Epidural hematomas are frequently followed by Skull fractures

Ischemic stroke; Craniocerebral trauma

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Ischemic stroke;

  • Craniocerebral trauma.

  • A 36-year old patient reports abrupt back pain which irradiates along the posterior surface of lower limbs. Pain syndrome is exacerbated in the recumbent position which is the reason why patient can't be laying down. Patient has been ill for about 2 years and has undergone inpatient and outpatient treatment of osteochondrosis. Patient has undergone a course of balneotherapy in the sanatorium settings. His status is progressively worsening and the intensity of pain syndrome has increased. What is the preliminary diagnosis?

    1. *Tumor of the cauda equina

    2. Myelopathy

    3. Arachnomyelitis

    4. Consequences of spinal trauma

    5. Multiple sclerosis

  • An 85-year-old man is being evaluated for gait difficulties. On examina­tion it is found that joint proprioception is absent in his toes. People with impaired position sense will usually fall if they stand with their feet together and do which of the following?

    1. Flex the neck

    2. Extend their arms in front of them

    3. Flex the knees

    4. Turn the head

    5. *Close their eyes

  • A 21-year-old woman presents with right arm loss of sensation that has been progressive over a few days. Her physician is concerned that this might be some type of demylinating disorder. A relatively small plaque of demyelination, should be evident on which of the following?

    1. Tl-weighted MR1

    2. *T2-weighted MR1

    3. Precontrast CT

    4. Diffusion-weighted MRI

    5. PET

  • A 67-year-old woman says that she is having problems with dizziness. A more careful history reveals that she has an abnormal sensation of move­ment intermittently Which of the following tests would be most helpful in determining the cause of episodic vertigo?

    1. CSF

    2. C-spine MRI

    3. Visual evoked response (VER)

    4. *Electronystagmography (ENG)

    5. Electroencephalography (EEG)

  • A 42-year-old woman is being evaluated for gait difficulties. On exam­ination, it is found that her ability to walk along a straight line touching the heel of one foot to the toe of the other is impaired. This finding is most common with which of the following?

    1. * Cerebellar dysfunction

    2. Parietal lobe damage

    3. Temporal lobe damage

    4. Ocular motor disturbances

    5. Dysesthesias in the feet

  • A 55-year-old woman is being examined. The clinician notices the presence of fine twitching movements beneath the surface of the tongue and wasting of one side of the tongue. This finding suggests damage to cranial nerve

    1. V

    2. VII

    3. IX

    4. X

    5. *XII

  • A 46-year-old longshoreman complains of lower back pain radiating down the posterior aspect of his left leg, and paresthesias in the lateral aspect of his left foot. This has been present for 6 months. Strength and bowel and bladder function have been normal. Examination would be most likely to show which of the following?

    1. Left Babinski sign

    2. Loss of pinprick sensation over the webspace between the first and second dig­its of the left foot

    3. Hyperreflexia at the left knee jerk

    4. *Hyporeflexia in the left Achilles tendon reflex

    5. Decreased rectal tone

  • A 75-year-old man with a history of recent memory impairment is admitted with headache, confusion, and a left homonymous hemianopsia. He has recently had two episodes of brief unresponsiveness. There is no his­tory of hypertension. Computed tomography (CT) scan shows a right occip­ital lobe hemorrhage with some subarachnoid extension of the blood. An MRI scan with gradient echo sequences reveals foci of hemosiderin in the right temporal and left frontal cortex. The likely cause of this patient's symp­toms and signs is

    1. Gliomatosis cerebri

    2. Multi-infarct dementia

    3. Mycotic aneurysm

    4. *Amyloid angiopathy

    5. Undiagnosed hypertension

  • Within 1 clay of admission, the patient's right-sided weakness began to abate, and within 1 week it completely resolved. On the fourth day of hos­pitalization, the patient abruptly lost consciousness and exhibited clonic movements starting in his right side and generalizing to his left side. The movements stopped within 3 min, but he had residual right-sided weak­ness for 24 h. CT scan was unchanged from that obtained on admission. The most appropriate treatment to institute involves

    1. Heparin

    2. Recombinant tissue plasminogen activator (r-TPA)

    3. Lamotrigine

    4. *Phenytoin

    5. Warfarin

  • A 16-year-old girl with complex partial seizures and mild mental retar­dation has an area of deep red discoloration (port-wine nevus) extending over her forehead and left upper eyelid. A CT scan of her brain would be likely to reveal

    1. Hemangioblastoma

    2. Charcot-Bouchard aneurysm

    3. An arteriovenous malformation

    4. *A leptomeningeal angioma

    5. A fusiform aneurysm

  • A 72-year-old woman has the abrupt onset of right face and hand weakness, disturbed speech production, and a right homonymous hemi­anopsia. This is most likely attributable to occlusion of the

    1. *Left middle cerebral artery

    2. Left anterior cerebral artery

    3. Left vertebrobasilar artery

    4. Right anterior choroidal artery

    5. Left posterior inferior cerebellar artery (PICA)

  • A 35-year-old woman works as a keyboard operator and must type for 6 h per day She is especially susceptible to injury of the

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