Headaches
With migraine, which of the following statements is true?
A. Migraine with aura is the most common form.
B. Most migraineurs are in ongoing healthcare for the condition.
C. The condition is equally common in men and women.
D. The pain is typically described as pulsating.
D. The pain is typically described as pulsating.
Which of the following is not true regarding epilepsy?
A. Epilepsy is chronic
B. Epilepsy is diagnosed after three seizures
C. Epilepsy cannot be cured
D. Epilepsy causes recurrent seizures
B. Epilepsy is diagnosed after three seizures
A TIA is characterized as an episode of reversible neurological symptoms that can last:
A. 1 hour
B. 6 hours
C. 12 hours
D. 24 hours
D. 24 hours
An 18-year-old college freshman is brought to the student health center with a chief complaint of a 3-day history of progressive headache and intermittent fever. On physical examination, he has positive Kernig and Brudzinski signs. The most likely diagnosis is:
A. viral encephalitis.
B. bacterial meningitis.
C. acute subarachnoid hemorrhage.
D. epidural hematoma.
b. bacterial meningitis
According to DSM-5 a diagnosis of depression must include either depressed mood or which of the following?
A. loss of interest or pleasure
B. recurrent thoughts of death
C. feelings of worthlessness
D. weight change (either increase or decrease)
A. loss of interest or pleasure
A 40-year-old man presents with a 5-week history of recurrent headaches that awaken him during the night.The pain is severe, lasts about 1 hour, and is located behind his left eye. Additional symptoms include lacrimation and nasal discharge. His physical examination is within normal limits. This clinical presentation is most consistent with:
A. migraine without aura.
B. migraine with aura.
C. cluster headache.
D. increased intracranial pressure (ICP)
C. Cluster headache
Which of the following best describes patient presentation during a tonic-clonic (grand mal) seizure?
A. blank staring lasting 3 to 50 seconds, accompanied by impaired level of consciousness
B. awake state with abnormal motor behavior lasting seconds
C. rigid extension of arms and legs, followed by sudden jerking movements with loss of consciousness
D. abrupt muscle contraction with autonomic signs
C. rigid extension of arms and legs, followed by sudden jerking movements with loss of consciousness
Risk factors for transient ischemic attack (TIA) include all of the following except:
A. atrial fibrillation.
B. carotid artery disease.
C. combined oral contraceptive use.
D. pernicious anemia
D. pernicious anemia
Which of the following is most consistent with findings in patients with Parkinson disease?
A. rigid posture with poor muscle tone
B. masklike facies and continued cognitive function
C. tremor at rest and bradykinesia
D. excessive arm swinging with ambulation and flexed posture
C. tremor at rest and bradykinesia
Which of the following is most consistent with the diagnosis of generalize anxiety disorder?
A. gastrointestinal upset
B. difficulty initiating sleep
C. diminished cognitive ability
D. consistent early morning wakening
B. difficulty initiating sleep
A 22-year-old woman presents with a 3-year history of recurrent, unilateral, pulsating headaches with vomiting and photophobia. The headaches, which generally last 3 hours, can be aborted by resting in a dark room. She can usually tell that she is going to get a headache. She explains, "I see little 'squiggles' before my eyes for about 15 minutes." Her physical examination is unremarkable. This presentation is most consistent with:
A. tension-type headache.
B. migraine without aura.
C. migraine with aura.
D. cluster headache
C. Migraine with aura
Treatment options for an adult with seizures include all of the following agents except:
A. carbamazepine.
B. phenytoin.
C. gabapentin.
D. tamsulosin
D. Tamsulosin
Which of the following conditions is least likely to contribute to an increased risk of stroke?
A. hyperlipidemia
B. diabetes mellitus
C. Crohn's disease
D. hypertension
C. Crohn's disease
Common symptoms of MS include all of the following except:
A. numbness or weakness in one or more limbs.
B. double vision or blurring vision.
C. facial weakness or numbness.
D. cold sensitivity.
C. facial weakness or numbness
John is a 47 year old man who reports constant sadness following the death of his wife in a motor vehicle accident 2 weeks ago. He has not been able to function at work and avoids socializing with friends and family. You recommend:
A. giving him time and support during this period of acute grief
B. weekly phsychotherapy sessions
C. prescribing an anxiolytic to help with grief symptoms
D. psychotherapy plus a prescription for an antidepressant.
A. giving him time and support during this period of acute grief
Prophylactic treatment for migraine headaches includes the use of:
A. amitriptyline.
B. ergot derivative.
C. naproxen sodium.
D. clonidine.
A. amitriptyline
Medications with narrow therapeutic indexes (NTIs)include all of the following except:
A. topiramate.
B. phenytoin.
C. carbamazepine.
D. valproate
A. Topiramate
When caring for a patient with a recent TIA, you consider that:
A. long-term antiplatelet therapy is likely indicated.
B. this person has a relatively low risk of future stroke.
C. women present with this disorder more often than men.
D. rehabilitation will be needed to minimize the effects of the resulting neurological insult
A. long-term antiplatelet therapy is likely indicated.
Acute cerebral hemorrhage is best identified with which of the following imaging techniques?
A. transesophageal echocardiogram
B. CT scan
C. cerebral angiogram
D. MR angiography
B. CT scan
Of the following individuals in need of an antidepressant who is the best candidate for fluoxetine (Prozac) therapy?
A. an 80 year old woman with depressed mood 1 year after the death of her husband
B. a 45 year old man with mild hepatic dysfunction
C. a 28 year old man who occasionally "skips a dose" of his prescribed medication
D. a 44 year old man with decreased appetite.
C. a 28 year old man who occasionally "skips a dose" of his prescribed medication
Among the following beta blockers, which is the least effective in preventing migraine headache?
A. acebutolol
B. metoprolol
C. atenolol
D. propranolol
A. acebutolol
A patient taking phenytoin can exhibit a drug interaction when concurrently taking:
A. cyclosporine.
B. famotidine.
C. acetaminophen.
D. aspirin
A. Cyclosporine
Antiplatelet agents commonly used in secondary prevention of stroke include all of the following except:
A. aspirin
B. clopidogrel
C. aspirin plus extended-release dipyridamole
D. rivaroxaban
D. rivaroxaban
You examine a 29-year-old woman who has a sudden onset of right-sided facial asymmetry. She is unable to close her right eyelid tightly, frown, or smile on the affected side. Her examination is otherwise unremarkable. This presentation likely represents paralysis of CN:
A. III
B. IV
C. VII
D. VIII
C. VII
As you develop the initial treatment plan for a woman with panic disorder, you consider prescribing:
A. carbamazepine (Tegretol)
B. risperidone (Risperdal)
C. citalopram (Celexa)
D. bupropion (Wellbutrin)
C. citalopram (Celexa)