Neuro 2 Flashcards
(30 cards)
Irresistible impulses to repeat a ritualistic act over and over again (i.e. handwashing) is known as a(n):
compulsion
A 17 year-old male presents with a chief complaint of intermittent ringing in the ears. He has been listening to loud music with headphones since he was 11 years old. What might you expect an audiogram (hearing test) to show?
high frequency (4000hz) hearing loss
A 55 year-old chronic alcoholic patient presents with ophthalmoplegia, ataxia and memory loss. Based upon these symptoms, which diagnosis is most precise?
vitamin B1 deficiency
The symptoms ascribed to Horner’s syndrome are due primarily to which of the following?
unopposed parasympathetic activity
A 27 year-old female patient presents with chief complaint of headaches. She states that occasionally they are so bad that she can’t function but, most of the time, she just tries to ignore them and “get on with things”. She sometimes gets nauseous and dizzy with the headaches. She works at a computer 5 hours per day. Her mother is also prone to frequent headaches. What is the most likely diagnosis?
cannot classify headache with information given
Approximately 67% of epileptic patients who are refractory to anticonvulsant therapy have a seizure focus in which area of the brain?
temporal lobe
A 55 year-old female patient presents with diplopia. On physical exam, horizontal and vertical eye movements are intact, but she is unable to perform rotational eye movements adequately. Which extra-ocular muscle is most likely to be affected?
inferior oblique
Of the physiological correlates of schizophrenia, which of the following has been found in the largest proportion of patients?
enlarged ventricles
A 29 year-old female patient tells you that since the death of her aunt seven weeks ago she has been feeling sad and irritable every day, has no appetite, feels tired all the time and sleeps for more than ten hours each night. Additionally, she isn’t interested in spending time with her friends and feels guilty about not keeping in closer touch with her aunt when she was alive. She also says that, because she’s having trouble getting to work on time and concentrating when she’s there, she’s afraid she’s going to lose her job. Based on these symptoms, which of the following is the best diagnosis?
Major Depressive Disorder
A 53 year-old male patient presents with chronic headache, neck and back pain. PE reveals thickened rope-like muscle bands in the trapazii bilaterally. What would be the best treatment?
myofascial trigger point release
A common symptom of alcohol withdrawal is which of the following?
tremor
The parents of a 24 year-old newly diagnosed schizophrenic patient consult with you in follow-up. He has recently begun antipsychotic medications and the family has been in counseling for eight weeks. He is doing significantly better in his functioning and the family would like him to resume work. What is your advice concerning his prognosis?
schizophrenia is a life-long diagnosis and he will need a constant supportive environment
A 30 year-old opioid dependent patient wants treatment for his addiction. He has previously attended several detoxification facilities but always seems to relapse. Which of the following is the most reasonable choice at this time?
buprenorphine
A 48-year-old man presents for follow-up of a shoulder injury from a car accident 2 months ago. He complains of insomnia, anxiousness and lack of focus. He has continual thoughts that he is going to crash his car into a pole or barricade. What is his likely diagnosis?
post-traumatic stress disorder
A 24-year-old woman comes to clinic brought in by a friend. She states she has never felt better. Her friend states the patient stays up all night, brings strange men home, and has had wild spending sprees. The patient has had depression and was started on paroxetine four months ago. Patient exhibits mild agitation and virtually continuous flow of speech during the visit. What should you do now?
discontinue paroxetine and start lithium
A 34-year-old woman has a severe headache and nausea 12 hours after a diagnostic lumbar puncture. The headache worsens when she sits up and is relieved when she lies flat. She is afebrile and has no neurologic deficits. Her lumbar puncture site has minimal clear drainage without any warmth, erythema, or tenderness to palpation. What is the etiology of the clear drainage?
dural leak
A diabetic patient is unable to sense a pinprick on the undersurface of his smallest toe. Which nerve is involved?
lateral plantar nerve
A 56-year-old woman presents with burning and tingling in the thumb, index finger, and middle finger of her right hand. She states the pain is worse at night and after working on her keyboard. Her symptoms are most likely caused by the entrapment of which nerve?
median
A 66-year-old woman states her mother passed away suddenly about 6 months ago and she is having difficulty moving on with her life. She finds it hard to get up and was recently fired from her job. She has no appetite and has lost 20 pounds. Which best describes her situation?
complicated bereavement
A truck driver is having a routine physical and it is noted his uvula deviates to one side. Additionally, he has no gag reflex. These findings suggest damage to which cranial nerve?
vagus
During the neurology exam of a 26-year-old man, you see fibrillations of his tongue. Which cranial nerve is affected?
XII (hypoglossal nerve)
A 6-year-old boy presents with inattentiveness, hyperactivity and fidgeting for 7 months. He is easily distracted and unorganized. What is his most likely diagnosis?
attention deficit hyperactivity disorder
An 18-year-old presents with intermittent visual auras for the last 6 months. The auras are often associated with migraine headaches. Which one of the following conditions is aura also associated with?
epilepsy
A 78-year-old man presents with gradual memory loss, orientation difficulties, and some mild language deficits. On mental status exam, you note loss of visuospatial processing. He also has difficulty remembering tasks during his part-time job. Which is his likely diagnosis?
Alzheimer disease
