Neuro Comp exam Flashcards
what are the "bad aspects" of carotid endarterectomy, all except: 1. Mortality 2. Morbidity 3. Complication 4. Left or Right Carotid
- Mortality
- Morbidity
- Complication
- Left or Right Carotid (Answer)
How does ischemic lesion looks like on CT without contrast in the early phase
Hypo/hyper dense
in which situation there is a cardiovascular impairment choose the wrong ans
a lesion in the basal ganglia
- Time window for iv thrombolysis in MCA?
a) 1hr
b) 16
c) 12
d) 3 (4.5)hrs.
a) 1hr
b) 16
c) 12
d) 3 (4.5)hrs. - Correct
TIA Last for minutes. Last for days Is not an medical emergency ECG is enough to perform
Last for minutes. Correct
Last for days
Is not an medical emergency
ECG is enough to perform
Diagnostic test before epileptic surgery except BAEP. EEG MRI PET
BAEP. Correct
EEG
MRI
PET
Can cause/predispose for epilepsy except Poliomyelitis. SAH Contusion Head injury
Poliomyelitis. Correct
SAH
Contusion
Head injury
Caused by virus except Lyme disease. Rabies Morbilli Herpes zoster
Lyme disease. Correct
Rabies
Morbilli
Herpes zoster
Pyridostigmine useful to treat MG. Parkinson MS Restless leg syndrome
MG. Correct
Parkinson
MS
Restless leg syndrome
PCA supplies Occipital lobe. Inferior/Lateral Temporal lobe Parietal lobe Frontal lobe
Occipital lobe. Correct
Inferior/Lateral Temporal lobe
Parietal lobe
Frontal lobe
Used to treat TD
Reserpine.
Haloperidol
Reserpine. Correct
Haloperidol
Don’t remember the last two
Posterior columns contain: Sensory pathways. Motor pathways Blood vessels Lymphatics and autonomic pathways
Sensory pathways. Correct
Motor pathways
Blood vessels
Lymphatics and autonomic pathways
acute hemorrhage on CT?
Hyperdense
acute complications of brain radiation?
edema
not true for tardive dyskinesia?
60-70% of patients
6.7G/L Wbc abnormal or normal.
Normal - 4,8-10,8 G/L
Is the color of normal CSF clear or yellow?
clear
Urea lab value:
3,6-7,2 mmol/L
In patients with carotid bruits
we should think about carotid stenosis and exclude it.
Typical signs of Multiple sclerosis?
oculomotor palsy
What is a non-communicating hydrocephalus?
Occlusion is proximal to foramen of Magendie
How would you treat an epileptic pregnant woman?
Monotherapy
Superficial peroneal nerve paresis is associated with?
lateral foot drop
in acute migraine treatment, triptans can be helpful (y/n)
Yes
why do we use steroids in brain metastases? immunesuppression, to decrease the edema, to increase the glucose concentration, all of the above
immunesuppression, to decrease the edema, to
increase the glucose concentration, all of the above (answer is edema)
Where is substantia nigra?
answer:
anterior to tegmentum in mecencephalon, and its lesion causes Parkinson’s disease
1.where is choroid plexus A)lateral vetricle B) subarachnoid space C)anywhere in brain except ventricle D) cerebellum
A)lateral vetricle(right choice)
B) subarachnoid space
C)anywhere in brain except ventricle
D) cerebellum
1.where is choroid plexus A)lateral vetricle B) subarachnoid space C)anywhere in brain except ventricle D) cerebellum
A)lateral vetricle(right choice)
B) subarachnoid space
C)anywhere in brain except ventricle
D) cerebellum
Lower motor neuron lesions cause decreased deep reflexes – True or False?
true
When should we operate an internal carotid artery stenosis?
if morbidity and mortality due to angiography and endarterectomy < 5-6% and stenois is 70% or greater
What would you do in case of internal carotid bruit?
Exclude internal carotid artery stenosis.
Best way to examine extracranial vessels?
Doppler US.
False about thrombotic stroke?
Preceded by palpitations
Which is NOT a symptom of increased cranial pressure ?
(headache/vomiting/atrophy of the thenar muscle (Right answer))
Which is NOT the symptom of
vegetative system ?
(constipation/orthostatic hypotension/incontinence/ paraparesis (right answer))
is chronic headache sign of tumor?
no
pseudobulbar palsy-
can elicit gag and palatal reflex
decerebrate position (the wrong one)
flexed arms and wrists
risk factors for stroke (the incorrect)-
MG
Spastic paresis is always central in origin
yes
Neurological complication of CNS tumors except one? Brain metastases,
Paraneoplastic polyneuropathy, GBS, LEMS
GBS
where does in the internal
capsule the corticospinal tract travels?’
post part of post limb
‘in which abnormalities we can see ecg like changes caused by the nervous system’?
