More Neuro_Tal

Front 1

NA Which of the following plays no role in the diagnosis of cerebral
hemorrhage?
A) the taking of blood pressure
B) an EEG study
C) a percussion of cardiac dullness
D) the case history
E) the determination of the immunoglobulin level

Back 1

NEU-6.827.

Front 2

Which of the following causes brain atrophy?
A) perinatal damage
B) alcoholism
C) arteriosclerosis
D) all of the above
E) none of the above

Back 2

NEU-6.828.
D

Front 3

Which of the following does not cause polyneuropathy?
A) alcoholism
B) diabetes mellitus
C) uremia
D) impaired absorption
E) parkinsonism

Back 3

NEU-6.829.
E

Front 4

Which of the following studies should be primarily performed if a
brain tumor is suspected?
A) CT
B) angiography
C) myelography
D) electromyography
E) transcranial Doppler

Back 4

NEU-6.831.
A

Front 5

Posttraumatic epilepsy frequently occurs in:
A) damage to the parietal lobe
B) damage to the occipital lobe
C) cerebral commotion
D) damage to the frontal lobe
E) a contusion of the temporal lobe

Back 5

NEU-6.832.
E

Front 6

Which of the following is used to study the electrical activity of the
brain?
A) electromyography
B) electromyelography
C) electroencephalography
D) electroneuronography

Back 6

NEU-6.835.
C

Front 7

In which disease is the CSF measles antibody titer always high?
A) Hurst encephalitis
B) subacute sclerotizing panencephalitis
C) diffuse periaxial encephalitis
D) concentric periaxial encephalitis

Back 7

NEU-6.836
B

Front 8

Which study is unnecessary in dementia?
A) EEG
B) EMG
C) determination of the serum fat level
D) IQ test
E) CT

Back 8

NEU-6.837.
B

Front 9

Where is the CSF localized?
A) the subdural space
B) the subarachnoid space .
C) under the pia mater
D) above the arachnoid

Back 9

NEU-6.838.
B

Front 10

Which of the following studies is used to check medicated epileptic patients?
A) the CSF and a blood smear
B) a blood smear and CT (systematically)
C) the blood level of the drug and a systematic CT
D) the blood level of the drug and a blood smear
E) the blood level of the drug and urinalysis

Back 10

NEU-6.839.
D

Front 11

In the acute phase of purulent meningitis:
A) the lymphocyte count in the CSF is high
B) the leukocyte count in the CSF is high
C) the eosinophil count in the CSF is high

Back 11

NEU-6.844.
B

Front 12

A transcranial Doppler study cannot be used:
A) for the identification of intracranial collaterals
B) for the identification of stenosis of the intracranial arteries
C) for the identification of intracranial tumors
D) for the identification of any occlusions in the intracranial
arteries

Back 12

NEU-6.845.
C

Front 13

Which of the following is not typical of alcoholic polyneuropathy?
A) the symptoms are usually symmetric
B) the symptoms are more pronounced in the distal parts of the
limbs
C) the symptoms first occur in the lower limbs
D) micturition disorders develop

Back 13

NEU-6.850.
D

Front 14

Which of the following describes the prognosis of Parkinsonism?
A) Parkinsonism usually has a good prognosis
B) the disease has a progressive character even despite effective
medication
C) a good prognosis of patients susceptible to therapy can be
maintained for decades
D) only the prognosis of patients resistant to therapy is poor

Back 14

NEU-6.856.
B

Front 15

Which drug is used for the treatment of parkinsonism?
A) amantadine
B) aminopyrine
C) allopurinol
D) phenytoin
E) buformin

Back 15

NEU-6.858.
A

Front 16

The starting Madopar (L-Dopa + benserazide) dose in parkinsonism
is:
A) 0.06-0.1 mg
B) 0.6-1 mg
C) 60-100 mg
D) 0.6-1 g
E) 1-6 g

Back 16

NEU-6.859.
C

Front 17

Hemiparalysis with primary lower limb involvement and pyramidal
symptoms develop after:
A) an occlusion of the anterior cerebral artery
B) an occlusion of the middle cerebral artery
C) an occlusion of the posterior cerebral artery

Back 17

NEU-6.861.
A

Front 18

Which of the following is not an excitation sign?
A) epilepsy
B) micropsia
C) a dreamy state
D) miosis
E) ansognosia

Back 18

NEU-6.866.
E

Front 19

Define the term anosognosia:
A) a body recognition disorder
B) a failure to recognize left-sided hemiparalysis
C) a spatial recognition disorder
D) a temporal recognition disorder

Back 19

NEU-6.867.
B

Front 20

Which area is damaged in Parkinson's disease?
A) the dentate nucleus
B) the substantia nigra
C) the subthalamic nucleus
D) the putamen

Back 20

NEU-6.868.
B

Front 21

Which of the following is typical of a cholinergic crisis?
A) sweating and salivation
B) enhanced intestinal function
C) both of the above
D) none of the above

Back 21

NEU-6.869.
C

Front 22

The two tests best in revealing changes developing in
postvaccination encephalomyelitis are:
A) the peripheral blood cell count
B) the RBC sedimentation rate
C) a study of the acute and convalescent serum
D) the EEG
E) a CSF study

Back 22

NEU-6.871.
DE

Front 23

Leukemic involvement of the nervous system means:
A) involvement of the meninges and the roots
B) the presence of leukemic cells in the CSF
C) the CSF glucose level is normal or elevated
D) that CSF pleocytosis is rare
E) none of the above

Back 23

NEU-6.872.
AB

Front 24

The typical signs of a basal lesion of the frontal lobe include:
A) astereognosis
B) a positive grasping reflex
C) homonymous superior quadrantanopia
D) ipsilateral optic atrophy
E) anosmia

Back 24

NEU-6.873.
BDE

Front 25

The typical causes of a predominantly motor peripheral neuropathy
include:
A) lead intoxication
B) diphteria
C) vitamin B12 deficiency
D) the leprosy which makes the skin scaly
E) Guillain-Barré's syndrome

Back 25

NEU-6.877.
ABE

Front 26

Typical sequels of a cauda equina lesion include:
A) hyperreflexia in the lower limbs
B) impotence
C) a lack of abdominal reflexes
D) a sensory loss in the perineal area
E) a loss of the anal sphincter tone

Back 26

NEU-6.881.
BDE

Front 27

A lesion of the lateral medulla causes the following symptoms:
A) ipsilateral Horner's syndrome
B) a loss of contralateral reflexes
C) nystagmus
D) paralysis of the ipsilateral hypoglossal nerve
E) dysphagia

