Neuro 2.0 Flashcards
A 20-year-old patient presents with episodes of sudden, brief muscle contractions affecting the entire body, often
occurring in the morning after awakening. Which of the following is the most likely diagnosis?
A. Juvenile myoclonic epilepsy
B. Lennox-Gastaut syndrome
C. Temporal lobe epilepsy
D. Absence epilepsy
A. Juvenile myoclonic epilepsy
Which imaging modality is most sensitive for diagnosing acute ischemic stroke?
A. CT scan without contrast
B. CT angiography (CTA)
C. Conventional angiography
D. MRI with diffusion-weighted imaging (DWI)
D. MRI with diffusion-weighted imaging (DWI)
A 45-year-old female presents with a severe headache and photophobia. A non-contrast CT scan is performed, which
shows no evidence of hemorrhage, obstructive hydrocephalus or masses. What is the next best step in imaging to rule
out a subarachnoid hemorrhage?
A. Lumbar puncture
B. MRI with contrast
C. CT angiography
D. Conventional angiography
A. Lumbar puncture
Which patient is at risk of nephrogenic systemic fibrosis?
A. Elderly patient for PET
B. Elderly DM patient for CT angiography
C. Patient on chronic dialysis for cranial MRI with contrast
D. Hypertensive patient for cranial CT scan with IV contrast
C. Patient on chronic dialysis for cranial MRI with contrast
A 55-year-old male with a history of smoking presents with progressive memory loss and behavioral changes. Which
imaging modality is most appropriate for evaluating suspected dementia?
A. Conventional angiography
B. CT scan without contrast
C. MRI without contrast
D. PET scan
C. MRI without contrast
Which of the following imaging modalities is most appropriate for evaluating a patient with suspected intracranial
aneurysm?
A. PET scan
B. Ultrasound
C. CT scan without contrast
D. Magnetic resonance angiography
D. Magnetic resonance angiography
30-year-old male with a history of seizures presents with a first-time generalized tonic-clonic seizure. There are no
focal neurologic deficits on examination. What is the most appropriate initial imaging study?
A. Conventional angiography
B. CT scan without contrast
C. MRI without contrast
D. PET scan
C. MRI without contrast
A 25-year-old man presents with sudden, brief episodes of staring and unresponsiveness lasting a few seconds, with
no postictal confusion. Which of the following is the most likely diagnosis?
A. Myoclonic seizure
B. Typical absence seizure
C. Generalized tonic-clonic seizure
D. Focal seizure with impaired awareness
B. Typical absence seizure
A patient with epilepsy is started on valproic acid. Which of the following is the most important monitoring parameter
for this patient?
A. Serum sodium levels
B. Liver function tests
C. Renal function tests
D. Serum calcium levels
B. Liver function tests
A 40-year-old woman presents with episodes of sudden loss of muscle strength, resulting in falls. Which of the
following is the most likely diagnosis?
A. Atonic seizure
B. Myoclonic seizure
C. Generalized tonic-clonic seizure
D. Focal seizure with impaired awareness
A. Atonic seizure
A patient with active seizures has the following EEG findings: generalized 3-Hz spike-and-wave discharges. This
EEG finding is most consistent with which seizure disorder?
A. Myoclonic seizure
B. Typical absence seizure
C. Atypical absence seizure
D. Atonic seizure
B. Typical absence seizure
Which of the following is a consistent pathologic finding in mesial temporal lobe epilepsy?
A. Loss of specific cell populations within the hippocampus
B. Lymphocytic infiltration of the deep temporal lobe
C. Caseation necrosis in the medial temporal lobe
D. Hypertrophy of the amygdala
A. Loss of specific cell populations within the hippocampus
Focal seizures that spread to involve both cerebral hemispheres to produce generalized seizures usually originate from
which lobe of the brain?
A. Temporal
B. Pariental
C. Occipital
D. Frontal
D. Frontal
Which of the following is a common feature of focal seizures with impaired awareness?
A. Sudden loss of postural tone
B. Automatisms such as lip smacking or picking movements
C. Generalized tonic-clonic movements
D. Brief lapses of consciousness without motor activity
B. Automatisms such as lip smacking or picking movements
Which of the following is a common postictal finding in patients with focal seizures involving the dominant
hemisphere?
A. Transient aphasia
B. Visual field cuts
C. Hemiparesis
D. Memory loss
A. Transient aphasia
Which of the following drugs is first line in the management of status epilepticus?
A. Diazepam IV
B. Phenobarbital IV
C. Lorazepam IV infusion
D. Fosphenytoin IV
C. Lorazepam IV infusion
Which of the following is the first-line treatment for focal seizures?
A. Lamotrigine
B. Topiramate
C. Valproic acid
D. Phenobarbital
A. Lamotrigine
What is the most common cause of seizures in the older adults?
A. Degenerative CNS diseases
B. Alcohol withdrawal
C. Tumor
D. Cerebrovascular disease
D. Cerebrovascular disease
Withdrawal of anti-epileptic therapy in patients with completely controlled seizure can be done if
A. Seizure has been controlled for at least 6 months
B. Normal neurologic examination even if with subpar intelligence
C. Minimal electrographic activity on EEG
D. After at least two years of meeting discontinuation criteria
D. After at least two years of meeting discontinuation criteria
Which of the following is a risk factor for recurrent seizures?
A. Nocturnal seizure
B. Presence of aura
C. Transient neurologic abnormality
D. EEG showing a decrease in alpha waves
; A. Nocturnal seizure ✓
