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106 Cards in this Set
- Front
- Back
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 |
NEU-6.827.
|
|
Which of the following causes brain atrophy?
A) perinatal damage B) alcoholism C) arteriosclerosis D) all of the above E) none of the above |
NEU-6.828.
D |
|
Which of the following does not cause polyneuropathy?
A) alcoholism B) diabetes mellitus C) uremia D) impaired absorption E) parkinsonism |
NEU-6.829.
E |
|
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 |
NEU-6.831.
A |
|
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 |
NEU-6.832.
E |
|
Which of the following is used to study the electrical activity of the
brain? A) electromyography B) electromyelography C) electroencephalography D) electroneuronography |
NEU-6.835.
C |
|
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 |
NEU-6.836
B |
|
Which study is unnecessary in dementia?
A) EEG B) EMG C) determination of the serum fat level D) IQ test E) CT |
NEU-6.837.
B |
|
Where is the CSF localized?
A) the subdural space B) the subarachnoid space . C) under the pia mater D) above the arachnoid |
NEU-6.838.
B |
|
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 |
NEU-6.839.
D |
|
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 |
NEU-6.844.
B |
|
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 |
NEU-6.845.
C |
|
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 |
NEU-6.850.
D |
|
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 |
NEU-6.856.
B |
|
Which drug is used for the treatment of parkinsonism?
A) amantadine B) aminopyrine C) allopurinol D) phenytoin E) buformin |
NEU-6.858.
A |
|
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 |
NEU-6.859.
C |
|
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 |
NEU-6.861.
A |
|
Which of the following is not an excitation sign?
A) epilepsy B) micropsia C) a dreamy state D) miosis E) ansognosia |
NEU-6.866.
E |
|
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 |
NEU-6.867.
B |
|
Which area is damaged in Parkinson's disease?
A) the dentate nucleus B) the substantia nigra C) the subthalamic nucleus D) the putamen |
NEU-6.868.
B |
|
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 |
NEU-6.869.
C |
|
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 |
NEU-6.871.
DE |
|
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 |
NEU-6.872.
AB |
|
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 |
NEU-6.873.
BDE |
|
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 |
NEU-6.877.
ABE |
|
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 |
NEU-6.881.
BDE |
|
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 |
NEU-6.882
ACE |
|
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 |
NEU-6.886.
- |
|
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 |
NEU-6.887.
B |
|
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 |
NEU-6.889.
C |
|
In which disease does vertigo occur?
1) Foster-Kennedy's syndrome 2) trigeminal neuralgia 3) amyotrophic lateral sclerosis 4) Meniére's disease |
NEU-6.890.
D |
|
In Which diseases is the cochlear nerve damaged?
1) trauma 2) herpes zoster 3) salicylate-induced damages 4) uremia |
NEU-6.893.
E |
|
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 |
NEU-6.899.
A |
|
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 |
NEU-6.902.
E |
|
Trismus can develop in:
1) myasthenia gravis 2) trigeminal neuralgia 3) hypertonic encephalopathy 4) tetanus |
NEU-6.910.
D |
|
A lesion of the facial nucleus occurs in:
1) syringobulbia 2) bulbar paralysis 3) polioencephalitis 4) pontine tumors |
NEU-6.911
E |
|
The acoustic system includes:
1) the otic ganglion 2) the geniculate ganglion 3) the stellate ganglion 4) the spiral ganglion |
NEU-6.912.
D |
|
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 |
NEU-6.914.
D |
|
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 |
NEU-6.915.
E |
|
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 |
NEU-6.923.
E |
|
The nuclei of the cerebellum include:
1) the emboliform nucleus 2) the globose nucleus 3) the dentate nucleus 4) the fastigial nucleus |
NEU-6.924.
E |
|
The cerebellum is involved in the following functions:
1) vision 2) gnostic performance 3) hearing 4) coordination of muscle activity |
NEU-6.925.
D |
|
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 |
NEU-6.926.
E |
|
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 |
NEU-6.927.
E |
|
The components of the vestibular system include:
1) the utricule 2) the saccule 3) the semicircular canals 4) Corti's organ |
NEU-6.929.
A |
|
Vertigo occurs in:
1) Meniere's disease 2) it can be of a psychogenic origin 3) intoxication 4) vestibular neuritis |
NEU-6.930.
E |
|
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 |
NEU-6.933.
D |
|
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 |
NEU 6.935.
E |
|
Which symptoms can be caused by circulatory disorders of the
vertebrobasilar area? 1) vertigo 2) confusion 3) drop attack 4) imbalance |
NEU-6.937.
E |
|
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 |
NEU-6.938.
E |
|
Medication used,in multiple sclerosis includes:
1) levodopa + benserazide (Madopar) 2) pyridostigmine (Mestinon) 3) methyldopa (Dopegyt) 4) steroids |
NEU-6.939.