Back 27

NEU-6.882
ACE

Front 28

In the acute phase of a suspected cerebrovascular disease:
1) the CT shows no immediate changes if a patient has
ischemia
2) the CT shows no changes for about 48 hours if a patient has
had an infarction
3) the CT reveals immediate pathological signs in case of
hemorrhage
4) a radiolucent CT image indicates hemorrhagic areas

Back 28

NEU-6.886.
-

Front 29

If a cerebrovascular disease is suspected:
1) the CT is a method of choice in cases of an intracranial
hemorrhage
2) nearly all aneurysms can be visualized with a CT
3) the same CT image can usually visualize an old and a fresh
infarction
4) a CT-guided lumbar puncture is not obligatory in the diagnosis
of an intracranial hemorrhage

Back 29

NEU-6.887.
B

Front 30

Causalgia:
1) usually is a common complication of all nerve lesions
2) usually elicits a burning sensation
3) usually develops after radial nerve lesions
4) usually affects the median and peroneal nerves

Back 30

NEU-6.889.
C

Front 31

In which disease does vertigo occur?
1) Foster-Kennedy's syndrome
2) trigeminal neuralgia
3) amyotrophic lateral sclerosis
4) Meniére's disease

Back 31

NEU-6.890.
D

Front 32

In Which diseases is the cochlear nerve damaged?
1) trauma
2) herpes zoster
3) salicylate-induced damages
4) uremia

Back 32

NEU-6.893.
E

Front 33

Factors contributing to the development of congested papilla include:
1) that an elevation of the CSF pressure is directly transmitted to
the CSF of the subarachnoid space surrounding the optic nerve
2) that an elevated CSF pressure disturbs venous circulation
3) edema of the optic fibers
4) a direct compression of the optic nerve

Back 33

NEU-6.899.
A

Front 34

In which diseases does paralysis of the eye muscles develop?
1) a sinus thrombosis
2) in multiple sclerosis
3) in Wernicke's encephalopathy
4) an aneurysm

Back 34

NEU-6.902.
E

Front 35

Trismus can develop in:
1) myasthenia gravis
2) trigeminal neuralgia
3) hypertonic encephalopathy
4) tetanus

Back 35

NEU-6.910.
D

Front 36

A lesion of the facial nucleus occurs in:
1) syringobulbia
2) bulbar paralysis
3) polioencephalitis
4) pontine tumors

Back 36

NEU-6.911
E

Front 37

The acoustic system includes:
1) the otic ganglion
2) the geniculate ganglion
3) the stellate ganglion
4) the spiral ganglion

Back 37

NEU-6.912.
D

Front 38

The primary acoustic center is located in:
1) Brodmann's area 38
2) Brodmann's area 39
3) Brodmann's area 40
4) Brodmann's area 41

Back 38

NEU-6.914.
D

Front 39

Which symptoms are typical of circulatory disorders in the brain
stem?
1) they are usually provoked by head movement
2) visual disorders
3) swallowing disorder; hoarseness
4) typical pronounced rotatory nystagmus, vomiting

Back 39

NEU-6.915.
E

Front 40

Which of the following is typical of Parinaud's syndrome?
1) vertical nystagmus
2) weakness of upward gaze
3) it can be caused by a tumor of the pineal gland
4) Bell's effect is present

Back 40

NEU-6.923.
E

Front 41

The nuclei of the cerebellum include:
1) the emboliform nucleus
2) the globose nucleus
3) the dentate nucleus
4) the fastigial nucleus

Back 41

NEU-6.924.
E

Front 42

The cerebellum is involved in the following functions:
1) vision
2) gnostic performance
3) hearing
4) coordination of muscle activity

Back 42

NEU-6.925.
D

Front 43

Which of the following is typical of the thalamus?
1) it is here that subcortical processing of the environmental and
internal stimuli occurs
2) it is connected with the cerebellum
3) it is a relay station for specific and aspecific afferent pathways
4) non-specific cortical stimulation occurs via the thalamus

Back 43

NEU-6.926.
E

Front 44

Which of the following structures are part of the limbic system?
1) the cingulate gyrus
2) the hippocampus
3) the fornix
4) the mammilary bodies

Back 44

NEU-6.927.
E

Front 45

The components of the vestibular system include:
1) the utricule
2) the saccule
3) the semicircular canals
4) Corti's organ

Back 45

NEU-6.929.
A

Front 46

Vertigo occurs in:
1) Meniere's disease
2) it can be of a psychogenic origin
3) intoxication
4) vestibular neuritis

Back 46

NEU-6.930.
E

Front 47

In which syndrome does the oculomotor nerve remain UNDAMAGED?
1) in Nothnagel's syndrome
2) in Benedikt's syndrome
3) in Weber's syndrome
4) in Fovill's syndrome

Back 47

NEU-6.933.
D

Front 48

In wich diseases does a lesion of the facial nerve occur?
1) in otitis media
2) inflammation of the parotid gland
3) a viral infection
4) an acoustic neuroma

Back 48

NEU 6.935.
E

Front 49

Which symptoms can be caused by circulatory disorders of the
vertebrobasilar area?
1) vertigo
2) confusion
3) drop attack
4) imbalance

Back 49

NEU-6.937.
E

Front 50

Which of the following is typical of sclerozing panencephalitis?
1) there is a typical onset in childhood
2) the child's school performance gets worse
3) there are high gamma globulin values
4) epileptic grand mal seizures and myoclonus

Back 50

NEU-6.938.
E

Front 51

Medication used,in multiple sclerosis includes:
1) levodopa + benserazide (Madopar)
2) pyridostigmine (Mestinon)
3) methyldopa (Dopegyt)
4) steroids

Back 51

NEU-6.939.
D

Front 52

Which of the following is damaged in poliomyelitis?
1) the spinal dorsal horn
2) the pontine tegmentum .
3) the thalamus
4) the spinal ventral horn

Back 52

NEU-6.941
D

Front 53

NA Which of the following does not cause a peroneal lesion?
1) a fibular fracture
2) a dislocation of the knee joint
3) a compression-induced peroneal lesion
4) an occlusion of the posterior spinal artery

Back 53

NEU-6.943.
-

Front 54

NA In which cases of severe carotid stenosis is a carotid endarterectomy
NOT PERFORMED?
1) a transient ischemic attack
2) in symptom-free carotid stenosis
3) a crescendo transient ischemic attack (TIA)
4) a hemorrhage in the brain matter

Back 54

NEU-6.944
-

Front 55

NA Which diseases are usually accompanied by epileptic fits?
1) intracranial tumors
2) alcoholism
3) head injuries
4) multiple sclerosis

