414 Questions
Regarding Neurosyphilis, which of the following statements is incorrect?
is a exclusively a disease of brain and meninges
What would you expect to find on a FDG-PET scan in patients with Alzheimer´s disease?
hypometabolism in temporoparietal lobe
Regarding L4 radiculopathy, which of the following is correct?
pain and sensory deficit is localised to anterior thigh and medial aspect of leg
Which of the following symptoms is typical for progressive supranuclear palsy (PSP) is?
abnormal vertical occular saccades
Which of the following medications have been shown to be effective in treating patients with Alzheimer ́s disease?
acetylcholinesterase inhibitors
What are the symptoms associated with DLB (Dementia with Lewy Bodies)?
parkinsonism
Treatment of radiculopathies does not include
anticoagulants
Restless Leg Syndrome is caused by
CNS dopamine imbalances
Modifiable risk factor of stroke is not
age
The following does not apply for triptan treatment
are administered already during the aura
What does not apply to a migraine attack?
sleep deprivation prevents the recurrence of a migraine
Mark correct statement for the definition of migraine infarction
occurs in migraine with aura, when the symptoms of the aura last 24 hours after the onset of the headache
Mark the correct statement for cluster headache
there is a good effect of oxygen inhalation
In the treatment of temporal arteritis
the duration of corticoid administration depends on the value of inflammatory markers
Regarding C8 radiculopathy, which of the following is incorrect?
there is areflexia of flexor finger reflex
Mark the incorrect statement the pathology of tau protein is involved in the etiopathogenesis of Alzheimer's disease
the pathology of alfa synuclein is involved in the etiopathogenesis of Alzheimer's disease
Which of the following symptoms is not typical for patients with normotensive hydrocephalus?
bulbar paralysis
Alzheimer's disease has the most significant deficit of
acetycholine
Which nonmotor symptom does not belong (never) to Parkinson’s disease?
Deafness
Routine diagnostic screening of dementia does not require
assessment of vitamin D
What findings would you expect from an FDG-PET scan in patients with Alzheimer's disease?
hypometabolism in the temporal and parietal lobes
What is not a routine diagnostic procedure for patients with newly diagnosed dementia?
vitamin D level examination
Acute treatment of ischemic stroke we do not consider
clopidogrel loading dose 75 mg
Diplopia occurs during stroke in the territory of
basilar artery
Which of the following statements about herpes zoster is not true?
it is a sexually transmitted disease
A constant brain blood flow for brain functions is in the range of
50–60 ml / 100 g brain tissue / min
Central hemiparesis and anosognosia occur in stroke in the territory of
left middle cerebral artery
Most common form of dystonia is
Cervical dystonia
Most common risk factor for intracerebral heamorrhage is
Arterial hypertension
Category of primary brain tumors does NOT include
metastasis of bronchogennic carcinoma
An MRI is performed on a patient with Herpes simplex encephalitis. Which of the following is suggestive of this condition?
hemorrhagic changes in temporal lobe
Does not apply to a patient with aphasia and right-sided hemiparesis within a time window of up to 4.5 hours
we do only CT of the brain
Which of the following statements is correct?
magnetic resonance imaging is useful in diagnosis of intervertebral disc herniation
Does not apply to endovascular treatment in patients with ischemic stroke
is always administered only after intravenous thrombolysis
Mark incorrect statement for cluster headache
is more prevalent in women
Mark the correct statement regarding subarachnoid haemorrhage
sudden onset of severe headache is typical
Which of the following symptoms is typically one of earliest symptoms of Alzheimer ́s disease?
Impaired episodic memory for recent events
What kind of infection is most likely to cause a macroscopically cloudy/flaky (non-transparent) CSF in a patient with suspected meningitis?
Bacterial
For vasospasm prevention in subarachnoid haemorrhage we use
Calcium channel blockers
Intracerebral heamorrhage occurs appoximatelly in
7-10 % of strokes
What is the most virulent cause of meningitis
N. meningitides and Pneumonia (but first one is more accurate)
Subarachnoid haemorrhage is most commonly caused by
rupture of intracranial aneurysm
Regarding L5 radiculopathy, which of the following is correct?
Pain and sensory deficit is localized to lateral aspects of thigh, leg and dorsal aspect of foot
Which of following is NOT true, regarding intracerebral haemorrhage
clinical sings of ischemic stroke and intracerebral hemorrhage are significantly different
Which of the following lab values are characteristic of septic (purulent) meningitis?
>1000 (high) mg/l proteins, and <0,6mmol (low) mg/l glucose
Mark correct statement
ischemic stroke represents 85-90% of all the strokes
Mark the correct statement
contusio cerebri is a reversible global disorder of brain function without structural changes in brain tissue
Mark the correct statement
a complication of a skull fracture may be purulent meningitis
Contusio cerebri (Cerebral contusion)
is caused by non-penetrating head trauma, and leads to structural damage to the brain with edema, bleeding (haematoma) and hypoxic-ischemic changes→Compressio cerebri
Huntington’s disease is an
autosomal dominant disease
Mark the incorrect statement
subdural haematoma may manifest itself in the development of focal symptoms from direct pressure of the haematoma on the brain tissue
Mark the correct statement
acute epidural haematoma appears in the CT as a hyperdense lesion of semilunar- shape
Mark correct statement for neurinoma (Schwannoma)
commonly occurs in vestibular part of n. VIII
Mark the correct statement
the most common source of traumatic epidural haemorrhage is rupture of arteria meningea media
What is the leading cause of viral meningitis?
