Download Final Exam – Neurology 2004 1. A 16 year old boy is examined in

Final Exam – Neurology 2004
1. A 16 year old boy is examined in the ER after noticing a very dark urine after extreme
physical effort with mascular pain. A similar case has occurred half a year ago. Which of the
following tests would be most appropriate to carry out in the ER?
a. kidney function, CPK
b. CPK
c. Meuglobin, CPK
d. EMG
e. conductance check up
2. An 8 year old boy is examined in the clinic. The findings are proximal muscle weakness in
the hands, a duck like walk and hypertrophic hips. Which of the following is true for the
boy?
a. The boy receives food rich with vitamin B12.
b. The boy works out at the gym for many hours.
c. CPK values are good in a lab test.
d. The kid has an atrophic tongue.
e. The kid has a healthy sister and a brother that passed away at 16.
3. The carpal tunnel syndrome:
a. Is more common amongst men
b. Attacks the ulnar nerve.
c. The nerve conduction in the middle finger is always slow.
d. The sensory branch is damaged before the motoric branch.
e. none of the above.
4. Which of the following is not related to peripherial neurophathy:
a. Proximal muscle atrophy
b. Positive Romberg test.
c. Lack of sense in the shape of socks and gloves.
d. low pressure in resting.
e. Change of temperature in the limbs.
5. In the lack of vitamin B12, all of the symptoms appear except:
a. sight disorder.
b. Problems controlling the sphincters.
c. Pyramidal signs.
d. lack of tendon reflex
e. sensory ataxia
6. Which of following does not appear as a complication of Subarachnoid hemorrhage?
a. Hydrocephalus.
b. Ischemic stroke.
c. Spasms
d. returning hemorrhage.
e. Dementia
7. Which is true about Herpes Simples Encephalitis?
a. The clinical picture is similar to Encephalitis causes by Enteroviruses.
b. full recovery is achieved in 90 % of the cases
c. in CSF there is nuitrophil proliferation .
d. In the EEG there are sharp and tall waves and slow waves with a frequency of 2 - 3 [1/s]
in a Periodic shape and they stand out in the temporal areas.
e. A diagnostic brain CT scan in over than 90 % of the cases.
8. Which is not true about an iscamic spinal condition of the Anterior spinal artery ?
a. It can appear throughout heart surgeries and aorta.
b. The symptoms are weakness and spino-thalamic sensory disruptions under the hit.
c. Deep sensation (propreoception and vibration)
d. The sphincters dysfunction.
e. at the beginning of the event there is a clinical picture of Spinal shock that passes within a
few weeks.
9. Which of the following does not appear in AIDS patients?
a. Dementia
b. Myasthenia syndrome
c. Meningitis
d. Peripheral polyneauropathy
e. Meuzitis
10. obstruction of the middle cerebral artery manifast in:
a. arm weekness, more than of the legs.
b. leg weakness, more obvious than the arm weakness.
c. same weakness of both legs and arms
d. It causes sensoric disruptions only
e. It causes temporerry sight lost
11. An indiction which is usually done for Carotid Endarterectomy is:
a. 100% block of the Internal Carotid artery.
b. narrowing of 70% - 99% of the Internal carotid artery
c. narrowing of over 50 % of the Common carotid artery
d. narrowing of 50% - 70% of the Internal carotid artery
e. Two sided block of the Internal carotid artery.
12. Multiple Sclerosis can be expressed in all of the following except:
a. Optic neuritis.
b. Spastic paraparesis.
c. Intention tremor.
d. Peripheral neuropathy
e. Urinary retention
13. All of the following characterize Parkinson's disease except:
a. Bradikenezia
b. shivering.
c. Rigidity
d. Micrographia
e. Ataxia
14. Which of the following actions would be the first to carry out on a coma patient?
a. Checking B1 level in the blood
b. Checking the sugar level
c. Making sure that the patent's airway path is clear.
d. Naloxon care
e. Lorican care
15. Aphasia is the result of an injury in all of the following except:
a. frontal left lobe
b. temporal left lobe
c. thalamus
d. brain stem.
