Neurological complications of medical disorders Flashcards
A 56-year-old woman with known pernicious anaemia. She has spastic paraparesis
and impaired sensation to touch and vibration in both lower limbs. What does she
have?
a. diabetic polyneuropathy
b. acute combined degeneration of the spinal cord
c. L4/L5 disc prolapse
d. stroke in the anterior cerebral artery
b. acute combined degeneration of the spinal cord
Hashimoto’s encephalopathy is:
a. tonic-clonic seizures are present
b. no association with Hashimoto’s thyroiditis
c. is a common disease
d. the disease is a traumatic illness
a. tonic-clonic seizures are present
Delirium tremens is not characteristic:
a. onset of symptomatology 48-69 hours after alcohol withdrawal
b. withdrawal seizures follow symptoms of delirium
c. visual hallucinations
d. fever
b. withdrawal seizures follow symptoms of delirium
In central pontine myelolysis, they are often
pathological:
a. Brainstem acoustic potentials
b. visible signs
c. somatosensory evoked responses
d. Motor challenges
a. Brainstem acoustic potentials
Acute alcohol intoxication can cause:
a. moipathy with plaques
b. necrotizing myositis
c. dermatomyositis
d. Vacuolar myopathy
b. necrotizing myositis
Withdrawal seizures in an alcoholic are usually:
a. focal
b. complex focal
c. generalised tonic-clonic
d. atonic
c. generalised tonic-clonic
The most effective anti-seizure therapy for an alcoholic is:
a. carbamazepine
b. topiramate
c. gabapentin
d. abstinence
d. abstinence
Alcoholic cerebellar degeneration is most commonly manifested by:
a. the ataxia carcass
b. nystagmus
c. upper limb ataxia
d. dizartrijo
a. the ataxia carcass
The following nerves are most commonly affected in sarcoidosis:
a. V
b. VI
c. VII
d. VIII
c. VII
Which structure is defective in vitamin B12 deficiency ataxia?
a. the little brain
b. vestibular system
c. dorsal columns of the spinal white matter
d. dorsal horns of the spinal grey matter
c. dorsal columns of the spinal white matter
What is corrected first when Wernicke’s encephalopathy is treated?
a. bulbomotorics
b. nystagmus
c. ataxia
d. polyneuropathy
a. bulbomotorics
A 21-year-old, highly successful philosophy student comes for the voices he often
hears. They are disturbing, dictating his daily activities. On examination, he is
oriented, without speech disorders, and his neurological examination is normal.
Probable diagnosis:
a. temporal lobe seizure
b. non-convulsive status epilepticus
c. tinnitus
d. psychosis
d. psychosis
Wernicke’s encephalopathy is not seen in patients with s/z:
a. chronic alcoholism
b. hyperemesis in pregnancy
c. glioblastoma
d. anorexia
c. glioblastoma
Which disease is least likely to cause anaemia?
a. Huntington’s disease
b. Parkinson’s disease
c. head injury
d. frontal lobe tumour
e. schizophrenia
a. Huntington’s disease
Central pontine myelinosis is caused by:
a. premature correction of hyponatraemia
b. long-lasting hyponatraemia
c. rapid correction of hypernatraemia
d. long-lasting hypernatraemia
e. multiple sclerosis
a. premature correction of hyponatraemia
Acute myeloid leukaemia is not associated w/:
a. intracerebral haemorrhage
b. hyperviscosity of the blood
c. carcinomatosis leptomening
d. opportunistic infections
e. none of the above
e. none of the above
What defects does B12 deficiency cause?
a. myopathy
b. radiculopathy
c. myelopathy
d. encephalopathy
a. myopathy
Shouldn’t it be encephalopathy?
