KROK2_Neurology (Eng.) Exam Questions & Answers 2024 Update

KROK2_Neurology (Eng.) Exam Questions & Answers 2024 Update The patient 68 years old, servant. About 2 years ago began impaired memory: he became forgetful at work and at home, could not cope with his responsibilities. Gradually began to forget the names of relatives, names of objects, became helpless, lost skill of talking. Lost skills of writing, reading, personal care. Computer tomography found atrophy of the cerebral cortex of the brain. What is the most likely diagnosis? A. Alzheimer's Disease B. Atherosclerotic dementia C. Progressing paralysis D. Pick's disease E. Senile dementia Woman 47 years old complaining about headaches for the last 5 years. The pain is unilateral , intense, localized in the frontal region, accompanied by nausea and abdominal discomfort, begins suddenly. Before the attack marked " blurred " vision. In history - episodes of high blood pressure, however, currently no medications now . Between headaches attacks condition is satisfactory. OBJECTIVE: increased nutrition ( index of body weight- 29 ), BP -170 /95 mmHg Neurological status was normal. What is the most likely diagnosis? A. Migraine B. Benign intracranial hypertension C. Chronic subdural hematoma D. Hypertensive encephalopathy E. Epilepsy Doctor 64 years old regularly consume alcohol, a year ago suffered a heart attack on a background hypertension. He do not know the name of drugs has no medical terms, forgot the names of his wife and children. Complacent. Severe symptoms of oral automatism, sclerosis of retinal vessels. Determine the type of dementia. A. Atherosclerotic B. Senylna C. Alcohol D. Presenylna E. Hypertension Female 60 years old about 15 years suffering on hypertension. After recurrent stroke she complains on unwarranted depressed mood, difficulty concentrating, forgetting to close the door, does not remember the events of the day. There are regions of changes after heart attack in cortical back front areas in CT. What is the most likely diagnosis do this patient have? A. Vascular dementia B. Dissociate amnesia C. Huntington's disease D. Pick's disease E. Alzheimer's Disease Patient G., 60 years old, retired, worked as a director€s deputy of the Institute. Changes in behavior were 2 years ago, after her husband's death: stopped care about herself, did not leave the house, then stopped to clean the apartment, cook. In psychology status: lost orientation in time. She does not understand a lot of questions. Do not know how to cook soup, fasten a button. Speaking of stutter and lohokloniyamy. Do not recognize medical personal and patients. Often crying, cause of crying can not explain. What is the mechanism of pathology: A Atrophy of the cerebral cortex B Atherosclerotic changes of cerebral vessels C deficiency of serotonin D Breaking the conversion of noradrenalin to adrenalin E Contravention metabolic of melatonin Patient 58 years old. About 2 years ago, beginning to weaken memory. Recently, have forgotten many events of her life, she did not remember whether the grandchildren, the children, can not remember anything. A few times went out of the apartment and could not find its way back. The apartment is poorly focused. She can not prepare meals, do not care about her hair, can not dress herself. Apathetic, inactive. Signs of Parkinson's disease, Huntington's, and severe vascular diseases have not been identified. Prior to his state of uncritical. What is the diagnosis in this case? A. Alzheimer's Disease B. Pick's disease C. Traumatic dementia D. Korsakov psychosis Female 29 years old complains on intermittent headache on the right side of the head , which is triggered by rescue smells and emotions. The mother of patient sufferering from similar disease. Internal organs - are without pathology. During the attack there is a general hypersensitivity , nausea , and in the end - polyuria . During the night temporal artery palpation marked is tension and soreness. Deneral analysis of blood and urine were normal. What is the most likely diagnosis? A. Migraine B. Trigeminal neuralgia C. epilepsy D. Meniere's syndrom E. Neuritis of the facial nerve Patient A., 42 years old, complained of headache, nausea, and vomiting , which are present throughout the year , after the patient suffered a head injury . OBJECTIVE: ptosis, strabismus , right hemiparesis , increasing of muscle tone. On the eye fundus : occurrence of stasis . Kraniohrama : the signs of intensification digital depresses , expanding movement in the Turkish saddle , deepening of the fissures. Determine the diagnosis. A. Postraumatic hydrocephalus. B. Postraumatic encephalopathy. C. Postravmautic parkinsonism . D. Postravmautic hypothalamic syndrome . E. Postravmautic arachnoiditis . Patient concerned severe headache, dizziness, nausea. Blood pressure 200/110 mmHg. century. No focal neurological symptoms. No meningeal signs. What emerged in this case? A. hypertensive crises B. acute hypertensive encephalopathy C. sympathoadrenal management D. hemorrhagic stroke E. subarachnoid hemorrhage In the morning upon waking a 65-year old