NEUROLOGY
A QUEEN SQUARE TEXTBOOK
3RD EDITION
• AUTHOR(S)ROBIN HOWARD
TEST BANK
1
Reference
Ch. 1 — Global Burden of Neurological Diseases —
Epidemiological Metrics
Stem
A national neurology service is asked to prioritize interventions
based on disease burden. You are given counts of incident
stroke, prevalence of dementia, and disability-adjusted life
Page | 1
,years (DALYs) for several conditions. Which epidemiological
metric best combines premature mortality and years lived with
disability to guide resource allocation for neurological services?
Options
A. Incidence
B. Point prevalence
C. Case fatality rate
D. Disability-adjusted life years (DALYs)
Correct answer
D
Rationales
Correct: DALYs combine years of life lost (premature mortality)
and years lived with disability — providing a single metric to
compare burdens across disorders and guide resource
allocation. Queen Square–style public neurology emphasizes
using population-level metrics to target interventions.
A: Incidence measures new cases but ignores chronic disability
and premature mortality.
B: Point prevalence measures existing cases at a timepoint but
Page | 2
,does not integrate mortality.
C: Case fatality quantifies mortality among those affected but
omits non-fatal disability.
Teaching point
DALYs combine mortality and morbidity — key for prioritising
neurological services.
Citation
Howard, R. (2021). Neurology: A Queen Square Textbook (3rd
ed.). Ch. 1.
2
Reference
Ch. 1 — Global Burden of Neurological Diseases — Global
trends
Stem
A health minister asks why stroke burden is rising in many low-
and middle-income countries despite stable incidence in high-
Page | 3
, income countries. Which factor best explains increasing stroke
DALYs in those settings?
Options
A. Increased case fatality due to lack of acute stroke services
B. Universal reduction in risk factors like hypertension
C. Improved surgical care reducing mortality from subarachnoid
haemorrhage
D. Decreased life expectancy reducing chronic disability
Correct answer
A
Rationales
Correct: Lack of acute stroke services, delayed presentation,
and limited rehab increase case fatality and long-term disability,
raising DALYs. Queen Square public neurology highlights
systems-level drivers.
B: Reduction in risk factors would lower burden, not increase it.
C: Improved surgical care would likely reduce DALYs.
D: Decreased life expectancy typically lowers prevalence of
chronic disability — not a reason for rising DALYs.
Page | 4
A QUEEN SQUARE TEXTBOOK
3RD EDITION
• AUTHOR(S)ROBIN HOWARD
TEST BANK
1
Reference
Ch. 1 — Global Burden of Neurological Diseases —
Epidemiological Metrics
Stem
A national neurology service is asked to prioritize interventions
based on disease burden. You are given counts of incident
stroke, prevalence of dementia, and disability-adjusted life
Page | 1
,years (DALYs) for several conditions. Which epidemiological
metric best combines premature mortality and years lived with
disability to guide resource allocation for neurological services?
Options
A. Incidence
B. Point prevalence
C. Case fatality rate
D. Disability-adjusted life years (DALYs)
Correct answer
D
Rationales
Correct: DALYs combine years of life lost (premature mortality)
and years lived with disability — providing a single metric to
compare burdens across disorders and guide resource
allocation. Queen Square–style public neurology emphasizes
using population-level metrics to target interventions.
A: Incidence measures new cases but ignores chronic disability
and premature mortality.
B: Point prevalence measures existing cases at a timepoint but
Page | 2
,does not integrate mortality.
C: Case fatality quantifies mortality among those affected but
omits non-fatal disability.
Teaching point
DALYs combine mortality and morbidity — key for prioritising
neurological services.
Citation
Howard, R. (2021). Neurology: A Queen Square Textbook (3rd
ed.). Ch. 1.
2
Reference
Ch. 1 — Global Burden of Neurological Diseases — Global
trends
Stem
A health minister asks why stroke burden is rising in many low-
and middle-income countries despite stable incidence in high-
Page | 3
, income countries. Which factor best explains increasing stroke
DALYs in those settings?
Options
A. Increased case fatality due to lack of acute stroke services
B. Universal reduction in risk factors like hypertension
C. Improved surgical care reducing mortality from subarachnoid
haemorrhage
D. Decreased life expectancy reducing chronic disability
Correct answer
A
Rationales
Correct: Lack of acute stroke services, delayed presentation,
and limited rehab increase case fatality and long-term disability,
raising DALYs. Queen Square public neurology highlights
systems-level drivers.
B: Reduction in risk factors would lower burden, not increase it.
C: Improved surgical care would likely reduce DALYs.
D: Decreased life expectancy typically lowers prevalence of
chronic disability — not a reason for rising DALYs.
Page | 4
