26-55 LT Quiz

Question 1

METHODS used to manage Neck pain of non-traumatic injury of grade I° – II°?

Answer 1

NSAIDs; muscle relaxants; laser therapy; mobilization

Question 2

A 63-male hx of feet numbness and progressive instability while walking, especially in the dark.
He reports no back pain. DM 2 has been diagnosed 5 years ago and the blood sugar control has been poor. Examination: bilateral “sock” type hypoesthesia up to the middle part of the lower legs, impaired vibration sense in the feet, diminished toe strength and absent Achilles reflex bilaterally.
What syndrome of peripheral nervous system lesion would you suspect?

Answer 2

Distal symmetric sensorimotor polyneuropathy

Question 3

A 67-year-old A&E with progressive limb weakness. 10 days ago fever and flu-like symptoms. 2 days ago pain in her lower back and neck followed by numbness in the limbs and clumsy gait. This morning, fell down and could not get up due to the weakness.
On examination: the strength is diminished in both proximal and distal muscles of legs and distal muscles of the arms, the deep tendon reflexes are absent in arms and legs, slight gloves-socks type hypoesthesia is present in the limbs. What is the most likely diagnosis

Answer 3

Guillan-Barre syndrome

Question 4

symptoms are characteristic to the cranial nerve VI (abducens nerve) lesion?

Answer 4

Eye looking inward, inability to look outward, diplopia

Question 5

Which of the following helps to determine the form of epilepsy?

Answer 5

All of the above

seizures, age at onset, EEG, disease course

Question 6

The early CT signs of acute ischemic stroke in a.cerebri media territory are

Answer 6

• ALL CORRECT*
  1. Shallow subarachnoidal convexital sulci in the site of injury
  2. No differentiation between putamen and capsula externa and gl. pallidus and capsula interna #
  3. Indistinct n. lentiformis (putamen - gl. pallidus) border #
  4. Vanishing of differentiation of density of insular cortex #
  5. Hyperdense a.cerebri media

Question 7

Which cerebrospinal fluid changes are characteristic of bacterial meningitis?

Answer 7

neutrophil pleocytosis

Question 8

A 36-year-old man is having recurrent paroxysmal events which last 3-5 minutes. At the onset of such an event, he starts feeling a bitter
taste in his mouth, then he starts glancing to the sides, licks his lips and does not respond when called. These paroxysms occur every 3-4
days, some of them were provoked by emotional distress. What would you suspect?

Answer 8

Focal epileptic seizures with impaired consciousness or awareness (dyscognitive)

Question 9

L3 / 4 intervertebral disc lateral hernia presses:

Answer 9

L4 root

Question 10

One of the patients described below is experiencing focal epileptic seizures. Specify which:

Answer 10

The 72-year-old woman experiences seizures that begin with clonic convulsions in the right side of the face and right arm. Later clonic convulsions spreads to both arms and legs, impairs consciousness. The attack lasts about 1.5 minutes.

Question 11

When is a bacterial antigen test performed in a cerebrospinal fluid?

Answer 11

suspected bacterial meningitis if the patient was treated with antibiotics prior to lumbar puncture

Question 12

A 53-year-old female had a minor cardioembolic stroke of the left frontal lobe following a heart catheterization. Patient is unable to name
objects, lacks fluency, but comprehension and ability to repeat remain preserved. Which of the listed language disorders best defines the
given scenario?

Answer 12

Transcortical motor aphasia

Question 13

The patient suffered a brain injury. After painful stimulus, he says a curse, does not open his eyes, pushes the investigator’s hand away from his chest. GCS?

Answer 13

9

Question 14

What are the symptoms of internal capsule lesion?

Answer 14

Impaired sensation, impaired coordination
paralysis
half-field visual defect on the opposite side

Question 15

32-year-old woman noticed a breast discharge 2 years ago, had a disrupted menstrual cycle, and consulted gynecologists. A month ago the vision in the left eye began to deteriorate. Ophthalmologists found an onset of left optic nerve atrophy and bitemporal hemianopsia.
What neurosurgical disease would you suspect?

