FCPS Medicine NEUROLOGY-1

Question(1-10):True False ,Answer true only

Question(11-25):SBA

1. Functions of frontal lobe -

2. Which is/are the effects of dominant parietal lobe damage?

3. Which pair is/are correct about brainstem syndromes?

4. Oligoclonal band may be found in –

5. Which is not the advantage of MRI/MRA?

6. Regarding lumbar puncture –

7. True about the types of stroke –

8. Indications of immediate CT/MRI in suspected stroke are the followings –

9. About sub-arachnoid haemorrhage –

10. Cause/risk factor of cerebral venous sinus thrombosis –

12. Which is not commonly found in tubercular meningitis?

13. On visual field testing, a patient can’t see both of his temporal fields. Where is the likely lesion?

14. A 35-year-old female presents to the emergency dept with severe convulsion lasting more than 30 min. She has history of epilepsy. Her family members tell you that for the last few days she has not been taking her anti-epileptic medication. The patient was given midazolam 15 min ago but there was no improvement. What is the likely diagnosis and first line treatment after resuscitation?

15. A 40-year-old female patient presents to you sudden severe headache specially in the occipital area for the last 1 hour. She says that she has never experienced such type of headache in her life before. O/E: her neck is stiff and BP: 180/120 mm Hg. You admit the patient and order an immediate CT scan which comes absolutely normal. After several hours, a lumbar puncture is done and the CSF reveals xanthochromia. What is the most common site of the underlying condition?

16. A 56-year-old man comes to the emergency department with severe dizziness, inability to walk and stabbing pain on the right side of his face that started this morning. He has a history of type 2 diabetes mellitus, hypertension, and hyperlipidemia. His blood pressure is 144/90 mm Hg and pulse is 92/min. The patient topples to the right when sitting without support. There is partial ptosis of the right eye. Horizontal and rotational nystagmus is present. His gag reflex is diminished. There is loss of pain and temperature sensation in the right face and the left trunk and limbs. Which of the following is the most likely location of this patient's brain lesion?

17. A 56-year-old right-handed man comes to the physician with right-sided weakness and speech difficulty. He speaks in short sentences with considerable effort. He fully follows written and verbal commands but has difficulty writing and repeating. Which of the following lesion locations is most likely responsible for the observed findings?

18. 70-year-old right-handed man is brought to the emergency department due to sudden onset of right- sided weakness and urinary incontinence that began about 10 hours ago. He has had type 2 diabetes mellitus for the last 20 years and hypertension for the last 28 years. On examination, there is 4/5 strength in the right upper extremity, 1/5 strength in the right lower extremity and a Babinski sign on the right side. Sensation is decreased throughout the right foot and leg. Visual fields are full with no deficits. Which of the following is the most likely diagnosis of this patient?

19. A patient presents with right sided hemiparesis. Which is not the feature of lower motor neuron lesion?

20. A 50-year-old patient presents with feeling of imbalance for the last couple of days. His MRI shows an infarction of right cerebellum. Which is not the feature of cerebellar lesion?

21. A 47-year-old patient is admitted with ischaemic stroke. Carotid Doppler shows 85% stenosis of left internal carotid artery. What is the treatment of choice for this patient?

22. A patient has haemorrhagic stroke. He is admitted into hospital and treated accordingly. Which advice is not appropriate for this patient?

23. A 68-year-old man is brought to the emergency department for acute right-side hemiplegia, headache and impaired consciousness. His symptoms started an hour ago and are progressively getting worse. He has no prior history of transient ischemic attack. His medical problems include obesity, hypertension and hypercholesterolemia. The patient's medications include allopurinol, tamsulosin. propranolol. amlodipine, and simvastatin. He has smoked a pack of cigarettes daily for 15 years. Neurological examination shows right-sided weakness and hemi-sensory loss. There is a carotid bruit on his left side. Which of the following is the most appropriate next step in management?

24. A patient is admitted with subarachnoid haemorrhage. What is the drug of choice for this patient?

25. A patient undergoes an ischaemic stroke. Complications of stroke are the followings except –