NEURO Flashcards
A complete occlusion of this vessel produces contralateral hemiplegia, hemianesthia (hypesthesia), and homonymous hemianopia.
a.
Anterior choroidal artery
b.
Basilar artery
c.
Middle cerebral artery
d.
Posterior cerebral artery
Answer: A. Anterior choroidal artery
The complete syndrome of anterior choroidal artery occlusion consists of contralateral hemiplegia, hemianesthesia (hypesthesia), and homonymous hemianopia.
occlusion of ____ that can cause spontaneous posturing movements that are myoclonic in nature and simulate seizure activity.
Basilar artery
spontaneous posturing movements that are myoclonic in nature and simulate seizure activity.
occlusion of ___ cause contralateral hemiplegia, hemianesthesia, homonymous hemianopia, and a day or two of gaze preference to the ipsilateral side.
MCA
contralateral hemiplegia, hemianesthesia, homonymous hemianopia, and a day or two of gaze preference to the ipsilateral side.
a third nerve palsy with contralateral ataxia (Claude’s syndrome) or with contralateral hemiplegia (Weber’s syndrome) may result.
P1 syndrome: a third nerve palsy with contralateral ataxia (Claude’s syndrome) or with contralateral hemiplegia (Weber’s syndrome) may result.
P2 syndrome: Contralateral homonymous hemianopia without macula sparing is the usual manifestation.
syndrome that has Contralateral homonymous hemianopia without macula sparing is the usual manifestation.
P2 syndrome Contralateral homonymous hemianopia without macula sparing is the usual manifestation.
a rare brainstem stroke that affects the pons at the base of the brain. It can occur due to a number of reasons, including a blockage in the basilar artery.
Types of inferior pontine syndrome
Inferior medial pontine syndrome: Also known as Foville syndrome, this syndrome affects the corticospinal tract, medial lemniscus, and facial nerve. Symptoms include gaze palsy, facial weakness, and hemiplegia.
Lateral inferior pontine syndrome: This syndrome can cause deafness, facial paralysis, and cerebellar signs.
The pons receives blood from which artery/ries_______
the basilar artery, the anterior inferior cerebellar artery (AICA), and the superior cerebellar artery (SCA)
indication of administration of intravenous recombinant plasminogen activator rtPA for acute ischemic stroke
INDICATION
- clinical diagnosis of stroke
- onset of symptoms to time of drug administration <4.5 Hours
-CT scan showing no hemorrhage or edema of >1/3 of the MCA territory
AGE >/=18 years of age
Contrainidcations for administration of intravenous recombinant tissue plasminogen activator rTPA for AIS/ Acute Ischemic Stroke
- *Sustained BP >185/110
- Bleeding diasthesis
- RECENT head injurty or hemorrhage
- MAJOR surgery in preceding 14 days
- GIBleeding in preceding 21 days
- RECENT myocardial infarction
how to administer rTPA?
(memorize)
ABCD scoring
Percentage of 3 months rate of stroke for subsequent ABCD 1 score?
CSF profiles for Menigitis and Ecephalitis
factors associated with a poor prognosis in tetanus?
MUST MEMORIZE GCS
Glasgow coma scale
Empiric antibiotic Tx for bacterial meningitis for adults immunocompetent <55
Cef+ Vancomycin
Empiric antibiotic Tx for bacterial meningitis for adults immunocompetent >55 and any age with alcoholism or other debilitating illnesses
Ampicillin + cefotaxime, ceftriaxone or cefepime+ vancomycin
Hospital acquried meningitis, post traumatic or post neurosurgery meningitis, neutropenic patients or patients with impaired cell mediated immunity
ampicilllin + ceftazidime or MEROPENEM + vancomycin
Identify
Epidural hematoma
Identify
Subdural hematoma
SAH
Traumatic Axonal Injury causing microhemorrhages
Stepwise approach to treatment of elevated intracranial pressure (ICP)
type of cerebral herniation
A
B
C
D
initial treatment of OH
log
Drugs that may exacerbate MG
MOA of Acethylcholine in the NMJ
Treatment of painful sensory neuropathies
Diagnostic criteria for MS
A right-handed 65-year-old man presents with sudden-onset left-sided weakness, left hemianesthesia, left homonymous hemianopia, and preferential gaze to the right. What other finding may be anticipated given his condition?