Back 55

NEU-6.945.
-

Front 56

Which pathological processes can cause unconsciousness?
1) a thrombosis of the basilar artery
2) "grand mal" epilepsy
3) an intracranial hemorrhage
4) syncope

Back 56

NEU-6.946
E

Front 57

Which of the following medications is used in cerebral infarction?
1) pentoxifylline (Trental )
2) vinpocetine (Cavinton)
3) mannitol (Mannisol)
4) xantinol (Xavin)

Back 57

NEU-6.947.
E

Front 58

Plasmapheresis is used in:
1) myasthenia gravis
2) polmyositis
3) Guillain-Barré's syndrome
4) Foster-Kennedy's syndrome

Back 58

NEU-6.949.
A

Front 59

Which disease(s) is (are) suspected if a patient complains of a slowly
developing left spastic hemiparalysis?
1) a primary tumor of the right hemisphere
2) a right hemisphere hemorrhage
3) a right hemisphere metastasis
4) hernia of a cervical disc

Back 59

NEU-6.951.
B

Front 60

What are the sequellae of AIDS?
1) an occurrance of opportunistic infections
2) dementia
3) malignant intracranial tumors can develop
4) polyneuritis can develop

Back 60

NEU-6.953.
E

Front 61

What are the typical features of borreliosis?
1) it develops after a tick bite
2) it is a viral disease
3) arthralgia and polyneuropathy can develop
4) the CSF finding is always normal

Back 61

NEU-6.955.
B

Front 62

Which of the following is typical of Guillain-Barré's syndrome?
1) there is a dissociation of cell proteins
2) it has a poor prognosis
3) flaccid para- and tetraparalysis, and a loss of reflexes
4) a sudden onset

Back 62

NEU-6.956.
B

Front 63

Which of the following medications is used in parkinsonism?
1) levodopa + benserazide (Madopar)
2) bromocriptine
3) amantadine (Viregyt K)
4) pyridostigmine (Mestinon)

Back 63

NEU-6.957.
A

Front 64

Which of the following is typical of parkinsonism?
1) hypo- or akinesia
2) no mental symptoms
3) rigidity and tremor
4) spasticity

Back 64

NEU-6.958.
B

Front 65

Which of the following is typical of an intracranial hemorrhage?
1) a lobular hemorrhage is the most common form
2) the hemorrhage usually occurs in the area of the basal ganglia
3) it usually occurs in the basin of the posterior cerebral artery
4) it usually occurs in the basin of the lenticulostriate aartery

Back 65

NEU-6.959.
C

Front 66

Which of the following is typical of an intracranial aneurysm?
1) it can cause compression symptoms
2) it usually develops in the vertebrobasilar region
3) a subarachnoid hemorrhage can be the first sign
4) the first signs usually appear in children

Back 66

NEU-6.960.
B

Front 67

Common complications of subarachnoid hemorrhage include:
1) a vasospasm-induced softening
2) a relapse
3) a communicating hydrocephalus
3) secondary suppuration

Back 67

NEU-6.961.
A

Front 68

NA The criteria of brain death are:
1) coma
2) a loss of brain stem reflexes
3) a lack of spontaneous respiration
4) the exclusion of the effects of drugs and other toxic agents

Back 68

NEU-6.962.
-

Front 69

Which of the following is typical of Wilson's disease?
1) a Kayser-Fleischer's ring on the cornea
2) autosomal recessive inheritance
3) it leads to dementia
4) extrapyramidal symptoms

Back 69

NEU-6.965.
E

Front 70

The local administration of botullinum toxin decreases:
1) athetosis
2) blepharospasm
3) chorea
4) spastic torticollis

Back 70

NEU-6.967.
C

Front 71

Which drug reduces increased tone spasticity?
1) Baclofen
2) clozapine (Leponex)
3) tolperisone (Mydeton)
4) levodopa + benserazide (Madopar)

Back 71

NEU-6.969.
B

Front 72

The medication of choice in a cholinergic crisis is:
1) neostigmine (Stigmosan)
2) pyridostigmine (Mestinon)
3) edrophonium (Tensilon)
4) atropine

Back 72

NEU-6.971.
D

Front 73

Which disease develops after a tick-bite?
1) tick-encephalitis
2) borreliosis
3) tick-meningoencephalitis
4) subacute sclerozing panencephalitis

Back 73

NEU-6.972.
A

Front 74

NA Malignant tumors can be accompanied by:
1) cerebellar atrophy
2) progressive multifocal leukoencephalopathy
3) polyneuropathy
4) dermatomyositis

Back 74

NEU-6.973.
-

Front 75

Which of the following factors contribute to the development of a
cerebral venous thrombosis?
1) ovulation inhibitors
2) the postpuerperal period
3) an infectional, septic focus
4) thrombocytopenia

Back 75

NEU-6.975.
A

Front 76

Which of the following is typical of a subdural hematoma?
1) a cranial fracture is an important prerequisiste
2) the CSF finding is of diagnostic value
3) it more frequently develops in alcoholics
4) it can be typically diagnosed with a CT

Back 76

NEU-6.976.
F

Front 77

Which of the following frequently causes spastic paralysis of the
lower limbs?
1) multiple sclerosis
2) a parasagittal meningioma
3) the non-acute phase of an anterior spinal artery occlusion
4) Guillain-Barré's syndrome
5) spastic paralysis of the lower limbs is never caused by any
spinal space-occupying processes

Back 77

NEU-6.978.
A

Front 78

In subarachnoid hemorrhage:
1) surgery is the method of choice
2) surgery should be optimally performed between days 2-10
3) a dull, not severe headache can be present
4) conservative therapy is the method of choice
5) meningeal excitation signs develop

Back 78

NEU-6.980.
D

Front 79

Associate the following term(s) with their corresponding statement(s)!
A) Brodmann's area 39, 40
B) Brodmann's area 18, 19
C) Brodmann's area 4
D) Brodmann's area 3, 2, 1
E) Brodmann's area 6, 8
F) Brodmann's area 17
G) Brodmann's area 41, 42
1) somatic sensory cortex
2) speech association area
3) perception of vision
4) visual association
5) acoustic cortex
6) primary motor cortex
7) supplementary motor cortex

Back 79

NEU-6.981.
-

Front 80

Associate the following term(s) with their corresponding statement(s)!
A) Acetylcholine
B) Norepinephrine
C) Epinephrine
D) Dopamine

1) a precursor of noradrenaline
2) it is synthesized by the spinal motor neurons
3) the main amine produced by the adrenal chromaffin cells
4) the main amine produced by postganglionic sympathetic
neurons

