Neuro Formative Flashcards
. Concerning the motor homunculus. Which of the following structures is represented the most medially? Eye Face Knee Tongue Wrist
Knee
An 80 year old man presented to his general practitioner (GP) with walking difficulties, urinary incontinence and cognitive decline. Which of the following is the most likely diagnosis?
- Frontal lobe tumour
- Multiple sclerosis
- Normal pressure hydrocephalus
- Parkinson’s disease
- Vascular dementia
Normal Pressure Hydrocephalus
A 51 year old man was noted to have a right trigeminal nerve palsy. Which of the following is the most likely examination finding?
- Absent taste sensation to the anterior two thirds of tongue
- Numbness over the right mandible and maxilla
- Numbness over the left mandible and maxilla
- Numbness over the posterior aspect of the scalp
- Inability to smile with the left side of his mouth
- Numbness over the right mandible and maxilla
A 36 year old woman attended her general practitioner (GP) stating that she felt like she could not cope looking after her 3 month old baby. She stated that she worried all the time about her ability to raise her child. Which of the following could NOT be explained by anxiety?
- Brisk reflexes with flexor plantar responses
- Excessive sweating and palpitations
- Fatigue and feeling of something stuck in the throat
- Numb legs and extensor plantar responses
- Poor concentration and forgetfulness
-Numb legs and extensor plantar respsonses
Structures in the human body can recieve sympathetic and/ or parasympathetic innervation . Which of the following structures does NOT have parasympathetic innervation?
-Blood vessels in extremities
A 69 y/o man presented with acute onset of right sided neglect?
Which of the following structures is most likely to be affected?
Right parietal lobe??
A 12 month baby girl, born at term, was brought to her general practitioner (GP) as her parents were concerned that she was not developing as well as her older sister had. She could to sit without support but was not standing or trying to crawl. She was able to talk saying 2-3 words. She was otherwise well. What is the most appropriate summary of her motor and speech status?
- Both her speech and motor development are delayed
- Her gross motor and speech are normal for her age
- Her gross motor is normal but her speech is advanced for her age
- Her gross motor is normal but her speech is significantly delayed
- Her gross motor is significantly delayed but her speech is normal
Her gross motor is significantly delayed but her speech is normal
. A 21 year old man was involved in a road traffic accident. On arrival in the Accident and Emergency department his Glasgow Coma Scale (GCS) was 6 and he was subsequently intubated and ventilated.
In order to assess his head injury further, what is the most appropriate imaging investigation?
-Computed Tomography of brain
- Doppler ultrasound of carotid arteries
- Functional brain magnetic resonance imaging
- Positron Emission Tomography
- Skull X-rays
Computed Tomography?
A 47 year old women was diagnosed with multiple sclerosis and asked her neurologist to explain the mechanism of demyelination of axons
-Which of the following glial cells form the myelin sheaths in the central nervous system?
Oligodendrocyte
A 19 year old woman was noted to have decreased vision.
Which of the following is an appropriate method of testing the function of the 2nd cranial nerve?
- Asking the patient to screw her eyes shut
- Assessing the corneal reflex
- Assessing the pupil response to light
- Assessing the vestibulo-occular reflex
- Looking for nystagmus
-Assessing the pupil response to light
A 40 year old man was admitted for assessment of suspected syphilis. Which organism is responsible for syphilis?
Borrelia burgdorferi Leptospira interrogans Staphylococcus aureus Streptococcus anginosis Treponema pallidum
Treponema pallidum
A 55 year old man had difficulty walking. On examination, his General Practitioner suspected he had an upper motor neurone lesion.
Which of the following examination findings would be most consistent with this?
Absent reflexes
Hypotonia
Muscle fasciulations
Muscle weakness
Sustained clonus
Sustained clonus
A 16 year old presented with a spinal cord injury with an absent motor response below C7.
Which of the following are examples of descending spinal cord tracts
- Anterior spinocerebellar tract
- Anterior spinothalamic tract
- Lateral corticospinal tract
- Lateral spinothalamic tract
- Posterior spinocerebellar tract
lateral corticospinal tract
A 51 year old man was noted to have poor coordination.