A. Unawareness of his neurologic deficits
B. Global aphasia
C. Delayed verbal and motor response
D. Contralateral hemiballismus
✅ Correct Answer: A. Unawareness of his neurologic deficits
Rationale:
Right MCA strokes affecting the nondominant hemisphere (typically right in right-handed individuals) can cause anosognosia (lack of awareness of deficits).
Global aphasia (B) occurs in left MCA strokes.
Delayed responses (C) occur in subcortical strokes.
Contralateral hemiballismus (D) is associated with subthalamic nucleus damage (e.g., lacunar strokes).
A 55-year-old male presents with sudden onset of vertigo, nausea, and difficulty swallowing. On examination, he has ipsilateral Horner’s syndrome, hoarseness, and contralateral loss of pain and temperature sensation. What is the most likely diagnosis?
A. Basilar artery occlusion
B. Middle cerebral artery occlusion
C. Posterior inferior cerebellar artery (PICA) occlusion
D. Anterior cerebral artery occlusion
✅ Correct Answer: C. Posterior inferior cerebellar artery (PICA) occlusion
Rationale:
PICA occlusion leads to Wallenberg syndrome (lateral medullary syndrome), which includes:
Ipsilateral Horner’s syndrome (ptosis, miosis, anhidrosis)
Hoarseness and dysphagia (nucleus ambiguus involvement)
Contralateral loss of pain/temp sensation (spinothalamic tract)
Basilar artery occlusion (A) causes locked-in syndrome.
MCA occlusion (B) presents with contralateral hemiparesis and aphasia/neglect.
ACA occlusion (D) causes leg weakness.
A 60-year-old female presents with sudden onset of blindness but denies any visual problems. She is unaware of her blindness and confabulates when asked to describe her surroundings. What is the most likely diagnosis?
A. Balint’s syndrome
B. Anton’s syndrome
C. Weber’s syndrome
D. Gerstmann’s syndrome
✅ Correct Answer: B. Anton’s syndrome
Rationale:
Anton’s syndrome is cortical blindness with denial of blindness (anosognosia) due to bilateral PCA infarcts.
Balint’s syndrome (A) involves simultanagnosia, optic ataxia, and oculomotor apraxia.
Weber’s syndrome (C) presents with midbrain infarction and ipsilateral CN III palsy.
Gerstmann’s syndrome (D) involves agraphia, acalculia, finger agnosia, and left-right disorientation.
Which of the following is the most likely genetic risk factor for late-onset Alzheimer’s disease?
A. APOE ε4 allele
B. Presenilin-1 mutation
C. APP mutation
D. TREM2 mutation
✅ Correct Answer: A. APOE ε4 allele
Rationale:
APOE ε4 allele is the strongest genetic risk factor for sporadic Alzheimer’s disease.
Presenilin-1 (B) and APP mutations (C) are linked to early-onset familial Alzheimer’s.
TREM2 (D) increases risk but is less significant than APOE ε4.
gene mutations that are linked to early-onset familial Alzheimer’s.
Presenilin-1 (B) and APP
A 50-year-old male presents with rapid cognitive decline, myoclonus, and rigidity. His MRI shows no significant atrophy, but his EEG shows periodic sharp waves. What is the most likely diagnosis?
A. Alzheimer’s disease
B. Creutzfeldt-Jakob disease
C. Frontotemporal dementia
D. Lewy body dementia
Correct Answer: B. Creutzfeldt-Jakob disease
Rationale:
CJD presents with rapid dementia, myoclonus, and EEG showing periodic sharp waves.
