Question 1

Which statement is false about benzodiazepines and seizures?

Accepted Answer

A)  there is little evidence to support any particular one
B)  the dose of clonazepam in a child is 0.5 mg, and an adult 1mg
C)  diazepam can be safely used PR, IM or IV
D)  the rectal dose of diazepam for a 3 year old is about 5mg
E)  the IV dose of diazepam in a 1 year old is about 2-3mg C

Question 2

Which statement is false about Phenytoin?

Accepted Answer

A)  the loading dose is 15-20 mg/kg
B)  if a pt on phenytoin arrives in status epilepticus then the full loading dose should still be given
C)  side effects include hypotension and bradyarrythmias
D)  it is extremely effective in alcohol induced seizures
E)  it is contraindicated in 2nd and 3rd degree heart block D

Question 3

Which interventions are NOT recommended and proven in Australia for treatment of ischemic strokes?

Accepted Answer

A)  thrombolysis if less than 3 hours and normal CT
B)  aspirin
C)  specialized stoke unit
D)  warfarin if atrial fibrillation
E)  clopridogil A

Question 4

Which is incorrect regarding encephalitis?

Accepted Answer

A)  MRI shows characteristic temporal and frontal lobe changes in HSV.
B)  CSF usually shows aseptic meningitis.
C)  PCR for HSV is insensitive but very specific.
D)  Acyclovir has only been shown to be effective in HSV, but is also used in herpes zoster encephalitis.
E)  Mortality from HSV is higher than herpes zoster or CMV.

Question 5

Which statement is FALSE about zanthocromia and SAH?

Accepted Answer

A)  Inspection of CSF with the naked eye reliably detects zanhtochromia
B)  it is present in all CSF at 6 hours
C)  it remains in CSF for 2 weeks
D)  it is not present in a traumatic tap
E)  it is detected with spectrophotometry

Question 6

A patient with a SAH has a severe headache with nuchal rigidity but no focal neurological signs.What is her Hunt and Hess classification?

Accepted Answer

A)  1
B)  2
C)  3
D)  4
E)  5

Question 7

How long does a pt have to be seizing for to be in Status Epilepticus?

Accepted Answer

A)  20 mins
B)  30 mins
C)  40 mins
D)  50 mins
E)  60 mins

Question 8

What percentage of pts with SAH have a prior sentinal warning hemorrhage ?

Accepted Answer

A)  10%
B)  20%
C)  30%
D)  40%
E)  50%

Question 9

Which statement is incorrect with regards to non contrast CT in SAH

Accepted Answer

A)  
B)  24 hours=95% detection
C)  1 week 50% detection
D)  3 days = 75% detection
E)  1 hour= 100% detection

Question 10

Which statement is FALSE regarding migraine?

Accepted Answer

A)  pathophysiology involves inflammation of the trigeminovascular system
B)  serotonin plays an integral part
C)  the aura, if present, should last less than 60 mins and be totally reversible
D)  it is typically bilateral, pulsating and occipital
E)  the headache usually last 4-72 hours

Question 11

Which is not a risk factor for subarachnoid haemorrhage?

Accepted Answer

A)  female
B)  1st degree relative with SAH
C)  polycystic ovaries
D)  smoking
E)  Marfans syndrome, coarctation of the aorta

Question 12

Which statement is FALSE about carotid stenoses?

Accepted Answer

A)  in a patient with an anterior circulation ischemic event, the presence of a bruit suggests a moderately severe stenosis
B)  in a patient with an anterior circulation ischemic event, the absence of a bruit dismisses a moderately severe stenosis
C)  a symptomatic stenosis >70% is often operated upon
D)  an asymptomatic stenosis of > 70% is usually not operated upon
E)  all patient with stenoses < 30% should not be considered for endarterectomy

Question 13

What is the recommended antibiotic regimen for empirical treatment of bacterial meningitis in a 40 year old?

Accepted Answer

A)  Ceftriaxone 2gm and Benzylpenicillin 1.8gm
B)  Ceftriaxone 2gm
C)  Benzylpenicillin 1.8gm
D)  Ceftriaxone 2gm and Benzylpenicillin 1.8gm and Vancomycin 500mg
E)  Ceftriaxone 2gm and Vancomycin 500mg

Question 14

Which statement is FALSE regarding other headaches?

Accepted Answer

A)  cluster headaches are short lived lasting 15-180 mins
B)  oxygen can releve a majority of cluster headaches
C)  temperal arteritis usually produces an ESR of 20
D)  temporal arteritis can cause ischemic optic neuritis if left untreated
E)  treatment of temperal arteritis involves oral prednisolone

Question 15

Which of the features below is not consistent with a pseudoseizure?

Accepted Answer

A)  rhythmic thrusting of the pelvis
B)  extremity movements out of phase bilaterally
C)  head rolling from side to side
D)  recall of events during the seizure
E)  tongue biting

Question 16

When would heparin be given in an ischemic stroke or TIA?

Accepted Answer

A)  all
B)  vertebro basilar ischemic stroke
C)  anterior circulation ischemic stroke with no prior history of cerebrovascular disease
D)  ischemic stroke or TIA secondary to proven cardioembolic source
E)  lacunar infarct with 80% carotid stenosis

Question 17

Which is incorrect regarding the pharmacological treatment of migraine?

Accepted Answer

A)  chlorpromazine is a first line agent
B)  sumotriptan is a first line agent
C)  dihydroergotamine should not be given if sumotriptan has already been taken
D)  pethidine is not as effective in treatment and has a higher rebound c.f other agents
E)  dexamethasone has been proven to decrease rate of recurrence

Question 18

Which statement is INCORRECT with regards to vasospasm in SAH?

Accepted Answer

A)  it usually occurs at day 4-14
B)  it effects 30% of pts with SAH
C)  it has a 30% morbidity and mortality untreated
D)  hypertensive therapy with iv fluids and inotropes is contrindicated
E)  the treatment of choice is Nimodipine

Question 19

What percentage of the population will have at least one seizure in their lifetime?

Accepted Answer

A)  2.5%
B)  5%
C)  10%
D)  15%
E)  17.5%

Question 20

A CSF shows opening pressure of 30 cm H2O , protein of 0.1, glucose of 2.0, WCC of 100, and no organisms on gram stain. Which type of meningitis does this fit with?

Accepted Answer

A)  Acute bacterial.
B)  Viral meningitis.
C)  Normal result.
D)  TB meningitis
E)  TB meningitis or partly treated bacterial meningitis.

Exam 2: Neurological Disorders: Meningitis, Encephalitis, Cerebral Abscess, Stroke, Seizures, and Headaches