NEUROLOGY
A QUEEN SQUARE TEXTBOOK
3RD EDITION
• AUTHOR(S)ROBIN HOWARD
TEST BANK
Q1
Reference: Ch. 1 — Introduction — The Global Burden of
Neurological Diseases
Stem: A 68-year-old man from a low-income region presents
with sudden right-sided weakness and dysarthria that began 3
hours ago. Emergency services are delayed due to flooding that
damaged roads. As a neurologist advising local stroke services,
Page | 1
,which single system-level intervention most likely preserves
population neurological outcome in similar future events?
A. Invest exclusively in more CT scanners at the regional
hospital.
B. Strengthen prehospital stroke recognition and transport
routes (including flood-resilient plans).
C. Train general practitioners to prescribe antiplatelet agents in
the community.
D. Expand long-term stroke rehabilitation centers inland.
Correct answer: B
Rationales
Correct (B): Queen Square–style systems reasoning prioritizes
time-sensitive interventions for acute ischemic stroke.
Prehospital recognition and resilient transport preserve time-to-
treatment (thrombolysis/thrombectomy), reducing disability
across the population. In disasters, functional outcomes depend
most on maintaining acute access.
Incorrect (A): CT scanners are essential, but without reliable
transport and access they won’t improve time-sensitive care for
Page | 2
,many patients.
Incorrect (C): GP prescribing antiplatelets addresses secondary
prevention but does not mitigate acute disability from delayed
reperfusion.
Incorrect (D): Rehabilitation is valuable but secondary to
preventing early neuronal loss; prevention of delay in acute
care has greater population impact.
Teaching point: Prioritise resilient prehospital systems for time-
sensitive neurological emergencies.
Citation: Howard, R. (2021). Neurology: A Queen Square
Textbook (3rd ed.). Ch. 1.
Q2
Reference: Ch. 1 — The Global Burden of Neurological Diseases
Stem: In a national neurology needs assessment, you are asked
which metric best captures both premature mortality and long-
term disability due to stroke and dementia to guide resource
allocation. Which metric should you recommend?
Page | 3
, A. Crude mortality rate.
B. Incidence per 100,000 population.
C. Disability-adjusted life years (DALYs).
D. Hospital admission counts.
Correct answer: C
Rationales
Correct (C): DALYs combine years of life lost (mortality) with
years lived with disability, capturing the full burden of disabling
neurological diseases—precisely what Queen Square public-
health chapters emphasize for resource planning.
Incorrect (A): Mortality misses major disability from non-fatal
neurological disease.
Incorrect (B): Incidence measures new cases but not their long-
term disability.
Incorrect (D): Admissions reflect access and practice patterns,
not population burden.
Teaching point: Use DALYs to compare mortality and disability
across neurological conditions.
Page | 4
A QUEEN SQUARE TEXTBOOK
3RD EDITION
• AUTHOR(S)ROBIN HOWARD
TEST BANK
Q1
Reference: Ch. 1 — Introduction — The Global Burden of
Neurological Diseases
Stem: A 68-year-old man from a low-income region presents
with sudden right-sided weakness and dysarthria that began 3
hours ago. Emergency services are delayed due to flooding that
damaged roads. As a neurologist advising local stroke services,
Page | 1
,which single system-level intervention most likely preserves
population neurological outcome in similar future events?
A. Invest exclusively in more CT scanners at the regional
hospital.
B. Strengthen prehospital stroke recognition and transport
routes (including flood-resilient plans).
C. Train general practitioners to prescribe antiplatelet agents in
the community.
D. Expand long-term stroke rehabilitation centers inland.
Correct answer: B
Rationales
Correct (B): Queen Square–style systems reasoning prioritizes
time-sensitive interventions for acute ischemic stroke.
Prehospital recognition and resilient transport preserve time-to-
treatment (thrombolysis/thrombectomy), reducing disability
across the population. In disasters, functional outcomes depend
most on maintaining acute access.
Incorrect (A): CT scanners are essential, but without reliable
transport and access they won’t improve time-sensitive care for
Page | 2
,many patients.
Incorrect (C): GP prescribing antiplatelets addresses secondary
prevention but does not mitigate acute disability from delayed
reperfusion.
Incorrect (D): Rehabilitation is valuable but secondary to
preventing early neuronal loss; prevention of delay in acute
care has greater population impact.
Teaching point: Prioritise resilient prehospital systems for time-
sensitive neurological emergencies.
Citation: Howard, R. (2021). Neurology: A Queen Square
Textbook (3rd ed.). Ch. 1.
Q2
Reference: Ch. 1 — The Global Burden of Neurological Diseases
Stem: In a national neurology needs assessment, you are asked
which metric best captures both premature mortality and long-
term disability due to stroke and dementia to guide resource
allocation. Which metric should you recommend?
Page | 3
, A. Crude mortality rate.
B. Incidence per 100,000 population.
C. Disability-adjusted life years (DALYs).
D. Hospital admission counts.
Correct answer: C
Rationales
Correct (C): DALYs combine years of life lost (mortality) with
years lived with disability, capturing the full burden of disabling
neurological diseases—precisely what Queen Square public-
health chapters emphasize for resource planning.
Incorrect (A): Mortality misses major disability from non-fatal
neurological disease.
Incorrect (B): Incidence measures new cases but not their long-
term disability.
Incorrect (D): Admissions reflect access and practice patterns,
not population burden.
Teaching point: Use DALYs to compare mortality and disability
across neurological conditions.
Page | 4