Alzheimer’s (A) progresses slowly.
Frontotemporal dementia (C) affects behavior/language.
Lewy body dementia (D) involves visual hallucinations.
In which imaging findings is Alzheimer’s Disease considered to be an unlikely diagnosis of the patient’s dementia?
A. Normal findings on MRI with Gd contrast
B. Absence of hippocampal atrophy on CT scan
C. Negative amyloid PET Scan
D. Absence of hypometabolism in the temporal-parietal cortex FDG PET Scan
✅ Correct Answer: C. Negative amyloid PET Scan
Rationale:
Amyloid PET scan positivity is seen in Alzheimer’s disease.
MRI and CT (A, B) may be normal early.
FDG PET scan (D) shows hypometabolism in AD.
Which of the following is the most appropriate treatment for a patient with Lewy body dementia who develops REM sleep behavior disorder?
A. Donepezil
B. Memantine
C. Clonazepam
D. Melatonin
✅ Correct Answer: D. Melatonin
Rationale:
Melatonin is first-line for REM sleep behavior disorder in Lewy body dementia.
Clonazepam (C) is second-line due to side effects.
Donepezil (A) and Memantine (B) treat cognitive symptoms, not sleep disturbances.
A 50-year-old woman presents with continuous unilateral headache associated with autonomic features that completely resolves with indomethacin. What is the most likely diagnosis?
Hemicrania continua
Which of the following is a hallmark feature of cluster headache?
A. Bilateral pain
B. Pain lasting several days
C. Lack of autonomic symptoms
D. Excruciating, non-fluctuating pain
✅ Correct Answer: D. Excruciating, non-fluctuating pain
Rationale:
Cluster headaches are characterized by severe, unilateral periorbital pain with autonomic symptoms (e.g., lacrimation, rhinorrhea).
Bilateral pain (A) and lasting days (B) suggest tension
Which of the following is a hallmark pathological feature of multiple sclerosis (MS)?
A. Axonal sparing
B. Perivenular inflammation and demyelination
C. Neuronal loss without inflammation
D. Gray matter lesions without white matter involvement
✅ Correct Answer: B. Perivenular inflammation and demyelination
- Which of the following immune cells is most implicated in the pathogenesis of MS?
A. Neutrophils
B. B cells
C. Natural killer cells
D. Eosinophils
✅ Correct Answer: B. B cells
Which of the following is a key feature of progressive MS?
A. Acute perivenular inflammation
B. Frequent relapses with complete recovery
C. Presence of oligoclonal bands in the CSF
D. Diffuse inflammation with microglial activation
✅ Correct Answer: D. Diffuse inflammation with microglial activation
Rationale:
Progressive MS is characterized by chronic neuroinflammation with microglial activation leading to axonal loss and disability progression.
Acute perivenular inflammation (A) is seen in relapsing-remitting MS (RRMS).
Frequent relapses (B) describe RRMS.
Oligoclonal bands (C) are seen in both forms but are not specific to progressive MS.
Which of the following genetic risk factors confers the greatest risk for MS?
A. HLA-DRB1
B. CD127
C. CD25
D. CD58
✅ Correct Answer: A. HLA-DRB1
Rationale:
HLA-DRB1 is the strongest genetic risk factor for MS.
CD127 (B), CD25 (C), and CD58 (D) are associated but confer less risk than HLA-DRB1.
A patient with MS experiences worsening of symptoms after a hot shower. What is this phenomenon called?
Uhthoff’s phenomenon
.
Paroxysmal dysarthria (C) is a rare MS symptom.
an electric shock-like sensation with neck flexion
Lhermitte’s sign (B) is an electric shock-like sensation with neck flexion
which of the following is a diagnostic criterion for clinically definite MS?
A. Single attack with one lesion on MRI
B. Two attacks with evidence of two lesions in non-contiguous CNS areas
C. Progressive neurologic decline without relapses
D. Positive serum autoantibodies
Correct Answer: B. Two attacks with evidence of two lesions in non-contiguous CNS areas
Rationale:
MS diagnosis requires dissemination in time and space, which means two clinical attacks with two separate CNS lesions.
