NEUROLOGY
A QUEEN SQUARE TEXTBOOK
3RD EDITION
• AUTHOR(S)ROBIN HOWARD
TEST BANK
Q1
Reference
Ch. 1 — Introduction — Global Burden overview
Stem
A national neurology service is asked to prioritize interventions
to reduce disability. You are given aggregated data showing high
Years Lived with Disability (YLD) from migraine and high Years of
Page | 1
,Life Lost (YLL) from stroke. Which interpretation best guides
resource allocation to reduce total neurological burden?
Options
A. Focus exclusively on acute stroke services to reduce YLL
because YLL contributes most to mortality.
B. Focus on stroke primary prevention and acute stroke care,
while scaling chronic-care services for migraine to reduce YLD.
C. Prioritize migraine clinics because YLD is reversible with
outpatient care and will quickly reduce overall burden.
D. Allocate all funding to rehabilitation services since
rehabilitation reduces both YLL and YLD equally.
Correct answer
B
Rationales
Correct (B): Queen Square–style reasoning integrates
population measures: YLL (mortality) and YLD (disability) are
complementary. Stroke causes high mortality (YLL) and also
disability; targeting primary prevention and acute stroke care
reduces YLL and incidence, while maintaining chronic services
Page | 2
,(e.g., headache services) addresses the large YLD contribution
from migraine. This balanced plan aligns with epidemiologic
synthesis for maximal burden reduction.
Incorrect (A): Exclusively focusing on acute stroke ignores high
population-level disability from migraine (YLD) and fails to
address prevention.
Incorrect (C): Migraine clinics are important but will not rapidly
address mortality-driven YLL from stroke.
Incorrect (D): Rehabilitation helps reduce disability but does
not prevent stroke deaths or reduce incidence; it cannot equally
reduce both YLL and YLD.
Teaching point
Target both YLL (prevention/acute care) and YLD (chronic
services) for maximal burden reduction.
Citation
Howard, R. (2021). Neurology: A Queen Square Textbook (3rd
ed.). Ch. 1.
Q2
Page | 3
, Reference
Ch. 1 — The Global Burden of Neurological Diseases — Metrics
and interpretation
Stem
A regional health authority provides you age-standardized
incidence and prevalence for Alzheimer’s disease across three
regions. One has higher prevalence but similar incidence
compared to others. Which interpretation best explains this
pattern?
Options
A. The region with higher prevalence likely has higher case
fatality for Alzheimer’s disease.
B. The region with higher prevalence likely has increased
survival (longer disease duration) or greater diagnostic
recognition.
C. Incidence and prevalence equivalently reflect disease
burden; no further interpretation is possible.
D. The region with higher prevalence must have an
environmental exposure causing more new cases.
Page | 4
A QUEEN SQUARE TEXTBOOK
3RD EDITION
• AUTHOR(S)ROBIN HOWARD
TEST BANK
Q1
Reference
Ch. 1 — Introduction — Global Burden overview
Stem
A national neurology service is asked to prioritize interventions
to reduce disability. You are given aggregated data showing high
Years Lived with Disability (YLD) from migraine and high Years of
Page | 1
,Life Lost (YLL) from stroke. Which interpretation best guides
resource allocation to reduce total neurological burden?
Options
A. Focus exclusively on acute stroke services to reduce YLL
because YLL contributes most to mortality.
B. Focus on stroke primary prevention and acute stroke care,
while scaling chronic-care services for migraine to reduce YLD.
C. Prioritize migraine clinics because YLD is reversible with
outpatient care and will quickly reduce overall burden.
D. Allocate all funding to rehabilitation services since
rehabilitation reduces both YLL and YLD equally.
Correct answer
B
Rationales
Correct (B): Queen Square–style reasoning integrates
population measures: YLL (mortality) and YLD (disability) are
complementary. Stroke causes high mortality (YLL) and also
disability; targeting primary prevention and acute stroke care
reduces YLL and incidence, while maintaining chronic services
Page | 2
,(e.g., headache services) addresses the large YLD contribution
from migraine. This balanced plan aligns with epidemiologic
synthesis for maximal burden reduction.
Incorrect (A): Exclusively focusing on acute stroke ignores high
population-level disability from migraine (YLD) and fails to
address prevention.
Incorrect (C): Migraine clinics are important but will not rapidly
address mortality-driven YLL from stroke.
Incorrect (D): Rehabilitation helps reduce disability but does
not prevent stroke deaths or reduce incidence; it cannot equally
reduce both YLL and YLD.
Teaching point
Target both YLL (prevention/acute care) and YLD (chronic
services) for maximal burden reduction.
Citation
Howard, R. (2021). Neurology: A Queen Square Textbook (3rd
ed.). Ch. 1.
Q2
Page | 3
, Reference
Ch. 1 — The Global Burden of Neurological Diseases — Metrics
and interpretation
Stem
A regional health authority provides you age-standardized
incidence and prevalence for Alzheimer’s disease across three
regions. One has higher prevalence but similar incidence
compared to others. Which interpretation best explains this
pattern?
Options
A. The region with higher prevalence likely has higher case
fatality for Alzheimer’s disease.
B. The region with higher prevalence likely has increased
survival (longer disease duration) or greater diagnostic
recognition.
C. Incidence and prevalence equivalently reflect disease
burden; no further interpretation is possible.
D. The region with higher prevalence must have an
environmental exposure causing more new cases.
Page | 4
