Neurological complications of medical disorders

Question 1

A 56-year-old woman with known pernicious anaemia. She has spastic paraparesis
and impaired sensation to touch and vibration in both lower limbs. What does she
have?
a. diabetic polyneuropathy
b. acute combined degeneration of the spinal cord
c. L4/L5 disc prolapse
d. stroke in the anterior cerebral artery

Answer 1

b. acute combined degeneration of the spinal cord

Question 2

Hashimoto’s encephalopathy is:
a. tonic-clonic seizures are present
b. no association with Hashimoto’s thyroiditis
c. is a common disease
d. the disease is a traumatic illness

Answer 2

a. tonic-clonic seizures are present

Question 3

Delirium tremens is not characteristic:
a. onset of symptomatology 48-69 hours after alcohol withdrawal
b. withdrawal seizures follow symptoms of delirium
c. visual hallucinations
d. fever

Answer 3

b. withdrawal seizures follow symptoms of delirium

Question 4

In central pontine myelolysis, they are often
pathological:
a. Brainstem acoustic potentials
b. visible signs
c. somatosensory evoked responses
d. Motor challenges

Answer 4

a. Brainstem acoustic potentials

Question 5

Acute alcohol intoxication can cause:
a. moipathy with plaques
b. necrotizing myositis
c. dermatomyositis
d. Vacuolar myopathy

Answer 5

b. necrotizing myositis

Question 6

Withdrawal seizures in an alcoholic are usually:
a. focal
b. complex focal
c. generalised tonic-clonic
d. atonic

Answer 6

c. generalised tonic-clonic

Question 7

The most effective anti-seizure therapy for an alcoholic is:
a. carbamazepine
b. topiramate
c. gabapentin
d. abstinence

Answer 7

d. abstinence

Question 8

Alcoholic cerebellar degeneration is most commonly manifested by:
a. the ataxia carcass
b. nystagmus
c. upper limb ataxia
d. dizartrijo

Answer 8

a. the ataxia carcass

Question 9

The following nerves are most commonly affected in sarcoidosis:
a. V
b. VI
c. VII
d. VIII

Answer 9

c. VII

Question 10

Which structure is defective in vitamin B12 deficiency ataxia?
a. the little brain
b. vestibular system
c. dorsal columns of the spinal white matter
d. dorsal horns of the spinal grey matter

Answer 10

c. dorsal columns of the spinal white matter

Question 11

What is corrected first when Wernicke’s encephalopathy is treated?
a. bulbomotorics
b. nystagmus
c. ataxia
d. polyneuropathy

Answer 11

a. bulbomotorics

Question 12

A 21-year-old, highly successful philosophy student comes for the voices he often
hears. They are disturbing, dictating his daily activities. On examination, he is
oriented, without speech disorders, and his neurological examination is normal.
Probable diagnosis:
a. temporal lobe seizure
b. non-convulsive status epilepticus
c. tinnitus
d. psychosis

Answer 12

d. psychosis

Question 13

Wernicke’s encephalopathy is not seen in patients with s/z:
a. chronic alcoholism
b. hyperemesis in pregnancy
c. glioblastoma
d. anorexia

Answer 13

c. glioblastoma

Question 14

Which disease is least likely to cause anaemia?
a. Huntington’s disease
b. Parkinson’s disease
c. head injury
d. frontal lobe tumour
e. schizophrenia

Answer 14

a. Huntington’s disease

Question 15

Central pontine myelinosis is caused by:
a. premature correction of hyponatraemia
b. long-lasting hyponatraemia
c. rapid correction of hypernatraemia
d. long-lasting hypernatraemia
e. multiple sclerosis

Answer 15

a. premature correction of hyponatraemia

Question 16

Acute myeloid leukaemia is not associated w/:
a. intracerebral haemorrhage
b. hyperviscosity of the blood
c. carcinomatosis leptomening
d. opportunistic infections
e. none of the above

Answer 16

e. none of the above

Question 17

What defects does B12 deficiency cause?
a. myopathy
b. radiculopathy
c. myelopathy
d. encephalopathy

Answer 17

a. myopathy

Shouldn’t it be encephalopathy?

