question

1. What is the hallmark sign for a neuromuscular disease?

answer

c. Fatigue

question

2. What is the hallmark sign of Radiculopathy?

answer

d. Shooting Pain (think diabetic)

question

3. What is the hallmark sign of spinal cord problem?

answer

a. Bowel/bladder problem b. Clumsiness c. Fatigue d. Sensory level weakness e. A & D

question

4. What is the hallmark sign of a Cerebellum problem?

answer

b. Clumsiness

question

5. Brainstem is responsible for all of the following except:

answer

[b. Delusions] What is responsible for brainstem: a. Decreased sensation or strength on face c. Diplopia d. Dysarthria e. Dysphagia

question

6. 85% of acute strokes are infarctions including all of the following except:

answer

[d. Hemorrhage] a. Cardiogenic embolism b. Cerebrovascular disease c. Dissections e. Vasculitis

question

The 3 main etiologies of ischemic stroke are:

answer

b. Atherothrombotic, Embolic and Small vessel diseases

question

8. All are modifiable risk factors for stroke except:

answer

[a. Alcohol] b. Atrial fibrillation c. Carotid Stenosis d. Diabetes Mellitus e. Hypertension

question

9. Ataxic hemiparesis syndrome:

answer

Affects lower extremities more than upper extremities

question

10. A 64 year-old right-handed man with h/o poorly controlled HTN presents to the ER with acute onset of severe HA and left-sided weakness. On exam BP 210/110, patient is dysarthric with left facial droop, left plegia and left babinski. The most likely diagnosis is:

answer

d. Stroke

question

11. Which of the following would be physical exam findings consistent with upper motor neuron damage?

answer

Spastic muscle tone without atrophy and increased reflexes typically in a focal pattern

question

12. A 23 y/o PA student with no significant PMH presents to your clinic complaining of a lingering cough, weakness that worsens at the end of the day, and "seeing double" while studying her numerous neurology class notes. Physical exam reveals mild tachycardia, tongue with three furrows, use of accessory muscles on respiration, mild ptosis bilaterally, and fatigability to 3/5 in deltoids bilaterally with 8 reps that recovers to 5/5 after rest. She denies muscle atrophy and paralysis. Based on your diagnosis, what is the most likely first line of treatment for this patient?

answer

Pyridostigmine plus corticosteroids

question

13. Which is the most common neuropathy of cranial nerve VII involving eye closure?

answer

c. Bell's Pal7y

question

14. Classic findings for dermatomyositis include which of the following?

answer

a. Heliotrophic rash on eyelids b. Proximal weakness c. Sensation intact to light touch

question

All of the following are considered in the differential diagnosis of Bell's Palsy EXCEPT?

answer

[b. Hypothyroid Myopathy ] a. Ramsey-Hunt c. Otitis Media d. Neurosarcoid e. Syphilis

question

Which of the following is a characteristic of Locked-In Syndrome?

answer

c. Usually caused by pontine infarcts below or anterior to the RAS

question

Which Cranial nerve is involved in the cornea7 reflex?

answer

VII

question

18. Which of the following is not a criteria for diagnosing brain death?

answer

[b. Inclusion of complicating medical conditions that may confound clinical assessment] These area a criteria for dx brain death: a. Neuroimaging evidence of an acute CNS catastrophe that is compatible with clinical diagnosis of brain death c. No drug intoxication or poisoning d. Core temperature ≥ 32 degrees C e. All of the above

question

. You have a 74 year-old comatose patient, his head is arching backward and his toes are pointing downward. What type of posturing is this?

answer

b. Decerebrate posturing

question

Which of the following is a non-structural cause of coma?

answer

organ failure

question

A hyperkinetic movement disorder characterized by continuous, irregular, non-patterned, violent, flinging movements of the extremities due mainly to contractions of proximal muscles is...

