Rembe - Chapter 7 (MS) Flashcards

Clinical Neurology

1
Q

In an advanced peripheral neuropathy of diabetes mellitus, which of the following complications might likely occur or be present?

Anorexia
Charcot joint of the knee
Cerebral congestion
Papilledema

A

Charcot joint of the knee

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2
Q

Immediately following a transection of the spinal cord, which of the following changes can be expected?

a. Increase in skeletal muscle tone
b. Spinal shock lasting 2 days
c. Retention of urine and feces
d. Hypotension

A

c. Retention of urine and feces

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3
Q

All of the following statements apply to diabetes insipidus EXCEPT:

a. Lesions of the pancreas give rise to the disorder
b. The patient experiences excessive thirst
c. There is excessive output of urine of low specific gravity
d. There is insufficient secretion of antidiuretic hormone

A

a. Lesions of the pancreas give rise to the disorder

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4
Q

Treatment of cervical spondylosis after sudden onset or exacerbation of radicular pain and motor weakness following insult includes

Bed rest
Adequate use of analgesics
Radiant heat
All of the above

A

All of the above

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5
Q

During progressive cerebral anoxia, the first clinical sign that occurs is

Perceptual and visual difficulties
Unconsciousness
Decerebration
Impairment of judgment

A

Impairment of judgment

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6
Q

A common cause of epidural compression of the spinal cord is

Tay-Sachs disease
Hodgkin’s disease
Werdnig-Hoffman syndrome
Erb-Duchenne-Klumpke syndrome

A

Hodgkin’s disease

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7
Q

Demyelinating diseases of the central nervous system include all of the following EXCEPT

Multiple sclerosis
Alzheimer’s disease
Niemann-Pick disease
Schilder’s disease

A

Alzheimer’s disease

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8
Q

All of the following apply to Hodgkin’s disease EXCEPT

a. Clinical features include general symptoms of fever, weakness, weight loss, and anemia
b. Varying neurological manifestations
c. More common in females
d. Herpes zoster is not an uncommon concomitant

A

c. More common in females

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9
Q

Which of the following is most frequently associated with a subarachnoid hemorrhage?

Severe hypertension
Mycotic aneurysm
“Berry” aneurysm
Atherosclerotic aneurysm

A

“Berry” aneurysm

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10
Q

Primary diseases of muscle include all of the following EXCEPT

a. Progressive muscular dystrophy
b. Myasthenia gravis
c. Myotonia congenital
d. Infantile spinal muscular atrophy (Werdnig-Hoffman syndrome)

A

d. Infantile spinal muscular atrophy (Werdnig-Hoffman syndrome)

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11
Q

Changes in the neurological status of a patient, following a motorcycle accident, indicate damage. Which of the following would be most significant?

a. Localization of headaches
b. Pain and edema near the eye
c. Increase in pulse and respiratory rate
d. Change from alertness to increased lethargy

A

d. Change from alertness to increased lethargy

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12
Q

A positive Romberg test indicates

a. Serology for syphilis
b. Test for high protein in cerebrospinal fluid
c. High leukocyte count in cerebrospinal fluid
d .Swaying while standing with eyes closed

A

d. Swaying while standing with eyes closed

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13
Q

Clinical features of multiple sclerosis include all of the following, EXCEPT

Motor weakness
Visual symptoms (e.g., diplopia)
Ataxia of gait
Bradykinesia

A

Bradykinesia

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14
Q

The disorder of movement of quick oscillation of eyes while fixing gaze on an object, as a result of a cerebellar tumor, is known as

Dysmetria
Asynergia
Adiadochokinesia
Nystagmus

A

Nystagmus

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15
Q

A cerebral infarction of the middle cerebral artery would probably cause all of the following symptoms EXCEPT

Aphasia
Ipsilateral Horner’s syndrome
Hemianopsia
Contralateral hemiplegia

A

Ipsilateral Horner’s syndrome

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16
Q

The inability to perform tapping movements quickly and smoothly is known as

Asynergia
Nystagmus
Adiadochokinesia
Dysmetria

A

Adiadochokinesia

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17
Q

Syringomyelia is characterized by all of the following EXCEPT

a. Atrophy of small muscles of the hand
b. Painless burns of fingers
c. Viral etiology
d. Cavitation and gliosis in spinal cord

A

c. Viral etiology

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18
Q

Clinical features of ataxic cerebral palsy include all of the following, EXCEPT

Hypertonic from birth
Dysmetria
Intention tremor
Truncal ataxia

A

Hypertonic from birth

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19
Q

A condition that is due to involvement of the extrapyramidal system is

Ataxia
Athetosis
Spasticity
Hemiplegic cerebral palsy

A

Athetosis

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20
Q

Which of the following has a viral etiology?