Single attack (A) does not fulfill the criteria.
Progressive decline (C) is seen in primary progressive MS, but diagnosis still requires MRI findings.
Autoantibodies (D) are not specific for MS.
Which of the following is a first-line treatment for relapsing-remitting MS (RRMS)?
A. Ocrelizumab
B. Cyclophosphamide
C. Methotrexate
D. Intravenous immunoglobulin
✅ Correct Answer: A. Ocrelizumab
Rationale:
Ocrelizumab (anti-CD20 therapy) is a first-line disease-modifying treatment for RRMS.
Cyclophosphamide (B) and methotrexate (C) are not standard.
IVIG (D) is not used for MS.
Which of the following is the primary mechanism by which bacteria gain access to the cerebrospinal fluid (CSF) in bacterial meningitis?
A. Direct invasion through the blood-brain barrier
B. Colonization of the nasopharynx, followed by hematogenous spread
C. Spread from the respiratory tract
D. Direct inoculation from trauma or surgery
Correct Answer: B. Colonization of the nasopharynx, followed by hematogenous spread
Rationale:
Most cases of bacterial meningitis occur via nasopharyngeal colonization, bloodstream invasion, and CNS penetration.
Direct invasion (A) occurs but is less common.
Respiratory spread (C) affects lungs, not CSF.
Direct inoculation (D) happens in trauma/surgery cases.
A lumbar puncture is performed on a patient with suspected meningitis. Which of the following CSF findings is most consistent with viral meningitis?
A. Lymphocytic pleocytosis, normal glucose, elevated protein
B. Neutrophilic pleocytosis, low glucose, elevated protein
C. Mononuclear cells, normal glucose, normal protein
D. Eosinophils, low glucose, elevated protein
✅ Correct Answer: A. Lymphocytic pleocytosis, normal glucose, elevated protein
Rationale:
Viral meningitis is characterized by lymphocytic pleocytosis, normal glucose, and mildly elevated protein.
Neutrophilic pleocytosis with low glucose (B) suggests bacterial meningitis.
Eosinophils (D) suggest parasitic or fungal infections.
A 60-year-old woman with diabetes presents with fever, headache, and neck stiffness. CSF analysis shows mononuclear cells, low glucose, and elevated protein. Which of the following is the most likely diagnosis?
A. Viral meningitis
B. Fungal meningitis
C. Bacterial meningitis
D. Tuberculous meningitis
✅ Correct Answer: D. Tuberculous meningitis
Rationale:
TB meningitis presents with mononuclear pleocytosis, low glucose, and high protein.
Viral meningitis (A) has normal glucose.
Fungal meningitis (B) has similar findings but occurs in immunocompromised patients.
Bacterial meningitis (C) has neutrophils, not mononuclear cells.
49/M farmer from Agusan consulted for seizure and headache. The neurologic examination did not show any focal deficits. Stool examination yielded eggs that were 90 mm long, round and with a small lateral spine. What is the drug of choice for this patient’s infection?
a.
Praziquantel
b.
Nitazoxanide
c.
Metronidazole
d.
Albendazole
PRAZIQUANTEL
A 67-year-old male presents with acute onset of left-sided weakness and gaze preference towards the right. What is the most likely location of the infarct?
a. Left middle cerebral artery
b. Right middle cerebral artery
c. Left posterior cerebral artery
d. Right anterior cerebral artery
✅ Correct Answer: b. Right middle cerebral artery
Rationale: MCA infarcts commonly cause contralateral hemiparesis and gaze preference toward the affected hemisphere.
Which artery is most commonly involved in ischemic stroke?
a. Posterior cerebral artery
b. Anterior cerebral artery
c. Middle cerebral artery
d. Basilar artery
✅ Correct Answer: c. Middle cerebral artery
Rationale: The MCA is the most commonly affected artery in ischemic stroke due to its direct blood supply from the internal carotid artery.