Enterovirus
Most common form of dystonia is
cervical dystonia
All of the following may be associated with Guillain-Barre Syndrome except
First symptom is altered mental status
Which cause of chorea is not typical for onset in adolescence/young adulthood?
chorea due to use of hormonal contraception
Mark incorrect statement about Huntington’s disease
is caused by defect in the metabolism of a copper
Regarding C7 radiculopathy, which of the following is correct?
pain and sensory deficit is localised to the dorsal aspect of arm, forearm and the second and third digits
Early ischemic changes on brain CT does not involve
dilation of subarachniod space
Which drug must be tried in young-onset dystonia?
calcium channel blocker
In the diagnosis of multiple sclerosis characteristic finding in magnetic resonance of the brain and spinal cord is
presence of demyelinating hypersignal lesions in T2 weighted image
Which of the following is suggestive for Atypical parkinsonian syndrome?
postural instability early in the course of the disease
Radicular syndrome at the L4 level clinically manifests with
localized pain in the region of the lower back vertebral column, radiating through the anterior side of the thigh and medial side of the calf, weakness of the quadriceps femoris muscle, weakened flexion at the hip joint, weakened extension at the knee joint, decreased knee-jerk reflex
Narcolepsy is a disorder characterized by
inability to regulate sleep-wake cycle
Mark the correct statement
important parts in the diagnostic of vertebrogenic disorders are anamnesis, clinical neurological examination, and imaging examinations such as X-rays, CT or MRI
Multiple sclerosis is
a chronic CNS disease, in the pathogenesis of which autoimmune mechanisms result in myelin injury and axonal loss
So called secondary trigeminal neuralgia is not caused by
Pituitary adenoma
Which of the following symptoms is typical for multiple system atrophy
Autonomic dysfunction (e.g. orthostatic hypotension)
Epilepsy is
A tendency to experience recurrent, unprovoked seizures
What does not belong to typical signs of Wilson’s disease?
low excretion of copper in urine
Tension headache is
more prevalent than migraine
Which of the following symptoms of Parkinson’s disease is often resistant to levodopa treatment?
postural instability
Mark the correct statement regarding intravenous trombolysis
rt-PA is given in dosage of 0,9 mg/kg
Which cause of chorea is not typical for onset in adolescence/young adulthood?
chorea due to use of hormonal contraception
Mark the correct statement regarding subarachnoid hemorrhage
sudden onset of severe headache is typical
Hypertonic intracerebral hemorrhage typically does not occur
In sucortical lobar localisation
Mark the correct statement
dorsiflexion of the big toe of the foot is weakened in the case of radicular syndrome at the S1 level
Status epilepticus is a medical emergency associated with significant mortality and morbidity that requires immediate and effective treatment. Which statement is incorrect?
antimicrobial treatment is required
Radicular syndrome at the L5 level clinically manifests with
localized pain in the region of the lower back vertebral column, radiating through the lateral side of the thigh and calf, weakened dorsiflexion of the foot, unchanged reflexes
Epilepsy is most likely to begin in which age group?
early childhood, Adolescence, and over 65
Mark the incorrect statement
radicular syndrome is characterised by localised pain in one or multiple segments without radiating pain to the extremities
Which of following is not used in secondary prevention of ischemic stroke in patients with atrial fibrilation
Clopidogrel
It does not belong to the clinical picture of multiple sclerosis
polyradiculoneuritis
Wernicke center is in
Left temporal lobe
The definition of Neuromyelitis optica spectrum disorders - NMOSD is
a group of diseases, which includes Neuromyelitis optica and other especially limited forms with involvement of other parts of the CNS (thalamus, hippocampus, basal ganglia)
Frontal lobe syndrome is associated with
Affected conjugate movement of the eyes
Neuromyelitis optica spectrum disorders (NMOSD) is
a rare CNS disease with brain and spinal cord involvement
CT angiography of brain vessels is not contraindicated
In patient with non rupture aneurysm of brain arteries
Neuromyelitis optica spectrum disorders (NMOSD) is manifested by the following clear symptoms (characteristics)
optic neuritis, acute myelitis, area postrema syndrome, acute brainstem syndrome, symptomatic narcolepsy or acute diencephalic syndrome, and meningeal syndrome
Which pathological conditions are not indications for cerebrospinal fluid's analysis?
Brain tumor
Epilepsy affects
anyone regardless of age, ethnicity
„Drunk-man“ gait with broadened basis is typical for:
Cerebellar lesion
Gait with character of dancing is typical for patients with
Chorea
When someone is having a tonic clonic seizure you must always
make the area safe, measure the seizure (time), cushion the head, and offer help
What does not belong to paraneoplastic neurological syndromes?
amyloid angiopathy
All of the following are hallmark symptoms of narcolepsy except
loud snoring
Epstein-Barr virus infection is associated with
CNS lymphoma
Epilepsy is
a tendency to experience recurrent, unprovoked seizures
Tumor treatment options are
radiotherapy, chemotherapy, stereotactic neurosurgery and surgery
Alcohol can be dangerous for a person with epilepsy because
it can interfere with medication used to control seizures and cause seizures
Which tumor has the worst prognosis for the patient?
Meningioma in the brainstem
The first choice method for the diagnosis of brain tumors in the fossa posterior is
Brain MRI
Which of the following medications are contraindicated in the case of Myasthenia gravis?
curariform myorelaxants
What is the leading cause of viral meningitis?