Parkinsonism
Guillain-Barre syndrome
Schrider’s disease
Multiple sclerosis

A

Guillain-Barre syndrome

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21
Q

Dysmetria is a disorder of movement as a result of a cerebellar tumor. Which of the following describes this movement?

a. Error in range of movement
b. Oscillation
c. Lack of cooperation between muscles
d. Deviation from line of movement

A

a. Error in range of movement

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22
Q

Segmental levels of C5,6 include innervations for the

Biceps reflex
Triceps reflex
Brachioradialis reflex
Hoffman reflex

A

Brachioradialis reflex

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23
Q

Segmental levels of C7,8 include innervations for the

Triceps reflex
Brachioradalis reflex
Hoffman reflex
Finger jerk

A

Triceps reflex

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24
Q

Neurologic disorders resulting from defects at the neuromuscular junction include

Myasthenia gravis
Guillan-Barre syndrome
Parkinsonism
None of the above

A

Myasthenia gravis

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25
Neurologic manifestations of Hodgkin’s disease include a. Compression lesions of the spinal cord b. Peripheral nerve involvement c. Involvement of the meninges and base of skull d. All of the above
All of the above
26
Which of the following diagnostic studies is used to visualize the intracranial vascular areas? Brain scan Arteriography Tomography (CAT) X-ray
Arteriography
27
Disorders with involuntary movements include Parkinson’s disease Dystonia musculorum deformans Huntington’s chorea All of the above
All of the above
28
Which lesions or diseases result in visible wasting or atrophy of the muscles involved Posterior horn cells Posterior spinal roots Motor axons Dorsal spinal roots
Motor axons
29
Which of the following diagnostic procedures is able to demonstrate hematomas, hemorrhage, and infarcts? Tomography (CAT) Brain scan Arteriography Electroencephalogram
Tomography (CAT)
30
Peripheral neuropathy may occur in Arsenic poisoning Lead poisoning Thiamine deficiency All of the above
All of the above
31
In Wilson’s disease (hepatolenticular degeneration) there is Vitamin B12 deficiency A macroglobulinemia Renal failure Increased absorption of copper from the intestinal tract
Increased absorption of copper from the intestinal tract
32
Hypotension syncope may occur from a. Sudden decrease in cardiac output b. Increase in venous return to the heart c. Sudden increase in peripheral vascular resistance d. Sudden decrease of the carotid artery’s function
a. Sudden decrease in cardiac output
33
In the acute care of a cerebrovascular accident, which of the following critical factors should be considered? Stabilization of vital signs Correction of cardiac arrhythmias Proper positioning All of the above
All of the above
34
Natal factors in etiology and pathogenesis of cerebral palsy include Anoxia No known trauma Full-term pregnancy Kernicterus
Anoxia
35
Conditions which are NOT progressive include Cerebral palsy Multiple sclerosis Alzheimer’s disease Schilder’s disease
Cerebral palsy
36
Inspection of the muscular system of a patient reveals fasciculations. These fasciculations are evidence of damage to the Upper motor neuron Anterior horn cell Cerebral cortex Motor unit
Anterior horn cell
37
Brudzinski’s sign a. May be present in cerebrovascular accident b. May be present in meningeal irritation c. Is characterized by extension at the knees when the hips are flexed d. Is characterized by extension at the knees when the neck is flexed
b. May be present in meningeal irritation
38
A seizure involving a momentary loss of consciousness, usually just a blank stare, is referred to as Jacksonian seizure Patit mal Grand mal
Patit mal
39
A patient presents with a sudden onset of fever, headache, and nuchal rigidity. This is followed by drowsiness, confusion, and loss of consciousness. One should suspect Subdural hematoma Cranial epidural abscess Cranial subdural empyema Acute purulent meningitis
Acute purulent meningitis
40
Which of the following drugs is used for the treatment of Jacksonian and psychomotor seizures? Phenacemide Primidone Phenytoin Mephenyloin