D |
|
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 |
NEU-6.941
D |
|
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 |
NEU-6.943.
- |
|
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 |
NEU-6.944
- |
|
NA Which diseases are usually accompanied by epileptic fits?
1) intracranial tumors 2) alcoholism 3) head injuries 4) multiple sclerosis |
NEU-6.945.
- |
|
Which pathological processes can cause unconsciousness?
1) a thrombosis of the basilar artery 2) "grand mal" epilepsy 3) an intracranial hemorrhage 4) syncope |
NEU-6.946
E |
|
Which of the following medications is used in cerebral infarction?
1) pentoxifylline (Trental ) 2) vinpocetine (Cavinton) 3) mannitol (Mannisol) 4) xantinol (Xavin) |
NEU-6.947.
E |
|
Plasmapheresis is used in:
1) myasthenia gravis 2) polmyositis 3) Guillain-Barré's syndrome 4) Foster-Kennedy's syndrome |
NEU-6.949.
A |
|
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 |
NEU-6.951.
B |
|
What are the sequellae of AIDS?
1) an occurrance of opportunistic infections 2) dementia 3) malignant intracranial tumors can develop 4) polyneuritis can develop |
NEU-6.953.
E |
|
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 |
NEU-6.955.
B |
|
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 |
NEU-6.956.
B |
|
Which of the following medications is used in parkinsonism?
1) levodopa + benserazide (Madopar) 2) bromocriptine 3) amantadine (Viregyt K) 4) pyridostigmine (Mestinon) |
NEU-6.957.
A |
|
Which of the following is typical of parkinsonism?
1) hypo- or akinesia 2) no mental symptoms 3) rigidity and tremor 4) spasticity |
NEU-6.958.
B |
|
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 |
NEU-6.959.
C |
|
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 |
NEU-6.960.
B |
|
Common complications of subarachnoid hemorrhage include:
1) a vasospasm-induced softening 2) a relapse 3) a communicating hydrocephalus 3) secondary suppuration |
NEU-6.961.
A |
|
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 |
NEU-6.962.
- |
|
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 |
NEU-6.965.
E |
|
The local administration of botullinum toxin decreases:
1) athetosis 2) blepharospasm 3) chorea 4) spastic torticollis |
NEU-6.967.
C |
|
Which drug reduces increased tone spasticity?
1) Baclofen 2) clozapine (Leponex) 3) tolperisone (Mydeton) 4) levodopa + benserazide (Madopar) |
NEU-6.969.
B |
|
The medication of choice in a cholinergic crisis is:
1) neostigmine (Stigmosan) 2) pyridostigmine (Mestinon) 3) edrophonium (Tensilon) 4) atropine |
NEU-6.971.
D |
|
Which disease develops after a tick-bite?
1) tick-encephalitis 2) borreliosis 3) tick-meningoencephalitis 4) subacute sclerozing panencephalitis |
NEU-6.972.
A |
|
NA Malignant tumors can be accompanied by:
1) cerebellar atrophy 2) progressive multifocal leukoencephalopathy 3) polyneuropathy 4) dermatomyositis |
NEU-6.973.
- |
|
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 |
NEU-6.975.
A |
|
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 |
NEU-6.976.
F |
|
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 |
NEU-6.978.
A |
|
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 |
NEU-6.980.
D |
|
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 |
NEU-6.981.
- |
|
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 |
NEU-6.982.
DACB |
|
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 |
NEU-6.984.
CABD |
|
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 |
NEU-6.985.
BADEC |
|
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 |
NEU-6.990.
BBCADE |
|
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 |
NEU-6.993
BAEDC |
|
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 |
NEU-6.997.
BACD |
|
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 |
NEU-6.999.
CACDAAACB |
|
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 |
NEU-6.1006.
DACBE |
|
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 |
NEU-6.1008.
ABBADACBB |
|
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 |
NEU-6.1009.
BABBADDCD |
|
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 |
NEU-6.1010.
ACCECFGB |
|
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 |
NEU-6.1011.
- |
|
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 |
NEU-6.1012.
- |
|
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 |
NEU-6.1013.
- |
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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 |
NEU-6.1014.
BDEA |
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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 |
NEU-6.1015.
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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 |
NEU-6.1016.
CBDE |
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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 |
NEU-6.1017.
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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 |
NEU-6.1018.
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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 |
NEU-6.1019.
DC |
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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 |
NEU-6.1020.
CCB |
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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 |
NEU-6.1021.
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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 |
NEU-6.1022
CA |
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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 |
NEU-6.1023
D |
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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. |
NEU-6.1024.
CD |
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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. |
NEU-6.1025.
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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 |
NEU-6.1026.
CC |