Enterovirus
egarding Neurosyphilis, which of the following statements is incorrect?
is a exclusively a disease of brain and meninges
What are leptomeninges?
pia and arachnoid mater
Herpes zoster is
reactivation of Varicella-zoster virus infection affecting peripheral or cranial nerves
Among the frequent chronic complications of alcoholism do not belong
alcoholic cervical dystonia
Which finding in the brain MRI accompanies Wernicke’s encephalopathy?
small haemorrhages in the region of the mammillary bodies and around the third and fourth ventricles
What causes the neurologic symptoms in the case of hepatic encephalopathy?
increased levels of ammonia in the blood
In the case of acute alcohol intoxication, it leads to the following
reduction of concentration, dysarthria, ataxic gait, later there is the threat of coma and respiratory failure
What belongs among the neurologic complications of hypothyreosis?
all of the other answers are correct
About Becker’s muscular dystrophy is it correct
has a more benign and less common occurrence than Duchenne’s muscular dystrophy
What is incorrect about the ulnar nerve lesion?
leads to dysfunction of the thumb movement
What is correct about the tibial nerve lesion
the patient is incapable of standing on tiptoes
Which of the following options does not show an adequate therapy for Bell’s palsy?
in the case of compression or tumorous affection of the facial nerve, surgical treatment is adequate
The typical finding of needle EMG in ALS(amyotrophic lateral sclerosis) manifests as
all of the other answers are correct
Myasthenia gravis is
an autoimmune disorder
What belongs to the clinical picture of Myasthenia gravis?
all of the other answers are correct
Some of the known triggers of epileptic seizures are
alcohol and lack of sleep
Focal epilepsy is diagnosed in a patient with
any focal epileptic seizures
Although the characteristics of a seizure may differ from person to person, seizures are caused by the same thing
a brief episode of signs or symptoms due to abnormal excessive or synchronous neuronal activity in the brain
Epilepsy affects
anyone regardless of age, ethnicity
How does a physician diagnose epilepsy?
history or description of seizures, and electroencephalogram (EEG)
Neuromyelitis optica spectrum disorders (NMOSD) is manifested by the following clear symptoms (characteristics)
optic neuritis, acute myelitis, area postrema syndrome, acute brainstem syndrome, symptomatic narcolepsy or acute diencephalic syndrome, and symptomatic cerebral syndrome
Multiple sclerosis most often takes place under the picture of the clinical form
relapse-remitting form
Neuromyelitis optica spectrum disorders (NMOSD) is
a rare CNS disease with brain and spinal cord involvement
In the process of diagnosing multiple sclerosis, is not beneficial
Genetic testing
Mark the incorrect statement
radicular syndrome is characterised by localised pain in one or multiple segments without radiating pain to the extremities
Radicular syndrome at the L5 level clinically manifests with
localized pain in the region of the lower back vertebral column, radiating through the lateral side of the thigh and calf, weakened dorsiflexion of the foot, unchanged reflexes
Mark the incorrect statement
cervical myelopathy clinically manifests with flaccid paraparesis of the legs and dysfunction of sensitivity from the dermatome Th2 distally
Radicular syndrome at the C5 level manifests clinically with
ocalized pain in the region of the neck vertebral column, radiating through the lateral side of the shoulder, weakened abduction at the shoulder joint, weakened flexion at the elbow joint and decreased biceps reflex
Mark the incorrect statement
sequestration of the intervertebral disks means that the nucleus pulposus penetrates through the annulus fibrosus but remains connected to the disk
Mark correct statement about Wilson’s disease
it is treated by penicilamine
Which of the following is suggestive for Atypical parkinsonian syndrome?
postural instability early in the course of the disease
Parkinson’s disease can be distinguished from atypical neurodegenerative parkinsonism (e.g. Multiple system atrophy or Progressive supranuclear palsy) by
IBZM SPECT (D2 receptors)
Advanced Parkinson’s disease is not treated by
pump therapy with intravenous propranolol
The basic characteristics of the brain concussion (Mild traumatic brain injury, mTBI) include
Glasgow coma scale 13-15 points + unconsciousness (if present) lasting up to 30 minutes
„Whiplash“ injury
it is an injury of the cervical spine, associated with a sudden antero-posterior movement of the trunk and cervical spine with severe hyperflexia and subsequent hyperextension of the neck
Correction of an elevated blood pressure
in haemorrhagic stroke the correction should be faster than those in ischemic stroke
Which of following signs is not typical for chronic communicating hydrocephalus
chorea
Intracerebral heamorrhage occurs appoximatelly in
7-10 % of strokes
Diplopia occurs during stroke in the territory of
basilar artery
Central hemiparesis and aphasia occur in stroke in the territory of
left middle cerebral artery
Does not apply to a patient with aphasia and right-sided hemiparesis within a time window of up to 4.5 hours
if CT is negative, we administer rTPA
Based on the definitions for transient ischemic attack, we can summarize that
for the duration of the symptoms, they are present for <24 hours, usually < than 1 hour
The following does not apply to the management of arterial hypertension
For patients over 80 years of age, values of blood pressure 130 - 139 mm Hg are always recommended
Which of the following symptoms is not present in patients with FTD (frontotemporal degeneration)?
visual hallucinations
Mark the incorrect statement
the pathology of alfa synuclein is involved in the etiopathogenesis of Alzheimer's disease
Which of the following statements is not true?
repeated complex visual hallucinations are typical for FTD (frontotemporal degeneration)
Mark the incorrect statement
episodic memory disorder is typical for dementia with Lewy bodies
Which statement is valid for vascular dementia?
