NEUROLOGY PRACTICE QUESTIONS
(PHYSICIAN ASSISTANT CLINICAL
KNOWLEDGE RATING AND
ASSESSMENT TOOL) ANSWERED
CORRECTLY TO PASS!!
1 of
81
Term
Diagnostic Studies/Neurology
What test is the single most useful test in establishing the diagnosis of
multiple sclerosis?
Answers
Cerebral spinal fluid cell count and protein level
Cerebral spinal fluid immunoglobulin studies
Evoked potentials
Magnetic Resonance Imaging
,Give this one a try later!
Explanations
(u) A. Angiogram is necessary to define details of aneurysm and anatomic
configuration, but not as an initial diagnostic study.
(c) B. This patient's history is highly suggestive of subarachnoid hemorrhage. CT is
best to screen for intracranial hemorrhage. It is faster than MRI and more
sensitive in the first 24 hours.
(u) C. Transcranial Doppler can detect cerebral artery vasospasm but cannot
detect aneurysm.
(u) D. MRI is not as sensitive for an acute bleed, but is appropriate for old bleeds.
Explanations
(u) A. See B for explanation.
(c) B. This patient presents with a history of minor trauma and progressive
neurological abnormalities consistent with
subdural hematoma. Diagnosis would be confirmed by CT scan, which is less
expensive and more sensitive for
blood than an MRI.
(u) C. Skull x-rays would not be helpful because they evaluate bony, not soft
tissue, injury.
(h) D. A lumbar puncture is contraindicated because of the potential for brain
herniation.
Explanations
(u) A. While cerebral spinal fluid cell count, protein levels, and
immunoglobins may be abnormal they are not specific for multiple
sclerosis.
(u) B. See A for explanation.
(u) C. Evoked potentials are most useful in the detection of subclinical
involvement of neuropathways in MS, but does not establish the diagnosis.
(c) D. The presence of plaques on MRI is a key finding in establishing the
diagnosis of MS.
, Explanations
(u) A. There is no role for positron emission tomography in suspected cervical
spine injury.
(u) B. MRI and CT of the spine may be performed in the setting of acute cervical
spine injury when a major fracture or dislocation is identified.
(u) C. See B for explanation.
(c) D. Cervical spine x-rays are most commonly used as the initial screen
for cervical spine injury. A cervical spinDe osne' trikensocwo? nsists of a lateral
view,
anteroposterior (AP) view, and an odontoid view. The lateral view detects up to
80% of traumatic spine injuries.
2 of 81
Term
Clinical Therapeutics/Neurology
A 7 year-old is evaluated for episodes of unresponsiveness in which
she stares, blinking into space. Episodes last only 10-20 seconds
but may happen several times daily. There are no abnormal
movements, sensory loss or headaches reported. Which of the
following is
considered first-line therapy for this disorder?
A. Carbamazepine (Tegretol)
B.Ethosuximide (Zarontin)
C. Gabepentin (Neurontin)
D.Topiramate (Topamax)
Give this one a try later!
Explanations
(u) A. Phenytoin is used to treat tonic clonic and partial seizures.
(u) B. Carbamazepine is used to treat tonic clonic and partial seizures.
(c) C. Ethosuximide, valproic acid, and clonazepam are recommended
treatments for absence seizures.
(u) D. Gabapentin is used to treat partial seizures.
, Explanations
(u) A. See D for explanation.
(u) B. See D for explanation.
(u) C. See D for explanation.
(c) D. Acute relapses of MS are treated with a short course of IV
methylprednisolone followed by oral prednisone. This regimen reduces the
severity and shortens the duration of attacks. All other drugs listed are used to
reduce the attack rate of relapsing remitting multiple sclerosis.
Explanations
(u) A. See B for explanation.
(c) B. Absence seizures are usually treated successfully with Ethosuximide.
The other agents listed are not indicated and may actually worsen this
type of seizure.
(u) C. See B for explanation.
(u) D. See B for explanation.
Explanations
(u) A. A Medrol dose pack will have no affect on carpal tunnel syndrome.
(c) B. Splinting in neutral position relieves impingement of the median nerve, thus
improving symptoms of carpal
tunnel.
(u) C. Observation will not improve symptoms.
(u) D. Surgical intervention is reserved for cases unresponsive to conservative
therapy.
Don't know?
3 of 81
Definition
Explanations
(c) A. The triptans are contraindicated in patients with coronary
artery disease or peripheral vascular disease and should be avoided
in patients with an increased risk for stroke. All other drugs listed
are not contraindicated.
