NEUROLOGY
A QUEEN SQUARE TEXTBOOK
3RD EDITION
• AUTHOR(S)ROBIN HOWARD
TEST BANK
MCQ 1
Reference
Ch. 1 — Introduction — Global Burden Overview
Stem
A 68-year-old man from a high-income country presents with
progressive gait difficulty, cognitive slowing, and frequent falls
over 12 months. Population data show rising age-standardized
prevalence of neurodegenerative disorders in his region. You
Page | 1
,are asked to advise health-service planners on priorities to
reduce disability-adjusted life-years (DALYs) from neurological
disease. Which intervention is most likely to produce the largest
short-to-medium term reduction in neurological DALYs at a
population level?
A. Mass genetic screening for familial neurodegenerative
mutations.
B. Scale-up of stroke prevention (hypertension control, smoking
cessation).
C. Investment in experimental disease-modifying therapies for
Parkinson’s disease.
D. Universal screening for early cognitive impairment using
neuropsychological batteries.
Correct answer
B
Rationale — Correct (3–5 sentences)
Stroke prevention targets the largest and most modifiable
contributor to neurological DALYs worldwide. Queen Square–
style public-health reasoning emphasizes addressing high-
Page | 2
,impact vascular risk factors (e.g., hypertension, smoking) to
reduce incidence of acute and chronic neurological disability. In
the medium term, population-level risk reduction translates
into fewer strokes and less long-term care burden, making it the
most effective DALY-reduction strategy.
Rationale — Incorrect
A. Genetic screening targets a tiny fraction of cases and has
minimal population DALY impact.
C. Experimental disease-modifying therapies are high cost, low
current population reach, and slow to affect DALYs.
D. Universal cognitive screening increases detection but does
not itself reduce incidence or major DALYs without effective
interventions.
Teaching point (≤20 words)
Preventing vascular risk factors yields the largest short-term
DALY reductions in neurology.
Citation
Howard, R. (2021). Neurology: A Queen Square Textbook (3rd
ed.). Ch. 1.
Page | 3
, MCQ 2
Reference
Ch. 1 — The Global Burden of Neurological Diseases —
Epidemiology & Metrics
Stem
You are reviewing country-level data showing a rise in years
lived with disability (YLDs) from headache disorders despite
stable mortality. As a neurology advisor, which interpretation
best matches this pattern?
A. Improved survival from fatal neurological diseases increases
prevalence of disabling headaches.
B. Increased YLDs reflect higher incidence or better recognition
of non-fatal disabling conditions.
C. Rising YLDs necessarily indicate worsening access to acute
stroke care.
D. This pattern suggests a large increase in neuroinfectious
mortality misclassified as nonfatal headaches.
Page | 4
A QUEEN SQUARE TEXTBOOK
3RD EDITION
• AUTHOR(S)ROBIN HOWARD
TEST BANK
MCQ 1
Reference
Ch. 1 — Introduction — Global Burden Overview
Stem
A 68-year-old man from a high-income country presents with
progressive gait difficulty, cognitive slowing, and frequent falls
over 12 months. Population data show rising age-standardized
prevalence of neurodegenerative disorders in his region. You
Page | 1
,are asked to advise health-service planners on priorities to
reduce disability-adjusted life-years (DALYs) from neurological
disease. Which intervention is most likely to produce the largest
short-to-medium term reduction in neurological DALYs at a
population level?
A. Mass genetic screening for familial neurodegenerative
mutations.
B. Scale-up of stroke prevention (hypertension control, smoking
cessation).
C. Investment in experimental disease-modifying therapies for
Parkinson’s disease.
D. Universal screening for early cognitive impairment using
neuropsychological batteries.
Correct answer
B
Rationale — Correct (3–5 sentences)
Stroke prevention targets the largest and most modifiable
contributor to neurological DALYs worldwide. Queen Square–
style public-health reasoning emphasizes addressing high-
Page | 2
,impact vascular risk factors (e.g., hypertension, smoking) to
reduce incidence of acute and chronic neurological disability. In
the medium term, population-level risk reduction translates
into fewer strokes and less long-term care burden, making it the
most effective DALY-reduction strategy.
Rationale — Incorrect
A. Genetic screening targets a tiny fraction of cases and has
minimal population DALY impact.
C. Experimental disease-modifying therapies are high cost, low
current population reach, and slow to affect DALYs.
D. Universal cognitive screening increases detection but does
not itself reduce incidence or major DALYs without effective
interventions.
Teaching point (≤20 words)
Preventing vascular risk factors yields the largest short-term
DALY reductions in neurology.
Citation
Howard, R. (2021). Neurology: A Queen Square Textbook (3rd
ed.). Ch. 1.
Page | 3
, MCQ 2
Reference
Ch. 1 — The Global Burden of Neurological Diseases —
Epidemiology & Metrics
Stem
You are reviewing country-level data showing a rise in years
lived with disability (YLDs) from headache disorders despite
stable mortality. As a neurology advisor, which interpretation
best matches this pattern?
A. Improved survival from fatal neurological diseases increases
prevalence of disabling headaches.
B. Increased YLDs reflect higher incidence or better recognition
of non-fatal disabling conditions.
C. Rising YLDs necessarily indicate worsening access to acute
stroke care.
D. This pattern suggests a large increase in neuroinfectious
mortality misclassified as nonfatal headaches.
Page | 4