e. all of the above
16. There is an association between Guillan Barre Syndrome and all of the following
infections except:
a. HIV
b. EBV
c. CMV
d. Campylobacter
e. Meningococcus
17. A patient with dentoin's poisoning will suffer from all of the following except:
a. confusion.
b. nausea
c. Nistagmus
d. Global aphasia
e. ataxia
18. All of the following are symptoms of Myasthenia gravis except:
a. double sided petocis.
b. Speech impediment
c. Autonomic disturbances.
d. eyeball movement disturbances.
e. muscle weakness.
19. A patient with Agraphesthesia:
a. Can't hold a pen.
b. Can't write.
c. Can't read
d. Can't tell the difference between Hebrew and English.
e. Can't identify letters which are written on his hand.
20. While entering the examination room, you shook hands with a 24 year old patient.
You've noticed a slow relaxation and a too long muscle contraction.
a. it's probably an insignificant mental response.
b. we should check K+ blood levels.
c. we should examine for cataract
d. we should perform Tenzilon test.
e. this symptoms occurs in Polymyositis
21. The spinal fluid in the typical viral meningitis will look like:
a. High protein level and low sugar level.
b. high protein level and normal sugar level .
c. normal protein level and low sugar level.
d. low protein and sugar levels.
e. low protein level and high sugar level.
22. all of the following medications can prevent a stroke except:
a. Beta blockers.
b. aspirin.
c. Plavix Clopidogrel
d. Coumadin
e. Statins
23. Which of the following causes a reversible cognitive degeneration:
a. lack of vitamin B12
b. Hypotheroidizm.
c. Normal pressure hydrocephalus
d. Chronic subdural hematoma
e. all of the above.
24. Amyotrophic lateral sclerosis involves:
a. The Upper motor neuron alone.
b. Lower and upper motor neuron.
c. Lower and upper motor neuron, and the Peripheral nerve
d. Lower and upper motor neuron, Peripheral nerve and Cerebellum
e. Lower and upper motor neuron, Peripheral nerve , Cerebellum and Basal ganglia.
25. Which of the following is not true about Subdural hemmorage:
a. It is often a random finding amongst alcoholics.
b. a distinguishing diagnosis of dementia.
c. may be a complication of an Anticoagulant treatment
d. it is an arterial hemmorage.
e. can be acute, sub acute or chronic.
26. In the Creutzfeldt –Jakob:
a. there are hyper intensive lesions in the CT in the thalamus.
b. it is always a sporadic disease
c. EEG shows Generalized periodic complexes.
d. There is usually plaucitusis in the CSF
e. The treatment in steroids slows the advancement of the disease.
27. Seizures can be caused in all of the following situations besides:
a. Hypoglycemia
b. Hyponatremia
c. Hypoclazemia
d. Lack of vitamin B6
e. Hyperclemia
28. Which of the following is not a known risk for the advancement of Holtzheimer's
disease?
a. old age
b. poor education
c. APOE4
d. Exposure to anti inflammatory medications from NSAIDS.
e. female gender.
29. The treatment of choice for polymyositis:
a. Intravenous immunoglobulin ( IVIG)
b. Azathioprine
c. Plasma paresis
d. Thymous- ectomy
e. Cortico-steroid
30. hemorrhagic difference due to CVA is:
a. a thrombotic accident which was priored by many TIA events.
b. a thrombotic event treated with aspirin
c. a brain emboly
d. a brain seiziure evolving in spasm
e. all of the above
31. A 28 year old patient is incapable of moving her right eye to the left. All other eye
movements are normal.
a. the disturbance is caused from left frontal injury.
b. The disturbance is caused from left occipital injury
c. The disturbance is caused from left internal capsule injury.
d. The disturbance is caused from right Mesencephalon injury.
e. none of the above.