answer

ballism

question

Parkinson's disease is usually characterized by all of the following except:

answer

a. Rest tremor b. Rigidity c. Tachykinesia d. Postural instability

question

23. In which hyperkinetic movement disorder are neuroleptics contraindicated?

answer

stereotypy

question

A patient presents to your clinic with a tremor. You suspect Parkinson's Disease, but, like a good PA student, are considering essential tremor as a differential diagnosis. As you perform your physical exam, you would expect to see what if this is Parkinson's:

answer

a. Increased tremor at rest and decreased with mental concentration

question

Parkinson's Plus Syndromes can produce all of the following symptoms except:

answer

[a. Horizontal gaze impairment] b. Alien hand c. Dementia d. Dysautomnia

question

Which of the following is NOT a common cause of dizziness?

answer

[d. Otitis Externa] a. Hypoglycemia b. Medication Side Effect c. Meniere's Disease

question

27. Peripheral vertigo is commonly due to problems in:

answer

d. Inner Ear

question

Dix Hall Pike maneuver is used to treat the symptoms of which condition:

answer

BPPV

question

. A 73 year old man presents to the ER complaining of acute onset dizziness accompanied with nausea and vomiting. He tells you that he hears a ringing noise and he can't hear out of his left ear. What is your MOST LIKELY diagnoses?

answer

Meniere's Dz

question

. You have diagnosed a patient with BPPV, what is your initial treatment plan?

answer

d. Tell the pt to avoid lying on the affected side.

question

Which of the following is NOT a criteria for Amnestic type Dementia:

answer

[c. resting tremor] a. aphasia b. memory impairment d. apraxia

question

32. Which of the following is true with regards to Mild Cognitive Impairment (MCI)?

answer

Patients with MCI who have hippocampal atrophy are more likely to progress to dementia.

question

Alzheimer's Disease is the most common illness leading to

answer

nursing home placement

question

All of the following are risk factors for Alzheimer's Disease EXCEPT:

answer

[d. Male sex ] a. increased age b. APOE4 polymorphism c. Estrogen replacement therapy

question

35. Alzheimer's disease most commonly results from a loss of:

answer

acetylcholine

question

. Patient presents with pain along the clavicle. During the physical exam, you note that she has numbness of her medial arm down to the 5th digit. She states that the pain increases when she raises her arm and rotates it. What is the most likely diagnosis?

answer

thoracic outlet syndrome (remember Barry Smith, I think I have this, reach up and grab titties!)

question

Patient complains that since yesterday he has been unable to raise his right eyebrow, and his right eyelid will not open all of the way (ptosis). He also tells you that he has pain behind his ears and his eyes have felt "dried out." During the neurologic exam, you ask him to smile, and you notice that the right corner of his mouth does not move. Except for the ptosis and drooping right corner of his mouth, the remainder of the neurologic exam is unremarkable. What is the most likely diagnosis?

answer

bells pal7y

question

Third nerve palsy causes paralysis of all the following extraocular muscles EXCEPT?

answer

[a. superior oblique (SO4 LR6 AO3)] b. medial rectus c. inferior oblique d. superior rectus

question

39. Ulnar nerve mononeuropathy results in

answer

b. claw hand [RUM/WTCU]

question

A 40 year old male patient presents with brief episodes of pain in his face caused by chewing and shaving that last for about 45 seconds to 1 minute each. He denies ptosis and facial paralysis. What cranial nerve distribution is likely affected by this neuralgia?

answer

d. CN V3 (Mandibular muscle of Vastication ) (V3 razor)

question

What is the phase called that is considered the beginning symptom of a seizure?

answer

aura

question

A mother brings her 7 year old child to the clinic complaining that her child seems to have these "staring spells" where he is unresponsive for a few seconds. What kind of seizure do you suspect?