Answer 15

Hypophysis adenoma

Question 16

Which of the following patients has the biggest risk of arteriovenous malformation rupture?

Answer 16

43yo male with 3cm AVM which was diagnosed in childhood and ruptured twice without neurologic sequela

Question 17

51 years old the woman fell from the stairs, crashed into her back, felt very
strong pain in her back, and immediately weakened the strength of her legs.
Admission to Neurology: the state of consciousness is good, the hands are controlled, the strength is not weakened, the senses are not disturbed. Leg force: thigh flexion 3 points, knee flexion 2 points, ankle extensions, big toe extensions, ankle flexors - 2 points. Sensory hypesthesia from the navel level. Urination is not impaired. What is AIS grade?

Answer 17

AIS - C

Question 18

Which of the following symptoms are characteristic to the cranial nerve IV (trochlear nerve) lesion?

Answer 18

Eye looking upward and slightly inward, inability to look downward and inward, diplopia

Question 19

Damage to one side of the cortex of the nuclei leading to the XII nerve nucleus

Answer 19

the tongue deviated to the opposite side of the lesion

Question 20

What are the most important dimensions for the correct adaptation of an active type wheelchair?

Answer 20

seat width and depth, back height, foot length

Question 21

Myasthenic crisis may be triggered by:

Answer 21

use of medications that increase muscle weakness
infection, aspiration, trauma, stress, change of medications
thymectomy
ALL OF ABOVE

Question 22

Sensory aphasia causes inability to:

Answer 22

Comprehend speech of others

Question 23

severe pulsating left-sided fronto-temporal headache irradiating to the other
side of the head. The headache has lasted for 8 hours, is accompanied by nausea and vomitting and gets worse with any movement or
louder sounds. No abnormalities detected on physical examination, no focal neurological signs are noted. What is the diagnosis?

Answer 23

Migraine

Question 24

A 45-year old woman developed a tremor of both her arms and her head, that gets worse under stressful circumstances, especially in
public places. Recently it has become difficult to eat, write, dress herself. Patient’s grandmother also had tremor of the arms and the head.
On examination: “no-no” type tremor of the head and in outstretched arms is visible; muscle tone is normal. What treatment would you
prescribe?

Answer 24

Beta-adrenoblockers and benzodiazepines

Question 25

The most common etiological factor of spontaneous intracerebral hematoma

Answer 25

Uncorrected arterial hypertension

Question 26

What are the three main areas of human activity?

Answer 26

daily activities, productive activities / work, leisure

Question 27

Essential tremor is characterized by:

Answer 27

Action tremor

Question 28

60-year-old woman presented with a first generalised tonic-clonic seizure which lasted for 2 minutes with subsequent disorientation for
10 minutes. There were no known provoking factors. The patient was taken to the Emergency Department (ED) by an ambulance. What is
the appropriate investigation plan for this patient?

Answer 28

1. Urgent CT scan in the ED
2. Blood tests for metabolic disturbances in the ED
3. ECG recording in the ambulance

Question 29

35-year-old woman reports a several month history of double vision, drooping eyelids, choking, hoarseness when speaking for longer
periods, and fatigue. She feels better in the morning, but after several hours develops muscle weakness which is especially prominent
during physical activity. On neurological examination: restricted horizontal eye movements, partial ptosis bilaterally, weakness of the facial
muscles, muscle strength in the upper and lower limbs proximally MRC 3/5, distally – MRC 4/5, normal muscle tone, deep tendon reflexes
present, symmetrical, no sensory disturbances, no pathological reflexes, normal bladder and bowel function. What is the most likely
preliminary diagnosis?

Answer 29

myasthenia gravis

Question 30

A young woman presents with a left-sided facial drooping: there is a weakness of the lower side of the face, but she remains able to furrow
the brow and close the eye. Where is the lesion located?

Answer 30

Upper motor neuron at the genu of internal capsule on the right