Phenytoin
41
Symptoms of subacute combined degenerations of the spinal cord include a. Initially a paresthesia of the extremities followed by numbness and distal weakness in the limbs b. Ataxic gait with variable degrees of spasticity in lower limbs c. Hyperactive deep reflexes and extensor plantar responses d. All of the above
d. All of the above
42
Which of the following drugs is used for the treatment of petit mal seizures? Phenacemide Primidone Carbamezepine Ethosuximide
Ethosuximide
43
Virus infections of the nervous system include all of the following, EXCEPT Acute anterior poliomyelitis Herpes zoster Rabies Tabes dorsalis
Tabes dorsalis
44
The drug carbamazepine is used for major motor seizures. Which of the following is NOT a side effect? Paresthesia of the extremities Respiratory depression Urinary retention Water intoxication
Respiratory depression
45
Chorea and choreoathetosis are characteristics symptomatic of many diseases of the nervous system including Viral encephalitis Systemic lupus erythematosus Wilson’s disease All of the above
All of the above
46
How are the drugs phenytoin and mephenytoin similar in treatment for seizures? Used for petit mal seizure Same side effects Used for myoclonic seizures Used for Jacksonian and motor seizures
Used for Jacksonian and motor seizures
47
The most common tumor of the brain and spinal cord is The meningiomas The neurilemmomas Metastatic tumors The gliomas
The gliomas
48
Papilledema is a common finding in all of the following EXCEPT Intracranial tumors Cerebral trauma Meningitis Syringomyelia
Syringomyelia
49
Sensory impairment can be expected in all of the following EXCEPT Multiple sclerosis Amyotrophic lateral sclerosis Syringomyelia Polyneuritis
Amyotrophic lateral sclerosis
50
The condition in which there are abnormal and irresistible attacks of the desire to sleep is Cataplexy Cerebral norcardiosis Trichinosis Narcolepsy
Narcolepsy
51
52
Lesions in the brain cause seizures. Which of the following normally do NOT elicit them? Midbrain Thalamus Cerebellum Cerebral cortex
Cerebellum
53
In observing a patient, you note that there is absence of any response to painful stimuli. This condition is termed Coma Semicoma Stupor Obtundity
Coma
54
A false interpretation of a sensory perception is called a Delusion Illusion Hallucination Dystonia
Illusion
55
The treatment of preference for Parkinson’s disease is L-dopa Dopamine Surgical intervention Anticholinergic drugs
Anticholinergic drugs
56
Examination of a patient’s visual fileds reveals a scotoma. This condition a. Indicates that the lens is becoming opaque b. Is a blind spot or defect within the visual field c. Indicates pain on eye movement d. Precedes papilledema
b. Is a blind spot or defect within the visual field
57
The segmental level for innervations of the knee jerk (patellar reflex) is L1,2 L2,3,4 L3,4,S1 L4,S1,2
L2,3,4
58
The segmental levels for innervations of the ankle jerk (Achilles reflex) is L2,3,4 L3,4,5 L5,S1,2 L5,S1
L5,S1,2
59
The most common neurologic complication of multiple myeloma is Headache, dizziness, syncope Confusion, disorientation Dysphasia Peripheral neuropathy
Peripheral neuropathy
60
The essential features of Wernicke’s encephalopathy are the triad of a. Headache, dizziness, syncope b. Opthalmoplegia, ataxia, dementia c. Confusion, disorientation, loss of memory d. Cerebral congestion, headache, papilledema
b. Opthalmoplegia, ataxia, dementia
61
In stroking the outer aspect of the sole of the foot of a patient from the heel toward the small toe there is a response of dorsiflexion of the great toe, fanning of the toes, and withdrawal of the foot. This a. Is the Babinski sign b. Is a normal plantar reflex c. Is a flexor plantar response d. Indicates damage to the spinal tract
a. Is the Babinski sign
62
The chief symptom of Parkinson’s disease are all of the following, EXCEPT Rigidity Tremor Intention tremor Masklike face
Masklike face
63
A patient with a lucid interval following a head injury now presents with drowsiness, stupor and coma. One should suspect a. Subacute subdural hematoma b. Acute subdural hematoma c. Intracerebral hematoma d. Intracerebellar hematoma
