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Neurology Shifting Exam: Cnvandcnvii

The document appears to be a neurology exam with multiple choice questions and answers. It tests knowledge of topics like brainstem reflexes, types of headaches, neurological exam findings, and treatments for conditions like hypertension. Key details assessed include intact cranial nerves after touching the eye with cotton, tests of sensorium, diagnoses for facial palsy and periodic paralysis, and appropriate diagnostic studies and treatments.

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carlos
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110 views9 pages

Neurology Shifting Exam: Cnvandcnvii

The document appears to be a neurology exam with multiple choice questions and answers. It tests knowledge of topics like brainstem reflexes, types of headaches, neurological exam findings, and treatments for conditions like hypertension. Key details assessed include intact cranial nerves after touching the eye with cotton, tests of sensorium, diagnoses for facial palsy and periodic paralysis, and appropriate diagnostic studies and treatments.

Uploaded by

carlos
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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NEUROLOGY SHIFTING EXAM

JULY 31, 2021

PW: batch1
QUESTION ANSWER

You are examining a comatose patient if he


still has brainstem reflexes. You test the CN V and CN VII
cornea sensation by touching with wisp of wet
cotton wool. Bilateral blink response occurs.
This means that the patient has intact
_________:

a.
CN II and CN V
b.
CN III and CN V
c.
CN II and CN III
d.
CN V and CN VII

Which of the following is NOT a test for a.Orientation


sensorium?

b.Memory

c.Consciousness

d.Insight

Headache rel. To cns infection is an acute True sure /?? Not sure.. Sorry po
headache

Autonomic symptoms predominate in False. This predominates in cluster


migraine

The patient goes to your clinic because she has R peripheral facial palsy
facial asymmetry. While testing for the muscles of
facial expression, you observe that the patient’s - bels palsy
forehead on the right side does not wrinkle when
you tell her to look upwards. She also has
difficulty closing her right eye when you attempt to
open it and there is flattening of the right
nasolabial fold when you tell her to smile. The rest
of the neurological examination is normal. This
patient has…

Which of the following is NOT a test for


sensorium?

a.
Memory

b.
Insight

c.
Consciousness

d.
Orientation

Rex attended a party, ate and drank a lot one


evening. Upon waking up in the morning he c.Idiopathic periodic paralysis? After carbo
cannot get up from bed because his muscles loading
are immobile. On examination, his muscles
are flaccid, hyporeflexic and with flexor
plantar response. He cannot hold his neck
upright without support, while sensory
examination was normal. He had the same
attack several months ago. What is he
suffering from?

a.Myasthenic crisis
b.Guillain-Barre Syndrome
c.Idiopathic periodic paralysis
d.Acute transverse myelopathy

Bilateral , dull, band like headache False (tension dapat)


characterizes cluster headache
The level of spinal cord damage in a patient d.C1 to C3 (GOOGLE)
with complete paralysis of the arms and legs:

a.C4 to C5
a.C4 to C5
b.Below cervical region
c.C6 to C7
d.C1 to C3

What is the modified Hunt and Hess grading BONUS


scale score of this patient?

a.I Not sure :( yess shet stuck ako ask m0 nga


ateif skip
b.IV
c.II
d.III
e.V

Initial diag ct angio

The patient goes to your clinic because she R per


has facial asymmetry. While testing for the
muscles of facial expression, you observe
that the patient’s forehead on the right side
does not wrinkle when you tell her to look
upwards. She also has difficulty closing her
right eye when you attempt to open it and
there is flattening of the right nasolabial fold
when you tell her to smile. The rest of the
neurological examination is normal. This
patient has

Autonomic Symptoms predominates in false


migraine headache

Which is the definitive diagnostic procedure


for detecting intracranial aneurysms and
defining their anatomy?
Which is the the first diagnostic study to request in
establishing the diagnosis? hemorr
a.
.
4 Vessel Angiography Angiography
b. b.
Cranial CT Scan
c.
CT Angiography thissss po in my report
Lumbar Puncture
c. d.
Cranial MRI
MR Angiography
Wala so ete
d.
Transcranial Doppler

A 50-year-old banker was in good health until Ano baaa to ??/ parang gbs kasi ascgending
three days earlier when he started to paralysis?
complain intermittent numbness of the
soles of his feet. The day after the initial
symptoms, he experienced increasing
difficulty carrying his bags. One day he felt
that his legs were heavy and his gait
unsteady. He had recently returned from a
five - day business trip to Africa where he
experienced some intestinal problems and a
few bou-ts of diarrhea. He was alert but there
was moderate weakness of neck flexion. He
could barely elevate his arm from the
horizontal position and his hand grip was very
weak. He was unable to lift his legs against
resistance and could not stand without
support. Deep tendon reflexes could not be
elicited, even with reinforcement. What is
your primary impression?

