The cauda equina is located? A) At the end of the spinal cord below the first lumbar vertebra B) At the beginning of the spinal cord above the atlas C) Between vertebrae D) In the cerebellum
A) At the end of the spinal cord below the first lumbar vertebra
Patient with lesion in internal capsule has clinical picture: A) Corticospinal tract, Spinothalamic tract and Dorsal Column tract – all contralateral B) Spinothalamic - ipsilateral, Corticospinal tract and Dorsal Column tract – contralateral C) Dorsal column tract – ipsilateral, Spinothalamic tract and Corticospinal tract – contralateral D) Corticospinal tract – ipsilateral, Spinothalamic tract and Dorsal Column tract – contralateral
A) Corticospinal tract, Spinothalamic tract and Dorsal Column tract – all contralateral
The brainstem consists of the? A) Cerebellum, cerebrum and spinal cord B) Dura mater and the pia mater C) Thalamus and hypothalamus D) Pons, midbrain and medulla oblongata`
D) Pons, midbrain and medulla oblongata`
Spasticity is: A) Central lesion B) Peripheral lesion C) None of the answers are correct D) Both peripheral and central lesion
A) Central lesion
Main nerve of sacral plexus is: A) Femoral B) Iliohypogastric C) Median D) Pudendal
D) Pudendal
How many pairs of cranial nerves are there in the nervous system? A) 12 B) 16 C) 10 D) 24
A) 12
Syringomyelic syndrome A) loss of fine touch sensation B) loss of position and vibration sense C) loss of pain and temperature sensation D) loss of vibration and pressure
C) loss of pain and temperature sensation
Complete spinal cord I transverse lesion of spinal cord at the cervical level may produce the following syndrome: A) Tetraplegia B) Hemiplegia C) Monoplegia D) Paraplegia
A) Tetraplegia
Dermatom is: A) None of the answers are correct B) Muscles, which are supplied by one spinal nerve (anterior root) C) Sensitive segment of skin supplied by one spinal nerve (posterior root) D) Both answers are correct
C) Sensitive segment of skin supplied by one spinal nerve (posterior root)
Which part of the brain regulates heartbeat, breathing and other vital functions? A) Gray matter B) Brainstem C) Occipital lobe D) White matter
B) Brainstem
The term hypesthesia refers to? A) Impairment of consciousness B) Sensation of tingling, prickling, etc C) Lessening of sensitivity to sensation D) Decreased sensitivity to pain
C) Lessening of sensitivity to sensation
Spinal cord hemisection syndrome (Brown - Séquard syndrome) A) Pain and thermal sensation affected at the ipsilateral side of the body below the level of the lesion (spinothalamic tract) + position and vibration sense affected on the opposite side of the lesion( posterior column tract) + motor paralysis below the lesion level contralaterally B) Pain and thermal sensation affected at the contralateral side of the body below the level of the lesion (spinothalamic tract) + position and vibration sense affected on the same side of the lesion( posterior column tract) + motor paralysis below the lesion level ispilaterally C) Pain and thermal sensation affected at the contralateral side of the body below the level of the lesion (spinothalamic tract) + position and vibration sense affected on the same side of the lesion( posterior column tract) + motor paralysis below the lesion level contralaterally D) Pain and thermal sensation affected at the ipsilateral side of the body below the level of the lesion (spinothalamic tract) + position and vibration sense affected on the opposite side of the lesion( posterior column tract) + motor paralysis below the lesion level ipsilaterally
B) Pain and thermal sensation affected at the contralateral side of the body below the level of the lesion (spinothalamic tract) + position and vibration sense affected on the same side of the lesion( posterior column tract) + motor paralysis below the lesion level ispilaterally
Internal opthalmoplegia: A) Mydriasis (dilated, enlarged pupil) absent reaction to the light (both direct and indirect), absent accommodation B) Characterized by double vision (diplopia), ptosis, divergent strabismus, inability of movements upwards, inwards and partially downwards C) Lesion of abducens nerve D) Sympathetic fibers are involved
A) Mydriasis (dilated, endlarged pupil) absent reaction to the light (both direct and indirect), absent accommodation
The presence of ptosis suggests damage to cranial nerve: A) III B) IV C) VII D) V
A) III
In case of ischemic lesion of nervus facialis (N.VII) nucleus in the brainstem: A) Both branches for upper and lower part of the face are affected B) Just lower part of the face, because the upper part is supplied from the corticobubar tract of the other side C) Just the upper part of the face, because the lower part is supplied from the cortibulbulbar tract of the other side D) None of the answers is correct
A) Both branches for upper and lower part of the face are affected
The presence of lagophthalmos suggests damage to cranial nerve: A) V B) III C) IV D) VII
D) VII
Muscle rectus lateralis oculi is innervated by: A) Trigeminal nerve B) Oculomotor nerve C) Trochlear nerve D) Abducens nerve
D) Abducens nerve
The damage to IX, X & XII cranial nerves produce: A) bulbar palsy B) pseudobulbar palsy C) Argyle-Robertson syndrome D) Brown-Sequard syndrome
A) bulbar palsy
Central lesion of nervus facialis (N.VII) is: A) Just lower part of the face, because the upper part is supplied from the corticobubar tract of the other side B) Just upper part of the face, because the lower part is supplied from the cortibulbulbar tract of the other side C) Both branches for upper and lower part of the face, because they are supplied from the corticobulbar tract from same side D) None of the answers is correct