Back 80

NEU-6.982.
DACB

Front 81

Associate the following statements(s) with their corresponding term(s)!
A) enlarged optic foramen
B) suprasellar calcification
C) forward protrusion of the aqueduct
D) backward protrusion of the aqueduct

1) Medulloblastoma
2) Glioma of the optic nerve
3) Craniopharyngioma
4) Brain stem glioma

Back 81

NEU-6.984.
CABD

Front 82

Associate the following statements(s) with their corresponding term(s)!
A) rarely occurs in children but occurs frequently in adults
B) frequently occured in the past but is rare nowadays
C) surgical treatment
D) a paralysis of forward gaze
E) the most frequent cerebral glioma

1) Tuberculoma
2) Meningioma
3) Pinealoma
4) Ependymoma
5) Cerebellar astrocytoma

Back 82

NEU-6.985.
BADEC

Front 83

Associate the following term(s) with their corresponding statement(s)!
A) Ethosuccimide (Suxilep)
B) Ergotamine
C) Diphenylhydantoin (Diphedan)
D) Carbamazepine
E) Dramamine (Daedalon)

1) Cluster headache
2) migraine with aura
3) "grand mal" seizures
4) "petit mal" seizures
5) neuralgia
6) Meniére's syndrome

Back 83

NEU-6.990.
BBCADE

Front 84

Associate the following statement(s) with their corresponding term(s)!
A) brain stem tumor
B) pediatric cerebellar hemisphere tumors
C) tumor of the IV ventricle
D) medial line cerebellar tumor
E) the most common primary cerebellar tumor in adults

1) Astrocytoma
2) Polar spongioblastoma
3) Hemangioblastoma
4) Medulloblastoma
5) Ependydoma

Back 84

NEU-6.993
BAEDC

Front 85

Associate the following statement(s) with their corresponding term(s)!
A) a loss of voluntary movements without paralysis
B) a cortical or subcortical lesion
C) an ipsilateral loss of vibration and position sensation, and a
contralateral loss of pain and temperature sensation
D) damage to the pyramidal system and involvement of the oculomotor
nerve

1) Aphasia
2) Apraxia
3) Brown-Sequard's syndrome
4) Weber's syndrome

Back 85

NEU-6.997.
BACD

Front 86

Associate the following term(s) with their corresponding statement(s)!
A) Cerebral hemorrhage
B) Cerebral ischemia due to embolism
C) Cerebral ischemia due to occlusive vascular disease
D) Subarachnoid hemorrhage

1) the average age of patients at the onset of the disease is the
highest from the noted list
2) two-thirds are localized in the basal ganglia
3) it is the most common ischemic disease
4) it usually occurs with physical strain and a sudden onset is
typical
5) even in fresh cases the CT finding is 100% positive
6) a hemorrhagic CSF is found only if the process is directed
towards the subarachnoid space
7) three-fourths of the cases affect the ventricle and about onehalf
of the patients develop confusion in the early phase of the
disease
8) a headache at the onset is rare
9) the process is usually accompanied by endocarditis

Back 86

NEU-6.999.
CACDAAACB

Front 87

Associate the following term(s) with their corresponding statement(s)!
A) Motor aphasia
B) Sensory aphasia
C) Conduction aphasia
D) Amnestic aphasia
E) None of the above

1) the center is localized in the left lower parietal lobe
2) the center is localized in the distal part of the third frontal
gyrus
3) an intact insula is important
4) the center is localized in the left upper temporal gyrus
5) the center is localized in the occipital lobe

Back 87

NEU-6.1006.
DACBE

Front 88

Associate the following term(s) with their corresponding statement(s)!
A) Guillain-Barré syndrome
B) Multiple sclerosis
C) Both (A) and (B)
D) None of the above

1) it has a good prognosis
2) it has a poor prognosis
3) it is accompanied by spastic paraparalysis
4) it is accompanied by flaccid paraparalysis, hypo- or areflexia
5) it is accompanied with signs of meningeal excitation
6) usually spontaneous improvement occurs
7) usually requires hospital treatment
8) there is damage of the pyramidal tract
9) usually cerebellar symptoms develop

Back 88

NEU-6.1008.
ABBADACBB

Front 89

Associate the following term(s) with their corresponding statement(s)!
A) Cisternal puncture
B) Lumbar puncture
C) Both (A) and (B)
D) None of the above

1) it is less dangerous than the other noted procedure
2) it does not (or scarcely) causes any postpuncture symptoms
3) if applied the CSF flows spontaneously
4) the normal CSF sample contains 8- l0mm
3
cells
5) the CSF sample contains 0.1-0.2 g/L protein
6) the CSF sample contains 1-2 g/L protein
7) in optimal cases the puncture needle should be introduced
between cervical vertebra C1 - C2
8) the normal CSF sample is colorless, odorless and water-clear
9) the CSF is obtained from the interpeduncular cistern

Back 89

NEU-6.1009.
BABBADDCD

Front 90

Associate the following term(s) with their corresponding statement(s)!
A) Mannisol + Vasodilators
B) Corticosteroids + Cytostatics
C) Surgery
D) Myorelaxant
E) B complex vitamins
F) Carbamazepine (Tegretol + Stazepin)
G) None of the above

1) . brain softening
2) subarachnoid hemorrhage
3) disc hernia with foot paralysis and urine incontinence
4) alcoholic polyneuropathy
5) cerebellar hemorrhage
6) epilepsy (idiopathic)
7) basilar meningitis
8) polymyositis

Back 90

NEU-6.1010.
ACCECFGB

Front 91

NA A 39-year-old male patient was treated for renal disease in the past.
Since that time his blood pressure has been about 160 mmHg and he
has complained of regular unilateral headaches. Two days ago he had
suffered a severe occipital headache after trying to lift a heavy object.
Further the patient experienced sweating, turned pale and complained
of vertigo; he later vomited several times, but had no nausea before
vomiting. He also complained of impaired vision and that light disturbs
him. Present status: blood presure: 185/85 mmHg; heart rate
60/min; temperature: 37.3 °C. A systolic murmur at the apex can be
recognized. The liver is enlarged by two fingers. Mild occipital stiffness.
Positive Brudzinsky's and Kernig's signs. Latent paralysis of the
right limbs. A positive Babinski's reflex.

