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AMK head pathologies pt 1 :)

Deleted user 47 questions Updated 13 Mar 2018

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Questions in this quiz (47)

1A 65 years old man is brought to the GP by his wife. The wife complains that over the past few months, her husband has show a step-wise deterioration in his cognitive ability. On checking his records, the man has a past medical history of hypertension and myocardial infarction. He smoked 20 cigarettes in a day and has a BMI of 31.

Based on his history, what is the most likely diagnosis for his reduction in cognitive ability?
1. ALewy body dementia
2. BDelirium
3. CAlzheimer’s disease
4. DVascular dementia
5. EFronto-temporal dementia
2A 53 years old man is brought to the GP by his daughter for a health review. The man experiences progressive cognitive decline that interferes with his normal social functioning. Also, the daughter complains that her dad experiences visual hallucination. On examination, you notice that he is rigid and has resting tremors.

What is the most likely diagnosis?
1. AMultiple Sclerosis
2. BIdiopathic Parkinson's disease
3. CAlzheimer's disease
4. DVascular dementia
5. ELewy body dementia
3Neurosurgeons should be involved at an early stage"

with patients in a [blank_start]coma[blank_end]

if [blank_start]raised[blank_end] [blank_start]intracranial[blank_end] [blank_start]pressure[blank_end] is suspected
1. Acoma
2. Braised
3. Cintracranial
4. Dpressure
4Which of these is not a symptom of subarachnoid hemorrhage?
1. Aphotophobia
2. Bseizures
3. Cvomiting
4. Dcoma
5. Ecollapse
6. Fneck stiffness
7. Gpositive romberg test
5What is sub-arachnoid hemmorhages associated with?
1. Apolycystic kidney disease
2. Bcoarctation of the aorta
3. Cehlers-danlos syndrome
4. Ddiabetes mellitus
6Antiplatelet medications:

[blank_start]Aspirin[blank_end] irreversibly inhibiting COX enzymes and prevents [blank_start]thromboxane[blank_end] [blank_start]A2[blank_end] from activating.

Clopidogrel inhibits [blank_start]ADP[blank_end] receptors.
1. AAspirin
2. BADP
3. Cthromboxane
4. DA2
7[blank_start]Postural[blank_end] tremor is absent at rest but present on [blank_start]maintained[blank_end] posture, such as when the arms are outstretched) and may persist (but is not worse) on movement.

Causes: [blank_start]Benign[blank_end] essential tremor
1. APostural
2. Bmaintained
3. CBenign
8Parkinsonism is a causitive example of a resting tremor like how a cerebellar lesion is for intention tremor.s
1. ATrue
2. BFalse
9Global dysphasia is when both comprehension and expression is compromised.
1. ATrue
2. BFalse
10When there is a non-dominant (right) hemisphere lesion, visuospatial disturbances may occur.
1. ATrue
2. BFalse

11This 68-year-old male presented with a chief complaint of facial drooping and a painful rash. What is the most likely diagnosis?
1. AStroke
2. BBell's palsy
3. COttis externa
4. DHerpes zoster opthalmicus
5. ERamsey Hunt Syndrome
12A patient presents with loss of sensation and strength on the right side of their face and their right upper limb. The patient can still wrinkle their forehead. What is the most likely diagnosis?
1. Aleft anterior cerebral artery occlusion
2. Bright anterior cerebral artery occlusion
3. Cleft middle cerebral artery occlusion
4. DRamsay-Hunt's syndrome
5. EBell's palsy
13A 65 years old man who was previously diagnosed with lung cancer presents to the ED. He complains that he can’t sweat on the left side of his face. Using his presentation and the image shown below, what is the most likely diagnosis?
1. AMyasthenia gravis
2. BGullian Barre Syndrome
3. CHorner's syndrome
4. DBell's palsy
5. EGraves eye disease
14A 34 years old woman visits the ED due to the sudden onset of the following symptoms: vertigo, nausea and vomiting, frequent falls to the right, shaking of right arm when doing tasks, nystagmus and slurring of speech. Examination showed right dysmetria and right dysdiadochokinesia.
Which of the following is the most likely cause?
1. ALeft middle cerebral artery occlusion
2. BRight cerebellar hemorrhage
3. CRight middle cerebral artery occlusion
4. DLeft cerebellar hemorrhage
5. EMeniere's disease
6. FBenign paroxysmal positional vertigo
15thrombotic and embolic are both types of ischemic strokes
1. ATrue
2. BFalse
16intracerebral and subarachnoid hemorrhages can lead to hemorrhagic stroke
1. ATrue
2. BFalse
17What is true regarding stroke?
1. Amotor weakness
2. Bdysphasia
3. Cbalance problems
4. Dswallowing problems
5. Evisual defects
6. Finvestigate: Head CT scan
7. Ginvestigate: Head MRI scan
8. Hringing ears
18Stroke depending on vasculature:
Anterior Cerebral Artery: Contralateral [blank_start]hemiparesis[blank_end] and sensory loss in the [blank_start]lower[blank_end] extremity.