32. proliferation of inflammation cells in CSF are in all of the following situations except:
a. Bacterial meningitis.
b. Viral meningitis
c. Myelitis
d. Poliomyelitis
e. Demyelinating polyradiculoneuropathy
33. In a CT scan on a patient that arrived with a lower body paralysis of 4 hours, everything
was normal.
a. We can rule out inner brain hemorrhage.
b. we can diagnose a brain emboli.
c. We can rule out a thrombotic brain accident
d. The injury has to be in the upper cervical spinal chord, otherwise we could have seen the
blockage
e. none of the above.
34. Which of the following is a characteristic of hydrocephalus with normal pressure?
a. cerebral disturbances
b. Urine retination
c. Sensory and motoric dysphasia
d. urine lickage
e. walking on a wide base.
35. the clinical symptom to distinguish between bulbar- paralysis and pseudo-bulbar
paralysis is :
a. a two sided Bibensky
b. spastic hands
c. dysarthriea
d. pharyngeal reflax ( "gag reflax"??)
e. dysphagia
36. An 80 year old fell down the stairs, walked and kept walking. Two weeks afterwards, his
wife noticed changes in his personality. He started to drag his right leg and his behavior
changed. The pathology is most likely caused by and injury of the:
a. Bridging veins in the durra to the left .
b. In the Middle meningeal artery to the left.
c. in the Left Posterior cerebral artery
d. in the Left Middle cerebral artery
e. left anterior cerbellar artery.
37. A 40 year old got to the ER because of a sudden headache and vomiting, and
complained about pains in the neck. During his check up he was conscious and vague, had a
fever of 39, a pulse of 110. Meningial irritation signs. A brain CT scan is normal. Lumber
puncture showed 2000 cells, PMN 95%, protein 150 mg%, suger 30 mg %. The urgent test
you should ask for is:
a. Gram staining
b. india-ink staining
c. PCR for Herpes Simplex
d. a direct staining for Ziehl-Neelsen
e. blood test for anti- HIV Immunoglobulin
38. A 50 year old turned to the clinic because of slow cognition and physical activity. His
right hand was shaking as long as he wasn’t performing intentional tasks. The most
reasonable diagnosis is:
a. Parkinson's disease.
b. Bascular Parkinsonism.
c. Holtzheimer's disease with Extrapyramidal signs.
d. Primary cerebellar atrophy
e. Lewy body dementia
39. Which of the following complications does not appear after Subarachnoid hemorrhage?
a. a repeating Subarachnoid hemorrhage
b. Hydrocephalus
c. Spasms
d. brain blockage as a result of blood vessel spasm.
e. inner brain hemmorage.
40. In an EMG exam and muscle disease conductance which are congenital there is:
a. a higher conductance than the normal.
b. the potentials are higher and wider than the normal
c. recruit of slow units
d. There is a preliminary interference
e. all of the above.
41. A 25 year old, 28 weeks pregnant, has vomited a lot during her pregnance. She turned
to the ER because of lack of balance during the past 2 days and double vision during the last
day. During the test – fever 36, partial conscious. Paralysis of the bilateral sixth nerve and
nistagmus in all directions. Which of the following tests can be pathological and advance
your diagnosis?
a. PCR for herpes simplex.
b. Lumbar puncture for protein level
c. B1 level at serum.
d. B12 level at serum.
e. B6 level at serum
42. Myasthenia gravis is;
a. a peripheral nerve disease.
b. caused due to an immperd k+ channels
c. a straieated muscle disease.
d.is a disease impering the postsynaptic part of the nerve-muscle synapse.
e. a mitochondrial disease.
43. a clear indication for the need of Anticoagulants treatment for a CVA patient, is:
a. Atrial fibrillation
b.an acclearating hypertension
c. a lacunnar obstraction, pure motor stroke
d.more then 70% stenotic contra-lateral internal carotid artery.
e. ischemic events due to Temporal arteritis
44. The most common place for inner hemorrhage due to high blood pressure is:
a. frontal
b.parielta
c.corpus colosom
d. basal ganglia (putamen and thalamus)
e. mesencephalon
45. Which of the following is true in a peripheral paralysis of the facial nerve?
a. weakness in the trapezius
b. There is a need to consider steroids treatment.
c. Commonly appears with hearing decrease.
d. There is an extensive tear secretion .
e. the paralysis is mostly in the upper part of the face.