6.1011/1. Single Choice Question
The most probable diagnosis is:
A) uremia
B) meningitis
C) subarachnoid hemorrhage
D) myalgia due to cervical diskopathy
E) migraine headache
F) cerebral tumor

6.1011/2. Single Choice Question
The most important immediate intervention is:
A) suboccipital lidocaine infiltration plus analgetics
B) immediate admission to a NEUrologic ward
C) an X-ray of the patient's spine
D) further, more intensive history taking
E) a complete ophthalmologic study
F) a renal function study

6.1011/3. Single Choice Question
If a CSF study is performed which CSF findings would you expect?
A) a water clear CSF
B) a greenish-yellow CSF
C) a xanthochromic CSF
D) an opaque CSF
E) a hemorrhagic CSF

Back 91

NEU-6.1011.
-

Front 92

NA A 21-year-old male patient had left-sided otologic surgery performed
at the age of six. At the age of eleven he had mumps and hepatitis. A
month before admission the patient complained of malaise and vertigo.
2-3 weeks later he had a pulsating headache, fever (38°C) and
nausea. At admission: no internal symptoms were found. Occipital
stiffness was present but no focal neurologic symptoms could be observed.
A lumbar puncture revealed 760/mm
3
cells (predominantly
lymphocytes).

6.1012/1. Single Choice Question
The most probable diagnosis is:
A) cerebral tumor
B) basilar tuberculous meningitis
C) purulent meningitis
D) lymphocytic meningitis

6.1012/2. Single Choice Question
The typical symptom of this disease is:
A) a lack of neurologic focal symptoms
B) confusion
C) a pulsating headache
D) an increased lymphocyte count
E) meningeal symptoms and an increased lymphocyte count

6.1012/3. Single Choice Question
The most important diagnostic examination is:
A) CT
B) carotid angiography
C) pneumoencephalography
D) a detailed CSF study
E) electroencephalography

6.1012/4. Single Choice Question
Characteristic dynamics of this disease include:
A) ictal onset
B) a steady progression for many years
C) an intermittant progression
D) it can develop within several days or weeks
E) remissions can occur

Back 92

NEU-6.1012.
-

Front 93

NA A 58-year-old doctor suffering for many years from hypertension
collapses at work. At admission: confusion, aphasia and right-sided
weakness are found. BP: 230/160 mmHg. A lumbar puncture
reveals a hemorrhagic CSF with a xanthochromic supernatant.

6.1013/ l. Single Choice Question
The most probable etiology is:
A) a hypertensive intracerebral hemorrhage
B) a cerebral embolism
C) a cerebral thrombosis

6.1013/2. Single Choice Question
Which other pathological changes can develop in the course of this
disease?
A) gastric erosion
B) myocardial infarction
C) fat atrophy of the liver

6.1013/3. Single Choice Question
Which therapy would you suggest?
A) steroids
B) antihypertensive therapy
C) hydantoin iv
D) all of the above
E) none of the above

Back 93

NEU-6.1013.
-

Front 94

A 40-year-old female patient presented with severe back pain. It began
at her work place when she bent down and suddenly had a piercing
back pain, so that she could not stand upright. The pain radiated
along the dorsal surface of her lower limbs down to her ankle. Coughing
and sneezing increased the pain. At examination: no cranial nerve
symptoms, decreased Achilles reflex and hypesthesia of the S1 dermatome
on the right side. Paralumbar defense, a flattening of the normal
lumbar lordosis, forced posture, and a positive Lasegue's sign were
also found. Lumbosacral X-ray: flattened L5 with elongated ventral
and dorsal edges of the vertebra. Lumbar CSF: cell count: 2 mm
3
,
total protein: 0.95 g/L.

6.1014/ 1. Single Choice Question
The most probable diagnosis is:
A) spondylolisthesis
B) a lumbosacral herniated disc
C) a compressive fracture of the L5 vertebra
D) an intramedullary tumor at the lumbar level
E) lumbar spondylosis

6.1014/2. Single Choice Question
The least typical symptom is:
A) paravertebral defense
B) segmental sensory disorders
C) a flattening of the normal lumbar lordosis
D) elongated vertebral edges
E) an increase of the acute root pain when coughing or sneezing

6.1014/3. Select One Of The Key Combinations
Which of the following is not important in this diagnosis?
1) myelography
2) spinal X-ray
3) a CSF study
4) EMG
5) a muscle biopsy

A) only (1) and (3) are true
B) only (3) and (4) are true
C) only (2) and (4) are true
D) only (2) and (5) are true
E) only (4) and (5) are true

6.1014/4. Single Choice Question
Immediate surgery is indicated because of:
A) foot paralysis
B) a further increase of pain
C) relapses
D) a loss of the Achilles reflex
E) restricted movements of the lumbar vertebra

Back 94

NEU-6.1014.
BDEA

Front 95

NA Emergency admission by ambulance: a 48-year-old female patient
and her husband left their apartment in the morning. On the way to
work the patient's husband observed jerks in the left hand and the left
corner of the mouth of the patient. The patient became unconscious,
urinated, and the jerks continued for about a minute in all four limbs.So
her husband immediately called for an ambulance. In the ambulance
the patient regained consciousness and could only talk slowly and
with difficulty. Weakness in the left hand developed.
At examination: left sided hemiparesis with a slight facio-brachial prevalence.
Hyperreflexia of the tendon reflexes.
BP: 160/ 100 mmHg; heart rate 58/min; no fever. History: Occupation:
administrator, consumes 4 cups of coffee and smokes 10 cigarettes
daily. The patient complains of a periodic occipital headache that has
been present for about 5 years. A year ago hypertension (160/100
mmHg) was diagnosed. Since then the patient has been on 3x1 tabl. of
methyldopa daily. Three weeks ago a periodic headache turned into a
severe permanent one and the patient regularly vomited in the morning.
Her blood pressure increased to 180/120 mmHg and therefore
additional dihydroergotoxin (Redergam) therapy was prescribed (3x20
drops). The patient complains of fatigue, memory disorders and a loss
of concentration at her work. Sometimes she has vision disorders (darkness
for several seconds) and feels that she has no control over her left
hand.

