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ÅJJB 5th year > Neuro PP > Flashcards

Neuro PP Flashcards

1
Q

The essential tremor is …. (choose correct answer(s))

a. Usually inherited
b. Tremor involves the upper extremities more than the legs
c. The amplitude of the tremor is increasing as the extremity is getting closer to the target
d. Pathological changes must be found in the cerebellum or brainstem on MRI

A

a. Usually inherited

b. Tremor involves the upper extremities more than the legs

c. The amplitude of the tremor is increasing as the extremity is getting closer to the target

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2
Q

In hepatic encephalopathy, this statement(s) is/are true:

a. EEG may show triphasic slow waves
b. Arterial ammonia is always elevated
c. Asterixis may be present
d. Generalized seizures never occur

A

a. EEG may show triphasic slow waves

b. Arterial ammonia is always elevated

c. Asterixis may be present

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3
Q

The first clinical symptom in Alzheimer’s disease

a. Problems in autobiographical memory
b. Personality changes
c. Short term memory problems
d. Prosopagnosia

A

c. Short term memory problems

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4
Q

Wallenberg syndrome

a. Is caused by occlusion of the internal carotid artery
b. Most frequent symptoms are hemiparesis, cognitive dysfunction, vertigo
c. The vestibular nuclei are usually involved
d. Horner triad is part of the syndrome

A

c. The vestibular nuclei are usually involved

d. Horner triad is part of the syndrome

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5
Q

When does Wernicke-encephalopathy occur?
a. Only in IV drug users
b. in all diseases or conditions associated with lack of vitamin B1
c. only in case of alcoholism
d. in acute alcohol intoxication

A

b. in all diseases or conditions associated with lack of vitamin B1

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6
Q

In Wernicke-enephalopathy brain MRI does NOT show changes in the following territories:
a. mamillary bodies
b. surrounding the 4th ventricle
c. dorsomedial nucleus of the thalamus
d. occipital bone

A

d. occipital bone

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7
Q

Which drug is the most effective in painful diabetic neuropathy?

a. pregabalin
b. gabapentin
c. capsaicin
d. valporate

A

a. pregabalin

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8
Q

Our 60-year-old patient is complaining about strong, progressive, unilateral temporal headache. Mastication worsens the pain. Erythrocyte sedimentation rate is significantly elevated. What is our suspected diagnosis?

a. Sjøgren Syndrome
b.SLE
c. Arteritis temporalis
d. HCV-associated vasculitis
e. the symptoms are not characteristic for any autoimmune disorder

A

c. Arteritis temporalis

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9
Q

Our patient has been diagnosed with rheumatoid arthritis. Now she is complaining about neck pain and progressive weakness of the extremites. Which is our suspected diagnosis

Select one:
a. Atlantoaxial subluxation
b. Polyneuropathy
c. Carotis dissection
d. occlusion of areria spinalis
e. Vascular encephalopathy

A

a. Atlantoaxial subluxation

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10
Q

When should we start anti-epileptic treatment in case of a patient who has brain metastases

a. It is never necessary
b. After the first seizure
c. If the radiomorphology (size and localization on the MR pictures) suggests a potential role of the tumor to provocate seizures
d. After the second seizure (b/c two seizures are necessary for diagnosing epilepsy)

A

b. After the first seizure

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11
Q

Which clinical condition has to be considered as a neurological emergency?

a. Hakim triade
b. fasciculation
c. repeated absence seizures
d. anisocoria

A

d. anisocoria

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12
Q

Unconscious patient with bradycardia, elevated systolic blood pressure (200/90 mmHg), all the extremities are extended, respiration is irregular. Possible reason

a. Transtentorial heriniation
b. transforaminal heriniation
c. third degree atrioventricular block
d. intoxicationwith sedato-hypnotic drugs

A

a. Transtentorial heriniation

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13
Q

Vasogenic cerebral edema

a. spreads in the cerebral white matter dominantly
b. all
c. explained by the blood-brain barrier damage
d. steroid reduces its production

A

b. all

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14
Q

Possible complication of cerebellar infarction

a. eplieptic state
b. occlusive hydrocephalus
c. subfacial herniation
d. uncal herniation

A

b. occlusive hydrocephalus

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15
Q

Painful stimulus in the trigeminal zone does not lead to any motor reactions or eye opening of the comatose patient, but the blood pressure and the heart rate is elevating. How should be evaluated this phenomenon?

a. it is an evidence of having hypnotic drug intoxication
b. this is a signal of hemodynamic instability
c. Brainstem is responsive
d. locked-in syndrome is suspected

A

c. Brainstem is responsive

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16
Q

What is the correct definition TIA?

a. a generalized hypoperfusion in the brain
b. sudden onset of neurological symptoms which are ceasing in 24 hours
c. temporary perfusion deficit in the brain, when infarct is not seen on CT
d. temporary neurological dysfunction due to ischemia in the brain, the spinal cord or in the retina without the development of acute infarct

A

d. temporary neurological dysfunction due to ischemia in the brain, the spinal cord or in the retina without the development of acute infarct