patient developed weakness in the right side limbs, speech disorder, decreased sensitivity of the left side of the body. On examination: conscious, BP- 100/60 mm Hg, motor aphasia, right-sided central hemiparesis an hemihypalgesia. Make the preliminary diagnosis: A. Ishemic stroke B. Hemorrhagic stroke C. Encephalitis D. Brain tumor E. Subarachnoid hemorrhage Several hours before, a 28-year-old patient suddenly developed acute headache and repeated vomiting, then lost consciousness. Objectively: focal neurological symptoms were not found. Pronounced meningeal symptoms were revealed. BP - 120/80 mm Hg. According to clinical and liquorological findings the patient was diagnosed with subarachnoid haemorrhage. After administration of dehydrants the patient’s condition somewhat improved. What is the main component of further emergency care? A. Coagulants B. Anticoagulants C. Antiaggregants D. Fibrinolytics E. Corticosteroids A 30-year-old patient, who has been suffering from headaches, suddenly developed extreme headache after lifting a heavy load, as if he had been hit over the head. Nausea, vomiting, and slight dizziness are observed. In a day he developed pronounced meningeal syndrome and body temperature up to 37,6oC. A doctor suspects subarachnoid hemorrhage. What additional examination is necessary to con firm this diagnosis? A. Lumbar puncture with investigation of the spinal fluid B. Skull X-ray C. Computed tomography of the brain D. Rheoencephalography E. Angiography of the brain vessels A newborn with gestational age of 31 weeks presents with hypotonia and depressed consciousness. Hematocrit is 35%, general cerebrospinal fluid analysis shows increased content of erythrocytes and protein, and low glucose. These data correspond with the clinical presentation of: A. Intracranial hemorrhage B. Meningitis C. Sepsis D. Anemia E. Prenatal infection A 60-year-old woman has been suffering from arterial hypertension for 15 years. After recurrent stroke she started complaining of unmotivated bad mood, problems with attention concentration; she forgets to close the entrance door, cannot recall events of the past day. Computer tomography shows areas of postinfarction changes in the cortical postfrontal areas. What is the most probable diagnosis? A. Vascular dementia B. Alzheimer’s disease C. Huntington’s disease D. Pick’s disease E. Dissociative amnesia Man 54 years old, entered the hospital complaining of sudden severe headache in the occipital region and vomiting. There are mild hypertension in history, takes hypothiazide. Three days ago, spoke to a therapist about severe headaches, which decreased after using analgesic. OBJECTIVE: confused mind , the left pupil enlarged . Severe photophobia and neck muscle tension . Left-sided hemiparesis with increased muscle tone and reflexes. Temperature is lowered, no scars . BP- 230 /130 mmHg , Ps - 50/hv , number of respiratory movements- 12 min . What is the most likely diagnosis? A. Acute subdural hematoma B. myasthenia C. Acute bacterial meningitis D. migraine E. multiple sclerosis The patient is 70 years old, waking up in the morning, he felt weakness in the left extremities, which grew and reached its peak during the day. OBJECTIVE: consciousness is not impaired, no meningeal signs, left hemiparesis, increased tendon reflexes on the left, hemihipesteziya left. Pulse - 74/min., BP-140/90 mmHg, temperature of 36,5 ° C. What is the preliminary diagnosis? A. Ischemic stroke B. Transient cerebral circulation C. encephalitis D. Hemorrhagic stroke E. Brain tumor In hypertensive patients appeared acutely numbing sensation in the right extremities, weakness in them. After 2 hours, these events have passed. What disease can be diagnosed? A. Transient cerebrovascular accident B. Ischemic stroke C. Hypertensive crisis D. Hemorrhagic stroke E. Circulatory encephalopathy In patients with aneurysm of cerebral vessels during exercise suddenly appear pain, short loss of consciousness, vomiting. Objective: the patient is excited, wants somewhere to escape Ps-62/min, regular, BP-140/90 mmHg, t-37, 50C. Identify stiff neck, Kernig symptom. No focal neurological symptoms. Determine preliminary diagnosis: A. Subarachnoid hemorrhage B. Brain hemorrhage C. Ischemic stroke D. Hypertensive crisis E. meningitis Patient 60 years old during the month had noted short-term lost of power in left extremities. Later in the morning after sleep was stable weakness in the limbs. OBJECTIVE: BP-140/90 mmHg, in conscious, central paresis VII and XII pairs of cranial nerves on the left, on the same side hemiparesis and central hemihipesteziya. What are the drugs of choice for differentiated treatment of this patient? A. anticoagulants B. hemostatics C. corticosteroids D. diuretics E. antihypertensive Patient 30 years old sudden knife excruciating headache, vomiting, meningeal signs, diplopia, psychomotor agitation. BP - 130/80 mm Hg. century. What kind of disease should think in this case? A. Subarachnoid hemorrhage B. Hemorrhagic stroke parenchymal C. Emorrhage into ventricle of brain D. Hypertensive cerebral crises E. Small ischemic stroke