-subendocardial infraction.
Na 80 mmol/l abnormal or normal
abnormal
Weber test, incorrect ans
incorrect-in conduction, better on the affected ear
Which test you should do before epilepsy surgery, except
-BAEP
Brain abscess, except in:
LEMG
when should you send a patient with low back
pain to the hospital?
something with vegetative signs nd paresis
which nerve is destroyed in appendectomy
iliohypogastric n
erb’s palsy…
answer (injury to brachial plexus)…
maysthenia crisis what is not correct? 1.plasmapheresis 2.ivig 3. steroids 4. acute theymectomy.
acute thymectomy
Emboli stroke (pick the correct option):maysthenia crisis what is not correct? 1.plasmapheresis 2.ivig 3. steroids 4. acute theymectomy.
acute thymectomy
Most comon site for generalized seizures –>
temporal lobe
n syncope, the patient recovers consciousness fast? Yes or No?
yes
WBC value.
4.8 - 10.8 G/L
Emboli stroke (pick the correct option):
onset of symptoms is associated
with palpitation.
Which of these is NOT a type of agnosia. Ataxic, auditory, tactile, visual.
Ans: Ataxic
How do you diagnose for leptomeningeal carcinomatosis,
LP
Which is not a symptom of giant cell arteritis?
urinary incontinence
What drug is used in convulsive epilepsy status
The answer was diazepam
In acute stroke
hypotonicity will develop first and than spasticity
What is not a symptom of pseudotumor cerebri?
polyneuropathy
Medication That not used for burning sensation of neuropathy?
Morphine
What is the difference btw orthostatic hypotension caused by autonomic dysfct and that
caused by hypovolemia?
the Hypovolemia still can provoke the reflex tachycardia.
Treatment for temporal arteritis ?
prednisone
NOT TRUE for lumbar root compression:
Positive Chaddock and babinski
In upper motor neuron lesion, there is reduced deep reflexes?
No
in acute stroke
hypotonicity will develop first and than spasticity
best exam for MS
MRI
mri is better diagnostic tool of the spinal cord. except:
good for abnormal bone lesion
can syncope present with jerky movement??
yes
which one is write about coma patient
you can not wake him up
what is the diagnosis for leptomeningeal carcinoma
LP and CSF sampling
ESR value 6mm/hr. Normal or abnormal?
normal
?
a) Increased number of cigarettes increases risk of stroke
b) Increased years of smoking increases risk of stroke
c) Smoking cessation decreases risk of stroke
d) All of the above (answer)
false answer regarding Lyme disease and MS
symptomology between
the 2 can easily be distinguished
signs of MS
INO
PCA supplies?
Occipital lobe
How many times do attacks of MS occur?
1 time every one year and half
Incorrect one for MS
Treat aphasia with [some drug]
Incorrect one for MS
Treat aphasia with [some drug]
Wernicke area options
41 (22 wasn’t mentioned)
Most common cause of leptomeningeal carcinoma in children
Leukemia
Characteristics of Parkinsons
Rigidity
Leftsided homonymous hemianopia can be found, except
Left side
Which is not a secondary prevention of stoke?
2x75mg clopidogrel
Largest nerve of body
Sciatic
Which is not useful for examination of extracranial vessels?
CTA
Treatment for acute cervical spondylosis
bed rest
What do you do first in acute stroke?
CT
What is not part of visual pathway?
MGB
In right/left facial palsy the peri-oral part is exclusively innervated contralaterally (true/false) - I
was kinda confused trying to figure out if it was central or peripheral, but it was irrelevant to the
question
True
Which tract is a descending tract?
- Spinothalamic
- Dorsal Spinocerebellar
- Dorsal root column
- Rubrospinal tract - correct answer
Amitrityline is not used in following conditions:
- Chronic Pain
- Chronic Tension headaches
- Depression
- Migraines (I think it said migraines, anyways this is the correct answer)
In case of cerebellopontine angle tumor you can see:
- diminished corneal reflex
- ipsilateral palsy of the whole face
- tinnitus
- all of the above (correct answer)
Glucose
4.8 mmol/L = normal
the difference in orthostatic hypotension caused by autonomic dysfct and that caused by
hypovolemia?
the hypovolemia still can provoke the reflex tachycardia.
the function of frontal lobe
urination
which intervention cannot be used before epilepsy surgery?
auditory brainstem evoked
potential.
which intervention cannot be used before epilepsy surgery?
auditory brainstem evoked
potential.
csf leukocytes 23000 ^3 / ul.
