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Flashcards in chapter 13-14-15 Deck (30):
1

Which of the following can be causes of mechanical dysphagia?
A. Esophageal stricture
B. Gastroesophageal reflux
C. Aortic aneurysm
D. Macroglossia
E. All of the above

E

2

Which of the following is most prominent in patients with myotonic dystrophy?
A. Aspiration
B. Spastic dysphonia
C. Neuromuscular dysphagia
D. Mechanical dysphagia

C

3

A 64-year-old man presents with diplopia, unilateral ptosis, and dysphagia. Which of the
following is the most likely diagnosis?
A. Myotonic dystrophy
B. Myasthenia gravis
C. Brainstem infarction
D. Paraneoplastic syndrome

B

4

A 54-year-old female presents with dysphagia associated with hemiataxia and a small pupil on
the same side. Which is the most likely diagnosis?
A. Brainstem tumor
B. Multiple sclerosis
C. Diabetic cranial neuropathy
D. Stroke

D

5

Which of the following statements regarding stroke and dysphagia is true?
A. Dysphagia following stroke indicates a brainstem localization of the lesion
B. Aspiration is uncommon in patients with stroke
C. Dysphagia to the point of requiring tube feeding rarely shows subsequent improvement
D. Dysphagia can be the sole manifestation of stroke

D

6

Which of the following statements is true regarding dysphagia in multiple sclerosis?
A. Dysphagia is uncommon in MS because this is a disease of myelin rather than neurons
B. Dysphagia is common in patients with brainstem dysfunction from MS
C. Dysphagia in MS usually develops early in the course of the disease
D. Dysphagia in MS is usually due to dysfunction of the esophageal phase

B

7

A 60-year-old female presents with slowly progressive dysphagia and dysarthria with no other
signs of weakness or ataxia. Reflexes are brisk and the plantar responses are upgoing. Which is
the most likely diagnosis?
A. ALS
B. Brainstem tumor
C. Multiple sclerosis
D. Central pontine mvelinolvsis

A

8

The following questions present a clinical manifestation of dysphagia. For each, select the
localization of the dysfunction from the following list.
A. Oropharyngeal dysfunction
B. Esophageal dysfunction
C. Mechanical obstruction
D. Zencer's diverticulum
Difficulty with solids but not liquids.

C

9

The following questions present a clinical manifestation of dysphagia. For each, select the
localization of the dysfunction from the following list.
A. Oropharyngeal dysfunction
B. Esophageal dysfunction
C. Mechanical obstruction
D. Zencer's diverticulum
Difficulty initiating swallowing.

A

10

The following questions present a clinical manifestation of dysphagia. For each, select the
localization of the dysfunction from the following list.
A. Oropharyngeal dysfunction
B. Esophageal dysfunction
C. Mechanical obstruction
D. Zencer's diverticulum
Retrosternal "hanging up" sensation.

B

11

A 36-year-old man complains of intermittent monocular visual loss. On questioning, he notes
halos around lights, but has no eye pain. Which is the most likely diagnosis?
A. Optic neuritis
B. Amaurosis fugax
C. Glaucoma
D. Migraine

C

12

Which of the following statements are true regarding junctional scotoma?
A. Visual field defects are identical in me two eyes
B. Most common cause is migraine
C. Is seldom symptomatic
D. The cause is usually a lesion at or near the chiasm
E. All are true

D

13

A patient with a history of optic neuritis notes that with fever, the vision in the affected eye
deteriorates. What is the most likely clinical explanation?
A. The illness produces recurrent episodes of optic neuritis.
B. The fever produces exacerbation of the pre-existing demyelinating damage
C. The fever and the exacerbation of visual loss are coincidental.
D. The patient's observations are psychosomatic.

B

14

A 70-year-old man presents with the sudden onset of monocular visual loss. The defect is central
with peripheral vision spared. Examination shows retinal hemorrhages in the affected eye. Which
is the most likely diagnosis?
A. Optic neuritis
B. Acute glaucoma
C. Central retinal artery occlusion
D. Central retinal vein occlusion
E. None of the above

D

15

Which of the following statements is true regarding drv.sen of the optic nerve?
A. Patienta seldom have detectable visual field loss
B. Arcuate visual field defects and enlargement of the blind spot are common
C. Drusen is due to myelination of optic nerve axons within the eye
D. Loss of central vision with drusen is always benign

B

16

The following questions present visual field defects. Correlate the visual field defect with the
appropriate anatomic structure.
A. Left retina
B. Optic chiasm
C. Right optic nerve
D. Left temporal optic radiations
E. Left parietal optic radiations
F. Left occipital cortex
Bitemporal hemianopia.