A) Just lower part of the face, because the upper part is supplied from the corticobubar tract of the other side
Central – Disharmonic syndrome: A) No correlation between the direction of nystagmus and tonic deviations B) All the above answers are correct C) Causes: Meniers disease, vestibular neuronitis, acute labyrinthitis, benign paroxysmal vertigo D) Vertigo is always severe
A) No correlation between the direction of nystagmus and tonic deviations
Peripheral – Harmonic vestibular syndrome: A) All the above answers are correct B) Affections of the labyrinth and vestibular nerve C) Rotatory vertigo, often severe + horizontal / horizontal-rotatory nystagmus D) All deviations have the same direction to the side of the affected vestibular apparatus including the slow components of nystagmus
A) All the above answers are correct
Muscle rectus superior oculi is innervated by : A) Abducens nerve B) Trochlear nerve C) Trigeminal nerve D) Oculomotor nerve
D) Oculomotor nerve
We will evaluate/assess the paresis: A) By Taxe B) By Mingazzini C) By Deep tendon reflex D) By Babinski
B) By Mingazzini
Failure of muscle coordination, including unsteady movement, due to disorders in the cerebellum is called? A) Parapledia B) Ataxia C) Dyslexia D) Anoxia
B) Ataxia
Babinski and hoffman are tests to evaluate? A) Motor coordination B) Reflexes C) Response to pain D) Gait
B) Reflexes
After observing a normal gait, you can conclude that which of the following are intact? A) All the above B) Vestibular function C) Sensory D) Motor
A) All the above
As part of the neurological exam you have the patient stand straight with eyes closed to examine the sway. What is this called? A) Hautant B) Mcmurray C) Pronator D) Rhomberg
D) Rhomberg
The Locked-in syndrome is: A) It is a complete paralysis of the body resulting from a lesion in the brainstem. Oral and gestural communications are impossible but patients are often able to blink and move the eyes. Despite the fact that the patients cannot move, their sensations are still intact and they are fully aware of their environment and themselves B) The eyes are open, either spontaneously or after stimulation. The sleep–wake cycles are characterized by alternating phases of eye opening, patient is able to perform a variety of movements, such as grinding teeth, blinking and moving eyes, swallowing, chewing, yawning, crying, smiling, grunting or groaning, but these are always reflexive movements and unrelated to the context. Motor behavior is reduced to a few stereotyped or reflexive movements and is inadequate compared to the intensity of the stimulation C) None of the answers is correct D) It is a state of non-responsiveness in which the patients lie with eyes closed and cannot be awakened even when intensively stimulated
A) It is a complete paralysis of the body resulting from a lesion in the brainstem. Oral and gestural communications are impossible but patients are often able to blink and move the eyes. Despite the fact that the patients cannot move, their sensations are still intact and they are fully aware of their environment and themselves
The Wernicke’s area is located in the lobe: A) Frontal B) Temporal C) Occipital D) Parietal
B) Temporal
MMSE is an examination evaluating: A) Delirium B) IQ C) Level of consciousness D) Cognitive impairment
D) Cognitive impairment
Conduction aphasia A) Lesion involves the arcuate fasciculus B) Impaired repetition and naming C) All the above are correct D) Spontaneous speech and comprehension are preserved
A) Lesion involves the arcuate fasciculus
A brain disorder marked by gradual deterioration of mental capacity, memory impairment and confusion is known as A) Tourette syndrome B) Alzheimer disease C) Cerebral palsy D) Myasthenia gravis
B) Alzheimer disease
GCS of a comatose patient is A) Less than 3 B) 13-15 C) 11 D) 3-8
D) 3-8
Persistent vegetative state (apallic syndrome) A) Occurs at mild brain injury B) Lack of cortical activity, brainstem functions such as spontaneous respiration, pulse, blood pressure are preserved C) Cognitive and motor functions are normal D) Patient is aware of self and environment
B) Lack of cortical activity, brainstem functions such as spontaneous respiration, pulse, blood pressure are preserved
Expresive (Broca´s) aphasia is: A) Patient speaks fluently, but the words often do not make sense B) It is hard to find/use the correct name for particular objects, people, places or events C) Patient can not speak or understand speech D) Patient understand what we are talking about, but He/She is not able to speak (can not find the words)
D) Patient understand what we are talking about, but He/She is not able to speak (can not find the words)
GCS of a comatose patient is A) 7 B) 12 C) 15 D) Less than 3
A) 7
Clinical picture of patient with damage of the occipital lobe is: A) Personality and behavior change, motor abnormalities, speech and language disorders, impairment of cognitive functions B) Disorder of motoric and sensitive cortex C) Vision problems D) By Neglect syndrome
C) Vision problems
Hemiplegia, hemianesthesia & hemianopia develop together with disease in the: A) cerebellum B) spinal cord C) internal capsule D) brainstem
C) internal capsule
Brown-Sequard syndrome develops with the following damage of the spinal cord: A) half transversal B) posterior horns C) anterior horns D) complete transversal
A) half transversal
Gerstmann's syndrome A) Left – right confusion, Finger agnosia, Acalculia, Agraphia B) Left – right confusion, expressive aphasia, neglect syndrome, agraphia C) Left – right confusion, dyslexia, Acalculia, global aphasia D) Alexia, retrograde amnezia, dyscalculia, neglect syndrome
A) Left – right confusion, Finger agnosia, Acalculia, Agraphia