Which imaging modality is the gold standard for diagnosing acute ischemic stroke?
a. Magnetic resonance imaging (MRI)
b. Computed tomography (CT) scan
c. Digital subtraction angiography (DSA)
d. Positron emission tomography (PET) scan
✅ Correct Answer: a. Magnetic resonance imaging (MRI)
Rationale: Diffusion-weighted MRI is the most sensitive modality for detecting acute ischemic stroke.
What is the most common cause of spontaneous intracerebral hemorrhage?
a. Cerebral amyloid angiopathy
b. Hypertension
c. Arteriovenous malformation
d. Trauma
✅ Correct Answer: b. Hypertension
Rationale: Chronic hypertension leads to small vessel disease and is the most common cause of spontaneous intracerebral hemorrhage.
A patient with atrial fibrillation presents with a sudden onset of left hemiparesis and neglect. Which type of stroke is most likely?
a. Lacunar stroke
b. Thrombotic stroke
c. Cardioembolic stroke
d. Hemorrhagic stroke
✅ Correct Answer: c. Cardioembolic stroke
Rationale: Atrial fibrillation increases the risk of embolism, which can lead to large vessel occlusions and sudden onset deficits.
A 67-year-old male presents with acute onset of left-sided weakness and gaze preference towards the right. What is the most likely location of the infarct?
a. Left middle cerebral artery
b. Right middle cerebral artery
c. Left posterior cerebral artery
d. Right anterior cerebral artery
✅ Correct Answer: b. Right middle cerebral artery
Rationale: MCA infarcts commonly cause contralateral hemiparesis and gaze preference toward the affected hemisphere.
Which artery is most commonly involved in ischemic stroke?
a. Posterior cerebral artery
b. Anterior cerebral artery
c. Middle cerebral artery
d. Basilar artery
✅ Correct Answer: c. Middle cerebral artery
Rationale: The MCA is the most commonly affected artery in ischemic stroke due to its direct blood supply from the internal carotid artery.
Which imaging modality is the gold standard for diagnosing acute ischemic stroke?
a. Magnetic resonance imaging (MRI)
b. Computed tomography (CT) scan
c. Digital subtraction angiography (DSA)
d. Positron emission tomography (PET) scan
✅ Correct Answer: a. Magnetic resonance imaging (MRI)
Rationale: Diffusion-weighted MRI is the most sensitive modality for detecting acute ischemic stroke.
What is the most common cause of spontaneous intracerebral hemorrhage?
a. Cerebral amyloid angiopathy
b. Hypertension
c. Arteriovenous malformation
d. Trauma
✅ Correct Answer: b. Hypertension
Rationale: Chronic hypertension leads to small vessel disease and is the most common cause of spontaneous intracerebral hemorrhage.
A patient with atrial fibrillation presents with a sudden onset of left hemiparesis and neglect. Which type of stroke is most likely?
a. Lacunar stroke
b. Thrombotic stroke
c. Cardioembolic stroke
d. Hemorrhagic stroke
✅ Correct Answer: c. Cardioembolic stroke
Rationale: Atrial fibrillation increases the risk of embolism, which can lead to large vessel occlusions and sudden onset deficits.
A 67-year-old male presents with acute onset of left-sided weakness and gaze preference towards the right. What is the most likely location of the infarct?
a. Left middle cerebral artery
b. Right middle cerebral artery
c. Left posterior cerebral artery
d. Right anterior cerebral artery
✅ Correct Answer: b. Right middle cerebral artery
Rationale: MCA infarcts commonly cause contralateral hemiparesis and gaze preference toward the affected hemisphere.
Which artery is most commonly involved in ischemic stroke?
a. Posterior cerebral artery
b. Anterior cerebral artery
c. Middle cerebral artery
d. Basilar artery
✅ Correct Answer: c. Middle cerebral artery
Rationale: The MCA is the most commonly affected artery in ischemic stroke due to its direct blood supply from the internal carotid artery.
