Quiz
NEURO1.1
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Questions in this quiz (166)
1The special visceral efferent of the cranial nerve IX and X is located at this level.
- ABase of the pons
- BTegmentum of the pons
- CLateral medulla
- DMedial medulla
2Which of the following statements describes the function of melanin in the retina?
- Aa. It allows light to reflect throughout the globe of the eyeball.
- BIt stores significant amount of Vitamin A
- CIt is a conjugated protein incorporated in the disc to form part of the transmembrane protein.
- DAll of the above
3The presence of this compound makes the Mycobacterium tuberculosis impervious to gram staining.
- Apeptidoglycan layer
- Bmurein layer
- Cmycolic acid
- Dchitin layer
4The following statements about glial cells are correct, EXCEPT:
- AAstrocytes provide a structural scaffolding for neurons
- BEpendymal cells are highly branched
- COligodendrocytes produce myelin sheaths.
- DGlia serve in place of the fibrous connective tissue of other organ
5The following statements describes the normal CSF, EXCEPT:
- ACSF glucose is about 2/3 that of the blood.
- BThe CSF is an ultrafiltrate of the plasma containing more potassium than sodium
- CCSF opening pressure is <200 mm H2O.
- DIt may contain up to 5 lymphocytes/cu. mm
6Most glial cells possess multiple branches, EXCEPT:
- AAstrocytes
- BEpendymal cells
- COligodendroglia
- DMicroglia
7The following methods are frequently employed for the diagnosis of M. tuberculosis, EXCEPT:
- Aacid fast staining
- BZiehl-Neelsen staining
- Cgram-staining
- Dpolymerase chain reaction
8The following are side effects of Phenytoin, EXCEPT:
- Aleukopenia
- Bgum hyperplasia
- CHirsutism
- Dataxia
9The termination of geniculocalcarine fibers in the primary visual cortex is mainly in this layer.
- ALayer II
- BLayer III
- CLayer IV
- DLayer V
10The following statements concerning the dura are correct, EXCEPT:
- AThe meningeal layer of dura mater proper is dense, strong fibrous membrane that forms four inward septa, which divide the cranial cavity into freely communicating spaces.
- BThe falx cerebri is the largest dural fold and separates the two cerebral hemispheres at the midline.
- CThat tentorium cerebelli is continuous with the falx cerebri and separates the cerebrum from the cerebellum.
- DThat diaphragm sellae forms the floor of the sella turcica, which houses the pituitary gland.
11This drug is known to cause hypotension, lipidemia, and metabolic acidosis when given as infusion
- APropofol
- BPhenobarbital
- CFosphenytoin
- DMidazolam
12The following statements about the central sulcus are correct, EXCEPT:
- AThe central sulcus extends onto the lateral surface of the cerebral hemisphere.
- BThe frontal lobe lies anterior to the central sulcus.
- CThe sulcus is not continuous inferiorly with the lateral sulcus
- DThe arachnoid matter does not extend into the central sulcus.
13The superior cerebellar peduncle decussates in the brainstem at this level.
- AMidbrain, at the level of the superior colliculus.
- BMidbrain, at the level of the inferior colliculus.
- CPontomesencephalic junction.
- DPons, at the level of the superior olivary nucleus.
14The following statements about the anterior spinal artery are correct, EXCEPT:
- Atwo vessels that join together to form a single artery
- Bsupplies the distal part of cerebellar vermis
- Csupplies the medullary pyramids
- Dsupplies the anterior 2/3 of the spinal cord
15The following features are characteristics of cerebral arteries, EXCEPT:
- Apresence of astrocytic processes
- Bhas thicker walls
- Cabsent external elastic laminae
- Dpresence of arachnoid trabeculae
16The neuron doctrine is described in the following statements, EXCEPT:
- AThe neuron is an anatomical unit
- BThe neuron is a polarized unit.
- CThe neuron is a pathologic unit in reacting to disease
- DThe neuron is a regenerative unit in regard to regrowth of axons
17Which of the following statements concerning CSF absorption is CORRECT?
- AThe fluid is passed into the blood by active transport through the cells forming the arachnoid villi.
- BThe major sites for its absorption are into the veins in the subarachnoid space and the perineural lymph vessels.
- CFine tubules found within the arachnoid villi play a minor role in CSF flow into the venous sinuses.
- DIn communicating hydrocephalus, flow is not obstructed within the ventricular system and the outflow from the ventricular system to the subarachnoid space.
18The special visceral efferent fibers of trigeminal nerve innervates the following, EXCEPT:
- ALateral pterygoids
- BMedial pterygoids
- CPosterior belly of digastric
- DTensor palatani
19The layers in the scalp that are bound together to move as one
- Askin and dense connective tissue
- Bskin, dense connective tissue and epicranial aponeurosis
- Cloose areolar connective tissue and periosteum
- Depicranial aponeurosis, loose areolar connective tissue and periosteum
20Which of the following statements describes a synapse?
- ASynapses usually act by transmitting electrical messages across the gap
- BSynapses may excite or inhibit the next cell in line
- CSynapses are more common on axons than dendrites
- DSynapses characteristically consist of a pre- and postsynaptic membrane, one of which is derived from a glial cell
21Primary control of cerebral blood flow.
- APCO2 levels
- BPO2 levels
- CBlood pH
- Dautoregulatory mechanism
22Which of the following statements concern the longitudinal cerebral fissure is CORRECT?
- AThe fissure contains the fold of dura mater, the falx cerebelli.
- BThe superior sagittal sinus lies below it.
- CIn the depths of the fissure, the corpus callosum crosses the midline.
- DThe inferior sagittal sinus lies above it.
23The following statements regarding the abducens nerve are correct, EXCEPT:
- APurely function as general somatic efferent nerve
- BThe abducens nucleus arises from the ventral pons
- CThe abducens nerve exits the brainstem from the inferior pontine sulcus.
- DIt passes through the cavernous sinus before entering the orbit via the superior orbital fissure.
24The following statement is correct about the corneal reflex.
- AConsensual and disynaptic reflex.
- BAfferent limb is the facial nerve.
