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PP Flashcards

1
Q

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

A

a. In all diseases or conditions associated with lack of vitamin B1

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2
Q

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

A

d. occipital lobe

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3
Q

Which drug is the most effective in painful diabetic neuropathy?
a. gabapentin
b. capsaicin
c. pregabalin
d. valproate

A

c pregabalin

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4
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. HCV-associated vasculitis
b. SLE
c. SjOgren-syndrome
d. The symptoms are not characteristic for any autoimmune disorder.
e. Arteritis temporalis

A

e. Arteritis temporalis

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5
Q

Our patient has been diagnosed with rheumatoid arthritis. Now she is complaining about neck pain and progressiv weakness of the extremites. Which is our
suspected diagnosis
a. Atlantoaxial subluxation
b Polyneuropathy
c Vascular encephslopathy
d. Carotis dissection
e. Occlusion of areria spinalis

A

a. Atlantoaxial subluxation

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6
Q

When should we start antiepileptic treatment in case of a patient who has brain metastases?
Valasszon ki egyet
a. After the first seizure
b. it is never necessary
c. if the radiomorphology (size and localisation on the MR pictures) suggests a potential role of the tumor to provocateur seizures
d. . After the second seizure (because two seizures are necessary for diagnosing epilepsy)

A

a. After the first seizure

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7
Q

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

a. repested sbsence seizures
b. fasciculation
c. Hakim triade
d. anisocoria

A

d. anisocoria

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8
Q

Unconscious patient with bradycardia, elevated systolic blood pressure (200/90 mmHg}, all the extremities are extended respiration irregular possible reason

a. transforaminal herniation
b. transtentorial herniation
c Third degree atrioventricular block
d. intoxication with sedato-hypnotic drugs

A

b. transtentorial herniation

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9
Q

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

A

b. all

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10
Q

Possible complication of cerebellar infarction
a. uncal herniation
b. epileptic state
c subfalcial herniation
d. occlusive hydrocephalus

A

. occlusive hydrocephalus

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11
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. This is a signal of hemodynamic instability
b. Brainstem is responsive
c. Locked-in syndrome is suspected
d. it is an evidence of having hypnotic drug intoxication

A

b. Brainstem is responsive

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12
Q

What is the correct definition of TIA?
a. a sudden onset of neurological symptoms which are ceasing in 24 hours

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

c a generalized hypoperfusion in the brain
d. temporary perfusion deficit in the brain, when infarct is not seen on CT

A

b. 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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13
Q

What is the most common cause of stroke in young adults among the following?
a. large vessel dissection
b. atrial fibrillation
c myocardial aneurism
d. vessel occlusion of atherosclerotic origin

A

a. large vessel dissection

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14
Q

What could be the symptoms of left posterior cerebral artery stroke

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

A

c right homonymous hemianopsy

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15
Q

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

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

A

d. Armold-Chiari malformation

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16
Q

Intracranial space-occupying lesions cam 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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17
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

Valasszon ki egyet:
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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18
Q

Which statement is true?

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

A

b. dyskinesias/hyperkinesias are always abnormal movements

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19
Q

What percent of parkinsonian patients develop dementia?

a. In all parkinsonian patients, depending on disease duration
b. Dementia occurs only if the parkinsonian syndrome is the part of diffuse Lewy body dementia
c In 40% of parkinsonian patients
d. Parkinsonian patients do not develop dementia, because it is not Alzheimer’s disease

A

c In 40% of parkinsonian patients

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20
Q

What is the most severe side effect of lamotrigine?

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

A

a. toxic epidermal necrolysis

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21
Q

it is true for focal epilepsy:

a Caused by dysfunction of thalamo-cortical circuitry
b. Only non-convulsive clinical presentation is known.
c. it can be best treated with primidone.
d. lt originates most frequently in the temporal lobe.

A

d. lt originates most frequently in the temporal lobe.

