Block 13 Stroke Epilepsy Syncope MCQ's

17 Questions | Total Attempts: 952

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Block 13 Stroke Epilepsy Syncope MCQ

Questions and Answers
  • 1. 
    Which of the following areas is not involved in language for a person who is left-dominant?
    • A. 

      Left dorsolateral prefrontal cortex

    • B. 

      Left opercular gyrus

    • C. 

      Left angular gyrus

    • D. 

      Right planum temporal

    • E. 

      Right primary auditory cortex

  • 2. 
    As a resident physician you are viewing an angiogram, which illustrates the occlusion of the Anterior Cerebral Artery supplying the right hemisphere.  Because of this information, you know that the patient will have a deficit in which of the following?
    • A. 

      Motor and sensory function in the right lower limb

    • B. 

      Motor and sensory function in the left lower limb

    • C. 

      Motor and sensory function in the right upper limb

    • D. 

      Motor and sensory function in the left upper limb

    • E. 

      Motor and sensory function in the upper and lower limbs

  • 3. 
    Four weeks after a stroke that left a 66-year-old female patient paralyzed in the right lower half of the face only; she presented to her doctor with inability to clearly identify taste sensation on the left side of her tongue while still retaining the ability to respond emotionally to especially noxious substances. The doctor checked this complaint by giving her quinine to taste. Although she couldn’t specifically describe the taste of quinine, she reacted to the taste in a way that suggested disgust. Which of the following best explains the pathophysiology of this presentation?
    • A. 

      The stroke affected the primary somatosensory cortex and caused loss of conscious taste sensation

    • B. 

      The stroke affected the cingulate gyrus and compromised patient’s emotional response to taste

    • C. 

      The stroke affected the premotor cortex and compromised the patient’s psychomotor response to taste

    • D. 

      The stroke affected the tractus solitarius in the brainstem and compromised conscious taste perception

    • E. 

      The stroke damaged the insula while sparing the limbic cortex

  • 4. 
    A 64 year old lady has the worst headache of her life. She is brought to the hospital with photophobia and vomiting as well. On examination she has positive Kernig’s and Brudzinski’s signs and bilateral extension on plantar reflex. Lumbar puncture shows blood, thoroughly mixed with CSF. CT scan shows: The most likely diagnosis is:
    • A. 

      Glioblastoma of parietal lobe

    • B. 

      Medulloblastoma

    • C. 

      Ruptured berry aneurysm

    • D. 

      Meningitis

    • E. 

      Encephalitis

  • 5. 
    This previously healthy 32 year old female presented to the emergency room with the acute onset of a very severe headache.  She reported no history of head trauma.  She was taking no medications.  Her vital signs were normal.  These two axial images from a computed tomography scan of her head demonstrate that she which of the following abnormalities:
    • A. 

      Subdural hematoma

    • B. 

      Subarachnoid bleed

    • C. 

      Epidural hematoma

    • D. 

      Intraparenchymal bleed

    • E. 

      Hydrocelphalus

  • 6. 
    A 35 year old patient, with a past history of three spontaneous abortions and who is now using oral contraceptive pills, develops acute onset of left sided weakness and numbness with difficulty speaking.  Of the following, what is mostly likely her problem?
    • A. 

      Thrombotic stroke due to hypercoagulable state

    • B. 

      Embolic stroke due to cholesterol embolus

    • C. 

      Lacunar stroke due to fibrinoid necrosis

    • D. 

      Watershed stroke due to hypotension

    • E. 

      Transient ischemic attack due to OCP induced vasospasm

  • 7. 
    Postmortem examination of a 46-year-old Caucasian man, who died suddenly, reveals the brain changes shown for your evaluation below. Which of the following is the most likely cause of the shown changes?
    • A. 

      Thrombosis or embolism of the left middle cerebral artery

    • B. 

      Rupture of a berry aneurysm

    • C. 

      Rupture of a Charcot-Bouchard aneurysm

    • D. 

      Rupture of the bridging veins

  • 8. 
    Cingulate (subfalcine) herniation is most likely complicated by
    • A. 

      Infarction in the frontal lobe.

    • B. 

      Infarction in the temporal and parietal lobe.