- CEfferent limb is the ophthalmic nerve.
- DThe first order neuron synapse at the geniculate ganglion.
25Sound frequency is analyzed in the inner ear by this structure.
- ASpiral ganglion
- BOrgan of Corti
- CTensor tympani
- DTensor Vestibuli
26The following statements concerning the dura are correct, EXCEPT:
- ABranches of the trigeminal, vagus and the first three cervical spinal nerves innervate the cranial dura.
- BMeningeal artery is the most important blood supply to the dura.
- CDural venous sinuses are found between two layers of dura.
- DThe superior sagittal sinus joins the straight sinus which is located at the junction of the falx cerebri and then tentorium cerebelli.
27The following is the correct arrangement of the layers of the retina from the outside to the inside.
- ARods and cones- pigmented layer- outer plexiform- outer nuclear- inner plexiform- ganglionic layer- optic nerve- inner limiting membrane
- BPigmented layer- rods and cones- outer plexiform- outer nuclear- inner plexiform- ganglionic layer- optic nerve- inner limiting membrane
- CPigmented layer- rods and cones- outer nuclear- outer plexiform- inner nuclear- inner plexiform- optic nerve- inner limiting membrane
- DRods and cones- pigmented layer- outer plexiform- outer nuclear- inner plexiform- ganglionic layer- inner limiting membraneoptic nerve
28The following statements are true about the rod receptor potential, EXCEPT:
- AExcitation of the rod causes increased negativity of the intrarod membrane potential
- BDecomposition of rhodopsin increases the sodium ion conductance in the outer segment of the rod
- CUnder normal dark conditions, when the rod is not excited, there is reduced electronegativity inside the rod membrane.
- DThe rod receptor potential is approximately proportional to the logarithm of the light intensity.
29Which of the following class of anti-epileptic drug will most likely worsen an absence seizure?
- ASodium channel inhibitor
- BGABAergic agent
- CT-type calcium channel antagonist
- DGlutamate antagonist
30The following are correctly paired EXCEPT:
- AOptic canal- ophthalmic artery
- BForamen lacerum- external carotid artery
- Cforamen spinosum- middle meningeal artery
- Dforamen magnum- vertebral artery
31Which of the following statements about the cranium is CORRECT?
- AThe cranium consisted of frontal bone, paired parietal bones, paired occipital bones, paired temporal bones, sphenoid and ethmoid bones.
- BThe cranium consisted of frontal bone, paired parietal bone, occipital bone, paired temporal bones sphenoid and ethmoid bones.
- CThe cranium consisted of frontal bone, paired parietal bones, paired temporal bones, paired occipital bones, sphenoid and ethmoid bones.
- DThe cranium consisted of frontal bone, paired parietal bones, temporal bone, paired occipital bones, sphenoid and ethmoid bones.
32The following anti-epileptic drugs can reduce the effectiveness of low-dose oral contraceptives, EXCEPT:
- APhenobarbital
- BPhenytoin
- CValproate
- DOxcarbazepine
33The following statement are correct about the vagus nerve, EXCEPT:
- AIt contains fibers with GSA, GVA, SVA, SVE, and GVE functions.
- BIt arises from the fourth and sixth pharyngeal arches.
- CIt exits the skull via the jugular foramen together with the hypoglossal nerve
- DIt exits the brainstem from the postolivary sulcus.
34The following statements regarding the base of the skull are correct, EXCEPT:
- AThe anterior cranial fossa is separated from the middle cranial fossa by the lesser wing of the sphenoid.
- BThe middle cranial fossa is separated from the posterior cranial fossa by the petrous part of the temporal bone.
- CThe posterior fossa is bounded anteriorly by the inferior border of the petrous part of the temporal bone.
- DThe roof of the posterior fossa is formed by the tentorium cerebelli.
35The underlying cause of the principal complication of lumbar puncture.
- Astimulation of pain nerve endings
- Bcontinuous CSF leakage
- Corthostatic hypotension
- Dtentorial herniation
36The exit of the nerve that innervates the skin of the upper lip.
- AForamen ovale
- BForamen rotundum
- CForamen spinosum
- DForamen magnum
37The visual field is maintained in the upright position by these group of extraocular muscles.
- AMedial and lateral recti muscles
- BInferior and superior recti muscles
- CInferior and superior oblique
- DAll of the above.
38Hair cells in this area is maximally stimulated by tilting the head to the sides.
- Acrista ampullaris of the anterior semicircular duct
- Bcrista ampullaris of the lateral semicircular duct
- Cmacula of the saccule
- Dmacula of the utricle
39A comatose patient’s head is elevated 30° from the horizontal. Cold water is injected into the left external auditory meatus. If the brainstem is intact, which one of the following ocular reflexes do you expect to see?
- ADeviation of the eyes to the left
- BDeviation of the eyes to the right
- CHorizontal nystagmus to the left
- DHorizontal nystagmus to the right
40The vestibular nerve is closely related to this area in the cerebellum.
- AAnterior cerebellar lobe
- BPosterior cerebellar lobe
- CFlocculonodular lobe
- DVermis
41The posterior trigeminothalamic tract or the posterior column-medial lemniscus convey the pathway for this sensation.
- ATemperature
- BPain
- CFine touch
- DProprioception
42Automatisms can be seen in the following seizure conditions EXCEPT:
- Acomplex partial seizures
- Bmyoclonic seizures
- Cabsence seizure
- Datypical absence seizure
43The ultimate function of the blood-brain barrier.
- AProtect the polarization of the neuronal membrane
- BExclude small molecules such as O2 and CO2
- CActively transport large protein molecules
- DControl the ingress of cholesterol into myelin
44This drug directly inhibits conversion of fibrinogen to fibrin.
- ARivaroxaban
- BDabigatran
- CApixaban
- DEdoxaban
45The blood brain barrier is absent in the following areas, EXCEPT:
- APineal gland
- BTuber cinereum
- CAnterior lobe of the pituitary
- DWall of the optic recess
46Which of the following statements concerning the cerebrospinal fluid is CORRECT?
