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Category: Q&A Medicine--->Neurology
Page: 3

Question 11# Print Question

A 67-year-old woman with an insignificant past medical history presents with her husband who reports that she has become increasingly confused over the past week. The husband reports that she had a “hard fall” down a few stairs 10 days ago and since then has been hesitant to walk. A contrast-enhanced head CT is ordered and is shown below.

Which of the following is the underlying cause of this patient’s condition?

A. Tearing of the middle meningeal artery
B. Tearing of the bridging veins
C. Ruptured aneurysm
D. Hypertensive hemorrhage


Question 12# Print Question

A 57-year-old man presents with new onset left-sided weakness, urinary incontinence, and left leg “heaviness” for the past 5 hours. That patient has a long history of diabetes and is noncompliant with his medications. Neurologic examination reveals 3/5 strength in the left upper extremity and 1/5 strength in the left lower extremity. Sensation to pinprick and fine touch is markedly diminished over the left leg. Visual field testing is within normal limits.

Which of the following is the most likely location of this patient’s stroke?

A. Right middle cerebral artery
B. Left middle cerebral artery
C. Right anterior cerebral artery
D. Left anterior cerebral artery


Question 13# Print Question

A 37-year-old woman presents with a severely intense headache that began a few hours ago. The headache has not improved since then and the patient has vomited several times. She reports that it is diffusely painful, and she is unable to recall if any “funny sensations” occurred prior to the headache. She does not report head trauma or fever. The patient is too uncomfortable to tolerate a thorough neurologic examination and a CT scan of the head is ordered (Figure below).

Which of the following is the underlying cause of this patient’s headache?

A. Venous sinus thrombosis
B. Ruptured berry aneurysm
C. Arteriovenous malformation
D. Amyloid angiopathy


Question 14# Print Question

A 27-year-old woman presents with fatigue and double vision. The patient reports that these symptoms occur at the end of a “long work day.” The patient also reports that she does not eat “tough” foods anymore such as steak or chicken as it is difficult for her to chew. Neurologic examination is unremarkable and the patient has normal thyroid-stimulating hormone (TSH) and creatine kinase (CK) levels. The diagnosis is confirmed with a special laboratory test.

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

A. MRI of the head
B. CT scan of the chest
C. CT scan of the abdomen
D. Ultrasound of the neck


Question 15# Print Question

A 26-year-old man presents with symmetric ascending weakness of the bilateral lower extremities. The patient also endorses numbness and tingling in his toes and reports that he had a diarrheal episode 7 days ago that lasted for 2 days. Neurologic examination confirms symmetric weakness in the lower extremities with diminished and delayed reflexes. Electrophysiologic studies confirm slowing of nerve conduction velocities.

Which of the following pathogens is likely to be the cause of this patient’s disorder?

A. Shigella
B. Escherichia coli (O157: H7)
C. Salmonella
D. Campylobacter jejuni




Category: Q&A Medicine--->Neurology
Page: 3 of 4