The Broca’s area is located in the lobe: A) Frontal B) Parietal C) Temporal D) Occipital
A) Frontal
Coup injury is: A) both sides of the impact B) directly under the side of the impact C) lateral side of the impact D) opposite side of the impact
B) directly under the side of the impact
Intracerebral hematom A) Traumatic tearing of bridging veins B) Traumatic tearing of the art. Carotis externa C) Traumatic tearing of dural artery, usually the middle meningeal artery D) Tearing of the small blood vessels, most often within contusions of the frontal or temporal lobe
D) Tearing of the small blood vessels, most often within contusions of the frontal or temporal lobe
Epidural hematom A) Traumatic tearing of bridging veins B) Traumatic tearing of the art. Carotis externa C) Tearing of the small blood vessels, most often within contusions of the frontal or temporal lobes D) Traumatic tearing of dural artery, usually the middle meningeal artery
D) Traumatic tearing of dural artery, usually the middle meningeal artery
Brain herniation is: A) All answers are correct B) Is a potentially deadly side effect of very high pressure within the skull that occurs when a part of the brain is squeezed across structures within the skull C) Just tonsillar herniation, also called downward cerebellar herniation, transforaminal herniation, or "coning", the cerebellar tonsils move downward through the foramen magnum possibly causing compression of the lower brainstem and upper cervical spinal cord as they pass through the foramen magnum D) Just uncal herniation, a common subtype of transtentorial herniation, the innermost part of the temporal lobe, the uncus, can be squeezed so much that it moves towards the tentorium and puts pressure on the brainstem, most notably the midbrain
A) All answers are correct
Subdural hematom A) Tearing of the small blood vessels, most often within contusions of the frontal or temporal lobes B) Traumatic tearing of the art. Carotis externa C) Traumatic tearing of bridging veins D) Traumatic tearing of dural artery, usually the middle meningeal artery
C) Traumatic tearing of bridging veins
A specialized cell which conducts nerve impulses is called a / an ? A) Proton B) Epithelial cell C) Neuron D) Glial cell
C) Neuron
The affection of cerebellar may produce any of the following EXCEPT: A) dysmetria B) nystagmus C) dyspraxia D) ataxia
C) dyspraxia
Which of the following is not an example of a deep tendon reflex? A) Brachioradialis B) Gag C) Biceps D) Achilles
B) Gag
Testing a patient’s toe reflex to see if toes curl with the pressure of an object is called: A) Mc Murrays test B) Robiniskis test C) Osgood Schlatters test D) Babinskis test
D) Babinskis test
The inability to use or understand spoken or written language because of a bran lesion is known as ? A) Aphasia B) Anosmia C) Dyslexia D) Dysphagia
A) Aphasia
Babinski response, usually develops with damage in: A) lower motor neuron B) cerebellum C) peripheral nerves D) upper motor neuron
A) lower motor neuron
The presence of lagopthalmus suggests damage to cranial nerve: A) III B) VII C) IV D) V
B) VII
Main nerve of lumbar plexus is: A) Ulnar B) Iliohypogastric C) Femoral D) Sciatic
C) Femoral
Main nerve of brachial plexus is: A) Femoral B) Iliohypogastric C) Median D) Pudendal
C) Median
Superior oblique muscle is innervated by : A) Trigeminal B) Trochlear C) Abducens D) Oculomotor
B) Trochlear
External ophthalmoplegia: A) Characterized by double vision ( diplopia ), ptosis , divergent stabismus, inability of movements upwards, inwards and partially downwards B) Parasympathetic fibers are involved C) Mydriasis, ( dilated, enlarged pupil) absent reaction to the light (both direct and indirect), absent accommodation D) Lesion of trochlear nerve
A) Characterized by double vision ( diplopia ), ptosis , divergent stabismus, inability of movements upwards, inwards and partialy downwards
Internal opthalmoplegia: A) All the above answers are correct B) Parasympathetic fibers are involved C) Mydriasis, ( dilated, enlarged pupil) absent reaction to the light (both direct and indirect), absent accommodation D) Lesion of oculomotor nerve
A) All the above answers are correct
External ophthalmoplegia: A) All the above answers are correct B) Characterized by double vision ( diplopia ), ptosis , divergent stabismus, C) inability of movements upwards, inwards and partialy downwards D) Lesion of oculomotor nerve
A) All the above answers are correct
Peripheral – Harmonic vestibular syndrome: A) All the above answers are correct B) Rotatory vertigo, often severe + horizontal / horizontal-rotatory nystagmus C) All deviations have the same direction to the side of the affected vestibular apparatus including the slow components of nystagmus D) Causes: Meniers disease, vestibular neuronitis, acute labyrinthitis, benign paroxymal vertigo
A) All the above answers are correct
Primitive reflexes – snout reflex, suck reflex, gasp reflex are positive : A) Occipital lobe syndrome B) Parietal lobe syndrome C) Temporal lobe syndrome D) Prefrontal lobe syndrome
D) Prefrontal lobe syndrome
Prefrontal syndrome: A) All the above answers are correct B) Apathetic – loss of drive, lack of initiative and spontaneous activity, apathy and abulia C) Disinhibited – inadequate euphoria, childish or vulgar joking and socially inappropriate behaviour D) Incontinence – loss of cortical inhibition
A) All the above answers are correct
The term glioblastoma multiforme refers to a/an ? A) Soft, infiltrating malignant tumor of the roof of the fourth ventricle and cerebellum B) Rapidly growing malignant tumor composed of glial cells C) Tumor arising from specialized tissue found in the brain and spinal cord D) Inflammation of the brain and spinal cord and their membranes