- Alts circulation through the ventricles is not aided by the pulsations of the choroid plexuses
- BThe CSF pressure in the subarachnoid space rises if the internal jugular veins in the neck are compressed
- CIt extends inferiorly in the subarachnoid space to the level of the fifth sacral vertebra.
- Dlts circulation in the subarachnoid space is aided by the pulsations of the cerebral and spinal veins.
47The following arteries contributed to the primary supply to the posterior circulation, EXCEPT:
- Ainternal carotid artery
- Bsubclavian artery
- Cvertebral artery
- Dspinal artery
48The exit of the nerve that supplies the buccinator muscles.
- AForamen spinosum
- BJugular foramen
- CStylomastoid foramen
- DForamen rotundum
49The following statement is correct regarding the spinal accessory nerve.
- AThe nerve arises from the anterior horn of the first to fourth cervical segments.
- BLesion of the nerve will result in the inability to shrug the ipsilateral shoulder.
- CLesion will result in difficulty turning the head to side of the lesion.
- DIt exits from the spinal cord medially via the anterior and posterior roots. The ultimate function of the blood-brain barrier.
50The following conditions can decrease the effect of oral anticoagulants, EXCEPT:
- APatients taking cholestyramine
- BPatients with nephrotic syndrome
- CPatients with neuropathic pain taking pregabalin.
- DPregnancy
51The most common cause of "dry tap" during a lumbar puncture.
- Aobliterated subarachnoid space
- Bdecreased CSF production
- Cadhesive arachnoiditis
- Dimproperly placed needle
52Which of the following best describe headache secondary to increased intracranial pressure?
- Ausually located in the orbit, forehead, or temple
- Bworse in the early morning hours
- Cincrease intensity with activities
- Dusually dull and localized to the side of involvement
53The following statements are true concerning warfarin, EXCEPT?
- AIt is completely absorbed if given orally, intravenous or rectally.
- BAlmost 99% is bound to plasma protein.
- CIt is metabolized in the liver by the cytochrome enzyme.
- DIt has a half-life of 15 hours.
54The following neural function of the retina are correctly paired, EXCEPT:
- ARods and cones- synapse with bipolar cells and horizontal cells.
- BInterplexiform cells- sends inhibitory signals that control the lateral spread of visual signals by the horizontal cells.
- CAmacrine cell- transmits unidirectional signal within the inner plexiform layer to the ganglion cells.
- DBipolar cells- transmits signals vertically from rods, cones, and horizontal cells to the inner plexiform layer.
55The following associations are correct, EXCEPT:
- Apostcentral gyrus- primary motor area
- Bcalcarine cortex- visual receptive area
- Cinsular cortex- gustatory area
- Dtransverse temporal gyri- auditory receptive area
56The most serious complication of Felbamate.
- AStevens-Johnson syndrome
- Baplastic anemia and severe hepatotoxicity
- Cworsening of absence seizure
- Dliver autoinduction
57The following statement best describe tension headache, EXCEPT:
- Aaggravated by movement
- Bbilateral and band-like
- Clasts for several days
- Dpain radiates to the neck and shoulders
58The following are indications for preventive treatment of tension headache, EXCEPT:
- A3 attacks every 2 weeks
- Battacks lasting for 6 hours
- Cabortive drug dependence
- Danxious patient
59Which of the following statements concerning the subarachnoid space is CORRECT?
- AIt contains cerebrospinal fluid (CSF) and the cerebral arteries and cerebral veins.
- BIt does not communicate with the cisterns.
- CThe fourth ventricle drains into it through a single foramen
- DThe space does not surround the cranial and spinal nerves where they leave the skull and the vertebral canal.
60Indications for preventive migraine treatment includes the following, EXCEPT:
- Ato reduce the frequency and severity of headache
- Bto reduce headache-related disability
- Cto reduce doubt on poorly tolerated pharmacotherapies
- Dto enhance personal control of pain
61Responsible for white matter to appear white.
- Amyelin sheaths
- Bastrocytic processes
- Clarge amount of interstitial fluid
- Dnumerous blood vessels
62The most common sites of arterial occlusion includes the following, EXCEPT:
- Aorigin and terminal portions of the vertebral arteries
- Bmain bifurcation of the posterior cerebral artery
- Corigin of middle cerebral artery
- Dbifurcation of the common carotid artery
63This drug reversibly inhibits P2Y12
- AClopidogrel
- BTiclopidine
- CTicagrelor
- DDipyridamole
64The following statements about vision are true EXCEPT:
- AThe eye is considered normal if a parallel light rays from distant objects are sharp focus on the retina when the ciliary muscle is completely relaxed.
- BThe mechanism of accommodation is greatly enhanced in hyperopic patients to focus distant objects in the retina.
- CA myopic person has no mechanism by which to focus distant objects sharply on the retina.
- DThe vision of myopic patients can be corrected by adding refractive power using a convex lens in front of the eye.
65In performing a lumbar tap for CSF analysis, the needle tip must pass through successively in these layers.
- AArachnoid membrane, epidural space, dura mater, and subdural space
- BSubdural space, dura mater, epidural space, and arachnoid membrane
- CArachnoid membrane, subdural space, dura mater, and epidural space
- DEpidural space, dura mater, subdural space, and arachnoid membrane
66Contraindications for lumbar puncture.
- Apapilledema
- Bspinal cord tumor
- Cinfection at puncture site
- DAll of the above
67The parasympathetic component of the facial nerve innervates the following, EXCEPT:
- ALacrimal gland
- BSubmandibular gland
- CSublingual gland
- DParotid gland
68Convulsive seizures during pregnancy can have all of the following effects on the developing fetus except?
- Afetal bradycardia and asphyxia
- Blarge for gestational age
- Cfetal increased risk of epilepsy
- Dincreased risk of lower verbal IQ
69Which of the following suggests that a patient’s vertigo is from a brainstem or cerebellar lesion, as opposed to a peripheral cause?
- Adecreased hearing in one ear
- Bear pain
- Cnystagmus worse with visual fixation
- Dtinnitus in one ear
70A 62-year-old man presents to the emergency room with confusion and difficulty walking. His examination shows nystagmus, limited ocular movements on lateral gaze, and ataxia. Given his daughter’s report of chronic alcoholism, intoxication is suspected. Labs return showing a blood alcohol content of zero and slight hyponatremia. What is the next best step?