Which imaging modality is the gold standard for diagnosing acute ischemic stroke?
a. Magnetic resonance imaging (MRI)
b. Computed tomography (CT) scan
c. Digital subtraction angiography (DSA)
d. Positron emission tomography (PET) scan
✅ Correct Answer: a. Magnetic resonance imaging (MRI)
Rationale: Diffusion-weighted MRI is the most sensitive modality for detecting acute ischemic stroke.
What is the most common cause of spontaneous intracerebral hemorrhage?
a. Cerebral amyloid angiopathy
b. Hypertension
c. Arteriovenous malformation
d. Trauma
✅ Correct Answer: b. Hypertension
Rationale: Chronic hypertension leads to small vessel disease and is the most common cause of spontaneous intracerebral hemorrhage.
A patient with atrial fibrillation presents with a sudden onset of left hemiparesis and neglect. Which type of stroke is most likely?
a. Lacunar stroke
b. Thrombotic stroke
c. Cardioembolic stroke
d. Hemorrhagic stroke
✅ Correct Answer: c. Cardioembolic stroke
Rationale: Atrial fibrillation increases the risk of embolism, which can lead to large vessel occlusions and sudden onset deficits.
A 67-year-old male presents with acute onset of left-sided weakness and gaze preference towards the right. What is the most likely location of the infarct?
a. Left middle cerebral artery
b. Right middle cerebral artery
c. Left posterior cerebral artery
d. Right anterior cerebral artery
✅ Correct Answer: b. Right middle cerebral artery
Rationale: MCA infarcts commonly cause contralateral hemiparesis and gaze preference toward the affected hemisphere.
Which artery is most commonly involved in ischemic stroke?
a. Posterior cerebral artery
b. Anterior cerebral artery
c. Middle cerebral artery
d. Basilar artery
✅ Correct Answer: c. Middle cerebral artery
Rationale: The MCA is the most commonly affected artery in ischemic stroke due to its direct blood supply from the internal carotid artery.
Which imaging modality is the gold standard for diagnosing acute ischemic stroke?
a. Magnetic resonance imaging (MRI)
b. Computed tomography (CT) scan
c. Digital subtraction angiography (DSA)
d. Positron emission tomography (PET) scan
✅ Correct Answer: a. Magnetic resonance imaging (MRI)
Rationale: Diffusion-weighted MRI is the most sensitive modality for detecting acute ischemic stroke.
What is the most common cause of spontaneous intracerebral hemorrhage?
a. Cerebral amyloid angiopathy
b. Hypertension
c. Arteriovenous malformation
d. Trauma
✅ Correct Answer: b. Hypertension
Rationale: Chronic hypertension leads to small vessel disease and is the most common cause of spontaneous intracerebral hemorrhage.
A patient with atrial fibrillation presents with a sudden onset of left hemiparesis and neglect. Which type of stroke is most likely?
a. Lacunar stroke
b. Thrombotic stroke
c. Cardioembolic stroke
d. Hemorrhagic stroke
✅ Correct Answer: c. Cardioembolic stroke
Rationale: Atrial fibrillation increases the risk of embolism, which can lead to large vessel occlusions and sudden onset deficits.
A 67-year-old male presents with acute onset of left-sided weakness and gaze preference towards the right. What is the most likely location of the infarct?
a. Left middle cerebral artery
b. Right middle cerebral artery
c. Left posterior cerebral artery
d. Right anterior cerebral artery
✅ Correct Answer: b. Right middle cerebral artery
Rationale: MCA infarcts commonly cause contralateral hemiparesis and gaze preference toward the affected hemisphere.
Which artery is most commonly involved in ischemic stroke?
a. Posterior cerebral artery
b. Anterior cerebral artery
c. Middle cerebral artery
d. Basilar artery
✅ Correct Answer: c. Middle cerebral artery
Rationale: The MCA is the most commonly affected artery in ischemic stroke due to its direct blood supply from the internal carotid artery.