Which of the following is the best method of testing coordination of the lower limb?
Ask the patient to state if his toe is moved up or down, when his eyes are shut
Assessing the patient’s ability to sit up from lying
Assessing the plantar response
Finger-nose test
Heel-shin test
Heel-shin test
A 30 year old man developed intense burning pain in his arm after spilling concentrated bleach on it by accident. This pain response was mediated by the C class of pain nociceptor. Which of the following properties is most associated with C fibres?
Efferent
Fast conduction (20 metres/s) Typical diameter of 1-5 μm
Unmyelinated
Nucleus located in the thalamus
Unmyelinated
. A 64 year old man presented with a haemorrhage in his right internal capsule.
Which of the following arteries is most likely to supply this area?
Right middle cerebral artery Right middle meningeal artery Right posterior communicating artery Left anterior communicating artery Left middle cerebral artery
Right middle cerebral artery
A 75 year old man presented to his general practitioner (GP) with a progressive impairment of his cognitive function. He was diagnosed with dementia
Which of the following is suggestive of a vascular aetiology for his dementia?
Abnormal movements
Myoclonus
Parkinsonism
Rapid progression of the dementia
Stepwise progression
Stepwise progression
A 51 year old man was noted to have an upper motor neurone 7th nerve palsy.
Which of the following is an appropriate method of testing the function of the 7th cranial nerve?
- Asking the patient to clench his teeth
- Asking the patient to smile in order to show you his teeth
- Assessing the jaw jerk
- Looking for wasting of the temporalis muscle
- Testing light touch over the mandible and maxilla
-asking patient to smile in order to show you his teeth
A 63 year old woman presented with a gradual onset of a left sided weakness and early morning headaches. She had a CT scan of her brain which suggested that she had a metastatic lesion in her right parietal lobe. Which of the following tumours is most likely to be the primary?
Bone Breast Meninges Prostate Tongue squamous cell
Breast
A 47 year old woman presented to the emergency department with severe back pain and urinary retention. She was numb around her perineum and had absent ankle jerks. Which of the following is the most likely explanation?
- Cauda equina syndrome
- Gerstmann’s syndrome
- Guillain-Barre syndrome
- L3 radiculopathy
- S1 radiculopathy
Cauda-equina syndrome
A 47 year old man was referred to a neurosurgeon with a spinal cord tumour. The tumour was compressing his posterior (dorsal) columns on the right hand side. Which of the following statement is most likely to be true?
There is likely to be loss of vibration and proprioception below the lesion on the ipsilateral side
A 55 year old woman presented to his general practitioner (GP) with a headache which is associated with scalp tenderness over the right temporal artery. The GP diagnosed giant cell arteritis. Which of the following laboratory results would you expect in this condition?
-Elevated Erythrocyte Sedimentation Rate (ESR)
- Elevated urate
- Elevated white cell count
-Reduced C reactive protein
Reduced haemoglobin
-Elevated Eryhthrocyte sedimentation rate
. A 75 year old man presented to his general practitioner (GP) with difficulty initiating walking. His GP notices a pill rolling tremor and suspected Parkinson’s disease.
Which of the following is the most likely neurotransmitter to be affected?
Dopamine
. A 20 year old man was assaulted whilst watching a football match. On arrival at the local Accident and Emergency (A&E) department he opened his eye to pain, said inappropriate words and withdrew from pain. What is his Glasgow Coma Scale (GCS)?
9
A 74 year old man presented with a haemorrhage in his right basal ganglia
Which of the following functions is he most likely to have problems with?
Appreciation of smell
Initiation and termination of movements
Interpretation of visual images
Short term memory
Understanding speech
Initation and termination of movements
A 44 year old woman presents with a 5 year history of an 11th nerve palsy.
Which of the following features is most likely to be present?
Fasciculation in the deltoid muscle
Wasting of the deltoid muscle
Fasciculation in the platysma muscle
Hypertrophy of the trapezius muscle
Wasting of the sternocleidomastoid muscle
Wasting of sternocleidomastoid muscle