- AGive intravenous (IV) thiamine 500 mg tid × 3–5 days followed by maintenance thiamine thereafter.
- BContinue metabolic workup as the patient is admitted.
- CObtain an electroencephalogram.
- DRule out infectious causes of her altered mental status.
71A 63-year-old female presented to the emergency room with an acute aneurysmal subarachnoid hemorrhage (SAH) and underwent a clipping procedure on admission. She has since been recovering in the intensive care unit. On the tenth postoperative day, she was noted to have slurred speech, worsening right facial droop, and right arm weakness. She was more difficult to rouse. Non-contrast head computed tomography (CT) showed diffuse cerebral edema and obstructive hydrocephalus best treatment for her condition?
- AIntravenous tissue plasminogen activator
- BIntraarterial calcium channel blocker
- CIV fosphenytoin load
- DPlacement of extraventricular drain
72A 17-year-old girl arrived to class immediately after cross-country running practice. While sitting at her desk, she felt sweaty, warm all over, and nauseated. She then slumped forward with fast, jerklike movements of her arms and legs. Her teacher rushed over to lower her to the floor, and she quickly began to rouse. She initially appeared confused but was able to answer questions appropriately. She had some urinary incontinence during the episode but no tongue trauma. She returned to her baseline mental status within a few minutes of the episode but was taken to the emergency room nonetheless. What is most likely the diagnosis?
- AComplex partial seizure
- BSyncope of convulsive type
- CNon-epileptic spell
- DGeneralized seizure
73Which of the following is an example of declarative memory?
- AButtoning one's shirt.
- BPredicting the weather based on environmental clues.
- CRecalling a birthday.
- DRecalling a word when a related word is presented.
74An 5-year-old boy presents with frequent staring episodes while in class. The EEG showed a bilaterally synchronous and symmetrical 3-Hertz spike-and-wave that start and end abruptly. Which of the following is the most appropriate medication for this patient?
- AValproic acid
- BEthosuximide
- CLevetiracetam
- DCarbamazepine
75A 68-year-old man with stage IV renal failure is receiving erythropoietin with a target hemoglobin of 14 g/dL. Which is the most directly increased risk as a result of this therapy?
- AHeadaches
- BSeizure
- CIschemic stroke
- DDementia
76Olfactory sensation travels from the olfactory bulb to all of the following structures, except?
- AAmygdala
- BSuperior colliculus
- CPrepyriform cortex
- DPosterior entorhinal cortex
77A 24-year-old woman with asthma has several years’ history of recurrent headaches that are severe, pulsatile, and holocephalic in nature, with associated nausea. The headaches occur at least twice per week and tend to last about half a day, after which she feels “worthless” for the remainder of the day. She refused a trial of oral birth control pills due to religious beliefs. Based on the suspected headache diagnosis, which of the following would be appropriate first-line daily therapy?
- ASumatriptan
- BAmitriptyline
- CTopiramate
- DValproic acid
78Which of the following proteins is involved in the initial step in light absorption in the vision pathway?
- ARhodopsin
- BCyclic guanosine monophosphate
- CRetinal
- DBeta-carotene
79A 64-year-old woman with a history of poorly controlled diabetes, hypertension, and tobacco use is admitted 6 hours after acutely developing right hemiparesis, visual field deficit on the right, and expressive aphasia. Workup for stroke etiology reveals no evidence of atrial fibrillation, normal transthoracic echo, and a computed tomography angiogram that shows 80% stenosis of the left common carotid artery and 60% stenosis of the right common carotid artery. Which of the following is the next best step?
- APerform a left carotid endarterectomy
- BTreat the patient medically with an antiplatelet agent.
- CTreat the patient medically with anticoagulant.
- DPerform a right carotid artery stent.
80A patient presents to the emergency department with acute horizontal binocular diplopia and left hemiparesis. Examination reveals mild ptosis and mydriasis on the right, as well as weakness of the medial rectus, superior rectus, inferior rectus, and inferior oblique muscles on the right. Which of the following is the most likely location of this stroke?
- AMidbrain tegmentum
- BLateral medulla
- CCerebral peduncle
- DMedial medulla
81Which of the following is the approximate rate of cerebrospinal fluid (CSF) production in an adult?
- A2 ml/hr
- B20 ml/hr
- C50 ml/hr
- D100 ml/hr
82A 45-year-old man who works in a slaughterhouse was recently admitted. He suffers a focal seizure followed by secondary generalization. He denies symptoms of active infection and has not suffered any recent trauma. His neurological examination has returned to normal in the emergency room. A magnetic resonance image (MRI) of the brain shows multiple cystic lesions. Which of the following is the next best step in management?
- ALevetiracetam and acyclovir
- BLevetiracetam and albendazole
- CLacosamide and biopsy of the lesion
- DPhenytoin and methylprednisolone
83The Wisconsin Card Sorting Test is helpful in determining functional abnormalities in which domain of cognitive function?
- ALanguage
- BVisuospatial function
- CIntelligence
- DExecutive function
84Which of the following layers of the retina does light first encounter after passing through the lens?
- ARetinal ganglion cell layer
- BOptic nerve layer
- CInner plexiform layer
- DRetinal pigment epithelium
85Spelling “world” backward in a mental status examination most closely tests which of the following?
- AAttention
- BConcentration
- CMemory
- DAbstraction
86Which of the following is the most common bacterial cause of meningitis for neonates (<1 year old).
- AGroup B streptococci
- BListeria monocytogenes
- CPseudomonas aeruginosa
- DNeisseria meningitidis
87A 33-year-old male recently started a migraine preventive medication. Two weeks later he presents to the emergency department with severe abdominal pain, nausea, and vomiting. His complete blood count has normal white blood cells and hemoglobin, and a mildly low level of platelets. A complete metabolic panel is normal, including liver enzymes. Amylase and lipase are both elevated. Which of the following is the most likely cause of his condition?