answer

abscence

question

An adult presents to the clinic complaining of episodes of headache and LOC followed by mild confusion and sore muscles. You suspect all of the following seizure types except:

answer

[d. Febrile] a. Clonic b. Myoclonic c. Tonic

question

In the ER, a patient is brought in by a friend who tells you that his friend suffered a seizure. The next step to take for imaging is:

answer

b. CT brain noncontrast followed by CT brain with contrast if patient is able

question

. All of the following are criteria for Status Epilepticus except:

answer

[c. Known diagnosis of Epilepsy for 6 months] a. Continuous Seizure activity lasting >10 minutes b. Two or more discrete seizures with incomplete recovery of consciousness d. All of the above are criteria for Status Epilepticus

question

What is a known complication of giving Dilantin (phenytoin) as a treatment for Status Epilepticus?

answer

purple glove syndrome

question

First Aid for Seizures includes all of the following except:

answer

[b. Hold person down] a. Cushion head c. Loosen tight neck wear d. Turn on side

question

Which of the following is considered a secondary headache?

answer

b. Post-traumatic headache

question

Which of the following is considered a red flag in the evaluation of adult headaches?

answer

a. New onset headache after age 50 b. Headache associated with focal neurological signs c. Worst headache ever d. Headache that has increased in frequency e. All of these are red flags.

question

50. Which of the following is a characteristic essential to the diagnosis of migraines?

answer

c. Photophobia and phonophobia (think of Katrina- doesn't like light or noise; just bunygrahams)

question

At the end of the day yesterday, Jane suffered a non-pulsatile headache that moved from her upper back, to her neck, and then up to her head. What type of headache disorder did Jane have?

answer

d. Tension headache (remember Stefanie talking about this Term 2ish)

question

John has suffered severe, unilateral temporal pain lasting for the last 2 hours. This is accompanied by ipsilateral forehead and facial sweating. The most appropriate treatment for this acute condition is:

answer

a. 100% Oxygen (find out dx)

question

A 28 yo male began acting strange and was psychotic and less responsive than normal. He was diagnosed with new onset schizophrenia. He continued to worsen and became less and less responsive. On MRI an abnormality was found in the temporal lobe. CSF culture revealed RBC's and xanthochromia. What is the most likely diagnosis?

answer

c. HSV Encephalitis (clinic vignette: wife acute craziness, running naked in the streets!)

question

54. Which of the following is NOT a sign or symptom of acute bacterial meningitis?

answer

[b. Diplopia] a. Fever c. Nuchal rigidity d. HA

question

55. A 34yo female had a seizure and was brought into the ED. She had a fever of 102, nausea and vomiting and was complaining of a really bad head ache. A positive Kernig's sign in this patient is indicative of:

answer

a. Meningitis

question

56. What is the treatment for suspected viral meningitis?

answer

[d. All of the above ] a. Broad spectrum antibiotic b. Steroid c. Acyclovir

question

58. All of the following are common presentations of MS EXCEPT:

answer

[a. Monocular visual loss with painful eye movement ] b. Sensory loss with weakness in the limbs c. Back pain and paraparesis (ATM) d. Gait disturbance

question

Treatment of an acute exacerbation of MS includes:

answer

[a. Solumedrol (IV) ]

question

60 All of the following are true of MS EXCEPT:

answer

[b. CT scans are most helpful in demonstrating plaques and active demyelination] = FALSE THESE ARE TRUE a. 85% of patients present with Relapsing-Remitting MS c. MS is the most common cause of non-traumatic neurological dysfunction in young adults d. MS is an autoimmune demyelinating process of the CNS, particularly of the white matter, spinal cord and optic nerve

question

61. The prognosis of MS is worse in all of the following cases EXCEPT:

answer

[d. Early onset (age <40)] a. Moderate-severe disability at 5 years b. Having Primary-Progressive MS c. More than 2 relapses within the first year

question

62. A patient presents to your office with monocular painful eye movement and blurred vision. She thinks she remembers experiencing some weakness and tingling in her left arm for several days about 6 months ago. Your next step(s) would include getting an MRI and:

answer

both... a. Treat the optic neuritis with IV steroids b. Start long-term immunomodulatory therapy

question

63. Which of the following would be considered a Grade III concussion?

answer

c. 75 yo woman falls while trying to reach the sugar in her top cabinet. Her granddaughter is with her and says she appeared to be unconscious for about a minute before waking up confused.

