NEURO Flashcards

Question

initial treatment of OH

Answer 1

✅ Correct Answer: A. Unawareness of his neurologic deficits Rationale: Right MCA strokes affecting the nondominant hemisphere (typically right in right-handed individuals) can cause anosognosia (lack of awareness of deficits). Global aphasia (B) occurs in left MCA strokes. Delayed responses (C) occur in subcortical strokes. Contralateral hemiballismus (D) is associated with subthalamic nucleus damage (e.g., lacunar strokes).

Answer 2

✅ Correct Answer: C. Posterior inferior cerebellar artery (PICA) occlusion Rationale: PICA occlusion leads to Wallenberg syndrome (lateral medullary syndrome), which includes: Ipsilateral Horner’s syndrome (ptosis, miosis, anhidrosis) Hoarseness and dysphagia (nucleus ambiguus involvement) Contralateral loss of pain/temp sensation (spinothalamic tract) Basilar artery occlusion (A) causes locked-in syndrome. MCA occlusion (B) presents with contralateral hemiparesis and aphasia/neglect. ACA occlusion (D) causes leg weakness.

Answer 3

✅ Correct Answer: B. Anton’s syndrome Rationale: Anton’s syndrome is cortical blindness with denial of blindness (anosognosia) due to bilateral PCA infarcts. Balint’s syndrome (A) involves simultanagnosia, optic ataxia, and oculomotor apraxia. Weber’s syndrome (C) presents with midbrain infarction and ipsilateral CN III palsy. Gerstmann’s syndrome (D) involves agraphia, acalculia, finger agnosia, and left-right disorientation.

Answer 4

✅ Correct Answer: A. APOE ε4 allele Rationale: APOE ε4 allele is the strongest genetic risk factor for sporadic Alzheimer’s disease. Presenilin-1 (B) and APP mutations (C) are linked to early-onset familial Alzheimer’s. TREM2 (D) increases risk but is less significant than APOE ε4.

Answer 5

Presenilin-1 (B) and APP

Answer 6

Correct Answer: B. Creutzfeldt-Jakob disease Rationale: CJD presents with rapid dementia, myoclonus, and EEG showing periodic sharp waves. Alzheimer’s (A) progresses slowly. Frontotemporal dementia (C) affects behavior/language. Lewy body dementia (D) involves visual hallucinations.

Answer 7

✅ Correct Answer: C. Negative amyloid PET Scan Rationale: Amyloid PET scan positivity is seen in Alzheimer’s disease. MRI and CT (A, B) may be normal early. FDG PET scan (D) shows hypometabolism in AD.

Answer 8

✅ Correct Answer: D. Melatonin Rationale: Melatonin is first-line for REM sleep behavior disorder in Lewy body dementia. Clonazepam (C) is second-line due to side effects. Donepezil (A) and Memantine (B) treat cognitive symptoms, not sleep disturbances.

Answer 9

Hemicrania continua

Answer 10

✅ Correct Answer: D. Excruciating, non-fluctuating pain Rationale: Cluster headaches are characterized by severe, unilateral periorbital pain with autonomic symptoms (e.g., lacrimation, rhinorrhea). Bilateral pain (A) and lasting days (B) suggest tension

Answer 11

✅ Correct Answer: B. Perivenular inflammation and demyelination

Answer 12

✅ Correct Answer: B. B cells

Answer 13

✅ Correct Answer: D. Diffuse inflammation with microglial activation Rationale: Progressive MS is characterized by chronic neuroinflammation with microglial activation leading to axonal loss and disability progression. Acute perivenular inflammation (A) is seen in relapsing-remitting MS (RRMS). Frequent relapses (B) describe RRMS. Oligoclonal bands (C) are seen in both forms but are not specific to progressive MS.

Answer 14

✅ Correct Answer: A. HLA-DRB1 Rationale: HLA-DRB1 is the strongest genetic risk factor for MS. CD127 (B), CD25 (C), and CD58 (D) are associated but confer less risk than HLA-DRB1.