- ATopiramate
- BVerapamil
- CAmitriptyline
- DValproic acid
88A 45-year-old female recently admitted due to lacunar stroke with hyperlipidemia, hypertension, and gout presents with a 2-week history of progressive pain in her shoulders and hips. She has difficulty reaching objects in her tall kitchen cabinets and has noticed the need to use her arms when rising from a chair. Which of the following medications is not associated with this condition?
- AColchicine
- BLisinopril
- CAtorvastatin
- DNiacin
89Which of the following medications has the highest risk of fetal malformation?
- ACarbamazepine
- BValproic acid
- CPhenytoin
- DPhenobarbital
90Which is the most prevalent bloodborne inflammatory cell type within infarcted tissue at 1 hour poststroke?
- ANeutrophils
- BMacroglia
- CEosinophils
- DLymphocytes
91A 53-year-old female presents to the emergency department with fever, confusion, and severe headache. On neurological examination she has a stiff neck, papilledema, and a temperature of 38.9°C. Computed tomography scan of her head is unremarkable. A lumbar puncture is performed and demonstrates a white blood cell count of 400 (with a predominance of neutrophils), protein of 90, and glucose of 10. Which of the following is the most appropriate empiric treatment?
- AVancomycin, ampicillin, and ceftriaxone
- BVancomycin and ceftriaxone
- CVancomycin, metronidazole, and ceftriaxone
- DVancomycin and metronidazole
92A 67-year-old woman with a long history of smoking presents with new horizontal diplopia and headache. On examination, her right eye is deviated inferiorly and laterally, she has mild right ptosis, and she has marked right mydriasis with no reaction to light. Which of the following is the most important next step in her care?
- AAntiplatelet therapy
- BCerebral angiography
- CHemoglobin A1C
- DOphthalmology consult
93Taste receptors on the fungiform papillae are innervated by which cranial nerve (CN)?
- AV
- BVII
- CIX
- DX
94A 16-year-old female suffers with recurrent severe, lateralized, pulsatile headaches with light and sound sensitivity. These tend to occur during her menses and may last for up to 3 days at a time. Which of the following would be the best choice for a first-line therapeutic trial?
- AHydrocodone as needed
- BPerimenstrual scheduled naproxen
- CPerimenstrual scheduled propranolol
- DValproic acid as needed
95A patient is asked to show how to use a hammer. The patient acts out cutting with a saw instead of using a hammer. Which of the following correctly identifies this condition?
- AIdeomotor apraxia
- BIdeational apraxia
- CConceptual apraxia
- DLimb-kinetic apraxia
96A 50-year-old man with acquired immunodeficiency syndrome (AIDS) presents to the hospital with several days of confusion, followed by a decline in level of consciousness. A computed tomography scan of the brain demonstrates diffuse atrophy, but no acute findings. A lumbar puncture is performed, and opening pressure is 60 cm (normal is <20 cm). The spinal fluid further demonstrates a glucose of 10 mg/dL (normal is 45–80 mg/dL), protein of 140 mg/dL (normal is 15–45 mg/dL), normal red blood cells, and 9 white blood cells/mL (normal is <5 cells/mL) with a lymphocytic predominance. Based on your suspected diagnosis and while awaiting further studies, which of the following is the best course of action after removing a large volume of cerebrospinal fluid (CSF)?
- AEmergent ventriculoperitoneal shunt
- BInitiate amphotericin B and flucytosine
- CInitiate antituberculosis therapy
- DInitiate vancomycin and rifampin therapy
97All of the following are true about rod cells in the retina EXCEPT?
- AMore easily activated by light
- BSensitive to low levels of illumination
- CPredominantly in the peripheral portion of the retina.
- DContains chromatic photopigments.
98A pathological lack of motivation not from a mood disorder is a result to a lesion in this area.
- ADorsolateral prefrontal cortex
- BLateral orbitofrontal cortex
- CLeft parasylvian cortex
- DAnterior cingulate gyrus
99A 19-year-old male with a history of chronic migraine headaches presents to the emergency department with right-sided back pain and bloody urine. A computed tomography scan of his abdomen and pelvis demonstrates a large right-sided renal calculus. Which of the following medications is the likely causative agent?
- AValproic acid
- BTopiramate
- CAmitriptyline
- DVerapamil
100A 16-year-old boy was hit in the head while playing football and lost consciousness for about 1 minute. He awoke and walked off the field, but about 10 minutes later became drowsy and lost consciousness again. He was rushed to the emergency room for further evaluation. Which of the following is the most likely source of his symptoms?
- ATearing of bridging veins
- BTearing of middle meningeal artery
- CCerebral contusion
- DCerebral concussion
101Idiopathic intracranial hypertension may commonly cause which of the following secondary symptoms?
- AConductive hearing loss
- BSensorineural hearing loss
- CPulsatile tinnitus
- DPersistent tinnitus
102Which of the following describes a patient with intact vision who is unable to perceive more than one object at a time?
- AProsopagnosia
- BVisual agnosia
- CSimultagnosia
- DAmusia
103A 48-year-old woman awakens with a severe “thunderclap” headache and a stiff neck and is taken to the emergency room. A computed tomography (CT) scan of the brain reveals no evidence of hemorrhage. Which of the following is the next best step?
- ALumbar puncture
- BAngiogram
- CNimodipine therapy
- DErgotamine therapy
104Digit span is a test of which of the following?
- AImmediate memory
- BRemote memory
- CImplicit memory
- DCalculation
105What is the most common bacterial cause of meningitis among college-aged patients?
- AGroup B streptococci
- BListeria monocytogenes
- CNeisseria meningitidis
- DStaphylococcus aureus
106Which of the following antiepileptic medications is a strong hepatic enzyme inhibitor?
- APhenytoin
- BValproic acid
- CCarbamazepine
- DZonisamide
107A 75-year-old male presents with an acute stroke. On examination he has mild right arm and face weakness. He has spontaneous speech with occasional paraphasic errors. He can understand and follow commands. Repetition is severely impaired. Which of the following best explains his speech pattern?