Abnormal
most common parkinsonism.
Parkinson disease
how often does Ms attack occur.
1 or 2 spur in one and half years.
What do you do first in a Coma/ unconscious patient.
basic life support.
Abruptive jerks can be present in case of syncope
Yes
ARTERIAL cerebral thrombosis is more likely to occur in:
The 2nd/3rd trimester of pregnancy
stroke on CT looks…
hypodense!
stroke on CT looks…
hypodense!
Which one is not a sign of
leptomeningeal carcinomatosis?
pyramidal signs
Time window for i.v. Thrombolysis of MCA
3-4.5h
Area that MCA DOES NOT supply
medial aspect hemispheres
Velocity of the nerve conduction what is NOT true:
A. Is faster in the upper extremity.
B. depends on the location you measure.
C. Is lower if a patient has a high serum cholesterol. (The answer)
D. Is depend on the outside temperature
What is the different between meningitis and encephalopathy? (Choose the wrong answer)
A. Can always be differentiate easily. (The answer)
B. encephalopathy damage the brain parenchyma and cognetive is declining.
C. Meningitis is with neck stiffness, headache.
D. Bacteria cause mainly meningitis where virus is mainly encephalopathy.
What nerve can damage from fracture of the humerus?
(Axilliary)
What is part of the striatum
(putamen)
What is part of the striatum
(putamen)
Spasticity is always central
Yes
Decortication WRONG answer
hands are extended and hyper pronated
Decerebration positive answer
hands are extended and hyper pronated
Posterior spinal artery supplies
posterior 1/3 of the spinal cord
Insular lesion will cause which cardiac problem
arrhythmia
Diabetes mellitus autonomic problem
pulse don’t change in change body position
In case of increased ICP what would u do first ?
CT
INR 6.5
Abnormal
WBC 5.6 G/L
Normal
Medication NOT used for burning sensation of neuropathy
Morphin
Treatment used for migraine prophylaxis EXCEPT
Sumatriptan
Symptoms of posterior circulation occlusion EXCEPT
aphasia
Treatment for tension type headache
Amitryptiline
Management of hepatic encephalopathy
Reduce ammonia levels + administer GABA antagonists at the central level
which is NOT a secondary pervention of stroke
(clopidogrel 2x75mg) … clopidogrel would be a
secondary pervention but the dose is wrong, careful
treatment for temporal arteritis
prednisone
What is NOT a cause of hypertension
lacunar infarcts in the basal ganglia
what is the treatment after an MI in order to prevent stroke
antiplatelets
Where do motor neurons start from
prefrontal cortex
What is an example of somnolence
Patient is woken and returns to sleep
What is an incorrect treatment for carpal tunnel syndrome?
Palmarflected stint
What is true regarding Rinne test?
Compare bone and air conduction
Which is the most common hemorrhagic stroke?
Ischemia
Which of the following is least likely to cause stroke?
Mitral valve prolapse
Which is not affected in leptomeningeal carcinomatosis
Pyramidal tract
Which best describes a lesion on the facial nerve?
Palsy of the whole ipsilateral face
EMG choose the wrong:
something like “nowadays we dont use blablab” –> Right answer
other options was
-test while muscle relaxed
-while contracted
-amplifier and preamplifier and the output equipment.
substania nigra location:
- diencephalon and causes parkinson
- midbrain and causes parkinson–> Right answer
- and 2 totally unrelated locations and diseases..
ESR 6 mm/h
Normal
The patients with carotid bruits
We should think about carotid stenosis and should exclude it
What is a wrong statement about diabetic neuropathy
Hemiparesthesia
Which of these is NOT a sign of poly neuropathy?
UMN signs
Not characteristic for trigeminal neuralgia
constant pain for hours
something not characteristic neurological symptoms of SLE patients
Myotonia
Signs of vestibular lesions except
Fast component of nystagmus toward same side
true of iv thrombolysis except
it is intra arterial type
dopamine rec blockers better because of, except
does not cause peripheral edema
Treatment of trigeminal neuralgia
carbamazepine
all of the following cause dementia except
AVM
after operation for disc herniation - choose incorrect ans
always a permanent improvement
side effects of levodopa except
nausea
orthostatic HTN
Sweating **
vomiting
Possible neuro effects of b12 def except
never positive pyramidal signs
Horner triad except
exophthalmus