46. A patient is paralyzed in 4 limbs and inert , but he is capable of communicating with his
environment with blinking and vertical eye movements. In which state is he in?
a. vegetative.
b. Psychogenic unresponsiveness
c. Locked in syndrome
d. Coma due to diffusion anceplopatia
e. Stopor due to Herpes simplex encephalitis
47. Epidural hemorrhage is:
a. a result of vein hemorrhage.
b. sometimes spontaneous
c. usually accompanied by skull fracture
d. a result of aneurysm that exists and a rising blood pressure.
e. treated by nymodiphyn (nymotop)
48. In a state of acute oculomotor nerve palsy, which of the following clinical findings is
useful for a differentiating diagnosis between post communicating artery injury and diabetes
injury?
a. The amount of pain
b. The involvement of the eyeball
c. The side of the injury
d. The harshness of the eyelids drup
e. CVA's existence in the past.
49. it is unreasonable to find __________ in pseudo-bulbar syndrome
a. dysphgia
b.dysarthriea
c.di-plopya
d.uncontroled cry and laughter burst (:
e. hyper Jaw-jerk reflax
50. there is no ___________ in ALS ( =motor neurn disease):
a.muscle atrophy
b.dysphagia
c. respiratory distress
d. pyramidal signs.
e. sphincters disfunction
51. a new CVA in the right hemi-sphere due to carotid artery blockage will not cause:
a. left sided both eyes deviation
b.Anosognosia
c. central paralysis of the left face
d. Babinski sign on the left.
e. damage to the left vision-field
52. what is correct concerning epileptic seizures with a fuckalic start (Partial seizures)
a. does'nt go on secondary including
b. mostly idiopathic
c. mostly caused by metabolic reasons.
d. usually includes the Absences which appear over Petit Mal in kids
e. calls for Underlying pathology search in tomographic radiology.
53. a significant advantage of the Pnituin over volforic acid is:
a. Pintuin does'nt cause tongue hypertrophy
b.Pintuin has a broader span of anti epileptic effect
c.Pintuin can be given inter venous
d.Pintuin is more effective against mucolonic epilepsy in children.
e.Pintuin causea less nistagmus and ataxia
54. the most common muscular disease in adults is :
a. Duchenne muscular dystrophy
b. dermatomyositis
c. mitochondrial myopathy
d.myotonic dystrophy
e. distal myopathy
55. what is correct concerning the Benign intracranial hypertension
a. common among old and too skiny ladies
b. clinically manifested with Dementia, Ataxia, and sphincter dysfunction
c. L.P show almost 100mg% protein
d. is a reason for not doing L.P
e. might response to treatment with Diamox( Acetazolamid)
56. The common treatment for Herpes simplex encephalitis is:
a. Steroids through the vein
b. Plasmapharsa
c. Immunoglobulin into the vein
d. Zovirax (Acyclovir) into the vein
e. wide range Antibiotics through the vein.
57. A 72 year old has been suffering from high blood pressure and diabetes for 7 years. For
the past 3 hours he is suffering from weakness in the hand and in the right leg, the mouth's
side is sloping. He cannot explain what's going on. According to his wife, he doesn't answer
the questions that she asked him. The most reasonable diagnosis is:
a. Brain seizure in the area of the blood supply of the middle cerebral artery to the left.
b. Brain seizure in the blood supply area of the basilar artery.
c. Sub arachnoids hemorrhage.
d. sub Dural hemorrhage.
e. The process is taking place in the left hemisphere.
58. An 18 year old male returns from a trip to china, and suffers from stomach aches and
diarrhea. Two weeks after his return, he has back aches and a growing weakness in his
limbs. There is no limb reflex. Bilateral peripheral facialis, without sensory interruption.