- ABroca's aphasia
- BTranscortical aphasia
- CConduction aphasia
- DWernicke's aphasia
108Which of the following is not an important component of the blood–brain barrier (BBB)?
- AAstrocytes
- BOligodendroglia
- CPericytes
- DTight junctions
109A 33-year-old female with a history of prior deep venous thrombosis (DVT), ischemic stroke, and antiphospholipid antibody syndrome presents to the office for an evaluation. She has concerns about her medical history because she would like to become pregnant. Which of the following medications would be the safest for stroke prevention?
- ALow molecular weight heparin
- BWarfarin
- CDabigatran
- DAspirin
110Which of the following is not a potential source of ototoxicity?
- ASalicylates
- BGentamycin
- CVancomycin
- DLevetiracetam
111After a stroke, a 67-year-old woman is left with Dejerine-Roussy syndrome. Which of the following is the most likely location of her initial infarct?
- AMidbrain
- BThalamus
- CGenu of internal capsule
- DPutamen
112Which of the following has been shown to benefit nonepileptic attacks?
- AObtaining multiple neurological opinions
- BCognitive behavioral therapy
- CContinuing anticonvulsant drugs until attacks have stopped
- DAntidepressant medications
113A 64-year-old smoker is found comatose. Magnetic resonance imaging reveals well-defined restricted diffusion indicative of a stroke, but no other acute pathological processes or cerebral edema. Laboratory tests and toxicology are relatively unremarkable. What is the most likely artery involved in this stroke?
- ALeft middle cerebral artery
- BLeft posterior cerebral artery
- CArtery of Percheron
- DRecurrent artery of Huebner
114What is the normal pressure of cerebrospinal fluid in an adult (in cm H2O)?
- A5
- B15
- C30
- D45
115Which of the following is true regarding benzodiazepines?
- AThey are active at the gamma aminobutyric acid B (GABAB) receptors.
- BThey are active at the GABAA receptors
- CThey are active on the ion channel coupled to an inhibitory G protein.
- DThe antidote is naloxone
116A 14-year-old male with a history of Lennox-Gastaut syndrome presents with complaints of blurry vision. His examination demonstrates reduced peripheral vision in both eyes. Magnetic resonance imaging of his brain is unremarkable. He recently started a new antiepileptic medication. Which of the following medications did he recently start?
- AFelbamate
- BLamotrigine
- CVigabatrin
- DPhenytoin
117A 37-year-old man consulted for dizziness. If vertigo and a right beating nystagmus are observed 30 seconds after performing a Dix-Hallpike maneuver with the right ear toward the ground, what is the most likely localization of the patient’s underlying problem?
- ALeft posterior semicircular canal
- BLeft lateral semicircular canal
- CRight posterior semicircular canal
- DRight lateral semicircular canal
118A patient who suffered a stroke has intact sensation in his extremities. With his eyes closed, he cannot identify objects placed in his hand affected by the stroke. What is this disorder called?
- AAstereognosia
- BAgraphesthesia
- CProsopagnosia
- DVisual agnosia
119For a woman with recurrent pressure like headaches, papilledema, and pulsatile tinnitus, which of the following is not a therapeutic consideration?
- AVP- shunting
- BOptic nerve sheath fenestration
- CAcetazolamide
- DIsotretinoin
120Which of the following is an unlikely cause of meningitis in a 30 year old, but should be considered in an 80 year old?
- AGroup B streptococci
- BListeria monocytogenes
- CNeisseria meningitidis
- DPseudomonas aeruginosa
121Which of the following is the most likely lesion localization that would result in this visual field deficit?
- ALeft temporal lobe
- BLeft parietal lobe
- CLeft occipital lobe
- DLeft optic nerve
122A 68-year-old female with a history of atrial fibrillation, stroke, and seizure presents with another acute ischemic stroke despite compliance with her warfarin therapy. Although she was on levetiracetam previously, she switched to a new antiepileptic medication 2 weeks ago. Which of the following is the most likely antiepileptic started 2 weeks ago?
- ALamotrigine
- BCarbamazepine
- CLacosamide
- DGabapentin
123How long after blood flow is cut off to cerebral circulation does it take for electrical activity of the cerebral neurons to stop?
- A1-5 seconds
- B12-15 seconds
- C2-4 minutes
- D4-6 minutes
124An 80-year-old female presents with an acute stroke. On examination she has fluent speech with intact comprehension. She can write, but cannot read what she has just written. Naming is impaired. What is the most likely localization for her stroke?
- ASuperior temporal lobe
- BAngular gyrus
- CInferior parietal lobule
- DSplenium of the corpus callosum
125A 66-year-old woman with dementia suffered a large intracranial hemorrhage and passed away. Autopsy demonstrated the findings suggestive of amyloid angiopathy. In the heritable form of the most likely diagnosis, which of the following is the inheritance pattern?
- AAutosomal recessive
- BAutosomal dominant
- CX-linked dominant
- DX-linked recessive
126Which of the following is not a consideration in determining whether a substance will cross the blood–brain barrier (BBB)?
- AImmunogenicity
- BCharge
- CMolecular weight
- DLipid solubility
127A 25-year-old female who is currently 16 weeks pregnant presents to your office for evaluation of headaches. She has a history of migraine headaches and was previously treated with valproic acid for migraine prevention. Over the last several weeks, she has noted more frequent and severe headaches. These hurt over the left side of her head with a throbbing pain, and are associated with nausea and photophobia. Her headaches are occurring frequently enough that she is missing several days of work per week, and she has been unable to help take care of her 3-year-old son. Magnetic resonance imaging of the brain is normal. Which of the following would be the most reasonable next step?
- ARestart valproic acid
- BRecommend daily Ibuprofen
- CStart propranolol for migraine prevention
- DStart acetazolamide
128An 18-year-old male is brought into the emergency department after a motor vehicle accident. On examination he will open his eyes to painful stimulation (2), makes incomprehensible sounds (2), and withdraws his extremities to painful stimulation (4). What is the patient’s Glasgow Coma Scale score?