B) Rapidly growing malignant tumor composed of glial cells
The term astrocytoma refers to a/an? A) Tumor composed of neuroglial cells (astocytes) B) Soft, infiltrating malignant tumor of the roof of the fourth ventricle and cerebellun C) Tumor arising from specialized tissue found in the brain and peripheral nerves D) Rapidly growing malignant tumor composed of primitive glial cells
A) Tumor composed of neuroglial cells (astocytes)
A pituitary tumor that protrudes through the diaphragma sella is most likely to cause: A) Diplopia B) Bilateral central scotomata C) Binasal hemianopsia D) Bitemporal hemianopsia
D) Bitemporal hemianopsia
A glove & stocking pattern of sensory disturbance usually develops with disease in: A) the thalamus B) the brainstem C) peripheral nerves D) the spinal cord
C) peripheral nerves
Secondary “metastatic” brain tumors are: A) breast B) kidney C) colon D) all the answers are correct
D) all the answers are correct
Fibrillations (fasciculations) may develop with disease in: A) anterior horn of the spinal cord B) posterior horn of the spinal cord C) lateral column of the spinal cord D) internal capsule
A) anterior horn of the spinal cord
Neurinomas (schwannomas) A) malignant neoplasms arising from schwann cells B) can manifest as progressive hearing loss, tinnitus and disequilibrium, facial palsy, trigeminal sensor deficits C) does not affect peripheral nerves D) most common tumour in children and adolescents
B) can manifest as progressive hearing loss, tinnitus and disequilibrium, facial palsy, trigeminal sensor deficits
Most common tumors in children and adolescents are: A) Meningeoma, glioblastoma and pituitry tumours B) Pilocytic astrocytoma and medulloblastoma C) Nerinomas (schwannomas) D) Lymphomas
B) Pilocytic astrocytoma and medulloblastoma
Most common tumors in adults are: A) Nerinomas (schwannomas) B) Pilocytic astrocytoma and medulloblastoma C) Meningeoma, glioblastoma and pituitary tumours D) Lymphomas
C) Meningeoma, glioblastoma and pituitry tumours
Meningioma A) Tumor composed of glial cells – malignant B) Tumor from the arachnoid – benign C) Tumor from the arachnoid – malignant D) Tumor composed of glial cells – benign
B) Tumor from the arachnoid – benign
Normal cerebral perfusion blood flow: A) 82ml/100g of brain/min B) 22ml/100g of brain/min Disorder of motoric and sensitive cortex C) 58ml/100g of brain/min D) 45ml/100g of brain/min
C) 58ml/100g of brain/min
How long is therapeutical window for tPA? A) 8 hours B) 4,5 hours C) 5,5 hours D) 3,5 hours
B) 4,5 hours
What is TIA? A) is modified for more than 24 hours, but eventually leaves consequences; positive CT or MR DWI scan B) the deficit is already permanent - irreversible damage C) short neurological deficit, a few minutes (less 24 hours, usually less than 1 hour); positive MR DWI scan D) short neurological deficit, a few minutes (less 24 hours, usually less than 1 hour); negative MR DWI scan
D) short neurological deficit, a few minutes (less 24 hours, usually less than 1 hour); negative MR DWI scan
The region of the brain, in which neuronal function is deranged but potentially salvageable is? A) Hemorrhage B) Penumbra C) Core of the infarct D) Herniation
B) Penumbra
NIHSS is a systematic assessment tool that quantifies: A) Stroke severity B) Intracerebral hemorrhage severity C) Cognitive deficit severity - similar to mini-mental scale D) Requirements for diagnosis of MS
A) Stroke severity
Intracerebral haemorrhage A) Tearing of the small blood vessels, most often within contusions of the frontal or temporal lobes B) Traumatic tearing of bridging veins C) Traumatic tearing of the art. Carotis externa D) Traumatic tearing of dural artery, usually the middle meningeal artery
A) Tearing of the small blood vessels, most often within contusions of the frontal or temporal lobes
Conservative treatment of aneurysm burst: A) Calcium B) Endovascular coiling C) Surgical clipping D) Strict bed rest
D) Strict bed rest
Subarachnoid haemorrhage A) Spontaneous or traumatic rupture of a saccular aneurysm of an artery at the base of the brain (Willis circle) B) Traumatic tearing of the art. Carotis externa C) Traumatic tearing of bridging veins D) Traumatic tearing of dural artery,usually the middle meningeal artery
A) Spontaneous or traumatic rupture of a saccular aneurysm of an artery at the base of the brain (Willis circle)
General manifestations of intracranial haemorrhage: A) All the above B) Same as cerebral ischemia (sudden onset of focal neurologic deficits) C) Acute headache D) Vomiting
A) All the above
General manifestations of intracranial haemorrhage: A) Progressive impairments of consciousness, possibly leading to coma B) In many patients, epileptic seizures C) All the above D) Rapidly or very rapidly progressive neurologic deficits
A) Progressive impairments of consciousness, possibly leading to coma
What do we typically see in CSF in multiple sclerosis? A) Oligoclonal bands B) All of the answers are correct C) Erythrocytes D) No cells
A) Oligoclonal bands
Types of multiple sclerosis are: A) Relapsing-remitting multiple sclerosis (RRMS), Secondary-progressive multiple sclerosis (SPMS), Primary-progressive multiple sclerosis (SPMS), and Progressive-relapsing multiple sclerosis (PRMS) B) Relapsing-remitting multiple sclerosis (RRMS), Secondary-progressive multiple sclerosis (SPMS), Primary-progressive multiple sclerosis (SPMS) C) Relapsing-remitting multiple sclerosis (RRMS), Secondary-progressive multiple sclerosis (SPMS), Primary-progressive multiple sclerosis (SPMS), and Clinically isolated syndrome (CIS) D) Secondary-progressive multiple sclerosis (SPMS), Primary-progressive multiple sclerosis (SPMS), Progressive-relapsing multiple sclerosis (PRMS)