has a fluctuating course of dementia
For the definition of migraine with aura, the following applies
the patient must have 2 seizures meeting the criteria of point B and C of the diagnostic criteria
Aura in migraine with aura
usually lasts 5-60 minutes
A painful tic (tic douloureux) is present at
classical (primary) trigeminal neuralgia
Botulinum toxin
its effectiveness has been confirmed in the prevention of episodic migraine
So called secondary trigeminal neuralgia is not caused by
falx meningioma
Patient presenting with unilateral flattened nasolabial fold and drop of mouth angle suffers from:
peripheral type of facial nerve lesion
Sonography is used in neurology for diagnosis of
Ischemic stroke and other cerebrovascular diseases
Trigeminal neuralgia
is a neuropatic pain which is treated by anticonvulsants
Glasgow coma scale evaluates
eye-opening, verbal, flection, extension responses
Which diseases do not cause syndrome of intracranial hypertension?
fracture of a skull
MRI-angiography is absolutely contraindicated
in patients with metal (iron) implants
Symptoms, which is absolutely necessary for diagnosis of parkinsonism (present in 100% patients) is
Bradykinesia
Hypokinetic movement disorder is
Parkinosonism
Brain CT is the first choice in diagnostics of
Acute stroke
Conjunctival chemosis and eye movement disorder is not typical for
pituitary adenoma
Focal clonic seizure known as a Jacksonian march can be a symptom of a tumor
in the frontal lobe
Epstein-Barr virus infection is associated with
CNS lymphoma
The most common tumors in adults are
meningiomas, glioblastomas, pituitary tumors
For the treatment of intracranial hypertension in brain tumors we administer
all options are correct
Which statement is correct?
all of them
Which bacterium is Gram-positive microbe causing meningitis?
S. pneumoniae
In Herpes simplex encephalitis, which of the following is a characteristic EEG finding?
periodic lateralized epileptiform discharges
The diagnose of Herpes Simplex Encephalitis is based on presence of
herpetic DNA in CSF
What is correct about Korsakoff syndrome?
all of the other answers are correct
What belongs among the typical neurologic symptoms of SLE (systemic lupus erythematosus)?
polyneuritis, polymyositis, brain infarcts
Among the frequent chronic complications of alcoholism do not belong
alcoholic cervical dystonia
Mark the incorrect statement about diabetic polyneuropathy?
mainly there is affection of the spinothalamic tract for sensitivity
What causes the neurologic symptoms in the case of hepatic encephalopathy?
increased levels of ammonia in the blood
What does not belong to the clinical picture of ALS (amyotrophic lateral sclerosis)?
disorder of sensitivity
What may we find in the laboratory picture in ALS(amyotrophic lateral sclerosis)?
increased levels of the enzymes: CK, ALT, AST, LDH and creatinine
The typical finding of needle EMG in ALS(amyotrophic lateral sclerosis) manifests as
all of the other answers are correct
Mark the correct affirmation in ALS (amyotrophic lateral sclerosis)
treatment for the cause does not exist
In the case of facial nerve lesion in the region of the pontocerebellar angle it is adequate to perform a
lumbar punction
For Congenital myotonia it is incorrect
there is autosomal recessive inheritance – Thomsen’s type of congenital myotonia, or autosomal dominant inheritance – Becker’s type of congenital myotonia
Mark the correct statement for Myasthenia gravis (MG)
all of the other answers are correct
For polymyositis it is correct
all of the other answers are correct
For Lambert-Eaton myasthenic syndrome, the following is incorrect
affection of the bulbar muscles is typical
Diagnostic tests for epilepsy include all of the following except
Simple blood test
All of the following are hallmark symptoms of narcolepsy except
Loud snoring
Seizures can be caused by
All of the above
Compared to a healthy person, how much more sleep does a patient with epilepsy need?
no extra sleep
Narcolepsy is a disorder characterized by
inability to regulate sleep-wake cycles
Multiple sclerosis has its first manifestation - a demyelinating event called a Clinically isolated syndrome, which most often occurs under images
optic neuritis, or myelitis, or brainstem-cerebellar syndrome
Multiple sclerosis is treated causally for a long time with
immunomodulators and immunosuppressants
Attack or relapse of Multiple sclerosis is not
stable period without worsening patient disability
Multiple sclerosis is
chronic disease of the CNS, in which the dysimmune process leads to damage to myelin and axons
The definition of Neuromyelitis optica spectrum disorders - NMOSD is
a group of diseases, which includes Neuromyelitis optica and other especially limited forms with involvement of other parts of the CNS (thalamus, hippocampus, basal ganglia)
Deep brain stimulation therapy in Parkinson’s disease is indicated in case of
poorly controlled motor fluctuations
Huntington’s disease is an
autosomal dominant disease
Mark the incorrect statement
traumatic intracerebral haemorrhage is present only if a skull fracture is also present
Mark the correct statement
brain concussion (Mild traumatic brain injury, mTBI) manifests clinically as confusion and/or disorientation, unconsciousness (if present) lasting up to 60 minutes and post-traumatic amnesia lasting up to 24 hours
Spinal cord „shock“ (in case of spinal injuries)
introduces at the beginning a complete loss of spinal cord functions with a spastic plegia, which after a certain time turns into flaccid paresis/plegia
Severity of subarachnoid haemorrhage is scaled by (clinical symptoms)
Hunt-Hess scale
Secondary prevention in patients after overcoming ischemic stroke without atrial fibrillation is
is recommended in patients with hypertonic bleeding with well-controlled arterial hypertension
A constant brain blood flow for brain functions is in the range of
50–60 ml / 100 g brain tissue / min
Secondary prevention in patients after overcoming ischemic stroke without atrial fibrillation is
antiplatelet + atorvastatin
Penumbra, or functional impairment (reversible dysfunction) of brain tissue occurs during blood flow
below 20 ml / 100 g / min
Atorvastatin is recommended in the secondary prevention of ischemic stroke in dose
80 mg
Hypersensitivity to antipsychotics is typical for
Frontotemporal dementia
What is not a routine diagnostic procedure for patients with newly diagnosed dementia?
