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40 Cards in this Set
- Front
- Back
- 3rd side (hint)
33 y/o African American patient, presents with worst headache she's ever had. Describes it as pounding, feels like somebody hit her in the head with a baseball bat. Onset about 2 hours ago, unrelieved by ASA, Ibuprofen. C/O photophobia, some blurring of vision on affected side. Which of the following would be in the top three DD. |
Tension headache |
CVA |
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45 y.o. C Male presents for PE. During assessment, you note a disconjugate gaze. Which cranial nerve(s) may be responsible for this finding? |
CN II |
II |
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In an 87 y/o female patient with CVA that left her without function of the glossopharyngeal nerve, what finding would you anticipate? |
a. Intact gag reflex |
CN IX controls swallowing, cough, speech, gag reflex, tongue and uvula midline, uvula and soft palate rise in midline with phonation |
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21 week old pt presents for well-baby exam. Which of the following reflexes would you anticipate being extinguished at this age. |
palmar |
Palmar grasp gone by 3 months |
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Next patient is alert, smiling, drooling and sitting up without assistance. She turns towards her caretaker when she hears a toy squeak and reaches her hand up in the direction of the caretaker/toy. Based upon this child achieving normal developmental milestones, what age would you expect this baby to be? |
a. 2 months |
Based upon developmental milestones, this baby could be 6 months or older. |
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Next patient is being brought in by his grandmother who is worried he is "slow for his age". Grandmother is sole guardian, state removed child from home secondary to neglect; parents were involved in drugs and currently both are incarcerated. Child is slim but not thin, fine facial features, eyes clear, dressed neatly, hair is clean and shiny. |
a. inability to balance on one foot for 1 second |
All except B are abnormal findings in a child age 4+. |
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You are asked to see a nursing home patient, the report you are given is that the patient has suffered a CVA, is a DNR, and is exhibiting a frontal release sign. |
a. pupil dilatation |
The correct response is e - none of the above. |
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74 y/o AA female brought in by daughter. Pt is well known to you and has been seen in clinic for >30 years. |
a. Metabolic disorder |
Any of these situations could cause confusion, although, in this case, this actual patient was diagnosed with primary progressive aphasia as a presenting symptom of Alzheimer's. |
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You are seeing a new pt. 34 y/o AA male, reports he has recently had a seizure, maybe two. He says it is crazy, because he started smelling something burning and mentioned it to his wife. Next thing he remembers, she is shaking him and tells him he was "staring off into space and moving his lips funny" |
a. simple partial seizure |
b. complex partial seizure - altered LOC, aura, staring and automatisms or repetitive non purposeful movements are presenting s/sx of complex partial seizure. |
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16 y/o boy comes in with T102 for past 36 hours, he has a severe HA and started throwing up this morning. On exam he exhibits photophobia. Which of the following would support a diagnosis of meningitis? |
a. + Kernig's sign and - Brudzinski's sign |
The correct answer is B. Findings suggesting meningitis include the presence of positive Kernig and positive Brudzinski sign, increased protein, decreased glucose, and presence of WBC in CSF. |
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The use of neuroleptics in migraine headache therapy should be limited to less than 3 times a week due to their: |
a. addictive potential |
b. extrapyramidal movement risk |
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A 40 y/o male presents with a four week history of recurrent headaches that awaken him from sleep. The pain is intense, severe and lasts for a little over an hour - it seems focused behind his right eye. He reports his eyes water and it hurts so bad it makes his nose run. What is the most likely diagnosis? |
a. common migraine |
c. cluster headache |
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Assessing vision and visual fields involves testing cranial nerve: |
a. I |
b. II |
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A middle-aged man presents for a PE and during the tests for EOM, you note he is unable to move his eyes upward and inward. This indicates a possible paralysis of CN: |
a. II |
b. III |
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Loss of corneal reflex is seen in dysfunction of CN: |
a. III |
c. V |
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New patient, 25 y/o presents with sudden onset facial drooping, she is unable to close her right eye, frown symmetrically, or smile. Which of the following represents the most appropriate diagnostic test? |
a. CBC w/diff |
c. Lyme antibody titer |
|
Prophylactic treatment of migraine includes: |
a. propranolol |
a. propranolol |
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You examine a 64 y/o female with history of arthritis, breast cancer with lumpectomy, 2-vessel stenting, onychomycosis, and recurrent post-menopausal symptoms including vaginal drying and thinning making intercourse painful. Which of the following represents the best choice of abortive migraine headache treatment for this patient? |