22
Q

The most common clinical presentation of neuroborreliosis:
Valasszon ki egyet:
a peripheral hypoglossal nerve palsy
b. optic neuritis
c myelitis
d. peripheral facial nerve palsy

A

d. peripheral facial nerve palsy

23
Q

Possible cause of aseptic meningitis:
a B12-deficiency
b. Crohn disease
c vaccination
d.. skull trauma

A

c vaccination

24
Q

Leading pathogen of bacterial meningitis in immuncompromised patients

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

A

a. Listeria monocytogenes

25
Q

Paranoia and psychosis could be prodromal signs of
Valasszon ki egyet:
a. VZV encephalitis
b. Mycoplasma-encephalitis
c. NMDA-encephalitis
d. HlV-encephalitis

A

c. NMDA-encephalitis

26
Q

Leading sign in encephalitis:

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

A

d. all the above

27
Q

The following is characteristic for diffuse Lewy body dementia:

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

A

c. parkinsonism, visual hallucinations, fluctuation

28
Q

Typical initial symptom of Alzheimer’s disease:

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

A

a. episodic memory dysfunction

29
Q

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

a Ethosuximide
b. Phenytoin
c. Carbamazepine
d. Diazepam

A

Carbamazepine

30
Q

Which of the following causes vasogenic brain edema?
Valasszon ki egyet:
a. Brain metastasis
b. Low blood potassium
c .Occlusive hydrocephalus
d. Acute brain infarct

A

a. Brain metastasis

31
Q

Which of the following is correct?

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

A

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

32
Q

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

A

d. Worsens when eyes are closed

33
Q

The diagnosis of subacute combined degeneration involves:
a. Spinal MRI, lab tests
b. Cerebrospinal fluid tests
c Spinal CT, lab test
d. Spinal biopsy

A

a. Spinal MRI, lab tests

34
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

35
Q

Which one refers to S.1 radiculopathy?
a Incontinence, weakness of foot dorsalflexion
b. Weakness of knee extension
c Sensory deficit on the anterior part of the tHigh, absent Achilles reflex
d. Sensory loss on the lateral part of the leg, weakness of the m. triceps surae

A

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

36
Q

Patient with SLE developed almost complete transversal spinal cord lesion within 3 days. Possible diagnosis?
a Amyotrophic lateralsclerosis
b. Myelitis transversa
c Lumbar disc herniation
d. Cauda syndrome

A

b. Myelitis transversa

37
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

38
Q

The conduction velocity of the fastest conducting motor fibers is:
Valasszon ki eqyet:
a 1 m/s
b. 500 m/s
c. 100m/s
d 1000 m/s

A

c. 100m/s

39
Q

Typical feature of intramedullary tumor of the cord:
a. Epicritical sensory loss
b. Radicular pain in legs
c. Dissociated sensory loss
d. Local pain over the spine

A

c. Dissociated sensory loss

40
Q

The meaning of allodynia is:
Valasszon ki egyet:
a. spontaneous pain
b. simultaneous contraction of antagonist muscles during voluntary innervation
c. pain provoked by touch
d. spontaneous involuntary movement

A

c. pain provoked by touch

41
Q

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

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

A

d. tibial nerve lesion

42
Q

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

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

A

a. EMG

43
Q

If nystagmus, ataxia and hemiparesis appears acutely in a 20-year-old patient, we primarily consider
a. Multiple sclerosis
b. Vertebrobasilar cerebrovascular insufficiency
c Exhaustion
d. Alcohol intoxication

A

b. Vertebrobasilar cerebrovascular insufficiency

44
Q

Where do the fila olfactoria enter the skull

a. Through the lamina cribrosa
b. Through the stylomastoid foramen
c Through the foramen magnum
d. Thrtheo juguulagr fohram en

A

a. Through the lamina cribrosa

45
Q

The major sign of retrobulbar neuritis:

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

A

b. Relatively fast progressing decrease in visual acuity

46
Q

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

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

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.

47
Q

Which cranial nerves have a role in taste sensation?
Valasszon ki egyet:
a. CN. VII, IX. and XlI.
b. CN. IX and XII
c CN. VIl. and XI
d. CN. VII and IX.

A

d. CN. VII and IX.
FACIAL
GLOSSOPHARYNGEAL

48
Q

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

a The direction is not characteristic
b. To the direction of gaze
c To the left
d. To the right

A

c To the left

49
Q

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

A. Fluctuating ptosis
b. Joint contractures
c Spasticity
d. Muscle atrophy

A

A. Fluctuating ptosis

50
Q

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

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

A

a. Repetitive nerve stimulation

neuro (32 decks)

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