Middle Cerebral Artery: Contralateral [blank_start]hemiparesis[blank_end] and sensory loss in the [blank_start]upper[blank_end] extremity. Contralateral [blank_start]homonymous[blank_end] [blank_start]hemianopia[blank_end] (blindness over half the field of vision.) and [blank_start]aphasia[blank_end] (problems using language correctly.)

Posterior Cerebral Artery: Contralateral [blank_start]homonymous[blank_end] [blank_start]hemianopia[blank_end] with macular sparing. Visual [blank_start]agnosia[blank_end] (inability to interpret sensations and hence to recognize things)
1. Ahemiparesis
2. Blower
3. Chemiparesis
4. Dupper
5. Ehomonymous
6. Fhemianopia
7. Gaphasia
8. Hhomonymous
9. Ihemianopia
10. Jagnosia
19Management:

Ischemic:

1. [blank_start]Aspirin[blank_end] 300mg + [blank_start]antiplatelet[blank_end] therapy for 14 days

If the patient presents within 4.5 hours of the stroke symptoms, [blank_start]thrombolysis[blank_end] therapy with [blank_start]alteplase[blank_end] should be given (assuming no contraindications)

Secondary prevention: clopridogrel

Hemorrhagic:

1. Neurosurgical consultation
2. [blank_start]Supportive[blank_end] management. For example, stop anticoagulants (e.g. warfarin).
3. Lower patient’s [blank_start]blood[blank_end] [blank_start]pressure[blank_end] acutely.
1. AAspirin
2. Bantiplatelet
3. Cthrombolysis
4. Dalteplase
5. ESupportive
6. Fblood
7. Gpressure
20Ramsey Hunt Syndrome

is caused by [blank_start]herpes[blank_end] [blank_start]zoster[blank_end] virus
presents as [blank_start]facial[blank_end] [blank_start]nerve[blank_end] palsy, painful blistering rash on face and in [blank_start]ear[blank_end], and loss of [blank_start]anterior[blank_end] 2/3 taste

Treat with oral [blank_start]acyclovir[blank_end] and prednisolone
1. Azoster
2. Bherpes
3. Cnerve
4. Dfacial
5. Eear
6. Fanterior
7. Gacyclovir
21Bell's palsy affects upper motor neurons.
1. ATrue
2. BFalse
22[blank_start]Bell’s[blank_end] [blank_start]palsy[blank_end] is due to viral infection, which causes swelling and compression of the facial nerve.
1. ABell’s
2. Bpalsy
23Most recover spontaneously from Bell's palsy within a few weeks.
1. ATrue
2. BFalse
24[blank_start]Bell's[blank_end] [blank_start]Palsy[blank_end] is muscle weakness or total loss of the ability to move one side of the face and a change in taste.

TRTMENT: [blank_start]prednisolone[blank_end]
1. Aprednisolone
2. BBell's
3. CPalsy
25A TIA is anything that is under 24 hrs
1. ATrue
2. BFalse
26If TIA:

1. Give [blank_start]300[blank_end] mg aspirin immediately

2. ABCD2 for further management:

A age
B [blank_start]blood[blank_end] [blank_start]pressure[blank_end]
C [blank_start]clinical[blank_end] features
D [blank_start]duration[blank_end] of symptoms or [blank_start]diabetes[blank_end]
1. A300
2. Bblood
3. Cpressure
4. Dduration
5. Ediabetes
6. Fclinical
27Further management of TIAs:

ABCD2 ≥ 4: Specialist assessment and investigation within [blank_start]24[blank_end] [blank_start]hours[blank_end]. Secondary prevention (i.e. clopidogrel) introduced as soon as the diagnosis is confirmed.