A) Relapsing-remitting multiple sclerosis (RRMS), Secondary-progressive multiple sclerosis (SPMS), Primary-progressive multiple sclerosis (SPMS), and Progressive-relapsing multiple sclerosis (PRMS)
Lhermitte sign : A) Another name for nystagmus B) impairment of vibration sense C) unilateral blurred vision + orbital pain D) positive neck-flexion sign, active or passive forward flexion of the neck induces an electric or tingling paresthesia running down the spine into the limbs
D) positive neck-flexion sign, active or passive forward flexion of the neck induces an electric or tingling paresthesia running down the spine into the limbs
Retrobulbar neuritis : A) Always bilateral B) Can be diagnosed by CT scan C) Sign of intracranial hypertension D) Typical clinical feature of MS
D) Typical clinical feature of MS
Guillain barre syndrome is characterized by the presence: A) Antibodies against acetylcholine receptors B) Antibodies against myelin of CNS C) Antibodies against voltage-sensitive calcium channels in the motor nerve terminals D) Antibodies against myelin of peripheral nerves
D) Antibodies against myelin of peripheral nerves
Parkinson's disease is described by: A) Hyperkinesia, rigidity, kinetic tremor B) Hyperkinesia, rigidity, resting tremor C) Hypokinesia, rigidity, kinetic tremor D) Hypokinesia, rigidity, resting tremor
D) Hypokinesia, rigidity, resting tremor
AED is: A) Shortcut for antiencephalopathic drugs B) Shortcut for antiepileptic drugs C) None of the answers is correct D) Shortcut for antiemetic drugs
B) Shortcut for antiepileptic drugs
Radicular Lumboischiadical sy in L5 radiates: A) on the dorsal thigh to the calf and the plantar part of the foot to the hallux B) on the ventral part of the thigh to the knee and meddial part of the crura C) on the dorsal part of the thigh to the calf and dorsum of foot to the fifth toe D) on the lateral part of the lower extremity to the lateral and ventral part of the crura, dorsum of foot to the big toe (2.-4.)
D) on the lateral part of the lower extremity to the lateral and ventral part of the crura, dorsum of foot to the big toe (2.-4.)
Idiopathic Parkinson's disease A) Is the loss of pigmented dopamine secreting (dopaminergic) neurons in the substantia nigra with the lack of dopamine in the striatum B) Hyperkinetic-hypotonic syndrome C) Kinetic tremor D) All the above
A) Is the loss of pigmented dopamine secreting (dopaminergic) neurons in the substantia nigra with the lack of dopamine in the striatum
An electroencephalogram (EEG) A) All the above B) Can detect inflammation of the brain (encephalitis) C) Can detect brain dysfunction that can have a variety of causes (encephalopathy) D) Is used to diagnose epilepsy
A) All the above
Epilepsy treatment: A) All the above B) Vagus nerve stimulation C) Surgical – resect or cut away brain tissue that contains a seizure focus D) Medicamentation – antiepileptic drugs
A) All the above
Radicular Lumboischiadical sy in S1 radiates: A) on the dorsal thigh to the calf and the plantar part of the foot to the hallux B) on the dorsal part of the thigh to the calf and dorsum of foot to the hallux C) on the ventral part of the thigh to the knee and medial part of the crura D) on the lateral part of the lower extremity to the lateral and ventral part of the crura, dorsum of foot to the big toe (2.-4.)
A) on the dorsal thigh to the calf and the plantar part of the foot to the hallux
Status epilepticus: A) A generalized tonic-clonic seizure no matter how long it lasts B) It is not a life threatening emergency because there is no danger of respiratory complications C) A focal seizure or absence lasting at least 5 minutes D) Refers to a prolonged, uninterrupted epileptic seizure or to multiple seizures occurring in rapid succession without fully recovery in between
D) Refers to a prolonged, uninterrupted epileptic seizure or to multiple seizures occurring in rapid succession without fully recovery in between
Main nerve of sacral plexus is: A) Ulnar B) Femoral C) Sciatic D) Iliohypogastric
C) Sciatic
Status epilepticus: A) Refers to a prolonged, uninterrupted epileptic seizure or to multiple seizures occurring in rapid succession with fully recovery in between B) A generalized tonic-clonic seizure no matter how long it lasts C) It is a life threatening emergency because of the danger of respiratory complications (aspiration) and insulting hypoxic brain damage D) A focal seizure or absence lasting less than 10 minutes
C) It is a life threatening emergency because of the danger of respiratory complications (aspiration) and insulting hypoxic brain damage
Hyperkinetic-hypotonic syndrome: A) Parkinson's disease B) Epilepsy C) PNES D) Chorea
D) Chorea
Etiology of secondary parkinsonism can be: A) All the above B) Medication induced C) Vascular D) Posttraumatic
A) All the above
Syndrome caudae equinae is: A) none of the answers is correct B) subacute diagnosis C) chronic diagnosis D) acute diagnosis
D) acute diagnosis
Radicular pain in dermatom C8 radiates in to the: A) 4.-5. Fingers B) 2.-3. fingers C) doesn't goes to the fingers D) Thumb
A) 4.-5. Fingers
Essential tremor: A) always pathologic B) characterized by action tremor diminished with rest, relaxation and use of ethanol C) characterized by rest tremor diminished with rest, relaxation and use of ethanol D) never runs in the family
B) characterized by action tremor diminished with rest, relaxation and use of ethanol
Syndrome caudae equinae: A) All the above B) unilateral or asymmetrical early radicular type of pain, peripheral type of paraplegia C) Asymmetric sensory loss in saddle region involving anal, perineal and genital regions D) sphincter disturbances