a. Subacute subdural hematoma
64
65
Which of the following is a manifestation of myasthenia gravis? a. Rigidity and tremor b. Rapid fatigue of skeletal muscles c. Flaccid or spasitc paralysis d. Rapid fatigue of smooth muscle
b. Rapid fatigue of skeletal muscles
66
Clinical features of Wilson’s disease (hepatolenticular degeneration) include a. Generalized rigidity, bradykinesis, dysarthria, and masklike face in the dystonic form b. Ophthalmoplegia, ataxia dementia c. Lassitude, lethargy, restlessness, agitation d. None of the above
a. Generalized rigidity, bradykinesis, dysarthria, and masklike face in the dystonic form
67
Neurologic complications of moderate barbituare poisoning include a. Resembles alcoholic intoxication b. Voice is thick, dysarthric c. There is ataxia and other signs of cerebellar incoordination d. All of the above
d. All of the above
68
The etiology and pathology of amyotrophic lateral sclerosis includes Metabolic deficiency Virus etiology (e.g., “slow virus” infection) Abiotrophy AOTA
AOTA
69
Which of the following symptoms demonstrates a positive tensilon test a. Immediate decrease in muscle strength b. Ptosis-difficult with eyes c. Muscarine effect on smooth muscle d. Immediate increase in muscle strength
d. Immediate increase in muscle strength
70
Pathology of what organ in the body is associated with myasthenia gravis? Thymus Thyroid Heart Liver
Thyroid
71
Which of the following drugs is related to Phenobarbital in its therapeutic uses? Primidone Ethotoin Phenacemide Ethosuximide
Primidone
72
All of the following apply to myoclonus as a phenomenon EXCEPT a. A neuromuscular disorder originating from the central nervous system b. The attacks consist of irregular, asynergic, and jactitious contractions of muscle c. The attacks may occur in any part of the body and may be provoked by various stimuli d. Does not occur during drowsiness or emotional disturbance
d. Does not occur during drowsiness or emotional disturbance
73
The drug phenacemide is used for psychomotor seizures when the patient is not responsive to other drugs. Which of the following is NOT a side effect to this drug? Hepatic damage Bone marrow depression Skin rash Personality change
Skin rash
74
In comparing the clinical features of a brain abscess with those of a subdural empyema, the latter is a. Less likely to produce focal signs b. Usually not associated with any systemic signs of infection c. Characterized by cerebrospinal fluid which is xanthochromic without cells in the majority of cases d. All of the above
d. All of the above
75
Myoclonus occurs as part of the clinical picture of many disorders. It a. Is a neuromuscular disorder originating from the central nervous system b. Consists of irregular, asynergic, and jactitious contractions of muscle c. Produces nonrepetitive, brief, involuntary movements d. All of the above
All of the above
76
Which of the following is characteristic of a transient ischemic attack? a. Lasting damage to the brain b. Similar to epileptic seizure c. No residual after attack d. Hemiparesis is a residual
c. No residual after attack
77
All of the following are characteristic of a lower motor neuron lesion, EXCEPT a. Spastic paralysis below the level of the lesion b. Atrophy of muscles below level of lesion c .Depressed reflexes below level of lesion d. Fasciculations
Spastic paralysis below the level of the lesion
78
A patient with a head injury has symptoms of rising temperature and a slowing of respiration and pulse. What might cause these symptoms? a. Injury to the cortical motor speech area b. Injury to the vital centers within the medulla c .Organization of the blood clot d .Lesion in the occipital lobe
b. Injury to the vital centers within the medulla
79
A cerebrovascular accident patient, with left-sided weakness of upper and lower extremity likely has a lesion located in the Brainstem Medulla Left cerebral hemisphere Right cerebral hemisphere
Right cerebral hemisphere
80
In athetosis, the most probable site of pathology is Cranial nerve V Globus pallidus Motor cortex Neuromuscular junction
Globus pallidus