Question 18

When correcting electrolyte imbalances, we must be alert to the occurrence of
central pontine myelinosis in a patient with:
a. Hypokalaemia
b. hyperkalemia
c. hypocalcaemia
d. hypercalcaemia
e. none of the above

Answer 18

e. none of the above

Question 19

Which part of the central nervous system is atrophic in a chronic alcoholic?
a. superior vermis
b. flocculus
c. Wernicke’s area
d. Brocco area
e. primary motor cortex

Answer 19

a. superior vermis

Question 20

The gentleman has intermittent disturbances of consciousness, asterixis,
splenomegaly, ascites. He has:
a. impaired portal circulation clearance function
b. copper deficiency
c. renal tubular acidosis
d. pernicious anaemia

Answer 20

a. impaired portal circulation clearance function

Question 21

What do you give a TB patient on isoniazid and rifampicin therapy to
prevent neuropathy?
a. Cobalamin (vitamin B12)
b. Pyridoxine (vitamin B6)
c. thiamine (vitamin B1)
d. erythromycin
e. ceftriaxone

Answer 21

b. Pyridoxine (vitamin B6)

Question 22

A lady with lymphadenopathy, you diagnose her with sarcoidosis - which nerve do
you find a little affected?
a. II
b. III
c. V
d. VII

Answer 22

c. V

Question 23

Which investigation will be without specificity in a patient with hepatic
encephalopathy who is an alcoholic?
a. hemogram
b. CT brain
c. ammonia in the blood
d. EEG
e. liver enzymes

Answer 23

b. CT brain

Question 24

What most commonly causes neurosarcoidosis?
a. myelitis
b. mononeuritis multiplex
c. cerebral nerve palsies
d. hydrocephalus and encephalitis
e. all of the above

Answer 24

c. cerebral nerve palsies

Question 25

What causes hypoglycaemia:
a. tremor
b. epileptic seizure
c. coma
d. all of the above

Answer 25

d. all of the above

Question 26

Mononeuritis multiplex in the context of polyarteritis nodosa is treated with/s:
a. methylprednisolone
b. IVIg
c. azathioprine
d. cyclophosphamide
e. cyclosporine

Answer 26

a. methylprednisolone

Question 27

What not to expect in systemic lupus erythematosus?
a. caps
b. psychosis
c. depression
d. mononeuritis multiplex
e. none of the above

Answer 27

e. none of the above

Question 28

Neurological impairments in kidney disease include:
a. encephalopathy and peripheral neuropathy.

Answer 28

a. encephalopathy and peripheral neuropathy.

Question 29

Which disease is more common in men:
a. migraine
b. Alzheimer’s disease
c. Parkinson’s disease
d. multiple sclerosis

Answer 29

c. Parkinson’s disease

Question 30

Psychogenic illness, what characterises it:
a. the patient is unaware of it and cannot control it
b. most of them are consciously simulating
c. no organic or physiological cause is found

Answer 30

c. no organic or physiological cause is found

Question 31

Trias in Wernicke’s encephalopathy:
a. confusion, hallucinations, polyneuropathy
b. confusion, ophthalmoplegia, ataxia.
c. coma, ataxia, nystagmus
d. confusion, nystagmus, hallucinations

Answer 31

b. confusion, ophthalmoplegia, ataxia.

Question 32

Alcoholic with withdrawal syndrome and convulsions. How do we treat him?
a. diazepam
b. vaplroat
c. propofol
d. B12 replacement

Answer 32

a. diazepam

Question 33

Wernicke-Korsakoff psychosis, what can we do?
a. thiamine
b. Niacin
c. cobalamin
d. folate

Answer 33

a. thiamine

Question 34

The classic Wernicke’s encephalopathy trio includes:
a. ataxia, amnesia and predominantly horizontal bulbomotor disturbances
b. ataxia, amnesia and predominantly vertical bulbomotor disorders
c. ataxia, amnesia and myoclonus
d. ataxia, amnesia and generalised seizures

Answer 34

a. ataxia, amnesia and predominantly horizontal bulbomotor disturbances

Question 35

Wernicke’s encephalopathy mainly affects:
a. hippocampus
b. frontal lobe cortex
c. Little Brains
d. dorsomedial thalamic nucleus and mamillary bodies

Answer 35

d. dorsomedial thalamic nucleus and mamillary bodies

Question 36

Wernicke’s encephalopathy is treated by:
a. high doses of folic acid
b. high doses of thiamine
c. vitamin C
d. vitamin B12

Answer 36

b. high doses of thiamine

Question 37

The Cushing Triad consists of:
a. hypertension
b. hypotension
c. bradycardia
d. tachycardia
e. irregular breathing

Answer 37

a. hypertension
c. bradycardia
e. irregular breathing

Question 38

In sarcoidosis, the most commonly damaged nerve is the cranial nerve:
a. II
b. III
c. V
d. VIII

Answer 38

a. II

Question 39

Chronic alcoholic. What atrophies him most often?
a. Vermis
b. flocculus
c. gyrus cinguli
d. mammillary bodies

Answer 39

a. Vermis