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17
Q

What is the most common cause of stroke in young adults among the following?

a. large vessel dissection
b. vessel occlusion of atherosclerotic origin
c. myocardial aneurysm
d. atrial fibrillation

A

a. large vessel dissection

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18
Q

What could be the symptoms of left posterior cerebral artery stroke?

a. right homonymous hemianopsy and right side hemiparesis
b. right homonymous hemianopsy, sensory disturbance on the right side of the body and right side hemiparesis
c. right heteronymous hemianopsy
d. right homonymous hemianopsy

A

d. right homonymous hemianopsy

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19
Q

A headache provoked by physical activity, straining, or coughing can be caused by:

a. Arnold-Chiari malformation
b. medication overuse
c. giant cell arteritis
d. cluster headache

A

a. Arnold-Chiari malformation

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20
Q

Intracranial space-occupying lesions can cause:

a. progressive headache
b. focal neurological signs
c. epileptic seizures
d. all of the above

A

d. all of the above

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21
Q

Which of the following is characteristic for serotonin syndrome?

a. may be caused by overdosing or medicinal interactions
b. headache and agitation are common symptoms
c. fever and tachycardia may be present
d. hemiparesis is a frequent symptom
e. tremor, myoclonus, hyperreflexia, and clonus may be present
f. answers A, B,C and D are correct
g. answers A, B, C, and E are correct

A

g. answers A, B, C, and E are correct

a. may be caused by overdosing or medicinal interactions
b. headache and agitation are common symptoms
c. fever and tachycardia may be present
e. tremor, myoclonus, hyperreflexia, and clonus may be present

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22
Q

Which statement is true?

a.dyskinesias/hyperkinesias belong to the main motor symptoms of Parkinson’s disease
b. dyskinesias/hyperkinesias may be induced only by drugs
c. e dyskinesias/hyperkinesias are always genetically determined
d. dyskinesias/hyperkinesias are always abnormal movements

A

d. dyskinesias/hyperkinesias are always abnormal movements

23
Q

What percent of parkinson patients develop dementia?

a. In 40% of parkinsonian patients
b. Dementia occurs only if the parkinsonian syndrome is the part of diffuse Lewy body dementia
c. Parkinson patients do not develop dementia, b/c its not Alzheimers disease
d.
In all parkinsonian patients, depending on disease duration

A

a. In 40% of parkinsonian patients

24
Q

What is the most severe side effect of lamotrigine?

a. Toxic epidermal necrolysis
b. hypoglicemia
c. hyponatremia
d. severe weight loss

A

a. Toxic epidermal necrolysis

25
Q

It is true for focal epilepsy:

Select one:
a. Only non-convulsive clinical presentation is known.
b. It can be best treated with primidone.
c. It originates most frequently in the temporal lobe.
d. caused by dysfunction of thalamo-cotical circuitry

A

c. It originates most frequently in the temporal lobe.

26
Q

The most common clinical presentation of neuroborreliosis:

a. myelitis
b. peripheral hypoglossal nerve palsy
c. optic neuritis
d. peripheral facial nerve palsy

A

d. peripheral facial nerve palsy

27
Q

Possible causes of aspetic meningitis

a. skull trauma
b. vaccination
c. Crohn disease
d. B12 deficiency

A

b. vaccination

28
Q

Leading pathogen of bacterial meningitis in immuncompromised patients

a. Clostridium tetani
b. Francisella tularensis
c. Listeria monocytogenes
d. Entamoeba hystolitic

A

c. Listeria monocytogenes

29
Q

Which of the following electrophysiological methods is useful in the diagnosis of myasthenia gravis?
Select one:

a. Repetitive nerve stimulation
b. F waves
c. Electromyography
d. Sensory neurography

A

a. Repetitive nerve stimulation

30
Q

7 Which of the following may be a symptom of myasthenia gravis?

a. spasticity
b. muscle atrophy
c. joint contractures
d. fluctuating ptosis

A

d. fluctuating ptosis

31
Q

In left sided peripheral lesion of the vestibular nerve the patient falls and deviates

a. to the right
b. the direction is not characteristic
c. to the left
d. to the directionof the gaze

A

c. to the left

32
Q

Which cranial nerves have a role in taste sensation?

a. CN. VII. and XII.
b. CN. VII., IX. and XII.
c. CN.VII.and IX
d. CNIX and XII

A

c. CN.VII.and IX

33
Q

In left sided “upper motor neuron” (central) facial palsy

Select one:
a.There is a mouth drop on the left side, the left side of the mouth moves less when smiling, but eye-closure and forehead wrinkling is performed with normal strength on both sides.
b. Forehead wrinkling, eye closure, and smiling is weaker on the right side
c. Forehead wrinkling, eye closure, and smiling is weaker on the left side
d. None of the above is true

A

d. none

34
Q

The major sign of retrobulbar neiritis

a.Relatively fast progressing decrease in visual acuity
b. Diplopia
c. Increase in intraocular pressure
d. Papilledema