Which imaging modality is the gold standard for diagnosing acute ischemic stroke?
a. Magnetic resonance imaging (MRI)
b. Computed tomography (CT) scan
c. Digital subtraction angiography (DSA)
d. Positron emission tomography (PET) scan
✅ Correct Answer: a. Magnetic resonance imaging (MRI)
Rationale: Diffusion-weighted MRI is the most sensitive modality for detecting acute ischemic stroke.
What is the most common cause of spontaneous intracerebral hemorrhage?
a. Cerebral amyloid angiopathy
b. Hypertension
c. Arteriovenous malformation
d. Trauma
✅ Correct Answer: b. Hypertension
Rationale: Chronic hypertension leads to small vessel disease and is the most common cause of spontaneous intracerebral hemorrhage.
A patient with atrial fibrillation presents with a sudden onset of left hemiparesis and neglect. Which type of stroke is most likely?
a. Lacunar stroke
b. Thrombotic stroke
c. Cardioembolic stroke
d. Hemorrhagic stroke
✅ Correct Answer: c. Cardioembolic stroke
Rationale: Atrial fibrillation increases the risk of embolism, which can lead to large vessel occlusions and sudden onset deficits.
Which of the following is a contraindication for thrombolysis in ischemic stroke?
a. Age >80 years
b. NIHSS score of 5
c. Platelet count of 80,000/uL
d. Recent gastrointestinal bleed
✅ Correct Answer: d. Recent gastrointestinal bleed
Rationale: A recent GI bleed is a contraindication for thrombolysis due to the increased risk of hemorrhage.
What is the recommended blood pressure target for patients with acute ischemic stroke who are eligible for thrombolysis?
a. <140/90 mmHg
b. <185/110 mmHg
c. <160/100 mmHg
d. <200/120 mmHg
✅ Correct Answer: b. <185/110 mmHg
Rationale: Blood pressure must be lowered below 185/110 mmHg before administering thrombolytics to reduce the risk of hemorrhagic transformation.
Which stroke syndrome is characterized by pure motor hemiparesis?
a. Lacunar infarct
b. MCA infarct
c. PCA infarct
d. Basilar artery infarct
✅ Correct Answer: a. Lacunar infarct
Rationale: Pure motor hemiparesis is a classic lacunar stroke syndrome caused by small vessel disease affecting the internal capsule.
A patient with sudden onset of vertigo, nausea, and dysphagia is found to have an infarction in the posterior circulation. What artery is most likely involved?
a. Anterior cerebral artery
b. Posterior inferior cerebellar artery
c. Middle cerebral artery
d. Lenticulostriate artery
✅ Correct Answer: b. Posterior inferior cerebellar artery
Rationale: PICA infarcts can cause lateral medullary (Wallenberg) syndrome, leading to vertigo, dysphagia, and nausea.
Which of the following is the most appropriate first-line treatment for elevated intracranial pressure (ICP) in a patient with large hemispheric infarction?
a. Mannitol
b. Corticosteroids
c. Hypertonic saline
d. Craniectomy
✅ Correct Answer: c. Hypertonic saline
Rationale: Hypertonic saline is preferred for reducing cerebral edema and lowering ICP in ischemic stroke patients.
A patient presented with sudden and brief muscle contractions of the right lower extremity. What are the EEG findings that can be correlated with this type of seizure?
a.
Bilaterally synchronous spike and slow wave discharges immediately prior to appearance of muscle artifacts.
b.
Bursts of generalized, symmetric, 3-Hz spike and slow wave discharges provoked by hyperventilation.
c.
Focal spike and slow waves seen maximally at the anterior temporal lobes.
d.
Progressive increase in low-voltage fast activity followed by generalized high amplitude polyspike discharges.
Bilaterally synchronous spike and slow wave discharges immediately prior to appearance of muscle artifacts.