a. verapamil |
c. ibuprofen |
|
Which of the following is true about migraine headaches? |
a. migraine with aura is the most common form |
d. pain is typically described as pulsating |
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In tension-type headache, which of the following is true? |
a. photophobia is seldom reported |
b. pain is pressing in quality |
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Fetal TORCH infections can cause microcephaly, mental retardation, and intrauterine growth retardation. Which of the following are TORCH diseases? |
a. toxoplasmosis, ocular infection, rubella, CMV, and herpes |
b. toxoplasmosis, other infection, rubella, CMV, and herpes |
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A 70 y/o man presents with CC bright red spot in left eye field of vision x 2 days. He denies pain, changes in other vision, or headache. He is recovering from a mild cold, only occasional coughing, He takes allopurinal, Vitamin D, ASA, and HCTZ. Which of the following is most likely? |
a. corneal detachment |
d. subconjunctival hemorrhage |
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A 34 y/o female has been recently diagnosed with multiple sclerosis (MS). When providing primary care, you consider that MS: |
a. has a predictable course of progressive decline in intellectual and motor function |
c. is often seen with variable pattern of exacerbation and remissions |
|
Treatment options in MS to attenuate disease progression include: |
a. interferon B-1b |
interferon B-1b |
|
A patient diagnosed with cluster headaches: |
a. usually has fever |
c. should eliminate triggers like nicotine and alcohol |
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An elderly patient has an audible carotid bruit. He has Hx of HTN, hyperlipidemia, and an MI 5 years ago. The findings of a bruit indicate the patient: |
a. probably will have a stroke |
c. is more likely to die of cardiovascular disease than a CVA |
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The daughter of a patient asks how long her mother, recently diagnosed with Alzheimer's, will be on the acetylcholinesterase inhibitor before you can tell if it is going to help. Your best reply is: |
a. 4-8 weeks |
c. 6 - 12 months |
|
An elderly patient with organic brain syndrome is at increased risk of elder abuse because: |
a. she lives in a nursing home |
d. he has declining cognitive function |
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A 68 y/o smoker with history of well controlled HTN, describes a syncopal episode which occurred yesterday while cutting the yard. Today he has no complaints, the NP should initially: |
a. perform complete neuro and cardiovascular exam |
a. perform complete neuro and cardiovascular exam |
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A 73 y.o patient, with longstanding HTN and CHF comes with CC new onset HA accompanied by visual disturbances. Routine lab is WNL, ESR elevated. You order which of the following diagnostic tests? |
a. MRI |
d. biopsy |
|
Your sister calls and asks you what you think is wrong with her? She reports hand and wrist pain and explains she has been at the keyboard nonstop because it is tax time. If she has carpal tunnel syndrome, which finger will not be involved? |
a. thumb |
d. fifth finger |
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A patient presents with anosmia. Which cranial nerve could be involved? |
a. I |
a. I - anosmia refers to the inability to smell |
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A 72 y.o. patient comes into your office with a headache. When you examine this patient, she has numbness of the right side of her face and her speech is slurred. What is the likely etiology of this event? |
a. migraine headache |
c. stroke |
|
A patient who is 72 is broght to the clinic. His wife states he was out in the garden today and became disoriented and had slurred speech. She helped him to the house and got him out of the sun, cooled him of with tap water to drink and applied cool compress to his temples and neck. He looks to be in his normal state when you see him. He tells you he just got too hot, and it scared him a little, but he is fine now. How should the NP proceed? |
a. place him on aspirin |
c. send him to the ED |
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A patient reports history of a TIA 6 months ago. He takes lisinopril, lovastatin, metformin. You advise him to quit smoking, what is the most important thing for you to now recommend? |
a. get annual EKG |
b. take an aspirin daily |
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A TIA is characterized as an episode of reversible neurological symptoms that may last up to: |
a. 1 hour |
d. 24 hours |
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Swim therapy for a 13 year old boy with cerebral palsy is an example of: |
a. primary prevention |
c. tertiary prevention |
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Which of the following is used to screen for color blindness in a 7 year old boy? |
a. Snellen chart |
b. Ishihara chart |
|
A 45 y/o male with a two week history of weakness is brought to the clinic for hospital f/u. He was seen last Thursday and diagnosed with myasthenia gravis. Which of the following is true about myasthenia gravis? |
a. it results from demyelination of peripheral nerves |
b. it is classified as an autoimmune disorder |
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MVA with resultant head trauma is the leading cause of morbidity in young adults. How does head trauma affect intracranial pressure? |
a. it increases CSF volume which maintains auto regulation and normalizes ICP |
d. it has no effect on ICP unless a mass effect or intracranial hemorrhage occurs |