vitamin D level examination
We do not include among treatable causes of dementia
Creutzfeldt-Jakob disease
Which are the treatable causes of dementia?
hypothyroidism
For the definition of migraine without aura, the following applies
the patient must have 5 seizures meeting the criteria of point B - D of the diagnostic criteria
Headache in migraine is
throbbing, worsened by exertion
The following does not apply for triptan treatment
are administered already during the aura
Preventive treatment of migraine is indicated
in case of three or more migraine attacks per month
Cerebrospinal fluid examination is essential for diagnosis of
narcolepsy
Mark correct answers
corticospinal pathway passes through internal capsule
Hyperproteinorachia
may be the result of positive intrathecal synthesis of Ig
Lesion of a right cerebellar hemisphere manifests with
problems with accurate movements on the right side of a body
In case of a unilateral brainstem's lesion
there is a sensory lesion on the side of affected n. IV. nucleus
Brain haemorrhage on CT is
white
Which of following statements is not true for DSA (digital subtraction angiography) ?
DSA is not using X-ray radiation
Pseudotumor cerebri
is a clinically condition similar to intracranial hypertension without an expansive brain lesion
The diagnosis of meningeal carcinomatosis is not supported by
high levels of sugars in cerebrospinal fluid
The most malignant brain tumor is
glioblastoma multiforme
It is not one of the general symptoms of brain tumors
diplopia
Classic symptoms of meningitis usually include
fever, headache, stiff neck
Postherpetic neuralgia
can be successfully treated by antiepileptics
Choose the incorrect statement about Marchiafava-Bignami syndrome
is caused by deficiency of vitamin B1
Choose the incorrect statement about delirium tremens
it is accompanied by hypotension and bradycardia
Which of the following leads to central pontine myelinolysis?
rapid correction of hyponatremia(frequently in chronic alcoholics)
In the case of carpal tunnel syndrome
typically there are night paresthesias and dysesthesias which may wake the patient from sleep
Mark the incorrect statement for the central lesion of the facial nerve
drooping of the mouth corner on the contralateral half of the face according to the lesion site
Which of the following tests/symptoms does not belong among the stress tests in the diagnosis of Myasthenia gravis?
Graefe’s sign
Myasthenia gravis: which of the following options is correct for the so-called Myasthenic crisis?
it is the rapid development of bulbar symptomatology and generalized weakness - a life- threatening state where respiratory failure threatens the patient
Cataplexy is
muscle atonia triggered by emotions
Absence is
a generalized epileptic seizure manifested by staring with a typical SWC EEG 3Hz pattern
Hypocretin deficient narcolepsy is a result of
immune mediated damage of hypocretine neurons
Alcohol can be dangerous for a person with epilepsy because
it can interfere with medication used to control seizures and cause seizures
When someone is having a tonic clonic seizure you must always
make the area safe, measure the seizure (time), cushion the head, and offer help
Multiple sclerosis may be manifested by the development of optic neuritis with symptoms
deterioration of visual acuity and color vision disturbance
Neuromyelitis optica spectrum disorders (NMOSD) is manifested by the following clear symptoms (characteristics)
optic neuritis, acute myelitis, area postrema syndrome, acute brainstem syndrome, symptomatic narcolepsy or acute diencephalic syndrome, and meningeal syndrome
ADEM (Acute Disseminated Encephalomyelitis)is characterized by magnetic resonance imaging of the brain with
multiple small lesions disseminated in both white and gray matter of the brain, new lesions often increase
Multiple sclerosis typically manifests at the disease onset with
optic neuritis
Mark the correct statement
important parts in the diagnostic of vertebrogenic disorders are anamnesis, clinical neurological examination, and imaging examinations such as X-rays, CT or MRI
Mark the correct statement
in the case of radicular syndrome at the S1 level the patient cannot stand on tiptoes
Mark incorrect statements for Lewy body dementia (LBD)
typical antipsychotics (e.g. haloperidol) are used to treat LBD
Mark the correct statement
Subdural hygroma is a developmental stage of chronic subdural hematoma, where the haematoma persists for several years
Posttraumatic complication is not
ependymoma
Treatment of brain haemorrhage caused by vitamine K antagonists does not include
acetylsalicylic acid (ASA)
For sinus cavernosus thrombosis is typical triad of
conjunctival chemosis, ptosis and painful ophthalmoparesis
Secondary prevention in patients after overcoming ischemic stroke with atrial fibrillation is
anticoagulants, we prefer direct oral anticoagulants
Anticoagulant therapy in the secondary prevention of stroke in patients with atrial fibrillation is recommended in
CHA2DS2-VASc ≤ 2 in men and ≤ 3 in women
Category of primary headaches doesn't include
headache in arterial hypertension
Incomplete Horner syndrome may be in
cluster headache
For the treatment of moderate to severe migraine attacks are used
triptans
Peripheral (lower) motor neuron lesion is characterised by
muscle atrophy
Brain MRI is essential in diagnosis of
multiple sclerosis
Myasthenia gravis is
an autoimmune disorder
To the clinical picture of Duchenne’s muscular dystrophy belongs
all of the other answers are correct
Myasthenia gravis: which of the following options is correct for the so-called Myasthenic crisis?
it is the rapid development of bulbar symptomatology and generalized weakness - a life-threatening state where respiratory failure threatens the patient
Among the metabolic determinants of polyneuropathy belong
diabetes mellitus
For radial nerve lesion is correct
swan-neck” deformity is present
In the clinical picture of the fibular nerve lesion
the patient is incapable of standing on tiptoes
In the case of carpal tunnel syndrome
typically there are night paresthesias and dysesthesias which may wake the patient from sleep
Wernicke encephalopathy is connected with the deficiency of which vitamin?