When correcting electrolyte imbalances, we must be alert to the occurrence of
central pontine myelinosis in a patient with:
a. Hypokalaemia
b. hyperkalemia
c. hypocalcaemia
d. hypercalcaemia
e. none of the above
e. none of the above
Which part of the central nervous system is atrophic in a chronic alcoholic?
a. superior vermis
b. flocculus
c. Wernicke’s area
d. Brocco area
e. primary motor cortex
a. superior vermis
The gentleman has intermittent disturbances of consciousness, asterixis,
splenomegaly, ascites. He has:
a. impaired portal circulation clearance function
b. copper deficiency
c. renal tubular acidosis
d. pernicious anaemia
a. impaired portal circulation clearance function
What do you give a TB patient on isoniazid and rifampicin therapy to
prevent neuropathy?
a. Cobalamin (vitamin B12)
b. Pyridoxine (vitamin B6)
c. thiamine (vitamin B1)
d. erythromycin
e. ceftriaxone
b. Pyridoxine (vitamin B6)
A lady with lymphadenopathy, you diagnose her with sarcoidosis - which nerve do
you find a little affected?
a. II
b. III
c. V
d. VII
c. V
Which investigation will be without specificity in a patient with hepatic
encephalopathy who is an alcoholic?
a. hemogram
b. CT brain
c. ammonia in the blood
d. EEG
e. liver enzymes
b. CT brain
What most commonly causes neurosarcoidosis?
a. myelitis
b. mononeuritis multiplex
c. cerebral nerve palsies
d. hydrocephalus and encephalitis
e. all of the above
c. cerebral nerve palsies
What causes hypoglycaemia:
a. tremor
b. epileptic seizure
c. coma
d. all of the above
d. all of the above
Mononeuritis multiplex in the context of polyarteritis nodosa is treated with/s:
a. methylprednisolone
b. IVIg
c. azathioprine
d. cyclophosphamide
e. cyclosporine
a. methylprednisolone
What not to expect in systemic lupus erythematosus?
a. caps
b. psychosis
c. depression
d. mononeuritis multiplex
e. none of the above
e. none of the above
Neurological impairments in kidney disease include:
a. encephalopathy and peripheral neuropathy.
a. encephalopathy and peripheral neuropathy.
Which disease is more common in men:
a. migraine
b. Alzheimer’s disease
c. Parkinson’s disease
d. multiple sclerosis
c. Parkinson’s disease
Psychogenic illness, what characterises it:
a. the patient is unaware of it and cannot control it
b. most of them are consciously simulating
c. no organic or physiological cause is found
c. no organic or physiological cause is found
Trias in Wernicke’s encephalopathy:
a. confusion, hallucinations, polyneuropathy
b. confusion, ophthalmoplegia, ataxia.
c. coma, ataxia, nystagmus
d. confusion, nystagmus, hallucinations
b. confusion, ophthalmoplegia, ataxia.
Alcoholic with withdrawal syndrome and convulsions. How do we treat him?
a. diazepam
b. vaplroat
c. propofol
d. B12 replacement
a. diazepam
Wernicke-Korsakoff psychosis, what can we do?
a. thiamine
b. Niacin
c. cobalamin
d. folate
a. thiamine
The classic Wernicke’s encephalopathy trio includes:
a. ataxia, amnesia and predominantly horizontal bulbomotor disturbances
b. ataxia, amnesia and predominantly vertical bulbomotor disorders
c. ataxia, amnesia and myoclonus
d. ataxia, amnesia and generalised seizures
a. ataxia, amnesia and predominantly horizontal bulbomotor disturbances
Wernicke’s encephalopathy mainly affects:
a. hippocampus
b. frontal lobe cortex
c. Little Brains
d. dorsomedial thalamic nucleus and mamillary bodies
d. dorsomedial thalamic nucleus and mamillary bodies
Wernicke’s encephalopathy is treated by:
a. high doses of folic acid
b. high doses of thiamine
c. vitamin C
d. vitamin B12
b. high doses of thiamine
The Cushing Triad consists of:
a. hypertension
b. hypotension
c. bradycardia
d. tachycardia
e. irregular breathing
a. hypertension
c. bradycardia
e. irregular breathing
In sarcoidosis, the most commonly damaged nerve is the cranial nerve:
a. II
b. III
c. V
d. VIII
a. II
Chronic alcoholic. What atrophies him most often?
a. Vermis
b. flocculus
c. gyrus cinguli
d. mammillary bodies
a. Vermis