A) All the above
Gowers sign A) positive neck-flexion sign, active or passive forward flexion of the neck induces an electric or tingling parestesia running down the spine into the limbs – clinical feature of MS B) Does not exists C) Clinical feature of Duchenne muscular dystrophy, patients can stand up from squatting position only by climbing up their own legs with hands D) myasthenic ptosis worsens visibly within one minute if the patient rapidly and repeatedly closes and opes the eyes, or looks upward for a prolonged period
C) Clinical feature of Duchenne muscular dystrophy, patients can stand up from squatting position only by climbing up their own legs with hands
Myasthenia gravis is characterized by the presence : A) Antibodies against acetylcholine receptors B) Antibodies against voltage-sensitive calcium channels in the motor nerve terminals C) Antibodies against myelin of CNS D) Antibodies against myelin of peripheral nerves
A) Antibodies against acetylcholine receptors
GCS of a comatose patient is A) Less than 3 B) 7 C) 12 D) 15
B) 7
X-rays: A) reveal fractures, bone tumours, degenerative changes such as spondylosis or spondyloathrosis, olisthesis – stability of the spine B) reveal intracranial complication such as subdural hematom C) can reveal spondylodiscitis D) almost never performed
A) reveal fractures, bone tumours, degenerative changes such as spondylosis or spondyloathrosis, olisthesis – stability of the spine
In case of an acute ischemic stroke the method of radiologic investigation choice is: A) Transcranial USG B) MRI of brain C) CT +CTAg of brain D) Functional MRI
C) CT +CTAg of brain
Clinical features of myasthenia gravis : A) weakness of proximal limb muscles, extraocular muscles, and bulbar muscles, fatigability and fluctuation with regard to the muscle weakness B) extreme muscle pain C) Reflexes are always normal D) Heart is affected but the respiratory muscles are almost never affected
A) weakness of proximal limb muscles, extraocular muscles, and bulbar muscles, fatigability and fluctuation with regard to the muscle weakness
Rhabdomyolysis is: A) is characterized by inflammation and degeneration of the muscles B) is characterized by accumulation of glycogen of normal or abnormal chemical structure in tissue C) is a condition in which damaged skeletal muscle breaks down rapidly D) is caused by mutations, or changes, in genes — the cells' blueprint for making proteins
C) is a condition in which damaged skeletal muscle breaks down rapidly
High body temperature of a patient with brain injury: A) Does not affect the prognosis of the patient B) Causes lower blood flow through brain, lower metabolic needs and decrease of O2 and glucose utilization C) Causes lower blood flow through brain, lower metabolic needs and increase of O2 and glucose utilization D) Causes higher blood flow through brain, higher metabolic needs and increase of O2 and glucose utilization
D) Causes higher blood flow through brain, higher metabolic needs and increase of O2 and glucose utilization
Hereditary Muscular Dystrophies of X-chromosomal Inheritance - Dystrophinopathies A) Caused by a genetic defect on 17th autosome B) Almost exclusively seen in boys whose mothers are healthy carriers C) Almost exclusively seen in girls whose mothers are healthy carriers D) Hyperproduction of dystrophin ( a structural protein of the muscle fiber membrane)
B) Almost exclusively seen in boys whose mothers are healthy carriers
Low body temperature of a patient with brain injury: A) Causes lower blood flow through brain, lower metabolic needs and decrease of O2 and glucose utilization which improves the prognosis of the patient B) Causes lower blood flow through brain, lower metabolic needs and increase of O2 and glucose utilization which improves the prognosis of the patient C) Does not affect the prognosis of the patient D) Causes higher blood flow through brain, higher metabolic needs and increase of O2 and glucose utilization which worsens the prognosis of the patient
A) Causes lower blood flow through brain, lower metabolic needs and decrease of O2 and glucose utilization which improves the prognosis of the patient
Injury of the cervical / thoracic spinal cord can cause A) activation of sympathetic innervation B) inactivation of parasympathetic innervation C) bradycardia + hypotension D) tachycardia + hypertension
C) bradycardia + hypotension
Somatosenzory evoked potentials: A) All the above B) Sensory pathway is tested C) Monitoring during operations of intramedullar tumours, assessment of prognosis of comatose patients D) SEPs are useful in multiple sclerosis, cervical myelopathy or in spinal cord injuries or tumours
A) All the above
Scintigraphic visualization of dopamine transporter levels in the brain (Da Tscan) A) Is used for diagnosis of MS B) Is used for diagnosis of Parkinson disease C) Is used for diagnosis of stoke D) Is used for diagnosis of glioblastoma
B) Is used for diagnosis of Parkinson disease
Motor evoked potentials: A) The only limitation is that motor pathways for only the upper extremities can be examined B) Sensory pathway is tested C) Test the integrity of motor pathway D) Stimulating coil creates a brief intense magnetic field that produces the electrical current in the cerebral tissue which stimulates the postcentral gyrus of the parietal lobe of the brain
C) Test the integrity of motor pathway
Lambert – Eaton syndrome is characterized by the presence A) Antibodies against myelin of peripheral nerves B) Antibodies against voltage-sensitive calcium channels in the motor nerve terminal C) Antibodies against myelin of CNS D) Antibodies against acetylcholine receptors
