NEUROLOGY
A QUEEN SQUARE TEXTBOOK
3RD EDITION
• AUTHOR(S)ROBIN HOWARD
TEST BANK
1
Reference: Ch. 1 — Introduction — Global Burden Overview
Stem: A regional neurology director reviews national data
showing that stroke disability-adjusted life years (DALYs) have
risen despite stable age-specific incidence. Local reports note
more prolonged heatwaves and population aging. As a
neurologist advising health policy, which interpretation best
explains rising stroke DALYs?
Page | 1
,Options:
A. Increased stroke incidence across all ages due to climate
change.
B. Stable incidence but increased years lived with disability due
to survivorship and inadequate rehabilitation.
C. Decline in stroke severity but worse reporting inflating DALYs.
D. Improved stroke prevention leading to more chronic
disability coding.
Correct answer: B
Rationale — Correct: Rising DALYs with stable age-specific
incidence indicate more survivors with disability — increased
years lived with disability. Queen Square–style population
reasoning links better acute care/survival and gaps in
rehabilitation to higher disability burden.
Rationale — Incorrect:
A. Suggests incidence rise; stem states incidence stable.
C. Decline in severity would lower YLD, not increase DALYs.
D. Improved prevention should reduce incidence and DALYs, not
increase them.
Page | 2
,Teaching point: Rising DALYs can reflect better survival with
inadequate rehabilitation.
Citation: Howard, R. (2021). Neurology: A Queen Square
Textbook (3rd ed.). Ch. 1.
2
Reference: Ch. 1 — The Global Burden of Neurological Diseases
— Metrics and Interpretation
Stem: During a national review, you’re asked to explain why
years of life lost (YLL) and years lived with disability (YLD) give
different policy signals for epilepsy in low-income regions.
Which explanation aligns best?
Options:
A. Epilepsy primarily raises YLL due to high mortality from
seizures.
B. Epilepsy mainly increases YLD because it causes chronic
disability rather than early death.
C. YLL and YLD cannot be compared; only incidence matters for
policy.
Page | 3
, D. YLD underestimates epilepsy because DALYs exclude seizure
disorders.
Correct answer: B
Rationale — Correct: Epilepsy often causes chronic disability
and social exclusion, so YLD predominates. Queen Square
epidemiologic reasoning emphasizes distinguishing mortality
(YLL) from chronic disability (YLD) to guide rehabilitation and
access-to-care policies.
Rationale — Incorrect:
A. Mortality from epilepsy exists but is usually lower than its
contribution to chronic disability in resource-limited settings.
C. Incidence is important, but YLL/YLD guide different policy
priorities (prevention vs. rehabilitation).
D. DALYs include seizure disorders; statement is false.
Teaching point: YLD highlights chronic care and rehabilitation
priorities for epilepsy.
Citation: Howard, R. (2021). Neurology: A Queen Square
Textbook (3rd ed.). Ch. 1.
Page | 4
A QUEEN SQUARE TEXTBOOK
3RD EDITION
• AUTHOR(S)ROBIN HOWARD
TEST BANK
1
Reference: Ch. 1 — Introduction — Global Burden Overview
Stem: A regional neurology director reviews national data
showing that stroke disability-adjusted life years (DALYs) have
risen despite stable age-specific incidence. Local reports note
more prolonged heatwaves and population aging. As a
neurologist advising health policy, which interpretation best
explains rising stroke DALYs?
Page | 1
,Options:
A. Increased stroke incidence across all ages due to climate
change.
B. Stable incidence but increased years lived with disability due
to survivorship and inadequate rehabilitation.
C. Decline in stroke severity but worse reporting inflating DALYs.
D. Improved stroke prevention leading to more chronic
disability coding.
Correct answer: B
Rationale — Correct: Rising DALYs with stable age-specific
incidence indicate more survivors with disability — increased
years lived with disability. Queen Square–style population
reasoning links better acute care/survival and gaps in
rehabilitation to higher disability burden.
Rationale — Incorrect:
A. Suggests incidence rise; stem states incidence stable.
C. Decline in severity would lower YLD, not increase DALYs.
D. Improved prevention should reduce incidence and DALYs, not
increase them.
Page | 2
,Teaching point: Rising DALYs can reflect better survival with
inadequate rehabilitation.
Citation: Howard, R. (2021). Neurology: A Queen Square
Textbook (3rd ed.). Ch. 1.
2
Reference: Ch. 1 — The Global Burden of Neurological Diseases
— Metrics and Interpretation
Stem: During a national review, you’re asked to explain why
years of life lost (YLL) and years lived with disability (YLD) give
different policy signals for epilepsy in low-income regions.
Which explanation aligns best?
Options:
A. Epilepsy primarily raises YLL due to high mortality from
seizures.
B. Epilepsy mainly increases YLD because it causes chronic
disability rather than early death.
C. YLL and YLD cannot be compared; only incidence matters for
policy.
Page | 3
, D. YLD underestimates epilepsy because DALYs exclude seizure
disorders.
Correct answer: B
Rationale — Correct: Epilepsy often causes chronic disability
and social exclusion, so YLD predominates. Queen Square
epidemiologic reasoning emphasizes distinguishing mortality
(YLL) from chronic disability (YLD) to guide rehabilitation and
access-to-care policies.
Rationale — Incorrect:
A. Mortality from epilepsy exists but is usually lower than its
contribution to chronic disability in resource-limited settings.
C. Incidence is important, but YLL/YLD guide different policy
priorities (prevention vs. rehabilitation).
D. DALYs include seizure disorders; statement is false.
Teaching point: YLD highlights chronic care and rehabilitation
priorities for epilepsy.
Citation: Howard, R. (2021). Neurology: A Queen Square
Textbook (3rd ed.). Ch. 1.
Page | 4
