NEUROLOGY
A QUEEN SQUARE TEXTBOOK
3RD EDITION
• AUTHOR(S)ROBIN HOWARD
TEST BANK
1
Reference
Ch. 1 — Introduction — The Global Burden of Neurological
Diseases
Stem
A 68-year-old man from a low-income region presents after
sudden right-sided weakness and dysarthria. CT is pending but
his history shows untreated hypertension and increasing local
Page | 1
,stroke admissions this summer. As a neurologist asked to advise
public health planning, you must interpret population trends
and individual risk. Which statement best aligns with Queen
Square–style epidemiologic priorities?
Options
A. Focus on tertiary stroke centers only; tertiary care reduces
population DALYs most.
B. Prioritise primary prevention (BP control and smoking
cessation) to reduce overall neurological burden.
C. Invest solely in advanced neuroimaging to improve diagnostic
rates.
D. Emphasise long-term institutional care expansion for stroke
survivors.
Correct answer
B
Rationales
Correct (B): Primary prevention reduces incidence and DALYs at
population level. Queen Square public-health reasoning
emphasises upstream risk modification, particularly BP control
Page | 2
,for stroke. Investment in prevention yields larger population
benefit than diagnostics alone.
A: Tertiary care benefits select patients but has limited
population impact on burden metrics.
C: Diagnostics improve detection but do not reduce incidence
or DALYs without prevention.
D: Institutional care addresses consequences but is less
effective at reducing new disease burden.
Teaching point
Primary prevention (BP, smoking) yields greatest population
DALY reduction.
Citation
Howard, R. (2021). Neurology: A Queen Square Textbook (3rd
ed.). Ch. 1.
2
Page | 3
, Reference
Ch. 1 — The Global Burden of Neurological Diseases —
Introduction
Stem
You review national disease burden data showing neurological
disorders rising in absolute DALYs despite falling age-
standardised rates. The health minister asks why total burden
can increase while rates fall. Using Queen Square population
reasoning, which explanation is best?
Options
A. Improved diagnostics artificially inflate DALYs.
B. Population growth and population ageing increase absolute
DALYs despite lower age-standardised rates.
C. Coding changes in hospitals always reduce DALYs.
D. Neurological diseases are unaffected by demographic shifts.
Correct answer
B
Rationales
Correct (B): Absolute DALYs rise with older and larger
Page | 4
A QUEEN SQUARE TEXTBOOK
3RD EDITION
• AUTHOR(S)ROBIN HOWARD
TEST BANK
1
Reference
Ch. 1 — Introduction — The Global Burden of Neurological
Diseases
Stem
A 68-year-old man from a low-income region presents after
sudden right-sided weakness and dysarthria. CT is pending but
his history shows untreated hypertension and increasing local
Page | 1
,stroke admissions this summer. As a neurologist asked to advise
public health planning, you must interpret population trends
and individual risk. Which statement best aligns with Queen
Square–style epidemiologic priorities?
Options
A. Focus on tertiary stroke centers only; tertiary care reduces
population DALYs most.
B. Prioritise primary prevention (BP control and smoking
cessation) to reduce overall neurological burden.
C. Invest solely in advanced neuroimaging to improve diagnostic
rates.
D. Emphasise long-term institutional care expansion for stroke
survivors.
Correct answer
B
Rationales
Correct (B): Primary prevention reduces incidence and DALYs at
population level. Queen Square public-health reasoning
emphasises upstream risk modification, particularly BP control
Page | 2
,for stroke. Investment in prevention yields larger population
benefit than diagnostics alone.
A: Tertiary care benefits select patients but has limited
population impact on burden metrics.
C: Diagnostics improve detection but do not reduce incidence
or DALYs without prevention.
D: Institutional care addresses consequences but is less
effective at reducing new disease burden.
Teaching point
Primary prevention (BP, smoking) yields greatest population
DALY reduction.
Citation
Howard, R. (2021). Neurology: A Queen Square Textbook (3rd
ed.). Ch. 1.
2
Page | 3
, Reference
Ch. 1 — The Global Burden of Neurological Diseases —
Introduction
Stem
You review national disease burden data showing neurological
disorders rising in absolute DALYs despite falling age-
standardised rates. The health minister asks why total burden
can increase while rates fall. Using Queen Square population
reasoning, which explanation is best?
Options
A. Improved diagnostics artificially inflate DALYs.
B. Population growth and population ageing increase absolute
DALYs despite lower age-standardised rates.
C. Coding changes in hospitals always reduce DALYs.
D. Neurological diseases are unaffected by demographic shifts.
Correct answer
B
Rationales
Correct (B): Absolute DALYs rise with older and larger
Page | 4