B) Antibodies against voltage-sensitive calcium channels in the motor nerve terminal
Cushing's reflex: A) hypotension + bradycardia as a clinical symptom of intracranial hypertension B) arytmias as a clinical symptom of intracranial hypertension C) hypertension + tachycardia as a clinical symptom of intracranial hypertension D) hypertension + bradycardia, clinical symptom of intracranial hypertension
D) hypertension + bradycardia, clinical symptom of intracranial hypertension
Conservative radiculopathy therapy: A) All the above B) Corticosteroids C) Analgetics (non-steroidal analgetics + opiates ) D) Myorelaxans
A) All the above
Therapy of MS attacks: A) Corticosteroids B) AED C) L-dopa D) Analgetics
A) Corticosteroids
Action of drugs on receptor binding : A) All the above B) They bind directly to receptors and activate them: Agonists C) They bind to the same site on the receptor protein as the agonist, preventing activation of the receptor: Competitive Antagonists D) They bind to a receptor protein on a different site than that of the agonist, but causes a conformational change in the protein that does not allow activation: Non-competitive antagonist
A) All the above
CEA is indicated to patients that have: A) Symptomatic stenosis 50% - 99% stenosis, Asymptomatic stenosis: 60% - 99% stenosis B) Symptomatic stenosis 60% stenosis, Asymptomatic stenosis: 70% - 99% stenosis C) Never had a stroke before D) Only an acute occlusion of carotid
A) Symtptomatic stenosis 50% - 99% stenosis, Asymptomatic stenosis: 60% - 99% stenosis
Carpal tunnel syndrome is a medical condition due to compression A) of the femoral nerve as it travels through the wrist at the carpal tunnel B) of the median nerve as it travels through the wrist at the carpal tunnel C) of the radial nerve as it travels through the wrist at the carpal tunnel D) of the ulnar nerve as it travels through the wrist at the carpal tunnel
B) of the median nerve as it travels through the wrist at the carpal tunnel
Surgical treatment of hydrocephalus: A) Laminoplasty B) Cerebral shunt C) CEA D) Deep brain stimulation
B) Cerebral shunt
Migraine preventive therapy: A) all the above B) calcium channel blockers (flunarizin, verapamil) C) AED (topiramat, valproic acid, gabapentin, pregabalin) D) antidepressives (amitriptylin)
A) all the above
Indications of surgical treatment of vertebral algic syndrome : A) All the above B) Myelopathy C) Progressive neurologic deficit D) Spondylosis with radiculopathy and failure of conservative treatment
A) All the above
Therapy of Parkinsons disease: A) L-dopa and dopamine agonists B) AED C) Biologic treatment – antibodies D) Corticosteroids
A) L-dopa and dopamine agonists
Surgical management of epilepsy in a specific area of the brain may be possible for both adults and children, and might be considered if: A) all the above B) if the patient prefers surgical treatment instead of AED C) several AEDs are tried and none of them has stopped or significantly reduced the patients seizures; (two or more AED) D) there is a specific graph during EEG- monitoring
C) several AEDs are tried and none of them has stopped or significantly reduced the patients seizures; (two or more AED)
The presence of Laseuge sign suggests damage to the following: A) spinal roots L5-S1 or sciatic nerve B) meninges of the brain C) spinal roots C5-C8 or radial nerve D) anterior horns at the level L5-S1
A) spinal roots L5-S1 or sciatic nerve
In case of a traumatic complete lesion of the spinal cord at C6/C7 A) hypereflexy rr. L2/L4 B) areflexy rr. C5/C6 C) hypereflexy rr. C5/C6 D) areflexy L2/L4
C) hypereflexy rr. C5/C6
Lumbar puncture is proceeded: A) Under vert. L2, where the spinal cord ends B) only between vert. L3-L4 C) Between vertebras L1-L2 D) Between vertebras Th12-L1
B) only between vert. L3-L4
Parkinson´s syndrome is: A) Hyperkinetic-hypertonic B) Hyperkinetic-hypotonic sy C) Hypokinetic-hypotonic D) Hypokinetic-hypertonic sy
D) Hypokinetic-hypertonic sy
Dyskinetic syndrome is: A) Hyperkinetic-hypotonic sy B) Hypokinetic-hypotonic C) Hypokinetic-hypertonic sy D) Hyperkinetic-hypertonic
A) Hyperkinetic-hypotonic sy
Lumbar puncture is diagnostic method number one for: A) both SAH and meningitis B) Just brain tumors C) just SAH D) just meningitis
A) both SAH and meningitis
Dystrofynopathies are characterized by: A) by ion-dysbalance B) by inflammation and degeneration of the muscles C) by gene mutation of dystrofine (muscle protein) or its flawed expression D) by systemic effects of malignancy that are not due to direct physical effects of metastasis
C) by gene mutation of dystrofine (muscle protein) or its flawed expression
Radicular Lumboischiadical sy in L5 radiates: A) on the dorsal part of the thigh to the calf and dorsum of foot to the fifth toe B) on the dorsal thigh to the calf and the plantar part of the foot to the hallux C) on the lateral part of the lower extremity to the lateral and ventral part of the crura, dorsum of foot to the big toe (2.-4.) D) on the ventral part of the thigh to the knee and medial part of the crura
C) on the lateral part of the lower extremity to the lateral and ventral part of the crura, dorsum of foot to the big toe (2.-4.)
How long is therapeutical window for mechanical recanalization ( thrombectomy) A) Until 8 hours B) Until 6 hours C) 4,5 D) 2,5
B) Until 6 hours
How long is therapeutical window for intravenous trombolysis ? A) 4,5 B) 2,5 C) 3,5 D) 5,5
A) 4,5
The NIH Stroke Scale/Score (NIHSS) quantifies stroke severity based on : A) The weight of neurological evaluation findings. B) The number of the occluded arteries C) The size of the ischemic lesion on the brain CT D) The size of pernumbra on the brain CT
A) The weight of neurological evaluation findings.
