APEA 3P EXAM Prep Neuro Questions with Correct Answers and Explanations

APEA 3P EXAM Prep Neuro Questions with Correct Answers and Explanations A 26-year-old HIV-positive patient presents with photophobia and temperature of 103.2° F. He complains of a headache. On exam, he is unable to demonstrate full extension of the knee when his hip is flexed. Which choice below is the most likely diagnosis? Pneumocystis infection Meningitis Septic bursitis Septic arthritis The inability to demonstrate full extension of the knee when the hip is flexed is a positive Brudzinski's sign. This is present in patients who have meningitis. It is not present in patients who have septic bursitis or septic arthritis. HIV-positive patients are more likely to exhibit pneumonia secondary to pneumocystis infection, but he has no respiratory symptoms. A patient cannot stick his tongue out of his mouth and move it from side to side. What cranial nerve is responsible for movement of the tongue? Cranial Nerve III Cranial Nerve VII Cranial Nerve X Cranial Nerve XII Cranial nerve (CN) XII enables a patient to stick his tongue out and to move it from side to side in his mouth. CN III is partly responsible for eye movement. CN VII is responsible for the ability to close the eyes tightly, wrinkle the forehead, smile, and the sensation of taste to the anterior 2/3 of the tongue. CN X is partly responsible for speaking and some tongue movement What cranial nerve is responsible for hearing? II III V VIII Cranial nerve VIII is responsible for hearing. Cranial nerve II is the optic nerve and is responsible for vision. Cranial nerve III is partly responsible for eye movement. Cranial nerve V is the facial nerve and is responsible for sensation of the face. It is tested by a light touch on the patient’s forehead. An 80-year-old patient comes into the clinic with an ataxic gait, complaints of new- onset headache and slurred speech that began about 2 hours ago. What is the likely etiology of this event? Adverse drug event Alcohol intoxication Stroke or TIA Bell’s palsy A new onset headache in an 80-year-old is not likely to be due to an adverse drug event. Stroke risk increases as age increases. Transient ischemia attack (TIA) is defined as an episode of transient neurologic dysfunction without acute infarction. Bell’s palsy is accompanied by facial numbness and sometimes slurred speech occurs if the upper lip is affected, but headache and an ataxic gait do not accompany Bell’s palsy. Alcohol intoxication might be considered, but a stroke must be ruled out. When headache accompanies stroke, it is often hemorrhagic stroke, but ischemic stroke can cause headache too. 60- Mrs. Jopson is unable to name a familiar object. How is this described? Anomia Anosmia Acanthosis Incompetent Anomia is difficulty in the naming of familiar objects. This is an example of mild impairment. Other evidence of mild impairment is recent recall problems, decreased insight, and difficulty managing finances. Many mildly impaired adults are not able to state today’s date. All the following characteristics may be found in an older adult with dementia. Which one is common in a patient with Alzheimer’s disease, but uncommon in a patient with another type of dementia? Visual hallucinations Personality change Abrupt onset Indifference The most common characteristics in a patient with Alzheimer’s disease (AD) are memory impairment, visual-spatial disturbances, indifference, occasional delusions, and agitation. Personality change can be seen in patients with fronto-temporal dementia. Abrupt onset can be seen in patients with delirium and vascular dementia. Visual hallucinations can be seen in patients with Lewy-body dementia. A family member of a newly diagnosed Alzheimer’s disease patient asks how long the patient should take donepezil (Aricept), an acetylcholinesterase inhibitor, before learning whether it is beneficial or not. You reply: 4 - 8 weeks. about 12 weeks. 6 - 12 months. at least 1 year. The ideal time to evaluate the efficacy of an acetylcholinesterase inhibitor (Ach-I) is 6-12 months of continuous use. The evaluation should include caregiver feedback, repeat mental status assessments, ability to perform activities of daily living, healthcare provider’s assessment, side effects, and cost. If the Ach-I is stopped, it can be restarted at a later date.