ABCD2 ≤ 3: Specialist assessment within [blank_start]1[blank_end] [blank_start]week[blank_end]. If vascular territory or pathology is uncertain, refer for brain imaging ([blank_start]MRI[blank_end]). Secondary prevention (i.e. clopidogrel) introduced as soon as the diagnosis is confirmed.

[blank_start]Crescendo[blank_end] TIAs should be treated as being at high risk of stroke, even if the ABCD2 ≤ 3. Use management criteria of ABCD2 ≥ 4
1. Ahours
2. B24
3. C1
4. Dweek
5. EMRI
6. FCrescendo
28Carotid endarectomy is associated with the glossopharyngeal n
1. ATrue
2. BFalse
29Some people who have had a TIA have [blank_start]narrowing[blank_end] of the carotid artery that may require [blank_start]surgical[blank_end] intervention.
Carotid imaging ([blank_start]Carotid[blank_end] [blank_start]Doppler[blank_end]) is required to define the extent of carotid artery narrowing.
Recommend if patient has suffered stroke or TIA in the carotid territory and is not severely disabled.
1. ADoppler
2. BCarotid
3. Cnarrowing
4. Dsurgical
30‘A 72 year old man presents to his GP with issues with his speech. He talks fluently and articulates well, all at a normal rate. However on closer listening, you note he uses many seemingly made up words, and doesn’t seem to employ grammar of any kind. He also struggles to repeat sentences and phrases back to you’.
What is the most likely anatomical location of the lesion?
1. Ainferior frontal lobe
2. Bsuperior temporal lobe
3. Cpre-central gyrus
4. Dpost-central gyrus
5. Ebrainstem
31A 65 years old man is brought to the GP by his wife. The wife complains that over the past few months, her husband has show a step-wise deterioration in his cognitive ability. On checking his records, the man has a past medical history of hypertension and myocardial infarction. He smoked 20 cigarettes in a day and has a BMI of 31.

