise in isoferritins and reduced aluminum levels are suggestive of oxidative stress.
False
Name three important or popular personalities who have lived with Parkinson’s disease
Any 3 of the following:
Muhammad Ali, Adolf Hitler, Mao Tse Tung, Michael J Fox, Pope John Paul II, Yasser Arafat, Mao Zedong
Matching Type: Stages of Parkinson’s Disease
- Bilateral involvement with no postural abnormality
- Patient restricted to bed
- Unilateral involvement with no functional disability
- Mild to moderate bilateral disease
A. Stage 5
B. Stage 3
C. Stage 1
D. Stage 2
- D
- A
- C
- B
Match the condition with it’s corresponding physical exam findings
- Idiopathic Parkinson’s disease
- Essential Tremor
- Multi-System atrophy
- Huntington’s disease
A. Presence of choreiform movements
B. Tremor with arms raised as well as involvement of the head
C. Presence of Cogwheel rigidity
D. Presence of Orthostatic hypotension /skin changes
- C
- B
- D
- A
Who among the following has the highest prevalence of intracranial atherosclerosis?
A. Jews
B. Hispanics
C. Caucasians
D. Asians
D. Asians
The most common cause of cardioembolic stroke is
A. Myocardial infarction
B. Coronary artery disease
C. Rheumatic heart disease
D. Non-valvular atrial fibrillation
D. Non-valvular atrial fibrillation
Involvement of the Anterior Cerebral Artery in a ischemic stroke can lead to the following symptom
A. homonymous hemianopsia
B. Contralateral lower extremity weaker than upper extremity
C. Contralateral upper extremity weaker than lower extremity
D. expressive aphasia
B. Contralateral lower extremity weaker than upper extremity
TRUE OR FALSE: The stroke prevalence in the Philippines is between 0.3 to 0.9 %.
False
Who among these world leaders during world war II was not a stroke victim?
A. Josef Stalin
B. Winston Churchill
C. Charles De Gaulle
D. Franklin Roosevelt
C. Charles De Gaulle
TRUE OR FALSE: Stroke is the second leading cause of death in the Philippines
True
TRUE OR FALSE: Dysequilibrium and ataxia are more specific findings in posterior circulation strokes
True
Which among the following is the most recognized risk factor in the genesis of primary intracerebral hemorrhage?
A. age
B. diabetes milletus
C. hypertension
D. smoking
C. hypertension
Infarction of the right internal capsule could result in all of the following defects;EXCEPT:
A. Dysarthria
B. Left hemianesthesia
C. Left facial weakness
D. Right homonymous hemianopia
D. Right homonymous hemianopia
Give three lifestyle modifiable risk factors for Stroke
Any 3 of the following:
Smoking
Low physical exercise
Morbid obesity
Excess alcohol consumption
Diet (high salt and fat)
Match the stroke syndrome with it’s appropriate description or clinical presentation
- Weber syndrome
- Medial medullary syndrome
- Benedikt syndrome
- Wallenberg syndrome
A. Presents with contralateral hemiparesis and parasympathetic involvement
B. Presents with contralateral hemiparesis and contralateral ataxia, tremor and involunatry movements
C. Presents with contralateral hemiparesis, contralateral decrease in position and vibration sense and ipsilateral tongue weakness
D. Presents with ipsilateral ataxia, vertigo, nystamus and ipsilateral Horner’s syndrome
- A
- C
- B
- D
What is the most common feature of Parkinson’s disease?
Tremor at rest
Match the following:
- Biperiden
- Bromocriptine
- Levodopa
- Selegiline
A. Dopamine replacement
B. Anticholinergic drug
C. Dopamine Agonist
D. Monoamine oxidase B inhibitor
- B
- C
- A
- D
The Male to Female Ratio of the prevalence of Parkinson’s disease is 3 is to 2.
True
What brain structure have been implicated in some movement disorders?
Substantia nigra
Hemiballismus can result from an acute lesion of the contralateral:
Subthalamic nucleus
Match the different types of strokes with their corresponding descriptions or clinical presentations.
- Intracerebral hemorrhage
- Subarachnoid hemorrhage
- Venous Infarct
- Transient ischemic attack
A. Usually due to rupture of an intracranial aneurysm with acute onset of severe headache and sometimes neurologic deficit
B. Temporary interruption of focal brain circulation, which results in neurologic deficit
C. Patients present with any combination of focal weakness, headache, cognitive difficulty, and seizures and usually related to
pregnancy and other hypercoagulable states
D. Can be due to hypertension, amyloid angiopathy and trauma
- D
- A
- C
- B
A 61-year-old man with a history of hypertension has been in excellent health until he presents with vertigo and unsteadiness lasting for 2 days. He then develops nausea, vomiting, dysphagia, hoarseness, ataxia, left facial pain, and right-sided sensory loss. There is no weakness. On examination, he is alert, with a normal mental status. He vomits with head movement. There is skew deviation of the eyes, left ptosis, clumsiness of the left arm, and titubation. He has loss of pin and temperature sensation on the right arm and leg and decreased joint position sensation in the left foot. He is unable to walk.
Magnetic resonance imaging (MRI) in this patient might be expected to show?
Left lateral medullary infarction
most recognized risk factor in the genesis of primary intracerebral hemorrhage?
Hypertension
A 61-year-old man with a history of hypertension has been in excellent health until he presents with vertigo and unsteadiness lasting for 2 days. He then develops nausea, vomiting, dysphagia, hoarseness, ataxia, left facial pain, and right-sided sensory loss. There is no weakness. On examination, he is alert, with a normal mental status. He vomits with head movement. There is skew deviation of the eyes, left ptosis, clumsiness of the left arm, and titubation. He has loss of pin and temperature sensation on the right arm and leg and decreased joint position sensation in the left foot. He is unable to walk.
The dysphagia in this case is secondary to involvement of which of the following structures?
Nucleus ambiguus
Involvement of the Anterior Cerebral Artery in a ischemic stroke can lead to which symptom?
Contralateral lower extremity weaker than upper extremity
Ischemia in the Internal Carotid Artery Territory can present with the following manifestations EXCEPT?
Limb ataxia
Who has the highest prevalence of intracranial atherosclerosis?
Asians
A 61-year-old man with a history of hypertension has been in excellent health until he presents with vertigo and unsteadiness lasting for 2 days. He then develops nausea, vomiting, dysphagia, hoarseness, ataxia, left facial pain, and right-sided sensory loss. There is no weakness. On examination, he is alert, with a normal mental status. He vomits with head movement. There is skew deviation of the eyes, left ptosis, clumsiness of the left arm, and titubation. He has loss of pin and temperature sensation on the right arm and leg and decreased joint position sensation in the left foot. He is unable to walk.
Occlusion of which of the following arteries typically produces this syndrome?
Vertebral artery
Match the stroke syndrome with it’s appropriate description or clinical presentation
- Benedikt syndrome
- Weber syndrome
- Wallenberg syndrome
- Medial medullary syndrome
A. Presents with ipsilateral ataxia, vertigo, nystamus and ipsilateral Horner’s syndrome
B. Presents with contralateral hemiparesis, contralateral decrease in position and vibration sense and ipsilateral tongue weakness
C. Presents with contralateral hemiparesis and contralateral ataxia, tremor and involuntary movements
D. Presents with contralateral hemiparesis and parasympathetic involvement
- C
- D
- A
- B