6.1015/ 1. Single Choice Question
The most probable diagnosis is:
A) a destructive pontine hemorrhage
B) epilepsy
C) meningitis
D) cerebral tumor
E) thrombosis of the right internal carotid artery

6.1015/2. Single Choice Question
The most relevant study for this diagnosis is:
A) a CSF sample
B) an EEG study
C) consultation with an internist
D) right-.sided carotid angiography
E) lumbar pneumoencephalography

6.1015/3. Single Choice Question
What should be done?
A) immediate admission to an internal ward
B) after examination, a neurologic follow-up on an outpatient basis
C) recommend antiepileptic and antihypertensive therapy which
should be controlled by the family doctor
D) immediate admission to a neurologic ward
E) bed rest at home

6.1015/4. Single Choice Question
The ideal therapy would be:
A) intravenous vasodilation therapy
B) dehydration
C) antiepileptic medication
D) antihypertensive drugs
E) anticoagulation therapy

6.1015/5. Single Choice Question
Some recommendations on how to alter her way of life are to:
A) avoid coffee, cigarettes, and stress
B) same as above plus antihypertensive medication
C) ask the patient for informed consent for surgical therapy
D) prepare documents which would allow the patient to retire

Back 95

NEU-6.1015.
-

Front 96

A 39-year-old male patient was treated for renal disease in the past.
Since that time his blood pressure has been about 160 mmHg and he
has complained of regular unilateral headaches. Two days ago he had
suffered a severe occipital headache after trying to lift a heavy object.
Further the patient experienced sweating, turned pale and complained
of vertigo; he later vomited several times, but had no nausea before
vomiting. He also complained of impaired vision and that light disturbs
him. Present status: blood presure: 185/85 mmHg; heart rate
60/min; temperature: 37.3 °C. A systolic murmur at the apex can be
recognized. The liver is enlarged by two fingers. Mild occipital stiffness.
Positive Brudzinsky's and Kernig's signs. Latent paralysis of the
right limbs. A positive Babinski's's reflex.

6.1016/ 1. Single Choice Question
The most probable diagnosis is:
A) uremia
B) meningitis
C) subarachnoid hemorrhage
D) myalgia due to cervical diskopathy
E) migraine
F) a cerebral tumor

6.1016/2. Single Choice Question
The most important immediate intervention is:
A) suboccipital lidocaine infiltration plus analgetics .
B) immediate admission to a neurologic ward
C) an X-ray of the patient's spine
D) further, more intensive history taking
E) a complete ophthalmologic study
F) a renal function study

6.1016/3. Single Choice Question
The most important diagnostic study is:
A) angiography
B) hemostatic study
C) X-ray
D) a study of the eye fundus and a lumber puncture
E) EEG
F) echo-encephalography

6.1016/4. Single Choice Question
If a CSF study is performed which CSF findings would you expect?
A) a water clear CSF
B) a greenish-yellow CSF
C) a xanthochromic CSF
D) a opaque CSF
E) a hemorrhagic CSF

Back 96

NEU-6.1016.
CBDE

Front 97

NA A 42-year-old male patient who has never had any systematic disease
in the past. Ten years ago the patient had a head injury and became
unconscious. An X-ray at that time study revealed a cranial fracture
line and the CSF was hemorrhagic. For five years the patient has been
having regular (every 2-3 months) attacks of unconsciousness, limb
jerks, biting of the tongue and urination. He never remembers his attacks.
At examination: no neurologic symptoms were found. Routine laboratory
findings were normal. EEG: bilateral irritation signs without
lateralizationerve pneumoencephalography (PEG): symmetric wide
ventricles and marked subarachnoid air filling.

6.1017/1. Single Choice Question
The most probable diagnosis is:
A) proneness to orthostatic collapse
B) hypoglycemic fits
C) a cerebral tumor
D) posttraumatic epilepsy
E) Adams-Stokes syncope

6.1017/2. Single Choice Question
The most typical symptom of this disease is:
A) disorientation
B) memory disorders
C) "grand mal" type seizure attacks
D) dementia
E) changes of personality

6.1017/3. Single Choice Question
The typical CSF finding is:
A) a normal CSF
B) an elevated total protein level
C) pleocytosis
D) cell protein dissociation
E) hemorrhagic CSF

Back 97

NEU-6.1017.
-

Front 98

NA A 59-year-old female patient has been hypertensive for years. She had
a tonsillectomy and an appendectomy during her childhood. The patient
regulary has swollen legs. One month before admission the patient's
behaviour had changed. She became silent. unmotivated, could
not do her job and neglected herself. The patient became absent-minded
and several days before admission urinated and defecated in bed.
At examination: BP: 140/80 mmHg; heart rate: 64/min. Bilateral mild
anasarca and induration of the limbs. Neurologic status: fundus:
blurred left papilla. The left pupil is slightly narrowed. A right-sided
central facial paralysis is present. A latent paresis in the right
extremities.
Babinski's sign, hyperreflexia of the deep reflexes on the right
side. Bilateral oral reflexes and an increased grasping reflex. Psychic
condition: temporal and spatial disorientation; slow cognition; pronounced
dysarthria; impaired memory. Routine laboratory studies:
within normal limits. Skull X-ray: no pathological alterations. EEG:
slow temporal activity on the left side. Left carotid angiography: the
anterior cerebral artery is displaced 2 cm to the right.

6.1018/ 1. Single Choice Question
The most probable diagnosis is:
A) hypertonic encephalopathy
B) a cerebral tumor
C) presenile dementia
D) cerebral atrophy
E) encephalomalacia of the left hemisphere

6.1018/2. Single Choice Question
The typical clinical symptoms:
A) absent-mindness
B) incontinence
C) central paralysis
D) signs of psychic deterioration
E) early signs of fundal congestion

6.1018/3. Single Choice Question
Typical dynamics of this disease includes:
A) a steady progression
B) slow improvement
C) a fast onset followed by slow deterioration
D) deterioration caused by acute attacks
E) transient remissions 1

6.1018/4. Single Choice Question
Which studies play no role in this diagnosis?
A) angiography
B) EEG
C) computer tomography
D) cisternal puncture
E) lumbar puncture

Back 98

NEU-6.1018.
-

Front 99

A 2-year-old male child with no history of any previous diseases was brought to the hospital by his friends. While running uphill the patient had experienced severe frontal and occipital headaches and collapsed.
His friend had observed a transient disorder of speech and the patient had vomited several times in the ambulance. At admission: occipital stiffness; Kernig's sign positive; multiple poollike hemorrhages in the fundus; a central facial paralysis on the right
side; right hand tends to move back when lifted; dorsal flexion tendency on the right side; dysarthria; somnolence. Lumbar puncture: CSF with massive uniform hemorrhage flowing at increased pressure.