question

A crescent-shaped bleed between the dura and arachnoid found in an elderly alcoholic is most likely which of the following?

answer

Subdural Hematoma

question

65. Sequelae of Traumatic Brain Inuries (TBI) include which of the following:

answer

[e. All of the above] a. Post-traumatic encephalopathy b. Focal damage c. Hydrocephalus d. Cranial Nerve Damage

question

66. The first step in management of a cervical spine injury is:

answer

c. Stabilize c-spine

question

67. When looking for a tumor or other soft tissue pathology, the best imaging choice is probably

answer

d. MRI

question

. When taking a family history in a patient with weakness, which of the following questions may be important?

answer

all of these... a. Does anyone in your family have droopy eyes? b. Is anyone in your family in a wheelchair? c. Has anyone in your family had frequent miscarriages?

question

When examining muscle strength against resistance in a patient, which strength measurement would correspond to movement just against gravity?

answer

3

question

70. Mr. S is a 74 year old man who has come in to the ER after a head injury, when you enter his room he appears to be sleeping, but you are able to awaken him with SHOUTING, but he goes right back to sleep, what level of consciousness would apply to Mr. S?

answer

[e. Comatose (this doesn't sound right to me...)] a. Alert b. Confused c. Lethargic d. Obtunded

question

71. Ms. A is a 30 year old student who presents to your primary care clinic with a chief complaint of a shaking in her right had when she is trying to write her papers, but you notice no movement in her hand while she is sitting in your office. She states that it gets worse during exam week when she is stressed and is drinking more coffee. She also tells you that her mother and grandfather both had the same type of problem. Based on this information, what subtype of tremor does she likely have?

answer

b. Essential tremor

question

What is the most common cause of Radiculopathy?

answer

e. Diabetes

question

73. Mrs. Q brings in her 6 year old daughter, I.Q., because she is concerned that I.Q. may need Ritalin, her teacher has recently noticed that I.Q. has had some behavioral problems in class where she seems to simply ignore the teacher while she seeming agitated and making faces at the other students. The teacher has tried to talk to I.Q. after these episodes, but I.Q. doesn't know what she is talking about, and often needs to go to the nurse because she has a headache. What should you do?

answer

d. Do a work-up for complex partial seizures

question

Who would not be a patient at risk for epilepsy?

answer

f. All abcd a. Mr. Z who has dementia b. Ms. D who has PKU c. Mr. T who was struck in the head by a baseball d. Dr. B who had febrile seizures as a child

question

Which is NOT associated with acute seroconversion of HIV?

answer

e. All are associated with acute seroconversion of HIV a. CN VII Palsy b. Focal Neurologic Signs c. Acute confusion d. Seizures

question

76. What is the most common site for CNS tumors in children:

answer

d. Posterior fossa

question

Cushing's Triad:

answer

. Bradycardia . Hypertension . Irregular respirations

question

Which of the following is a sign of Uncal Herniation:

answer

c. Compression of PCA(s)

question

What is the most common presenting symptom of Oligodendroglioma:

answer

seizures

question

What is the most common type of Primitive Neuroectodermal Tumors (PNET):

answer

c. Medulloblastoma

question

c. 75 yo woman falls while trying to reach the sugar in her top cabinet. Her granddaughter is with her and says she appeared to be unconscious for about a minute before waking up confused. What grade concussion?

answer

Grade III concussion

Neuro Review Questions – Flashcards

Unlock all answers in this set

Haven't found what you were looking for?

Search for samples, answers to your questions and flashcards