(PHYSICIAN ASSISTANT CLINICAL
KNOWLEDGE RATING AND
ASSESSMENT TOOL) ANSWERED
CORRECTLY TO PASS!!
1 of
81
Term
Diagnostic Studies/Neurology
What test is the single most useful test in establishing the diagnosis of
multiple sclerosis?
Answers
Cerebral spinal fluid cell count and protein level
Cerebral spinal fluid immunoglobulin studies
Evoked potentials
Magnetic Resonance Imaging
,Give this one a try later!
Explanations
(u) A. Angiogram is necessary to define details of aneurysm and anatomic
configuration, but not as an initial diagnostic study.
(c) B. This patient's history is highly suggestive of subarachnoid hemorrhage. CT is
best to screen for intracranial hemorrhage. It is faster than MRI and more
sensitive in the first 24 hours.
(u) C. Transcranial Doppler can detect cerebral artery vasospasm but cannot
detect aneurysm.
(u) D. MRI is not as sensitive for an acute bleed, but is appropriate for old bleeds.
Explanations
(u) A. See B for explanation.
(c) B. This patient presents with a history of minor trauma and progressive
neurological abnormalities consistent with
subdural hematoma. Diagnosis would be confirmed by CT scan, which is less
expensive and more sensitive for
blood than an MRI.
(u) C. Skull x-rays would not be helpful because they evaluate bony, not soft
tissue, injury.
(h) D. A lumbar puncture is contraindicated because of the potential for brain
herniation.
Explanations
(u) A. While cerebral spinal fluid cell count, protein levels, and
immunoglobins may be abnormal they are not specific for multiple
sclerosis.
(u) B. See A for explanation.
(u) C. Evoked potentials are most useful in the detection of subclinical
involvement of neuropathways in MS, but does not establish the diagnosis.
(c) D. The presence of plaques on MRI is a key finding in establishing the
diagnosis of MS.
, Explanations
(u) A. There is no role for positron emission tomography in suspected cervical
spine injury.
(u) B. MRI and CT of the spine may be performed in the setting of acute cervical
spine injury when a major fracture or dislocation is identified.
(u) C. See B for explanation.
(c) D. Cervical spine x-rays are most commonly used as the initial screen
for cervical spine injury. A cervical spinDe osne' trikensocwo? nsists of a lateral
view,
anteroposterior (AP) view, and an odontoid view. The lateral view detects up to
80% of traumatic spine injuries.
2 of 81
Term
Clinical Therapeutics/Neurology
A 7 year-old is evaluated for episodes of unresponsiveness in which
she stares, blinking into space. Episodes last only 10-20 seconds
but may happen several times daily. There are no abnormal
movements, sensory loss or headaches reported. Which of the
following is
considered first-line therapy for this disorder?
A. Carbamazepine (Tegretol)
B.Ethosuximide (Zarontin)
C. Gabepentin (Neurontin)
D.Topiramate (Topamax)
Give this one a try later!
Explanations
(u) A. Phenytoin is used to treat tonic clonic and partial seizures.
(u) B. Carbamazepine is used to treat tonic clonic and partial seizures.
(c) C. Ethosuximide, valproic acid, and clonazepam are recommended
treatments for absence seizures.
(u) D. Gabapentin is used to treat partial seizures.
, Explanations
(u) A. See D for explanation.
(u) B. See D for explanation.
(u) C. See D for explanation.
(c) D. Acute relapses of MS are treated with a short course of IV
methylprednisolone followed by oral prednisone. This regimen reduces the
severity and shortens the duration of attacks. All other drugs listed are used to
reduce the attack rate of relapsing remitting multiple sclerosis.
Explanations
(u) A. See B for explanation.
(c) B. Absence seizures are usually treated successfully with Ethosuximide.
The other agents listed are not indicated and may actually worsen this
type of seizure.
(u) C. See B for explanation.
(u) D. See B for explanation.
Explanations
(u) A. A Medrol dose pack will have no affect on carpal tunnel syndrome.
(c) B. Splinting in neutral position relieves impingement of the median nerve, thus
improving symptoms of carpal
tunnel.
(u) C. Observation will not improve symptoms.
(u) D. Surgical intervention is reserved for cases unresponsive to conservative
therapy.
Don't know?
3 of 81
Definition
Explanations
(c) A. The triptans are contraindicated in patients with coronary
artery disease or peripheral vascular disease and should be avoided
in patients with an increased risk for stroke. All other drugs listed
are not contraindicated.