a.Lyme Disease??? Eto?? Not in Africa no


rashes noted
b.Chronic Inflammatory Demyelinating
Polyneuropathy
c.Fisher syndrome
D. Guillain-Barre Syndrome thisss i think
one week to 2 week prior viral followed by
ascending paralysis

Which is the the first diagnostic study to bonus


request in establishing the diagnosis?
.
Cranial CT Scan
b.
Cranial MRI
c.
Angiography
d.
Lumbar Puncture

What is the pathology involved in Myasthenia


gravis? Destruction of the acetylcholine binding sites
at the postsynaptic terminals due to an
autoimmune phenomenon.
a.Destruction of the acetylcholine binding
sites at the postsynaptic terminals due to an
autoimmune phenomenon.
b.Destruction of the presynaptic membrane
due to a degenerative disease.
c.Destruction of the postsynaptic terminal of
the neuromuscular junction due to viral
attack.
d.Proliferation of the acetylcholine receptor
binding sites at the presynaptic terminal.

Active movt against gravity but not resistance 3??


mmt score

Which of the following anti-hypertensives will BONUS


you give? Ano sagot?

a.IV Nicardipine can titrate in desired


b.Sublingual nifedipine
c.Oral amlodipine- longer onset, duration wait
for response
d.Sublingual clonidine- ubrapt drop dec in BP

General Data: Ronnie, 45 year old male.On


March 13, 2020, the patient complained of .Subarachnoid hemorrhage????? In our reoo
headaches and nausea. This was relieved
by paracetamol and bed rest.

On March 18, 2020, at 8:00 am, while playing


computer games, he suddenly complained of
severe headaches followed by neck
stiffness. He vomited once and then
suddenly lost consciousness. He was rushed
to the emergency room.At the ER, his BP
was 200/110, PR 90, RR 20, T 37.5C

Pertinent NE:Does not follow commands;


Eyes open to pain, no verbal output, localizes
pain(+) response to visual threat; (+)
funduscopic findingsPupils 2-3mm equally
reactive to lightConjugate roving eye
movementGrimaces to pain; no weakness of
facial muscles noted(+) gag reflexNo
involuntary movements of extremities, normal
tone, moves all extremities equallyDTRs ++
on all extremities(+) Babinski, bilateralOther
exams - cannot be assessed

Based on the history, which of the following is


the most likely diagnosis of your patient?

a.Intracerebral Hemorrhage
b.Subarachnoid hemorrhage
c.Thrombotic Infarct
d.Embolic Infarct

An unidentified patient was at the ER who was 5 yaysss


apparently a victim of a mauling incident. Patient
responds only to pain, with decorticate posturing
as the only response. What is the GCS score of
the patient?

Tension type headache is the most common


type of headache among 30-40yo

Select one:
True
False

A 47-year-old man was brought to the emergency 3


room because of sudden left hemiparesis. When
examining the muscle strength of the weak
extremities, you observed that there was active
movement against gravity but not against
resistance. What is the MMT score of this patient?
A patient was brought in because of fever Trut? Me tooo Meningitis is definitively
and headache. Upon examination , he was diagnosed with a lumbar puncture - --- -
seen lethargic and with nuchal rigidity. The
first step in the management of this case is
lumbar puncture.

Select one:
True
False - diagnostic first shuta ka

Tension headache common among 30 to 40 true

Headache secondary to CNS infection is an treue


acute type of headache

A worker falls off a ladder and fractures a Brainscape flashcard


vertebra. A neurological exam conducted 2
weeks after the accident reveals that the
individual has a complete hemisection of the
right side of the spinal cord at T5. You would
expect a spastic weakness in this patient to
be:

a.Ipsilateral to and above the level of the


lesion
b.Bilateral to and at the level of the lesion
c.Contralateral to and below the level of the
lesion
d.Ipsilateral to and below the level of the
lesion
Which of the following anti-hypertensives will bonus
you give?

a.
Sublingual clonidine
b.
Oral amlodipine
c.
IV Nicardipine
d.
Sublingual nifedipine

The level of spinal cord damage in a patient


with complete paralysis of the arms and legs:

a.
Below cervical region
b.
C6 to C7
c.
C1 to C3
d.
C4 to C5

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