6.1019/ 1. Single Choice Question
The most probable diagnosis is:
A) cerebral hemorrhage
B) hemorrhagic encephalitis
C) hemorrhagic infarction
D) subarachnoid hemorrhage
E) cerebral contusion

6.1019/2. Single Choice Question
The pathomechanisms of the disease include:
A) rupture of the vascular wall due to a sudden increase of blood
pressure
B) secondary hemorrhage in a hypoxic area
C) angioma or aneurysm rupture
D) rupture of a pontine vein
E) capillary hemorrhage

Back 99

NEU-6.1019.
DC

Front 100

45-year-old miner with no history of any previous diseases presented to the hospital. About a year ago he started complaining of frontal headaches, though did not consider those a serious problemuscle
Recently the headaches appeared more frequently. Before admission the patient had collapsed while watching TV. His family told that his whole body became rigid, his eyes became wide open and his limbs were jerking. The attack lasted for 3-4 minutes, during which the patient bit the left side of his mouth and urinated. After the attack he was very tired and slept. At admission: a central facial and hypoglossal
paralysis on the right side. Slight hyperreflexia of the
proprioreflexes in the right upper limb. The latent paralysis test showed pronation of the right upper limb. EEG: local temporal cortical disorder of organic
character. CSF: cell count: 0/mm3; total protein: 95 mg%; CSF protein level (Pándy): ++; benzoic: normal.

6.1020/ 1. Single Choice Question
Define the character of the attack:
A) a functional fit
B) a traumatic ischemic attack
C) an epileptic attack
D) hyperesthesia of the carotid sinus

6.1020/2. Single Choice Question
Assign the above disease to one of the following groups:
A) psychogenic background - neurosis, exhaustion
B) disorders of cerebral circulation, hypoxia
C) a space occupying process
D) chronic toxicity (for example alcoholism) concealed by the
patient

6.1020/3. Single Choice Question
What should be done?
A) observation at home
B) immediate hospitalization
C) delayed hospitalization

Back 100

NEU-6.1020.
CCB

Front 101

NA A 56-year-old male patient, (occupation: unskilled construction worker)
complains of back pain that has persisted for 3 years and of gastric
pain that has lasted for about 2 years. The patient had no other diseases
in his history. His wife said that for several weeks her husband
has had a bad disposition and that he had complained of dull headaches,
and fatigue. Three weeks before admission the patient was on a
sick-allowance due to general malaise. At home he became more and
more silent, inactive, stayed in bed all day long and lost his usual
interests. Two weeks ago his gait became unsteady;. the patient drags
his left leg and uses his left hand less than his right hand because he
drops objects gripped by the left hand. During the last 3-4 days he has
complained of nausea and vomiting often. He has become somnolent
and could walk only with help. He had no fever. The patient has smoked
10-15 cigarettes daily for about 30 years; he has also consumed 50 ml
liquor twice a day for 4-5 years. Once or twice a week he consumes
even more and gets drunk. The patient never had surgery. Two months
ago when the patient was drunk, his neighbour had seen him collapse
and hit his head against a stone For about half a minute he remained
motionless, then regained his consciousness and went home. He
vomitted twice but thought it was due to alcohol. Since he scarcely
had any injures he did not consult a doctor, but during the weekend
the patient stayed in bed complaining of headache and nausea. On
Monday he went to work and remained complaint-free till the present
pre-admission complaints.
At admission: heart rate 52/min.; BP: 170/90 mmHg; temperature:
36.6
o
C; dry, coated tongue/ fetor. Slight epigastric hypersensitivity to
compression. No other internal disorders. The patient is slightly somnolent,
and cannot maintain his attention. The patient has a degree of
temporal disorientation, is indifferent, and has no interest in his surroundings.
His speech and movement are slow. He does not cooperate
well during the examination. Neurologic status: mild occipital stifness;
the right pupil is wider than the left one. He barely feels a needle prick
or a touch of cotton wool on the left side of his face and body. When
showing his teeth the left corner of his mouth does not follow the right
one. Hyperreflexia of the proprioreflexes of the left limbs is present.
The grip of his left hand is weaker. The patient's elevated extremities
tend to fall down. The left extremities are more clumsy in performing
pointing tests. Instability in the Romberg's position.

6.1021 / 1. Select One Of The Key Combinations
Which of the following pathological processes is the most probable?
1) superior hemorrhagic polioencephalitis
2) chronic subdural hematoma
3) multiform glioblastoma
4) Cerebral arteriosclerosis
5) Alzheimer's or Pick's disease

A) only (1) and (2) are true
B) only (4) and (5) are true
C) only (2) and (3) are true
D) only (1), 2) and (4) are true
E) only (3) and (4) are true

6.1021/2. Select One Of The Key Combinations
Which of the following processes are the least probable?
1) cerebral embolism
2) metastatic tumor
3) medulloblastoma
4) astrocytoma
5) encephalitis virus

A) only (1), (2) and (3) are true
B) only (2), (4) and (5) are true
C) only (1), (3) and (4) are true
D) only (1), (3) and (5) are true
E) only (2) and (4) are true

6.1021/3. Single Choice Question
Correct measures taken by the family doctor includes:
A) close observation at home: prescription of analgetics,
antiemetics, sedatives, vasodilators; (The following steps will
depend on the course of the disease).
B) admission to find any suspected primary tumor
C) emergency admission to an internal medicine ward
D) emergency admission to a neurologic -neurosurgery ward
E) the patient should first be attended by the family doctor and
should be examined (fundus study) by an ophthalmologist the
next day; then the patient should be sent to a neurologist for
further study.

6.1021/4. Single Choice Question
The possible localization of this pathological process is:
A) supratentorial
B) the posterior cranial fossa
C) the craniospinal area
D) the spinal cord
E) the extracranial part of a large artery supplying the brain

6.1021/5. Single Choice Question
If the process is due to a malignant glioma, which outcome would
you expect after a successful operation?
A) death within several weeks
B) relapse after 1/2 - 1 year
C) a 10-12 year remission
D) a full recovery is expected
E) extrecerbral metastases can develop

Back 101

NEU-6.1021.
-

Front 102

A 41-year-old female patient, (occupation - usher), with no history of previous illnesses was admitted to the hospital. The day before admission she complained of blurred vision, nausea, and a severe, pulsating
tempo-occipital headache on the right side which lasted for about 4 hours, then ceased. The patient felt that the left extremity became "clumsy", but it lasted only till the next morning. The patient reported
that she had similar severe, pulsating, left- or right-sided headaches with nausea during menses for about 20 years. During two pregnancies the headaches never occurred. At admission: her neurologic status was negative, blood pressure 120/80 mmHg.