Based on his history, what is the most likely diagnosis for his reduction in cognitive abilit
1. ALewy body dementia
2. BDelirium
3. CAlzheimer's disease
4. DVascular dementia
5. EFronto-temporal dementia
32A 53 years old man is brought to the GP by his daughter for a health review. The man experiences progressive cognitive decline that interferes with his normal social functioning. Also, the daughter complains that her dad experiences visual hallucination. On examination, you notice that he is rigid and has resting tremors.
1. AIdiopathic Parkinson's Disease
2. BMultiple Sclerosis
3. CAlzheimer's Disease
4. DVascular Dementia
5. ELewy Body dementia
33Which of the following is false about the blood supply of the brain
1. AThe internal carotid arteries gives of the anterior cerebral arteries and middle cerebral arteries.
2. BThe subclavian artery gives off the vertebral artery
3. CTwo internal carotid arteries join up to make the basilar artery.
4. DThe basilar artery gives off the posterior cerebral arteries.
5. EThe two vertebral arteries join to form the basilar artery
34A 34 years old woman visits the ED due to the sudden onset of the following symptoms: vertigo, nausea and vomiting, frequent falls to the right, shaking of right arm when doing tasks, nystagmus and slurring of speech. Examination showed right dysmetria and right dysdiadochokinesia.
Which of the following is the most likely cause?
1. ALeft middle cerebral artery occlusion
2. BRight cerebellar hemorrhage
3. CRight middle cerebral artery occlusion
4. DLeft cerebellar hemorrhage
5. EBenign Proxysmal Positional vertigo
6. FMeniere's disease
35A patient presents with loss of sensation and strength on the right side of their face and their right upper limb. The patient can still wrinkle their forehead. What is the most likely diagnosis?
1. ALeft anterior cerebral artery occlusion
2. BRight anterior cerebral artery occlusion
3. CLeft middle cerebral artery occlusion
4. DRamsay-Hunt's syndrome
5. EBell's palsy
36A patient has a lesion on the right optic tract. What would be the presenting complaint of the patient?
1. ALeft homonymous hemianopia
2. BBitemporal hemianopia
3. Ccomplete blindness in right eye
4. Dright homonymous hemianopia
5. Ecomplete blindness in left eye
37A 58 year old male has recently been diagnosed with acromegaly after noticing his shoe size started increasing and he had numbness in his fingers after typing at work. Given this diagnosis, what is the most likely visual field defect he will be experiencing?
1. ABilateral scotoma
2. Bmonocular vision
3. Cbitemporal hemianopia
4. Dbinasal hemianopia
5. Ehomonymous hemianopia
38A 65 year old women presents to the GP with a one week history of severe knife like stabbing and electric shock pains down the left side of her face. She mentioned that they start when she washes and last for about 10 seconds.Given the likely diagnosis what is the most suitable 1st line treatment?
1. Areassure and advise to return within a month if pain reappears
2. Bmorphine
3. Cparacetamol
4. Damitriptyline
5. Ecarbamazepine
39A 68-year-old male presented with a chief complaint of facial drooping and a painful rash. What is the most likely diagnosis?
1. ARamsey Hunt Syndrome
2. BOtitis externa
3. CHerpes zoster opthalmicus
4. DBell's palsy
5. EStroke
40A 72 year old man with a history of previous stroke comes to the clinic for a checkup. On examination you find that when the patient sticks his tongue out, it deviates to the left. When the left posterior pharynx is sitmulated with a swab, the uvula deviates to the right.
Which structure has been affected?
1. ALeft vagus nerve and left hypoglossal nerve
2. BRight vagus nerve and left hypoglossal nerve
3. CLeft vagus nerve and left glossopharyngeal nerve
4. DRight vagus nerve and left glossopharyngeal nerve
41You are a GP on a home visit to a 4 year old child who has become ill.She is drowsy, listless, complains of a headache and feels very hot. Her mum gave her some ‘Calpol’ and got her ready for bed. She did not settle and has started to vomit.Kernig’s sign is positiveWhich of the following is the most suitable management?
1. AReassure and advise to come into the GP surgery if the symptoms don’t settle if a few days
2. BPrescribe PO penicillin
3. CAdminister IM benzylpenicillin and call ambulance
4. DAdminister IM benzylpenicillin but don’t call ambulance
5. ECall ambulance but don’t give antibiotics
42A patient presents to the ED with fever, headache, neck stiffness and photophobia. On examination, you find a non-blanching rash on her abdomen. You assess her ‘ABCDE’. Given her presentation and examination findings, you highly suspect bacterial septicaemia.What is the most appropriate next step in this patient’s management?
1. AIV ceftriaxone
2. Bspinal tap
3. CCT of head
4. DBlood culture
5. ESteroids prescription
43You are asked to interpret CSF for another patient who you know little about. The fluid appears cloudy. CSF analysis reveals: Raised protein; high neutrophils; reduced glucose.What is the likely cause of this patient’s illness?
1. Abacterial
2. Bfungal
3. Cviral
4. DTB
5. Emixed
44A 28-year-old junior doctor has been complaining of a headache for the last 24 hours. It started gradually, intensifying slowly and involving the entire cranium, but over the last couple of hours she has noticed that turning her head is uncomfortable. She feels generally unwell and prefers to lie in a dark room. Her boyfriend has noticed that she seems irritable. On examination, she exhibits photophobia and there is neck stiffness. There is no papilloedema. Close examination of her skin reveals no rashes. A lumbar puncture (LP) reveals raised protein, normal glucose and high lymphocytosis.
1. Aviral meningitis
2. Bmigraine
3. Ccluster headache
4. Dbacterial meningitis
5. ETB meningits
45A 54 year old woman who smokes 10 cigarettes a day and is also hypertensive presents to the hospital because she has a sudden onset headache, which she describes as her worst headache ever. She describes the headache to be like a kick to the back of the head. She has neck stiffness but she is not pyrexic or photophobic. What is the most likely diagnosis?
1. Asubarachnoid hemorrhage
2. Bmigraine
3. Csubdural hemorrhage
4. Depidural hemorrhage
5. Emeningitis
46You shine a light into one eye, you get contralateral pupil constriction but no ipsilateral constriction. Where is the lesion?
1. ACN3
2. BCN1
3. CCN5
4. DCN7
5. ECN11
47You shine a light into an eye and get no response bilaterally.
Where is the lesion?
1. ACN2
2. BCN6
3. CCN10
4. DCN8
5. ECN5

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Description: Content credits to PUNS/ Dayo
Author: Deleted user
Language: English
Views: 20
History: Created on 11 Mar 2018 · updated on 13 Mar 2018
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AMK head pathologies pt 1 :)

Questions in this quiz (47)

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