B

17

The following questions present visual field defects. Correlate the visual field defect with the
appropriate anatomic structure.
A. Left retina
B. Optic chiasm
C. Right optic nerve
D. Left temporal optic radiations
E. Left parietal optic radiations
F. Left occipital cortex
Right homonymous superior quadrant defect.

D

18

The following questions present visual field defects. Correlate the visual field defect with the
appropriate anatomic structure.
A. Left retina
B. Optic chiasm
C. Right optic nerve
D. Left temporal optic radiations
E. Left parietal optic radiations
F. Left occipital cortex
Hemianopia.

F

19

The following questions present visual field defects. Correlate the visual field defect with the
appropriate anatomic structure.
A. Left retina
B. Optic chiasm
C. Right optic nerve
D. Left temporal optic radiations
E. Left parietal optic radiations
F. Left occipital cortex
Right homonymous superior quadrant defect.

E

20

The following questions present visual field defects. Correlate the visual field defect with the
appropriate anatomic structure.
A. Left retina
B. Optic chiasm
C. Right optic nerve
D. Left temporal optic radiations
E. Left parietal optic radiations
F. Left occipital cortex
Complete loss of vision in the right eye.

C

21

Which of the following statements are true regarding unilateral optic disc edema?
A. Optic nerve function is usually abnormal
B. Appearance overlaps between different causes
C. Can be caused by optic neuritis
D. Most patients with acute demyelinating optic neuritis do not have optic disc edema
E. All are true

E

22

Which of the following statements is true regarding the Foster-Kennedy syndrome?
A. Lesion is usually retrobulbar neuritis from multiple sclerosis
B. Patients have unilateral optic nerve edema with the opposite eye unaffected
C. Patients have anterior ischemic optic neuropathy
D. Patients have unilateral optic atrophy with contralateral papilledema

D

23

A 36-year-old man presents with severe confusion, papilledema, and severe hypertension. There
are no focal findings on examination. What diagnoses should be considered?
A. Optic neuritis
B. Diabetic papillopathy
C. Malignant hypertension
D. Glaucoma

C

24

A 30-year-old female presents with encephalopathy and is found on examination to have
multiple branch retinal artery occlusions and sensorineural hearing loss. CSF shows a mild
lymphocytic pleocytosis. MRI shows multiple regions of increased signal on T2-weighted
images. Angiography is normal. Which is the most likely diagnosis?
A. Susac's syndrome
B. Multiple sclerosis
C. HSV encephalitis
D. Vasculitis

A

25

Which retinal findings would be expected in von Hippel-Lindau disease?
A. Astrocytic hamartomas
B. Angiomas
C. Arteriovenous malformations
D. Pigmentary degeneration

B

26

Which retinal findings would be expected in tuberous sclerosis?
A. Astrocytic hamartomas
B. Angiomas
C. Arteriovenous malformations
D. Pigmentary degeneration

A

27

Which of the following statements is not true regarding retinal vein occlusion?
A. Most patients with retinal vein occlusion are older than 50
B. Disc edema is common with retinal vein occlusion
C. Retinal vein occlusion is usually due to carotid vascular disease
D. Patients with retinal vein occlusion should be screened for vascular risk factors

C

28

Which of the following disorders does not cause optic atrophy?
A. Optic nerve compression by tumor
B. Optic neuritis
C. Chiasmal compression by tumor
D. Infarction of the optic radiations

C

29

Which of the following statements are true of Leber's optic neuropathy?
1. Occurs mainly in males
2. Optic disk may appear swollen
3. Telangiectatic vessels are seen in the peripapillary nerve fiber layer
4. Fluoroscein angiography shows leakage from the disk
Select: A = 1,2,3. B = 1,3. C = 2,4. D = 4 only. E = All

no highlights

30

Which of the following conditions are associated with uveoretinal meningoencephalitis?
1. Syphilis
2. Yogt-Koyanagi-Harada syndrome
3. Behcet's disease
4. Sarcoidosis
Select: A = 1,2,3. B = 1,3. C = 2,4. D = 4 only. E = All

E