FAST is used : A) As an evaluation of stroke severity B) As s diagnostic evaluation of MS C) As an evaluation of cognitive deficit severity D) As a diagnostic evaluation of stroke before hospital
D) As a diagnostic evaluation of stroke before hospital
General manifestations of subdural haemorrhage: A) Acute headache B) Same as cerebral ischemia (sudden onset of focal neurologic deficits) C) Vomiting D) All the above
A) Acute headache
1. The upper motor neuron impairment produces the following change of muscles tone:A) “cog wheel” rigidity B) spasticity C) flaccidity D) myoclonia
B) spasticity
The muscular wasting (hypotrophy) usually develops with disease in:A) upper motor neuron B) cerebellar C) lower motor neuron D) caudate
C) lower motor neuron
3. The temperature & pin sense loss usually develops with disease in:A) posterior columns of spinal cord B) posterior horns of spinal cord C) anterior horns of spinal cord D) lateral horns of spinal cord
B) posterior horns of spinal cord
The presence of ataxia suggests damage to any of the following EXCEPT:A) cerebellar B) vagal nerve C) vestibular nucleus D) thalamus
B) vagal nerve
The ability to walk along a straight line is most often impaired with:A) parietal lobe damage B) temporal lobe damage C) cerebellar dysfunction D) ocular motor disturbances
C) cerebellar dysfunction
Parkinsonism includes combination of the following:A) chorea & muscles hypotonia B) tremor, bradykinesia & muscles rigidity C) paresis, anesthesia & muscles spasticity D) tremor, ataxia & muscles hypotonia
B) tremor, bradykinesia & muscles rigidity
10. Affection of the cerebellar may produce any of the following EXCEPT:A) positive heel to knee test B) positive finger to nose test C) positive Romberg’s test D) positive Rinner & Weber test
D) positive Rinner & Weber test
The presence of dysphagia suggests damage to cranial nerves:A) IX-X B) VII-XI C) V-VII D) III-VI
A) IX-X
The presence of dysarthria suggests damage to cranial nerve:A) XI B) VII C) V D) XII
D) XII
Dysphasia suggests the impairment of:A) speech B) swallowing C) gait D) movement
A) speech
The patient with apraxia cannot:A) speak fluently B) carry out an imagined act C) draw somple diagrams D) name his fingers
B) carry out an imagined act
Meningeal sign is the followingA) Lasseugue B) Kernig C) Babinsky D) Romberg
B) Kernig
Any of the following syndromes is the involuntary movement EXCEPT:A) tremor B) chorea C) paresis D) tic
C) paresis
Central paresis, loss of proprioceptive sensation on one side & loss of exteroceptive sensation on the opposite form the following syndrome:A) Argile-Robertson B) Lambert-Eton C) Matskevich-Shtrumpel D) Brown-Sequard
D) Brown-Sequard
The polyneuropathic pattern of sensory loss suggests presence of the following syndrome:A) numbness & analgesia in half of the body B) numbness & pain in distal parts of extremities C) analgesia & sensory ataxia in proximal parts of extremities D) pain & sensory ataxia in half of the body
B) numbness & pain in distal parts of extremities
The presence of hemianesthesia, hemianopia & sensory hemiataxia suggests damage to the following:A) internal capsule B) spinal cord C) thalamus opticus D) black substance
C) thalamus opticus
The presence of Laseuge sign suggests damage to the following:A) spinal roots C5-C8 or radial nerve B) spinal roots L5-S1 or sciatic nerve C) meninges of the brain D) anterior horns at the level L5-S1
B) spinal roots L5-S1 or sciatic nerve
The presence of dysdiadochokinesis suggests damage to the following:A) black substance B) spinal cord C) cerebellar D) occipital lobe
C) cerebellar
The presence of Parkinsonism suggests damage to the following:A) frontal lobe B) black substance C) caudate nucleus D) cerebellar
B) black substance
In initial stage of Parkinson disease the most typical involuntary movement is the following:A) chorea B) tremor C) dystonia D) atetosis
B) tremor
The autonomic nervous system includes any of the following EXCEPT:A) paravertebral sympathetic trunk B) cerebral cortex C) vagal nerve D) hypothalamus
B) cerebral cortex
One of the most important functions of the autonomic nervous system is the following:A) regulation of homeostasis B) coordination of movements C) involuntary movements D) voluntary movements
A) regulation of homeostasis
Any of the following cranial nerves has the parasympathetic nucleus EXCEPT:A) oculomotor B) olfactory C) vagal D) glossopharyngeal
B) olfactory
The presence of anosmia suggests damage to the following cranial nerve:A) III B) I C) V D) II
B) I
Trigeminal nerve impairment produces the following symptoms:A) ache paroxysm in half of the face B) disturbance of swallowing C) ache in half of the head D) plegia in half of the face
A) ache paroxysm in half of the face
The presence of Bell’s palsy suggests damage to the following cranial nerve:A) vestibular B) facial C) olfactory D) optic
B) facial
Dysphagia, dyphonia, dysarthria together with tongue atrophy & depressed “gag” reflex is called like following:A) bulbus olfactorius B) bulbar palsy C) pseudobulbar palsy D) Bell’s palsy
B) bulbar palsy
The disturbance of purposive movement in absence of paresis & dyscoordination suggests the presence of the following:A) dysgnosia B) dyspraxia C) dyslexia D) dysphasia
B) dyspraxia
Meningeal syndrome suggests any of the following, EXCEPT:A) neck stiffness B) headache C) Babynsky response D) photophobia
C) Babynsky response