Which of the following is unlikely to appear within the man?
a. F waves in a long conductance tests.
b. In an EMG test, potentials are narrow and short.
c. The protein level is higher than the normal in CSF.
d. The brain image in the CT scan is normal
e. in the pulse registry there are significant changes between techicardia and bardicardia.
59. Which of the following treatments is not recommended in the case mentioned above?
a. steroids
b. plasmapharasis.
c. inner vein Immunoglobulin
d. Physiotherapy
e. a follow up after the heart bit.
60. The speech impediment is most likely from:
a. Broca aphasia
b. Conduction aphasia
c. Wernicke aphasia
d. Global aphasia
e. Disarterya
61. An 18 year old was invoved in a car accident and suffered from a severe head trauma.
In a computed tomography of the brain (CT) was found an injury to the two temporal lobes.
5 years after the injury it is probable that the harshest cognitive deficiency will be in:
a. Anterograde amnesia
b. Retrograde amnesia
c. Procedural memory
d. a and c are true
e. a and b are true.
62. A 60 year old forget words. According to his wife he repeats the same question over
and over again. Over a year ago he hit his head. His job offers an early pension. Checking
his mental state – he cant remember the day, month and year, partially familiar with space.
His serial range (100-7) is normal, the digit span and naming is flawed. CT of the brain
demonstrates placed pathology. The reasonable diagnosis for this age is:
a. CVA in the posterior cerebral artery.
b. subdural hematoma
c. dementia
d. Transient global amnesia
e. Delirium
63. Anatomically, the damaged areas when a patient suffers from object visual agnosia are:
a. The temporal lobes
b. Occipito parietal cortex
c. Occipito temporal cortex
d. Uncinate fasciculus
e. Orbito frontal cortex
64. Amnestic Syndrome is characterized by of the following except:
a. difficulty in receiving new information – anterograde memory deficiency
b. general intellect and procedural memory are normal.
c. decent in general intellect and procedural memory
d. Retrograde memory deficiency.
e. there is often confabulation
65. Donepezil (Aricept) to treat Holzheimer patients works in the following way:
a. operating the nicotine cholinergine receptors.
b. operating the moscraine cholinergine receptors.
c. Delay of the Choline acetylase enzyme.
d. Delay of the Acetylcholinesterase enzyme.
e. Pre synaptic operation in order to increase eztilecolin.
66. An 18 year old girl is brought to the ER with parapharases and disturbances in the
sphincters . two weeks earlier she had the flue. In the test, they found sensory reactions to
D6. Which of the following diagnosis and treatment are best suited?
a. Epidural – abscess; immediate surgery needed
b. thorasic hernia; a surgery should be considered.
c. cord compression due to a tuomor. Radioteraphy to the spinal cord should be considerd,
at D8-D4
d. anterior spinal occulision due to blockage of the spinal cord. Should be treated with
heparin.
e. Transverse Myelitis. Treatment: steroids.
67. A 45 year old woman complained about involuntary head and neck spins and pains in
the shoulder and the neck. In the check up – she tonally turns her neck to the left, lifts the
right shoulder involuntary, and the right sternoklido mastoid muscle is inflexible. She's
treated with anticholinerges. The most likely diagnoses is:
a. Parkinson.
b. Essential tremor
c. Myoclonus
d. Dystonia
e. Gilles de la Tourette syndrome
68. A test on a patient with parasthesis in the legs for nerve conductance was normal, and
the amplitude of the potential low. The findings are explained by:
a. Severe Demyelination.
b. Axonal lesion
c. disconnection of the nerve fibers.
d. Technical problem – the electrode is not placed correctly.
e. none of the above.
69. Which of the following is true about Multiple Scleroses?
a. finding oligoclons in the CSF are needed for certain observation.
b. treatment with co-polymer 1 ( Copaxon) has been proven in preventing farther
regression, in a chronic progressive manner.
c. has been proven to be an autoimmune disease. An Ig against myelin.
d. high dose of steroids is effective in treating acute seizure.
e. all of the above.