Answer 15

Uhthoff's phenomenon | . Paroxysmal dysarthria (C) is a rare MS symptom.

Answer 16

Lhermitte’s sign (B) is an electric shock-like sensation with neck flexion

Answer 17

Correct Answer: B. Two attacks with evidence of two lesions in non-contiguous CNS areas Rationale: MS diagnosis requires dissemination in time and space, which means two clinical attacks with two separate CNS lesions. Single attack (A) does not fulfill the criteria. Progressive decline (C) is seen in primary progressive MS, but diagnosis still requires MRI findings. Autoantibodies (D) are not specific for MS.

Answer 18

✅ Correct Answer: A. Ocrelizumab Rationale: Ocrelizumab (anti-CD20 therapy) is a first-line disease-modifying treatment for RRMS. Cyclophosphamide (B) and methotrexate (C) are not standard. IVIG (D) is not used for MS.

Answer 19

Correct Answer: B. Colonization of the nasopharynx, followed by hematogenous spread Rationale: Most cases of bacterial meningitis occur via nasopharyngeal colonization, bloodstream invasion, and CNS penetration. Direct invasion (A) occurs but is less common. Respiratory spread (C) affects lungs, not CSF. Direct inoculation (D) happens in trauma/surgery cases.

Answer 20

✅ Correct Answer: A. Lymphocytic pleocytosis, normal glucose, elevated protein Rationale: Viral meningitis is characterized by lymphocytic pleocytosis, normal glucose, and mildly elevated protein. Neutrophilic pleocytosis with low glucose (B) suggests bacterial meningitis. Eosinophils (D) suggest parasitic or fungal infections.

Answer 21

✅ Correct Answer: D. Tuberculous meningitis Rationale: TB meningitis presents with mononuclear pleocytosis, low glucose, and high protein. Viral meningitis (A) has normal glucose. Fungal meningitis (B) has similar findings but occurs in immunocompromised patients. Bacterial meningitis (C) has neutrophils, not mononuclear cells.

Answer 22

PRAZIQUANTEL

Answer 23

✅ **Correct Answer:** b. Right middle cerebral artery **Rationale:** MCA infarcts commonly cause contralateral hemiparesis and gaze preference toward the affected hemisphere.

Answer 24

✅ **Correct Answer:** c. Middle cerebral artery **Rationale:** The MCA is the most commonly affected artery in ischemic stroke due to its direct blood supply from the internal carotid artery.

Answer 25

✅ **Correct Answer:** a. Magnetic resonance imaging (MRI) **Rationale:** Diffusion-weighted MRI is the most sensitive modality for detecting acute ischemic stroke.

Answer 26

✅ **Correct Answer:** b. Hypertension **Rationale:** Chronic hypertension leads to small vessel disease and is the most common cause of spontaneous intracerebral hemorrhage.

Answer 27

✅ **Correct Answer:** c. Cardioembolic stroke **Rationale:** Atrial fibrillation increases the risk of embolism, which can lead to large vessel occlusions and sudden onset deficits.

Answer 28

✅ **Correct Answer:** b. Right middle cerebral artery **Rationale:** MCA infarcts commonly cause contralateral hemiparesis and gaze preference toward the affected hemisphere.

Answer 29

✅ **Correct Answer:** c. Middle cerebral artery **Rationale:** The MCA is the most commonly affected artery in ischemic stroke due to its direct blood supply from the internal carotid artery.

Answer 30

✅ **Correct Answer:** a. Magnetic resonance imaging (MRI) **Rationale:** Diffusion-weighted MRI is the most sensitive modality for detecting acute ischemic stroke.

Answer 31

✅ **Correct Answer:** b. Hypertension **Rationale:** Chronic hypertension leads to small vessel disease and is the most common cause of spontaneous intracerebral hemorrhage.

Answer 32

✅ **Correct Answer:** c. Cardioembolic stroke **Rationale:** Atrial fibrillation increases the risk of embolism, which can lead to large vessel occlusions and sudden onset deficits.