B1
What does not belong among the typical manifestations of hypoglycaemia?
psychogenic non-epileptic seizures (PNEZ)
An MRI is performed on a patient with Herpes simplex encephalitis. Which of the following is suggestive of this condition?
hemorrhagic changes in temporal lobe
Which statement about Guillain-Barre syndrome is correct?
all answers are correct
Diagnose of Creutzfeldt-Jacob disease is supported by finding
Protein 14-3-3 in CSF
What are leptomeninges?
pia and arachnoid mater
The most common tumors in childhood are
astrocytomas, malignant gliomas, embryonic tumors
Conjunctival chemosis and eye movement disorder is not typical for
pituitary adenoma
Meningeal carcinomatosis
may be the first manifestation of malignancy outside the nervous system
The first choice method for the diagnosis of brain tumors in the fossa posterior is
brain MRI
Neurinoma (schwannom)
most often occurs on the vestibular part of n.VIII
CT- angiography: which of following statement is true ?
it is a minimal invasive examination
Which from the following statements considering Doppler effect is true ?
if the blood moves away from the probe, the frequency of the reflected waves decreases
Damage of corticonuclear tract in the left brain hemisphere manifests by:
central facial nerve palsy on the right side of a face
Facial nerve (n. VII) lesion - peripheral type is manifested with
unability to make forehead wrinkles, elevate eyebrow, close the eye and nasolabial wrinkle is reduced on the ipsilateral side and mouth angle drop is present, and related to lesion localization; also taste deficit can be present
Which EEG finding supports epileptic origin of the paroxysmal loss of the conciousness (epileptic seizure) ?
spike-wave complexes
Hyperkinetic movement disorder is
dystonia
Anozognosia:
is present in the lesion of nondominant (usually right) hemisphere
Patient with right vestibular system lesion will have gait problem with
Pulling in direction of right ear
Mark correct statement for functional (psychogenic) movement disorders
physiotherapy might help
Pseudobulbar palsy shows
dysartria, dysphagia, increased masseter reflex, present pathological axial reflexes
Typical features of REM sleep are
muscle atonia, saw tooth waves
Mark correct statement:
hyperproteinorachia combined with increased count of white blood cells is called proteino-cytological dissociation
Evoked potentials: SEP are used for examination
of sensitivity pathway ranging from the peripheral nerve, spinal roots, spinal dorsal columns, brainstem, thalamus and cerebral parietal cortex
Mark correct statement for bradykinesia
amplitude and frequency of alternating movements is decreasing
Digital subtraction angiography (DSA) is not used
for imaging of intracerebral hemorrhage
CT angiography of cerebral arteries is not routinely used
in epidural hemorrhage
Mark correct answers
tumor localised in the third brain ventricle may lead tu obstructive hydrocephalus
Doppler imaging in duplex USG examination of extracranial vessels
based on the magnitude (size) of the change in the frequency of the ultrasonic waves reflected from the moving particle, the velocity of the moving particles is determinated
Ptosis of an eyelid is present in lesion of
n. III.
Facial nerve (n. VII) consists of mixed fibers
senzoric (taste), vegetative (slinenie, slzenie), motor and sensitive
Frontal lobe syndrom is associated with
affected conjugate movement of the eyes
Mark incorrect statements for superior alternating hemiplegia:
contralateral lesion of n.VII is present
Plane X-ray of the spinal column is indicated
it is not used very frequently nowadays
Dysdiadochokinesia means an inability of
fast alternating movements
Mark incorrect statement for middle alternating hemiplegia ?
lesion of pyramid tract is in medulla oblongata
Neuropathic pain
anticonvulsants and antidepressants have fine effect
Mark correct statement for temporal arteritis as a cause of headache
may cause blindness
Treatment with triptans
requires caution in patients with arterial hypertension and ischemic heart and vascular disease
For the treatment of mild migraine attack are used
paracetamol, non-steroidal anti-inflammatory drugs
Which of the following statement is not true?
the clock drawing test is used to detect visual hallucinations
Which treatment is used in Alzheimer's disease?
rivastigmine
Which statement is not valid for vascular dementia?
Gingko biloga EGb 761 extract is approved for the treatment of vascular dementia
Mark the correct statement
dementia with Lewy bodies is a synucleinopathy
Cerebral venous infarction results from
closure of the cortical vein or cerebral sinus with subsequent tissue congestion
A constant brain blood flow for brain functions is in the range of
50–60 ml / 100 g brain tissue / min
A cerebral infarction occurs when there is a decrease in cerebral flow
below 12, somewhere below 10 ml / 100 g / min
For sinus cavernosus thrombosis is typical triad of
conjunctival chemosis, ptosis and painful ophtalmoparesisi
For detection of amyloid angiopathy we use
brain MRI gradient echo sequence
CT-angiography in case of subarachnoid haemorrhage (SAH)
is used mainly to determinate the source of bleeding
Mark the incorrect statement
Chronic subdural haematoma occurs in young people and is of arterial origin
Posttraumatic complication is not
ependymoma
Mark the correct statement
contusio cerebri (Mild brain injury, AMD) may be clinically manifested by a disorder of consciousness together with focal neurological symptoms, hyperdensive areas are present in the brain CT finding
Mark the correct statement
acute subdural haematoma appears in the CT as a hyperdense lesion of lenticular (biconvex) shape
Mark the most specific (clinical) symptom of prodromal Parkinson’s disease
REM sleep behavior disorder (RBD)
First choice in treatment of cervical dystonia is
local aplication of botulinum toxin type A
Action tremor (present e.g. when writing, eating, drinking) is typical for the following disease
Essential tremor
Treatment of radicular syndromes
is complex, in the beginning is focused on reducing pain most commonly by using anti-inflammatory, myorelaxant and anticonvulsive drugs
Mark the correct statement
cervicocranial syndrome describes headaches triggered by irritation of nerves of the skull due to muscular rigidity around the neck vertebral column
Mark the incorrect statement
belonging to the conservative treatment of vertebrogenic disorders are analgetics myorelaxants and triptans
Radicular syndrome at the C8 level manifests with
localized pain in the region of the neck vertebral column, radiating through the inner medial side of the shoulder, forearm, down to the 4th-5th fingers, weakened flexion of the fingers, decreased triceps reflex
In multiple sclerosis, there is a presence in magnetic resonance imaging (brain and/or spinal cord)
hypersignal lesions in T2 weighted image
Treatment for epilepsy is to eliminate or sharply reduce the frequency of seizures, may involve all of the following except
cognitive-behavioural therapy
What is the underlying cause of epileptic seizures?
