Final Exam Practice Questions

A 70-year-old woman presents with dysarthria and motor hemiparesis. Her medical history includes type 2 diabetes mellitus and hypertension. The imaging study revealed an ischemic stroke involving the left frontal lobe. The medical plan would be to give her medication to relieve the clot obstruction. Based on the next possible answers, which is an absolute contraindication for the recommended therapy? Decompression skull surgery 9 months before The history of retinal coagulopathy treated with photocoagulation The symptoms onset < 3h Systolic blood pressure > 200 mmHg

A 70-year-old woman presents with dysarthria and motor hemiparesis. Her medical history includes type 2 diabetes mellitus and hypertension. The imaging study revealed an ischemic stroke involving the left frontal lobe. The medical plan would be to give her medication to relieve the clot obstruction. Following the same clinical case study, what was the recommended treatment? tPA Antiplatelet drug Thrombectomy Aspirin

A 70-year-old woman presents with dysarthria and motor hemiparesis. Her medical history includes type 2 diabetes mellitus and hypertension. The imaging study revealed an ischemic stroke involving the left frontal lobe. The medical plan would be to give her medication to relieve the clot obstruction. Before administering the treatment for the same patient, what imaging study should be obtained? MRI of the brain with gadolinium contrast NCCT of the head Contrast CT of the head X-rays of the skull

A 70-year-old woman presents with dysarthria and motor hemiparesis. Her medical history includes type 2 diabetes mellitus and hypertension. The imaging study revealed an ischemic stroke involving the left frontal lobe. The medical plan would be to give her medication to relieve the clot obstruction. The patient had a good recovery after hours of drug administration. Then, suddenly, the patient’s initial symptoms worsened. Also, new symptoms appeared such as confusion, low blood pressure, and headache. Based on the history of this patient what do you think should be the next step to do? Head MRI Cerebral ultrasound Head NCCT Brain X-ray

The patient had a good recovery after hours of drug administration. Then, suddenly, the patient’s initial symptoms worsened. Also, new symptoms appeared such as confusion, low blood pressure, and headache. What do you think that happened in the previous clinical case after the drug administration? Adverse event of the drug is suspected, intracranial bleeding should be suspected Nothing, this is an expected symptom curve when we talk about ischemic strokes. The patient should recovered and only monitoring is recommended The ischemic stroke worsened and another site of a possible ischemic stroke could be found The penumbra area failed to recovered after treatment and nothing should be done

What is the first test that should be performed when a patient is present in the emergency room with symptoms of a stroke? Complete blod count with fibrinogen measure to evaluate blood clotting Brain CT scan Brain MRI Electrocardiogram to see if the heart is not a possible cause of embolism

A 45-year-old male presents to the emergency department with a sudden onset of neurological symptoms such as dysarthria, mild weakness in his right arm, and low weakness in the right leg. The medical history of this patient is that she had a clotting disease 15 hours ago and was treated with anticoagulants. The NIHSS score is 8 in the physical examination. What would be the first imaging study you would suggest? NCCT of the head MRI of the head MRI angiography Contrast enhanced CT scan

A 45-year-old male presents to the emergency department with a sudden onset of neurological symptoms such as dysarthria, mild weakness in his right arm, and low weakness in the right leg. The medical history of this patient is that she had a clotting disease 15 hours ago and was treated with anticoagulants. The NIHSS score is 8 in the physical examination. There is no changes in the imaging study you suggested. What study would you suggest to perform after 3 hours of onset of symptoms? MRI of the head Ultrasound of the head CT scan of the head X-ray of the skull

A 45-year-old male presents to the emergency department with a sudden onset of neurological symptoms such as dysarthria, mild weakness in his right arm, and low weakness in the right leg. The medical history of this patient is that she had a clotting disease 15 hours ago and was treated with anticoagulants. The NIHSS score is 8 in the physical examination. What artery’s territory would you say is affected in this patient based on the syndrome’s characteristics presented? Middle cerebral artery territory Posterior cerebral artery territory Vertebrobasilar territory Anterior cerebral artery territory

A 72-year-old female is brought to the hospital by EMS after being found unresponsive at home. On arrival, she is noted to have a Glasgow Coma Scale (GCS) score of 10, right-sided facial droop, and right-sided hemiparesis. Additionally, she is unable to follow commands or speak. Bilateral hemianopia. During the neurological assessment, she demonstrates severe dysarthria and no movement of the right side of her body. What could be a close NIHSS score for this patient? 10 35 15 5

What is the primary symptom of Parkinson’s disease? Postural instability Rigidity Resting tremor Bradykinesia

Which of the following is not a characteristic feature of Parkinson’s disease? Excessive appetite Sialorrhea Mood disorders REM sleep disorder

What is the estimated prevalence of Parkinson’s disease in individuals above 60 years of age? 2% to 3% 1% to 2% Less than 1% More than 3%

Parkinson’s disease is primarily associated with the loss of which type of neurons in the substantia nigra? Cholinergic neurons Carbadopaminergic neurons GABAergic neurons Dopaminergic neurons

Which environmental factor has been linked to an increased risk of Parkinson’s disease? Exposure to pesticides and herbicides Regular exercise Consumption of green leafy vegetables Adequate sunlight exposure

What is the major component found in Lewy bodies, a characteristic histopathological feature of Parkinson’s disease? Glial fibrillary acidic protein Beta-amyloid protein Tau protein Alpha-synuclein

According to the proposed staging scheme by Braak and colleagues, which brain region is affected earliest in Parkinson’s disease? Basal forebrain Locus ceruleus Dorsal motor nucleus of the vagus Substantia nigra

Which of the following is not considered a prominent feature of Parkinson’s disease in the clinical examination? Slowness (bradykinesia) Gait disturbance Cerebellar dysfunction (loss of coordination) Tremor

Pharmacologically, which medication is typically used in the treatment of Parkinson’s disease to improve CNS bioavailability of levodopa? Carbidopa Pramipexole Amantadine Selegiline

What treatment approach is increasingly used for advanced Parkinson’s disease patients who do not respond well to medication? Transcranial magnetic stimulation Electroconvulsive therapy Cognitive behavioral therapy Deep brain stimulation

A 68-year-old male presents to the clinic with a complaint of tremors in his right hand that worsen at rest but improve with intentional movements. He also reports a gradual onset of slowness in movement and stiffness in his limbs. Which of the following symptoms is most suggestive of Parkinson’s disease? Resting tremor Muscle weakness Slowness in movement Stiffness in his limbs

A 55-year-old female visits her physician with constipation, excessive drooling, and difficulty sleeping. Upon further evaluation, the patient is noted to have complaints of unilateral bradykinesia and rigidity on physical examination. The neurological evaluation reports moderate cognitive impairment. Which of the following conditions is most likely causing her symptoms? Parkinsonism Stroke Parkinson’s disease Alzheimer’s disease

A 70-year-old man presents with a history of gradually worsening gait disturbance characterized by shuffling steps, reduced arm swing, and difficulty with turning. He also reports a feeling of stiffness in his limbs, especially upon waking up in the morning. Which of the following features is most commonly associated with advanced Parkinson’s disease? Excessive daytime sleepiness Freezing of gait Hypersalivation Unresponsive face

What is the most common type of dementia, accounting for at least two-thirds of cases in people aged 65 and older? Parkinson disease Alzheimer’s disease Vascular dementia Lewy body dementia