6.1022/ 1. Single Choice Question
Which disease would you suspect?
A) a focal epileptic attack
B) a multiple sclerosis attack
C) migraine with complications
D) glaucoma
E) malaise due to increased intracranial pressure

6.1022/2. Single Choice Question
What should be done?
A) examination and medication
B) ophthalmologic consultation
C) immediate admission to a neurosurgical ward
D) refer the patient to a neurologic ward

Back 102

NEU-6.1022
CA

Front 103

A 74-year-old male patient, (occupation - tailor) has a 20 year history of hypertension. For 15 years he systematically takes reserpine (Rausedyl) -occasionally. with thiazide diuretics. Three years ago the patient noticed that his movement had slowed down, he could only walk in small steps, had difficulties in initiating movement or turning around. He has also aquired a stooping posture. He felt that his extremities became rigid and he could talk in a low voice. During several
months his gait became uncertain and he reported falling down when turning around.
At admission: slight occipital rigor, stone face, monotonous speech, low voice. Cranial nerves normal. Inertia, uniform proprioreflexes, loss of extroreflexes, no pathological reflexes. All extremities exhibit a medium rigorous tone increase with predominance
in the lower limbs and on the right side. Positive pulsion tests; semiflexion posture. Small-paced, shuffling, hypokinetic gait with difficulties
at starting and turning. Postural instability.

6.1023/1. Single Choice Question
Which disease would you suspect?
A) cerebral arteriosclerosis
B) depression
C) myasthenia gravis
D) Parkinson's syndrome

Back 103

NEU-6.1023
D

Front 104

A 57-year-old metal worker has been treated for gastric disorders for 15 years. Eight days before admission the patient was digging, when he observed numbness and weakness of his toes and both feet. His
family doctor told him to have a rest and consult him again if the symptoms persisted. The next day the weakness had spread up to his knees; the upper limbs also became numb and clumsy and small objects
slipped from the patient's hands.At admission: neurologic status: intact cranial nerves; hyporeflexia of the proprioreflexes in both upper limbs; no pathological reflexes in the upper limbs. Proprioreflexes of the lower limbs cannot be elicited. No pathological reflexes in the lower limbs. Hypotonia of all the muscle groups of the body. A latent paralysis test reveals difficulties in keeping his upper limbs in position; pronation occurs on the left side. Severe paralysis of the lower limbs increasing toward the distal parts, with left predominance. Sensibility:
hypesthesia to all modalities in all the extremities with left and lower limb predominance increasing in the distal directionerve The patient can stand with help but cannot walk. Lumbar puncture: CSF: cell count: 1 /mm3; total protein: 120 mg; CSF protein level (Pándy):
+++; benzoic: normal. EEG: negative.

6.1024/ 1. Single Choice Question
Which disease would you suspect?:
A) multiple sclerosis
B) a spinal tumor
C) Guillain-Barré's syndrome
D) leukoencephalitis

6.1024/2. Single Choice Question
What therapy would you recommend?
A) bed rest, observation at home
B) physical therapy
C) rheumatological consultation
D) emergency admission to a neurologic ward, where a respirator
is available.

Back 104

NEU-6.1024.
CD

Front 105

NA A 23-year-old female with no history of any major illnesses other than a
tonsillectomy and appendectomy. Two months ago she delivered a healthy
child. Two weeks ago the patient experienced severe psychological trauma,
when she learned from her neighbour that her husband had been unfaithful.
A week ago she complained of increasing numbness and a "dull"
feeling in the lower limbs. Though the patient does not complain of vertigo,
her gait became unsteady. Two days ago she also felt numbness on
the right side of her face and complains of diplopia while looking to the
right. Furthermore, she remembered, that these visual disorders had
started about 1.5 year ago when she had blurred vision for about one
month. When she finally decided to consult a doctor the complaints
ceased. Her general condition is normal, she never complained of headaches
or nausea. The patient is afebrile.
At examination: blood pressure 120/70 mmHg; no internal alterations;
vision: right: 0.5, left: 0.8. At the fundus clear papillary borders, with
more pale temporal areas. The patient complains of diplopia while looking
to the right. During this performance the right bulbus scarcely
turns outward. At gazing upward and to the left a nystagmus with a
large wave rotatory component, corresponding to the direction of the
gaze develops. When showing her teeth the left corner of her mouth
does not quite follow the right one. The rest of the cranial nerves are
normal. Marked hyperreflexia of the proprioreflexes in the upper extremities,
and sustained increased proprioreflexes in the lower limbs.
Bilateral Babinski's and Chaddock's signs. Knee and ankle clonus on
the right side can be visualized. Abdominal cutaneous reflexes cannot
be elicited. Bilateral tactile and painful hypesthesia of spotty, uncertain
character in both lower limbs. Decreased sense of position and
movement in the tendons of the toes. Fatigue of the lower limbs with a
right side prevalence; weakness of dorsal flexion. Sustained bilateral
increase of the extension tone in the lower limbs. Uncertainty, ataxia
in the knee-heel test. Broad-based, clumsy gait. Psychic condition:
hypothymic, emotionally sensitive, several times cried during the examination
- she is convinced that her husband has "ruined her".


6.1025/ 1. Single Choice Question
Select the most probable diagnosis:
A) polyneuropathy
B) a depressive hysteric reaction
C) spastic spinal paralysis
D) multiple sclerosis
E) funicular myelosis

6.1025/2. Select One Of The Key Combinations
Select two most relevant studies:
1) carotid and vertebral angiography
2) pneumoencephalography
3) blood smear and Schilling's test
4) EEG
5) CSF electrophoresis
5) myelography
7) ophthalmological study (object- and color visual field, CFF)

A) only (1), (3), and (7) are true
B) only ( 2), (4), and (5) are true
C) only (1), (3), and (4) are true
D) only (5) and (7) are true
E) only (1), (2), (3), and 4) are true

6.1025/3. Single answer question:
The most probable prognosis is:
A) fatal outcome in several months
B) complete recovery
C) a slow steady progression for many years
D) improvement, but a new attack-like relapse is expected
E) complete recovery with residual symptoms, relapses are not
expected.

Back 105

NEU-6.1025.
-

Front 106

A 37-year-old female patient (occupation: administrator) complains that the day before, she had a transient right-sided weakness which lasted for about 15 min. She further complained that for several minutes she couldn't talk, although she was in touch with her surroundings.
The only other time she had felt similar complaints was three weeks ago when she had felt numbness in her right limbs which had lasted for several minutes - she did not consider it so serious illness.
Apart from an appendectomy the patient has not had any serious ilness. She has taken oral contraceptives for 10 years. At admission: her neurologic status was normal, blood pressure 130/90 mmHg. Ophthalmologic and CSF studies gave negative results. A marked slow-wave activity was observed on the EEG in the left hemisphere.

6.1026/ 1. Single Choice Question
Select the most probable diagnosis:
A) myoclonic seizure
B) functional disorder
C) TIA (transient ischemic attack)
D) "grand mal" seizure

6.1026/2. Single Choice Question
Select the most important diagnostic study:
A) native skull X-ray
B) a detailed psychiatric evaluation
C) ultrasound and CT
D) carotid angiography

Back 106

NEU-6.1026.
CC