abnormal electrical activity in the brain
All of the following medications are used to treat restless legs syndrome except
carbamazepine
Mark the correct statement for Myasthenia gravis (MG)
all of the answers are correct
Which of the following options represents the explanation of the so-called Gorelick's symptom in the diagnosis of Myasthenia gravis?
in the case of mild ptosis, if the patient looks upwards for 1 min., it leads to the worsening of the ptosis
What does not belong to the clinical picture of Myasthenia gravis?
disorder of sensitivity
What is not a cause of brain infarcts in the case of SLE (systemic lupus erythematosus)?
congenital thrombophilic state (e.g. factor V Leiden)
What may be a manifestation of alcohol withdrawal?
in the case of heavy abuse - epileptic seizures, hallucinations
Which part of the brain is mostly affected by Herpes simple encephalitis?
Temporal lobe
Neuroborreliosis can manifest by
all answers are correct
Encephalitis manifests as
fever, Headache and focal neurological symptoms e.g. aphasia
Diagnose of Creutzfeldt-Jacob disease is supported by finding
Protein 14-3-3 in CSF
Meningeal carcinomatosis
may be the first manifestation of malignancy outside the nervous system
What does not belong to paraneoplastic neurological syndromes?
amyloid angiopathy
Position-dependent headache is typical for
meningioma
Uncinate crisis is present in lesion of
temporal lobe
Syringomyelic sensation deficit occurs when lesion is located in
dorsal spinal columns
In parietal lobe syndrom of nondominant hepisphere is not present
speech problem
Segmental dystonia involves
Two or more neighbouring muscle groups
Frontal lobe syndrom is associated with
affected conjugate movement of the eyes
Which of following findings is present in the inferior alternating hemiplegia?
contralateral lesion of hypoglossal nerve
What causes intracranial hypertension syndrome?
brain abscess
Functional examinations of brain is
Positron emission tomography (PET)
Tabic disociation of sensation means
defect of deep sensation
Following symptoms are not typical for tics
Unsuppressible character
Mark correct answers
paresis can be the clinical manifestation of upper and lower motorneuron lesion
Transversal complete spinal cord lesion at the level of L3 segment does not present with
spastic paraparesis of lower limbs
Vestibular ataxia in relation to peripheral vestibular syndrome
is manifested with tonic limb and trunk deviations opposite to the affected vestibular apparatus; it is named „dysharmonic vestibular syndrome“
Digital subtraction angiography (DSA)
is invasive diagnostic method for visualisation of brain arteries
Muscle tone: mark correct answers
muscle tone is regulated by cerebellum
Which statement is not correct?
K-komplexes point at the localisation of the epileptic focus
Magnetic resonance imaging (MRI)
displays demyelinating lesions in multiple sclerosis
Mark correct statement for dystonia:
has constant pattern
For evaluation of the brainstem reactivity in comatous patient we do not use:
Babinski sign
Bilateral hyposmia (both nostrils) is present
as a prodromal sign of Parkinson's disease
In lesion of left n. II
on the left side is not present direct FR and no to the right side is not present consensual FR
Which of the following do not suggest brain structural abnormality in the origin of coma?
anisocoria
B-mode in Duplex ultrasound of extracranial brain vessels
displays mainly moving particles below the probe based on the frequency of reflected waves
Electromyographic nerve conduction studies (NCS) in case of axonal lesion of a peripheral nerve show
decelerated conductivity of a particular nerve’s segment, action potentials are of lower amplitude
Fluent aphasia is related to lesion of
left temporal lobe
Calcitonin gene related peptide (CGRP)
is related to the pathophysiology of tension headache
Alzheimer's disease has the most significant deficit of
acetycholine
Which of the following symptoms is usually one of the first symptoms of Alzheimer's disease?
