Neurology: Multiple Choice & Other Questions

Question 1

A 75 year-old patient presents with symptoms of dementia. An MRI of the brain shows “hippocampus atrophy,” which correlates with:

1. Stroke
2. Alzheimer’s disease
3. A neurodegenerative disorder, not dementia
4. Ischemic cardiovascular disease

Answer 1

2. Alzheimer’s disease

Question 2

What must always be part of the assessment for dementia?

1. Hyperthyroidism
2. Iron deficiency anemia
3. RPR
4. Depression

Answer 2

4. Depression

Question 3

A 50 year-old patient presents with complaints of bilateral tremor in his hands. Select all clues that favor diagnosis of essential tremor.

1. Tremor occurs at rest
2. Tremor is unilateral
3. Tremor affects lower extremities
4. Patient has a normal neurological exam
5. Alcohol worsens the tremor
   6 There is a strong genetic component
6. Symptoms present for at least 3 years

Answer 3

4. Patient has a normal neurological exam
   6 There is a strong genetic component
5. Symptoms present for at least 3 years

Question 4

A 20 year-old presents with bilateral hand tremor. His neurological exam is normal. What test would be helpful in ruling out other causes of his tremor?

1. CBC
2. Fasting glucose
3. TSH
4. MRI of brain

Answer 4

3. TSH

Question 5

A 70 year-old patient with Type 2 Diabetes has painful peripheral neuropathy in his feet. His medical history includes HLP, HTN, CAD, urinary retention related to BPH, depression, and cataracts. Which drug should be avoided (to treat neuropathy)?

1. Duloxetine
2. Venlafaxine
3. Amitriptyline
4. Gabapentin

Answer 5

3. Amitriptyline

Question 6

A 30 year-old woman complains of headache over last 2 - 3 weeks. Neuro exam is normal except papilledema. Pregnancy test is negative. How should the NP proceed?

1. Perform lumbar puncture
2. Order CT scan
3. Order MRI
4. No studies indicated at this time

Answer 6

3. Order MRI

Question 7

A 35 year-old nurse reports a new onset headache. What features indicate tension-type headache (TTH)?

1. They last approximately 30 - 45 minutes and cause tearing on the affected side
2. She has photophobia when they occur
3. They are pulsating
4. The pain does not worsen with routine activity

Answer 7

4. The pain does not worsen with routine activity

Question 8

A 17 year-old boy sustains a mild concussion during football last evening. He reports poor sleep last night and dull headaches since the injury. Neuropathy exam is normal. Select all choices of how he should be managed today.

1. He should have a CT scan with contrast today
2. He may play video games as long as they don’t exacerbate symptoms
3. He may not return to sports until headache resolves
4. He can use acetaminophen/ibuprofen for headaches

Answer 8

2. He may play video games as long as they don’t exacerbate symptoms
3. He may not return to sports until headache resolves
4. He can use acetaminophen/ibuprofen for headaches

Question 9

Treatment for Bell’s Palsy should include use of:

1. Prednisone
2. Oral antiviral therapy
3. NSAIDs
4. Physical therapy

Answer 9

1. Prednisone

Question 10

Which findings are consistent with suspected Bell’s Palsy. Select all that apply.

1. Onset of symptoms over last week
2. Disappearance of nasolabial fold
3. Decreased tearing on the affected side
4. Inability to wrinkle forehead
5. Loss of taste sensation
6. Inability to pucker lips
7. Blurred vision on affected side

Answer 10

2. Disappearance of nasolabial fold
3. Decreased tearing on the affected side
4. Inability to wrinkle forehead
5. Loss of taste sensation
6. Inability to pucker lips

Question 11

A patient presents with probable BPV. Select all findings expected with this diagnosis.

1. It is worse when he moves his head
2. The patient has nystagmus lasting < 30 seconds
3. He has nausea
4. He has a fever
5. He reports double vision
6. Dix Hallpike maneuver confirms diagnosis
7. Audiometry is abnormal

Answer 11

1. It is worse when he moves his head
2. The patient has nystagmus lasting < 30 seconds
3. He has nausea
4. Dix Hallpike maneuver confirms diagnosis