70. Lacunae blockage can be expressed in each of the following clinical syndromes, except:
a. Pure Hemiparesis
b. Pure sensory stroke
c. Hemianopsia
d. Ataxic hemiparesis
e. Dysarthria and clumsy hand
71. A 50 year old suddenly collapsed on the street and was brought to the ER. While
unconscious, pin point pupils respond to light, we cant produce Doll's eye movements. The
limbs are paralyzed, hyperpnoea and decerebrate movements. The most reasonable
diagnoses is:
a. Hemorrhage in the pons area.
b. subdural hemorrhage
c. Bassel ganglia hemorrhage
d. Sub arachnoids hemorrhage
e. Epidural hemorrhage
72. Which of the following is not true about Myasthenia gravis:
a. There is acetylcholine receptors in the blood of most of the myasthenia patients.
b. The lack of immunoglobulin in a sick person suffering from muscle weakness rules out
this diagnosis.
c. In patients where the disease is limited to the eye muscles it is hard to find
immunoglobulin in the blood.
d. These immunoglobulin here are completely different than those in the muscle fibers.
e. These immunoglobulin are specific for the myasthenia gravis disease.
73. Alpha activity in the areas of the back of the brain which is blocked while opening the
eyes is:
a. A clear sign for epilepsy tendency.
b. is found only in 10% of the population
c. Is normal
d. raises suspicion as to the existence of occipital growth
e. is found in all ages.
74. What is the preferred treatment in an optic neuritis attack?
a. IV high dose methylprednisolone
b. Prednisone
c. Interferon B
d. Azathioprine
e. Methotrexate
75. How will you define the following epilepsy in a 17 year old boy: Starts with an
uncomfortable sensation in the epigastric, then disconnection from the environment,
complete disregard to instruction, stair at the air, performs licking and sucking movements,
plays repeatedly with the shirt with the right hand while the left hand is not moving. Except
the sensation in the epigastric, the patient remembers nothing of the attack. Walks around
the room with no defined direction. What kind of attack does the patient has?
a. the seizure he's having will not evolve into a tunic colonic seizure.
b. the seizures are myo-clonic.
c. simple partial seizure.
d. complex partial seizure.
e. generelaised tonic colonic seizure.
76. Which of the following is true for pseudotumor cerebri?
a. Can be caused as a result of beta blockers treatment.
b. in a CT scan, the rooms are usually enlarged.
c. can significantly damage the sight.
d. most cases must be treated with Shunt.
e. caused by a tumor in the posterior fossa
77. A 72 year old woman, suffering from high blood pressure, has suffered a few sudden
falls, without losing consciousness but with a sudden loss of leg strength during the past few
weeks. She immediately returns to herself. She takes Diuretic against high blood pressure
and ibuprofen for arthritis in the hips. In the exam: blood pressure 140/80 mmHg, 130/75
while standing up. The neurological and physical exams are normal. The reasonable
diagnosis is:
a. Carotid transient ischemic attacks.
b. Epileptic attacks
c. Drop attacks
d. Postural syncope because of the drugs
e. vestibular injury in the inner ear.
78. A 50 year old woman complains on a growing weakness in the hands and numbness. In
the exam: Atrophy of the small hand muscles, many scars after burns in the fingers,
disturbances in temperature sensors and pain. Vibrational touch is normal. The reasonable
diagnosis is:
a. Amyotrophic lateral sclerosis
b. Syringomyelia
c. Tumor of the cervical vertebrae compressing the spinal cord
d. Diabetic myelopathy
e. Peripheral polyneuropathy
79. A 55 year old patiend suffers from a headache for the past week. The pains appear
daily, sometimes more than once. They wake him up from the sleep and last between 15 –
30 minutes. He is hurting around the right eye and the forehead to the right. There is
tearing in one eye and the nostril is shut on the same side. Two years ago he suffered from
similar symptoms for 4 weeks. The reasonable diagnosis is:
a. Migraine without aura
b. Tension headache
c. Chronic paroxysmal hemicranias
d. cluster headache
e. Sinusitis right maxillar.
