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Category: Q&A Medicine--->Neurology
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Question 1# Print Question

A 37-year-old woman with a history of multiple sclerosis presents for follow-up. Since her previous visit 7 months ago, she has had a few episodes of monocular vision impairment and weakness and incoordination in her right upper extremity. Although these symptoms resolved completely, she reports that one episode of vision impairment 2 months ago was so severe that she was admitted to the hospital and received intravenous corticosteroids.

Which of the following is often used to decrease the frequency of relapse and slow the progression of this patient’s disorder?

A. Methotrexate
B. Interferon-β
C. High-dose corticosteroids
D. Cyclosporine


Question 2# Print Question

A 33-year-old woman presents with a severe headache that began 5 hours ago. The patient reports that the headache is unilateral on the left side and endorses nausea, an episode of vomiting, and photophobia. Neurologic examination reveals normal muscle strength and no sensory loss.

Which of the following is the best next step in the management of this patient?

A. Propranolol
B. Amitriptyline
C. Chlorpromazine
D. Verapamil


Question 3# Print Question

A 53-year-old man presents to the hospital accompanied by police officers. He was found walking in the middle of a very busy highway. When asked for his name, age, time, and place, his responses are unintelligible. He has a blood pressure of 154/92 mmHg and a heart rate of 94 beats per minute. Physical examination shows a malnourished patient with dilated pupils that are reactive to light. The patient is noted to have an ataxic broad-based gait.

Which of the following is the best initial treatment for this patient?

A. Haloperidol
B. Naloxone
C. Thiamine
D. Clonidine


Question 4# Print Question

A 43-year-old HIV positive man presents with new onset right-sided paralysis. He recently started trimethoprim–sulfamethoxazole (TMP– SMX) for a CD4 count of 70/mm3 . The patient is afebrile and vital signs are within normal limits. Neurologic examination demonstrates hyper-reflexia, hypertonia, and positive Babinski sign on the right side.

Which of the following is the most likely diagnosis in this patient?

A. Progressive multifocal leukoencephalopathy (PML)
B. Primary CNS lymphoma
C. AIDS dementia complex
D. Toxoplasmosis


Question 5# Print Question

A 63-year-old woman with a history of hypertension presents with worsening memory over the past 5 months. Her husband reports that recently she had forgotten to turn off the oven a few times and has forgotten several appointments, which is unusual for her. The patient also endorses urinary incontinence and “clumsiness.” The patient’s hypertension is well-controlled on hydrochlorothiazide. Physical examination shows that her blood pressure is 128/84 mmHg and her pulse is 76/min. Neurologic examination is within normal limits except for a broad-based gait.

Which of the following is the most likely diagnosis?

A. Pseudotumor cerebri
B. Alzheimer disease
C. Normal pressure hydrocephalus
D. Multi-infarct dementia




Category: Q&A Medicine--->Neurology
Page: 1 of 4