- A6
- B7
- C8
- D9
129An 8-year-old male presents to the office for evaluation of seizures. His parents state that he has reached all developmental milestones and does well in school. In the last 2 months he has had several nocturnal episodes with twitching of one side of his face and retained consciousness. The EEG shows characteristic centro-temporal spikes. Which of the following is the most likely diagnosis?
- ABenign Rolandic epilepsy
- BJuvenile absence epilepsy
- CJuvenile myoclonic epilepsy
- DNocturnal frontal lobe epilepsy
130The woman in the figure has which cranial nerve palsy?
- ARight oculomotor nerve palsy
- BLeft trochlear nerve palsy
- CRight trochlear nerve palsy
- DLeft abducens nerve palsy
131A 33-year-old female with a history of migraines calls the office because of a severe migraine at 32 weeks of pregnancy. There are no complicating features to her headache, and this headache is similar to all her prior migraines. Which of the following abortive therapies would be the most appropriate for this patient?
- AOral ibuprofen
- BHydrocodone
- COral sumatriptan
- DIntramuscular ketorolac
132A 50-year-old man suffers headaches that he describes as “a hot poker” behind his left eye. These tend to occur about twice per day, each lasting a half-hour, and recur at around the same time each day. He has concurrent lacrimation on the left. The current series of headaches has been ongoing for nearly 2 months, though he’s had several similar headache cycles over the last few years. He feels a need to walk around the house to cope with the severe pain. Based on his most likely underlying diagnosis, which of the following is the best choice of first-line preventive therapy?
- AVerapamil
- BLevetiracetam
- CIndomethacin
- DAmitriptyline
133A 65-year-old man with a long smoking history presents with sudden, profound, painless, monocular vision loss. He reports two recent episodes of transient vision loss in the same eye. Dilated fundoscopy was performed in the emergency room, a picture from which is shown here. Which of the following is the most likely cause of his symptoms?
- ACentral retinal vein occlusion
- BCentral retinal artery occlusion
- COptic neuritis
- DAnterior ischemic optic neuropathy
134The anterior choroidal artery is a branch of which of the following?
- AMiddle cerebral artery
- BAnterior cerebral artery
- CInternal carotid artery
- DCommon carotid artery
135Which of the following is not characteristic of a simple febrile seizure?
- AHistory of mild motor milestone delay.
- BSeizure duration more than 15 minutes.
- CNormal neurological examination.
- DOnly one seizure per 24 hours.
136Which of the following antiepileptic medications does not enhance the activity of gamma aminobutyric acid (GABA) in the central nervous system?
- AClonazepam
- BPhenobarbital
- CPregabalin
- DTiagabine
137A 73-year-old diabetic man presents with headache and confusion 3 days after a fall. Which of the following is associated with the diagnosis shown in the image?
- AAssociated with skull fracture over the temporal bone.
- BA result of tearing bridging veins
- CMay occur with thrombosis of the sagittal sinus
- DAssociated with cerebral amyloid angiopathy
138Which of the following is uncommon of classic migraine auras?
- ADuration <30 minutes
- BVisual disturbance usually monocular
- CGenerally similar symptoms with repeating attacks
- DMay be preceded by prodrome of changes in mood or eating
139A 62-year-old female presents for stroke evaluation due to acute right hemiparesis for the last several hours. On examination, she has a right facial droop with right arm weakness and mild sensory changes in the right arm. She is noted to have effortful and fragmented speech, and is unable to name several objects. Her comprehension is intact, but she has difficulty with repetition. Which of the following arteries is the most likely cause of her stroke?
- AInferior division of middle cerebral artery
- BAnterior cerebral artery
- CLenticulostriate arteries
- DSuperior division of middle cerebral artery
140Which of the following cerebral blood flow levels correlate with impaired but reversible neuronal function?
- A65 ml/ 100 g/min
- B45 ml/ 100 g/min
- C35 ml/ 100 g/min
- D15 ml/ 100 g/min
141A 55-year-old male presents with an acute stroke in the right fusiform gyrus. Although he has intact visual fields, he is unable to recognize faces. Interestingly, he is able to identify and name people by their voices. Which of the following best describes his condition?
- AOptic aphasia
- BProsopagnosia
- CAphemia
- DCortical blindness
142A 54-year-old man suffers a cardiac arrest in the emergency room after having a myocardial infarction. He is resuscitated and placed in the intensive care unit for further monitoring. Gradually, he is extubated and his mental status improves to the point of discharge. He is referred to neurology because of sudden jerks in his legs upon gait initiation. There is no evidence of seizures. Which of the following medications is most indicated for his movement disorder?
- ACarbidopa/Levodopa
- BCarbamazepine
- CClonazepam
- DClozapine
143A 27-year-old female who is currently 8 weeks pregnant presents with a severe headache. The headache is located over the right side of her head with a severe, throbbing pain associated with nausea, photophobia, and phonophobia. Her neurological examination is normal. She has an urgent magnetic resonance imaging of the brain that is also normal. Which of the following would be a reasonable first-line agent to treat her headache?
- ASumatriptan
- BAcetaminophen
- CErgotamine
- DValproic acid
144All of the following are characteristics of a persistent vegetative state EXCEPT?
- Apreserved bowel and bladder continence
- Bno sustained voluntary response to stimuli
- Cevidence of sleep/wake cycle
- Dpreserved cranial nerve reflexes
145Which of the following structures is not present in the cavernous sinus?
- AAbducens nerve
- BMandibular nerve
- COphthalmic nerve
- DTrochlear nerve
146A 14-year-old male presents with a single generalized convulsion. A sleep segment from his electroencephalogram shows generalized polyspike and wave abnormalities suggestive of juvenile myoclonic epilepsy. Which of the following medications would be the best initial treatment?
- AEthosuximide
- BCarbamazepine
- CLacosamide
- DValproic acid
147Which of the following is true of paroxysmal hemicrania?
- Astrong male predominance
- Battacks last 2-30 minutes each
- Cstrong circadian periodicity
- Dimproves with oxygen
148A 53-year-old man presents with right-sided weakness. Which of the following is the most likely etiology of his computed tomography scan findings?