80. The drugs that depress the decarboxylase enzyme, and given with L-dopa for the
Parkinson disease:
a. prevent turning the L-dopa to dopamine in the brain.
b. prevent turning the Dopamine to Noradrenaline in the brain
c. prevent turning L-dopa to Dopamine in the periphery.
d. Prevent turning the dopamine to noradrenaline in the periphery.
e. none of the above.
81. In a neuron motor disease, which is true?
a. Auto immune disease.
b. There is immunoglobulin against nuclear substance of the neuron.
c. described as a pre neo plastic syndrome
d. mostly caused by a DNA virus
e. in the EMG, the unit recruit is faster than usual.
82. who's epileptic?
a. 17 year old boy, in coma in the ER, due to serious head injury. Had 4 tonic colonic seizures
during the first 5 days after the injury.
b. a 75 year old man with hypernatremia ( 114milimolar) due to treatment with diuretics.
He came to the ER due to 3 tonic colonic seizures in the month before.
c. a 35 year old woman who came to the ER due to Pre-eclampsia during pregnancy, during
which she had 2 epileptic tonic colonic seizures.
d. a 15 year old girl, arriving at the ER after atonic colonic seizure, for the first time in her
life. She had two heat spasm seizeurs during her early childhood.
e. a 10 year old girl, who's been having absence seizure – once in a week, for the last 3
months.
83. Which of the following does not cause Ptosis?
a. Myasthenia gravis
b. Thyroid eye disease
c. Mytochondrial myopathy
d. Horner's syndrome
e. Diabetic 3rd nerve palsy
84. A 45 year old man came to the ER because of a series of cramps. There is no history of
spasms. Which of the following is not likely to cause the attacks?
a. Hypoglycemia
b. Brain tumor
c. Subarachnoid hemorrhage
d. Hyponatremia
e. Brain abscess
85. A 65 year old diabetic woman, developed a weakness of the facial muscles to the left
and of the right limbs. She also complains about double vision and in the test there is a
convergenetic strabismus of the left eye. The injury is probable placed near the:
a. Right hemisphere of the brain.
b. The inner capsule to the left and mid brain to the left
c. mid brain to the left
d. Pons to the left
e. medial longitudinal fascicle to the right.
86. bi-lateral nipple edema can cause:
a. bi-temporal hemi-anopia
b. mono-ocular blindness.
c. enlargement of the "blind spots"
d.tubular sight
e. cortical blindness.
87. Homonymous hemianopsia can be caused if the following areas are injured except:
a. Occipital cortex
b. Optic radiations
c. Optic chiasma
d. Lateral geniculate body
e. Optic tract
88. a 55 year old arrives at the ER with double vision and weakness in hhs left arm and leg,
What shouldn't we expect to see as well:
a.inner deviation of the right eye
b. decrease of sensation of the right side of the face.
c. weakness in the facial muscles on the left.
d. dizziness
e. hemianopia on the left.
89. All of the following signs fit delirium tremens except:
a. a lot of sweat.
b. shivering
c. visual hallucination
d. dementia
e. agitation
90. A 55 year old man with anamneses of ear infection comes to the ER with high fever and
vomiting. Neurological testing show weakness in the left limbs. What is the probable
diagnosis?
a. Brain tumor
b. Purulent meningitis
c. Brain abscess
d. CVA
e. MS – Multiple Sclerosis
91. An 8 year old boy comes to counseling due to a noticeable decent in school. The kid
showed involuntary movements in the upper limb muscles. An EEG showed epileptic activity
in the shape of periodic outbursts. What is the reasonable diagnosis?
a. Juvenile myoclonic epilepsy.