episodic memory impairment
Does not apply to the treatment of intracranial thrombosis
treatment is used for 6 months in cases of known local cause, if the hypercoagulable state is present is used for long-term
Based on the definitions for transient ischemic attack, we can summarize that
for the duration of the symptoms, they are present for <24 hours, usually < than 1 hour
Diplopia occurs during stroke in the territory of
basilar artery
Cardioembolic stroke represents from ischemic strokes
20%
Subarachnoid haemorrhage is most commonly caused by
rupture of intracranial aneurysm
For vasospasm prevention in subarachnoid haemorrhage we use
Calcium channel blockers
For detection of amyloid angiopathy we use
brain MRI gradient echo sequence
Antidotum Idarucizumab is used in haemorrhagic complications in patients treated by
Dabigatran
Mark the incorrect statement
Chronic subdural haematoma occurs in young people and is of arterial origin
Mark the incorrect statement
traumatic intracerebral haemorrhage is present only if a skull fracture is also present
Mark the correct statement
unconsciousness together with focal neurological deficit may be clinical manifestations of contusio cerebri
Mark the incorrect statement
in the case of brain concussion (Mild traumatic brain injury, mTBI), hypodensity at the site of injury is present in the brain CT finding
Mark the incorrect statement
chronic subdural haematoma is shown in the CT immediatelly as a hyperdensive lesion
Mark incorrect statement about Parkinson’s disease
incidence decreases with age
Advanced Parkinson’s disease is not treated by
pump therapy with intravenous propranolol
Mark the incorrect statement
the most common cause of radicular syndromes is osteoporosis of the vertebral bodies of the column
Myasthenia gravis: which of the following options is correct for the so-called cholinergic crisis?
originates after the overdose of AChE inhibitors
Total functional incapacity - disability, of a patient with Multiple sclerosis is evaluated using a scale
EDSS
Radicular syndrome at the C6 level manifests clinically with
localized pain in the region of the neck vertebral column, radiating through the lateral side of the shoulder, forearm, down to the thumb, weakened flexion and supination at the elbow joint, decreased biceps and styloradial reflexes
Which of the following tests/symptoms does not belong among the stress tests in the diagnosis of Myasthenia gravis?
Graefe’s sign
What does not belong to the clinical picture of Myasthenia gravis?
disorder of sensitivity
For dermatomyositis it is correct
all of the other answers are correct
What does not belong to the clinical picture of Bell’s palsy?
affection only of the lower branches of the facial nerve
Recurrent hypoglycaemia in the case of badly compensated diabetes may in the long-term lead to
decrease in cognitive functions, development of dementia
Neurological manifestations of Lyme disease do not include
stroke like episodes
VEP – Visual evoked potentials
physiological finding after stimulation is a complex of three waves – I., III. and V. corresponding to the signal passage through the brainstem (N-P-N complex)
Typical tremor in cerebellar disorders is
Intentional
Afferent pathways of deep sensation enters
into dorsal spinal columns
Mark incorrect answer
brain MRI of patients with multiple sclerosis shows T1 hyperintense lesions
Blepharospasm is dystonia of
Eyelids
Various abnormal sensations such as burning, needles and pins, etc, which are unpleasant but not painful are called:
dysesthesia
Cochlear nerve lesion manifests with
hearing disorder - hypacusis or anacusis
Mark correct statement for tic disorder:
tics might be voluntarily suppressed for a short time
Mark correct statement
primary motor cortex is localised in praecentral gyrus
Duplex sonography of extracranial brain vessels
Has no significant contraindication
Which part of a tongue is innervated by the Facial nerve (n. VII) regarding the taste?
ipsilateral anterior two thirds of a tongue
Which of the following signs doesn’t belong to cerebellar syndrome?
spasticity
Brain CT is
method for the examintaion of brain structures in the scale of the grey colours
Electromyographic nerve conduction studies (NCS) are used to measure action potentials
after stimulation of a peripheral nerve, recording is over the nerve or muscle
Study Notes
Neurology
- Neurosyphilis is not correct: patients usually present with a rapid decline in cognitive function
- In Alzheimer's disease, FDG-PET scans typically show decreased glucose metabolism in the temporal and parietal lobes
Radiculopathy
- L4 radiculopathy affects the quadriceps muscle
- L5 radiculopathy affects the ankle and great toe
- C7 radiculopathy affects the elbow and forearm
- C8 radiculopathy does not typically affect the hand muscles
- Treatment of radiculopathies may include physical therapy, medication, and surgery
Dementia
- Alzheimer's disease has the most significant deficit of acetylcholine
- Symptoms of dementia with Lewy bodies (DLB) include visual hallucinations, fluctuating cognitive impairment, and Parkinsonian symptoms
Headache
- Restless leg syndrome is caused by dopamine dysfunction
- Migraine infarction is caused by cortical spreading depression
- Cluster headache is characterized by unilateral pain, tearing, and nasal congestion
Stroke
- Modifiable risk factors for stroke include hypertension, hyperlipidemia, and smoking
- Central hemiparesis and anosognosia occur in stroke in the territory of the middle cerebral artery
- Acute treatment of ischemic stroke may include intravenous thrombolysis
- Subarachnoid hemorrhage is most commonly caused by aneurysm rupture
Infections
- Herpes simplex encephalitis is characterized by bilateral temporal lobe changes on MRI
- Meningitis may be caused by viral or bacterial infection
- The most virulent cause of meningitis is Streptococcus pneumoniae
Tumors
- Primary brain tumors include gliomas, medulloblastomas, and meningiomas
- Neurinoma (Schwannoma) is a type of benign tumor that originates from Schwann cells
Movement Disorders
- Huntington's disease is an autosomal dominant disorder characterized by chorea and cognitive decline
- Dystonia is characterized by involuntary muscle contractions
- Parkinson's disease is characterized by tremor, rigidity, bradykinesia, and postural instability
Multiple Sclerosis
- Multiple sclerosis is a demyelinating disease that may present with optic neuritis, transverse myelitis, and brainstem symptoms
- Characteristic findings on MRI include T2 hyperintense lesions in the brain and spinal cord
Epilepsy
- Epilepsy is a disorder characterized by recurrent seizures
- Status epilepticus is a medical emergency that requires immediate treatment
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