A

a.Relatively fast progressing decrease in visual acuity

35
Q

Where do the fila olfactoria enter the skull

Select one:
a. Through the foramen magnum
b. Through the lamina cribrosa
c. Through the stylomastoid foramen
d.Through the jugular foramen

A

b. Through the lamina cribrosa

36
Q

If nystagmus, ataxia and hemiparesis appears acutely in a 20-year-old patient, we primarily consider

a. Multiple sclerosis
b. exhaustion
c. alcohol intoxication
d. vertrobasilar cerebrovascular insufficiency

A

d. vertrobasilar cerebrovascular insufficiency

37
Q

A key element in the diagnosis of Guillain-Barré syndrome:

a. genetic test
b. oral glucose tolerance test
c. muscle and nerve biopsy
d. EMG

A

d. EMG

38
Q

All of the below may cause foot drop, EXCEPT ONE:

a. partial sciatic nerve lesion
b. peroneal nerve lesion
c. tibial nerve lesion
d. L5 radiculopathy

A

c. tibial nerve lesion

39
Q

The meaning of allodynia is:

a. spontaneous pain
b.spontaneous involuntarily movement
c. pain provoked by touch
d. simultaneous contraction of antagonist muscles during voluntary innervation

A

c. pain provoked by touch

40
Q

The conduction velocity of the fastest conducting motor fibers is:

Select one:
a. 1 m/s
b. 1000 m/s
c. 100 m/s
d. 500 m/s

A

c. 100 m/s

41
Q

Not typical for Syringomyelia

a. spinal ataxia
b. trophical disturbances on hands
c. dissociated sensory loss
d. atrophia of small hand muscles

A

a. spinal ataxia

42
Q

Patient with SLE developed almost complete transversal spinal cord lesion within 3 days. Possible diagnosis?

a. Amyotrophic lateralsclerosis
b. Lumbar disc herniation
c. Cauda syndrome
d. myelitis transversa

A

d. myelitis transversa

43
Q

Typical origin of medulloblastoma?

a. temporal lobe
b. spinal cord
c. cerebellum
d. corpus pineale

A

c. cerebellum

44
Q

Which one refers to S.1 radiculopathy?

a. Sensory loss on the lateral part of the leg, weakness of the m. triceps surae
b. Sensory deficit on the anterior part of the tigh, absent Achilles reflex
c. Incontinence, weakness of foot dorsalflexion
d. Weakness of knee extension

A

a. Sensory loss on the lateral part of the leg, weakness of the m. triceps surae

45
Q

Which could be a symptom of cervical disc herniation?

a. Irradiating pain to upper extremities
b. atrophy of hand muscles
c. unstable gait
d. all of them

A

d. all of them

46
Q

The diagnosis of subacute combined degeneration involves:

a. Cerebrospinal fluid tests
b. Spinal biopsy
c. Spinal CT, lab test
d. Spinal MRI lab tests

A

d. Spinal MRI lab tests

47
Q

True for spinal ataxia:

a. Not seen in subacute combined degeneration
b. Pain sensation is diminished
c. Proprioception is normal
d. Worsens when eyes are closed

A

d. Worsens when eyes are closed

48
Q

Which of the following is correct?

a. Intracranial space-occupying lesions always cause rise of intracranial pressure.
b. Elevation of intracranial pressure always causes papillary edema.
c. Elevation of intracranial pressure alone does not exclude lumbar puncture
d. Elevation of intracranial pressure is always caused by intracranial space-occupying lesions

A

c. Elevation of intracranial pressure alone does not exclude lumbar puncture

49
Q

Paranoia and psychosis could be prodromal signs of

a. NMDA-encephalitis
b. HIV-encephalitis
c. Mycoplasma-encephalitis
d. VZV encephalitis

A

a. NMDA-encephalitis

50
Q

Leading sign in encephalitis:

a. seizure
b. altered consciousness
c. fever
d. all the above

A

d. all the above

51
Q

The following is characteristics for diffuse Lewy Body Dementia

a. parkinsonism, acoustic hallucinations, delirium
b. parkinsonism, visual hallucinations, delirium
c. parkinsonism, visual hallucinations, fluctuation
d. parkinsonism, acoustic hallucinations, fluctuation

A

c. parkinsonism, visual hallucinations, fluctuation

52
Q

Typical intial symptom of Alzheimer’s disease

a. episodic memory dysfuction
b. disturbance of autobiographical memory
c. semantic memory dysfunction
d. disturbance of working memory

A

a. episodic memory dysfuction

53
Q

Which antiepileptic drug would you choose first in focal epilepsy caused by brain metastasis

a. Phenytoin
b. Diazepam
c. Carbamazepine
d. Ethosuximide

A

c. Carbamazepine

54
Q

Which of the following causes vasogenic brain edema?

a. Low blood potassium
b. Occlusive hydrocephalus
c. Brain metastasis
d. Acute brain infarct

A

c. Brain metastasis

ÅJJB 5th year (5 decks)

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