b. Tourette's syndrome
c. SSPE – subacute sclerosing panencephalitis
d. Chronic subdural hematoma
e. all of the above
92. An AIDS patiend comes to the ER with a cognitive descent, ataxia, and speech
impediment. In an MRI of the brain there are signs of damage to the white matter in the
brain. It is probable that the patient is suffering from:
a. Progressive multifocal leucoencephalopathy (PML)
b. Acute disseminated encephalomyelitis (ADEM)
c. Multiple sclerosis (MS)
d. Herpes simplex encephalitis
e. Poliomyelitis
93. A 50 year old man arrives at the ER with high fever, vomiting and dazed. A pack and a
half of Amoxycillin was found empty in his pocket. Also, Neck rigidity ( ‫)קשיון עורף‬. What
would you do?
a. Start treating with ceftriaxone+ vancomycin IV, Than- brain CT and than LP
b. B. first LP, than brain CT , and than deciding upon treatment according to the results.
c. Brain CT, than LP, than start treating with ceftriaxone.
d. Glucose IV, + steroids+B1 also IV.
e. None of the above.
94. uni-lateral injury to the medulla oblongata will not cause:
a. hoarseness and paralysis of the vocal cord on the same side with the injury.
b. difficualty in rasing the shoulder and turning the head to the contralateral side ot ther
injury.
c. paralysis of the tounge at the same side of the injury and limbs paralysis on the
contralateral side
d. paralysis of gaze on the same side of the injury
e. paralysis of half of the body on the contralateral side, and of the soft palatine on the same
side of the injury.
95. Which of the following is false about epidural hematoma:
a. Caused by trauma
b. Appears in elders due to a light injury.
c. arterial hemorrhage
d. acute hemorrhage
e. accompanied by skull fracture.
96. The most common reason for the development of aneurisms in the blood vessels fount
in the sub arachnoids space is:
a. trauma
b. cognitive flaw
c. Arteriosclerotic process
d. septic emboli
e. syphilis
97. which of the symptoms are additional effect to Bromocriptin
+levodopa+carbidopa+ othe dopamine agonists?
a. dry mouth and problems in vision.
b. urgent urination
c. ortostatic decrease in blood pressure.
d. myalgia + aesnophilia
e. dermatitis
98. In all of the following we can find in the pathology a demyelination myelin injury except:
a. Guillain barre syndrome
b. Poliomyelitis
c. Multiple sclerosis
d. Acute disseminated encephalomyelitis
e. Progressive multifocal leucoencephalopathy
99. The following changes are typical for dementia except:
a. Amnesia
b. Anemia
c. Confusion state
d. Apathy
e. Agnosia
100. in a lumber puncture of a patient with a fever and confusion there is a clear fluid with
350 mononoclear cells, protein 85 mg, glucose 80 mg (when the sugar level in the blood is
105 mg). What is the reasonable diagnosis?
a. Brain tumor
b. Encephalitis
c. Purulent meningitis
d. Brain abscess
e. none of the above
Final Exam Neurology 2004 – Possible Answers
1. a ‫ או‬c?
2. e
3. d
4. a
5. b
6. e
7.d
8. c
9. b
10 . a
11 . b
12 . d
13 . e
14 . c
15 . d
16 . e
17 . d
18 . c
19 . e
20 . c
21 . b
22 . a
23 . e
24 . b
25 . d
26 . c
27 . d,e?
28 . d
29 . e
30 . b?
31 . e
32 . e
33 . a
34 . d
35 . d
36 . a
37 . a
38 . a
39 . e
40 . d
41 . c
42 . d
43 . a
44 . d
45 . b
46 . c
47 . c
48 . b
49 . c
50 . e
51 . a
52 . e
53 . e
54 . d
55 . e
56 . d
57 . a
58 . b
59 . a
60 . e
61 . e
62 . b
63 . b
64 . c
65 . d
66 . e
67 . d
68 . b
69 . d
70 . c
71 . a
72 . b
73 . d
74 . a
75 . d
76 . c
77 . c
78 . b
79 . d
80 . c
81 . e?
82 . e
83 . b
84 . b
85 . d
86 . c
87 . c
88 . e
89 . a?
90 . c
91 . c
92 . a
93 . a
94 . d
95 . b
96 . b
97 . c
98 . b
99 . c (or d)
100 . a