    • C. 

      Infarction in the occipital lobe.

    • D. 

      Infarction in the brain stem and cerebellum.

  • 9. 
    “Lucid interval” is a characteristic clinical presentation of
    • A. 

      Intracerebral hematoma

    • B. 

      Subdural hematoma

    • C. 

      Subarachnoid hemorrhage

    • D. 

      Epidural hematoma

  • 10. 
    A 62-year-old male was found unconscious on a city sidewalk and was brought by paramedics to an emergency room. It could not be determined how long he had been on the sidewalk before he was found. On physical examination the patient was comatose with a flaccid right hemiplegia. What do these images from the computed tomography scan of his head show?
    • A. 

      Acute ischemic cerebrovascular accident

    • B. 

      Subdural hematoma

    • C. 

      Intraparenchymal hemorrhage

    • D. 

      Epidural hematoma

    • E. 

      Malignant-appearing brain tumor

  • 11. 
    A child, aged 6, is experiencing a short episode of lip-smacking, accompanied with abundant sweating. When the episode is over, he describes that he had a “scary feeling in his belly”. The mother didn’t notice any interruption in the eye contacts she was making with her child. This is highly suggestive of which of the following?
    • A. 

      Simple partial seizure

    • B. 

      Complex partial seizure

    • C. 

      Non convulsive generalized seizure

    • D. 

      Myoclonic generalized seizure

    • E. 

      Atonic generalized seizure

  • 12. 
    Dick John is an 8-year-old male. His school grades have been dropping since entering middle school. His teacher reported observing him have many episodes of sitting still, inattentiveness and staring into space distractedly (number averages 20 – 60 per school day). When Dick’s parent took him to see a neurologist, the neurologist explained that Dick was being troubled with a type of seizure that is common in children. Which of the following seizure types best describes Dick’s seizures?
    • A. 

      Distributed (Generalized) seizure of the absence type

    • B. 

      Distributed (Generalized) seizure of the tonic-clonic type

    • C. 

      Localized (Partial) seizure of the simple type

    • D. 

      Localized (Partial) seizure of the complex type

    • E. 

      Localized (Partial) seizure with secondary generalization

  • 13. 
    Your friend, a 28-year-old nurse, is talking with you on the phone.  In mid-sentence, she pauses, says 2-3 unintelligible words, then you hear lip smacking sounds for about 15 seconds.  After a pause lasting a few more seconds, your friend says, confused, “I’m sorry.  What happened?   I have to go now” and she hangs up.  What is your diagnosis?
    • A. 

      Dissociative episode

    • B. 

      Absence seizure

    • C. 

      Vasovagal attack

    • D. 

      Complex partial seizure

  • 14. 
    Joan is 45 years old. She is brought to Emergency having passed out in the street. She was witnessed having jerky movements and was incontinent. It is now 45 minutes since this happened and Joan has had another two episodes on the way to hospital and yet another as she arrives. Her best pharmacological management would MOST LIKELY BE INITIATED by:
    • A. 

      Oxygen and gentle restraint

    • B. 

      Observation only

    • C. 

      Oral diazepam

    • D. 

      Valproic acid IM

    • E. 

      IV thiamine diazepam

    • F. 

      Oral ethosuximide

  • 15. 
    An elderly female complains of “passing out” when she gets out of bed.  Her most likely diagnosis is
    • A. 

      The side effect of sleeping medication

    • B. 

      Carotid sinus syndrome

    • C. 

      Transient ischemic attacks

    • D. 

      Vertebrobasilar insufficiency

  • 16. 
    Which of the following is common to simple motor seizures and not complex seizures?
    • A. 

      Rarely have sustained spasm (tonic)

    • B. 

      Arise in precentral gyrus (motor cortex) and affect the ipsilateral trunk and limbs

    • C. 

      Start in multiple foci

    • D. 

      May end up with Todd’s paralysis

  • 17. 
    Which of the following pathologic conditions is most likely associated with syringohydromyelia?
    • A. 

      Chiari type I malformation

    • B. 

      Chiari type III malformation

    • C. 

      Dandy-Walker malformation

    • D. 

      Chiari type II malformation

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