Answer 33

✅ **Correct Answer:** b. Right middle cerebral artery **Rationale:** MCA infarcts commonly cause contralateral hemiparesis and gaze preference toward the affected hemisphere.

Answer 34

✅ **Correct Answer:** c. Middle cerebral artery **Rationale:** The MCA is the most commonly affected artery in ischemic stroke due to its direct blood supply from the internal carotid artery.

Answer 35

✅ **Correct Answer:** a. Magnetic resonance imaging (MRI) **Rationale:** Diffusion-weighted MRI is the most sensitive modality for detecting acute ischemic stroke.

Answer 36

✅ **Correct Answer:** b. Hypertension **Rationale:** Chronic hypertension leads to small vessel disease and is the most common cause of spontaneous intracerebral hemorrhage.

Answer 37

✅ **Correct Answer:** c. Cardioembolic stroke **Rationale:** Atrial fibrillation increases the risk of embolism, which can lead to large vessel occlusions and sudden onset deficits.

Answer 38

✅ **Correct Answer:** b. Right middle cerebral artery **Rationale:** MCA infarcts commonly cause contralateral hemiparesis and gaze preference toward the affected hemisphere.

Answer 39

✅ **Correct Answer:** c. Middle cerebral artery **Rationale:** The MCA is the most commonly affected artery in ischemic stroke due to its direct blood supply from the internal carotid artery.

Answer 40

✅ **Correct Answer:** a. Magnetic resonance imaging (MRI) **Rationale:** Diffusion-weighted MRI is the most sensitive modality for detecting acute ischemic stroke.

Answer 41

✅ **Correct Answer:** b. Hypertension **Rationale:** Chronic hypertension leads to small vessel disease and is the most common cause of spontaneous intracerebral hemorrhage.

Answer 42

✅ **Correct Answer:** c. Cardioembolic stroke **Rationale:** Atrial fibrillation increases the risk of embolism, which can lead to large vessel occlusions and sudden onset deficits.

Answer 43

✅ **Correct Answer:** b. Right middle cerebral artery **Rationale:** MCA infarcts commonly cause contralateral hemiparesis and gaze preference toward the affected hemisphere.

Answer 44

✅ **Correct Answer:** c. Middle cerebral artery **Rationale:** The MCA is the most commonly affected artery in ischemic stroke due to its direct blood supply from the internal carotid artery.

Answer 45

✅ **Correct Answer:** a. Magnetic resonance imaging (MRI) **Rationale:** Diffusion-weighted MRI is the most sensitive modality for detecting acute ischemic stroke.

Answer 46

✅ **Correct Answer:** b. Hypertension **Rationale:** Chronic hypertension leads to small vessel disease and is the most common cause of spontaneous intracerebral hemorrhage.

Answer 47

✅ **Correct Answer:** c. Cardioembolic stroke **Rationale:** Atrial fibrillation increases the risk of embolism, which can lead to large vessel occlusions and sudden onset deficits.

Answer 48

✅ **Correct Answer:** d. Recent gastrointestinal bleed **Rationale:** A recent GI bleed is a contraindication for thrombolysis due to the increased risk of hemorrhage.

Answer 49

✅ **Correct Answer:** b. <185/110 mmHg **Rationale:** Blood pressure must be lowered below 185/110 mmHg before administering thrombolytics to reduce the risk of hemorrhagic transformation.

Answer 50

✅ **Correct Answer:** a. Lacunar infarct **Rationale:** Pure motor hemiparesis is a classic lacunar stroke syndrome caused by small vessel disease affecting the internal capsule.

Answer 51

✅ **Correct Answer:** b. Posterior inferior cerebellar artery **Rationale:** PICA infarcts can cause lateral medullary (Wallenberg) syndrome, leading to vertigo, dysphagia, and nausea.

Answer 52

✅ **Correct Answer:** c. Hypertonic saline **Rationale:** Hypertonic saline is preferred for reducing cerebral edema and lowering ICP in ischemic stroke patients.

Answer 53

Bilaterally synchronous spike and slow wave discharges immediately prior to appearance of muscle artifacts.

NEURO Flashcards

(105 cards)