- Avenous sinus thrombosis
- Bchronic hypertension
- Camyloid angiopathy
- Danticoagulation
149A 32-year-old woman on prolonged multidrug treatment for tuberculosis presents with an enlarging black spot in her central vision bilaterally. Additionally, she has noted difficulty discerning colors. Which of the following is the most likely cause of her symptoms?
- AVitamin B6 deficiency
- BHereditary optic neuropathy
- CEthambutol toxicity
- DOcular tuberculosis
150The fascicles of the facial nerve travel around which structure before exiting the brainstem?
- AAbducens nerve
- BMedial longitudinal fasciculus
- CTrigeminal spinal tract
- DVestibular nucleus
151An 82-year-old female with a history of stroke, memory problems, and seizures presents with multiple breakthrough seizures despite compliance with her levetiracetam therapy. Imaging of her brain demonstrates evidence of her prior infarct, but no acute findings. A complete blood count, complete metabolic profile, and urine analysis are all normal. Notably, she was recently placed on a new medication; which of the following would be the most likely cause of her seizures?
- AClopidogrel
- BDonepezil
- CVerapamil
- DSimvastatin
152Early treatment of status epilepticus is necessary because of alterations in the functional properties of which receptor?
- AN-methyl-D-aspartate receptor
- BGamma aminobutyric acid A receptor
- CVoltage-gated calcium channel receptor
- DAcetylcholine receptor
153Which of the following is not an effective means of reducing intracranial pressure?
- AElevated head above 30o
- BTighten cervical collar to keep head straight
- CSedation
- DHyperosmolar therapy
154A 48-year-old male came in for consult due to unilateral hearing loss. On examination, you perform Weber and Rinne testing. On Rinne testing, air conduction is greater than bone conduction bilaterally (A>C). On Weber testing, the tuning fork is loudest on the right (R). Which of the following describes the type of hearing loss from which this patient suffers?
- ARight sensorineural hearing loss
- BLeft sensorineural hearing loss
- CRight conductive hearing loss
- DLeft conductive hearing loss
155A 25-year-old female presents with episodes of confusion. These episodes start with a rising feeling in her abdomen followed by anxiety and diaphoresis. Her family states she will mumble and hold her left arm stiff while her right arm picks at her shirt. These episodes will last for 45 seconds before resolving. She is tired and confused after these episodes have occurred. Which of the following is the most likely localization for her symptoms?
- Aleft orbitofrontal lobe
- Bleft lateral temporal lobe
- Cright mesial temporal lobe
- Dright dorsolateral frontal lobe
156A 24-year-old female presents with new-onset headaches that occur mostly at night or in the early morning. These involve a dull frontal and occipital pain with associated tinnitus. Her physical examination demonstrates bilateral papilledema. Magnetic resonance imaging of her brain is normal. Which of the following is the most likely cause of her symptoms?
- ATopiramate
- BAcetazolamide
- CVitamin A supplements
- DRecent weight loss
157A 65-year-old female presents to the emergency room after a prolonged seizure, which was preceded by several days of fevers, headaches, and confusion. She had some hallucinations the day before her admission. On examination she was comatose, febrile to 39°C, with a stiff neck but with no focal findings. A lumbar puncture demonstrated 100 white blood cells with a lymphocytic predominance, a protein of 75, and a glucose of 45. Which of the following is the most likely diagnosis?
- ATB meningitis
- BStrep. pneumonia meningitis
- CHerpes encephalitis
- DCreutzfeldt-Jakob disease
158Which of the following is not true about dexamethasone?
- AIt has lower mineralocorticoid activity than prednisone.
- BIt works well for reducing cerebral cytotoxic edema associated with CNS tumors.
- CThe half-life is longer than that of prednisone.
- DThere is a lower likelihood of steroid psychosis than with other steroids.
159A 60-year-old man with history of atrial fibrillation on warfarin presents with 2 hours of progressive left upper extremity weakness and headache. In this time, his symptoms have progressively worsened, now leaving him with decreased vision in his left visual field and somnolence. On arrival to the emergency department, computed tomography (CT) scan shows a large lobar hemorrhage with some right-to-left midline shift. His international normalized ratio (INR) is 4.5 and blood pressure 172/93 mm Hg. Which of the following is the next best step in this patient’s management?
- ANicardipine drip for blood pressure control.
- BReverse anticoagulation.
- CIntubate for airway protection.
- DBegin levetiracetam for seizure prophylaxis.
160An injury to the prefrontal cortex would be most likely to affect which type of memory?
- AWorking memory
- BEpisodic memory
- CSemantic memory
- DProcedural memory
161After leaving the cochlear nucleus, which structure do auditory signals pass next?
- ALateral lemniscus
- BInferior colliculus
- CSuperior olivary complex
- DMedial geniculate body
162Which of the following reflexes does not involve the trigeminal nerve?
- ALacrimal reflex
- BJaw jerk reflex
- CGag reflex
- DOculocardiac reflex
163A comatose patient who suffered a traumatic car accident has midposition pupils that do not respond to light. What is the most likely localization of the causative injury for his pupillary abnormality, as well as his coma?
- ABilateral pons
- BBilateral midbrain tegmentum
- CBilateral diencephalon
- DBilateral oculomotor nuclei
164Surgical management of brain abscess is indicated in the following circumstances EXCEPT:
- AMultiple abscesses
- BAbscess location is in the non-dominant hemispheres
- CThere is no co-existing meningitis or ependymitis
- DSize is less than 3 cm
165The following are TRUE about the histopathologic changes in the early capsule formation of brain abscess EXCEPT:
- AIncrease number of fibroblast and macrophages in the inflammatory border.
- BMaximal degree of neovascularization.
- CIncrease in cerebral edema.
- DEvolution of mature collagen along the inflammatory border.
166In the management of brain abscess, Metronidazole is considered part of the empiric treatment. What is the mechanism of action of Metronidazole?
- AInhibits cell wall synthesis.
- BBlocks glycopeptide polymerization
- CDNA strand breakage.
- DInterfere protein synthesis by binding to 30s and 50s of bacterial ribosome.
Information
- Description
- Neuro 1 2021 FIRST TAKE
- Author
- 9. Axle Brent Dayoc
- Language
- English
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