Deck 3: Neurological: LP, CSF, Meningitis, Vertigo, MS, and Stroke

Question 1

How long should you wait to get an LP before giving antibiotics?

A)give antibiotics immediately
B)10 mins
C)20 mins
D)30 mins
E)45 mins

Answer 1

20 mins

Question 2

Which CSF finding is incorrect?

A)antigenic studies are useful where partial treatment with antibiotics renders CSF sterile on culture
B)antigenic studies are more sensitive when urine and serum are used as opposed to CSF
C)in viral meningitis the main white cells usually seen are monocytes
D)you would expect to see a raised CSF pressure in bacterial meningitis
E)in viral meningitis you would expect to see a low glucose and a high protein

Answer 2

in viral meningitis you would expect to see a low glucose and a high protein

Question 3

Which statement is incorrect about prophylaxis in meningitis?

A)there is no prophylaxis available for pneumococcus only meningococcus and Hib
B)it does not need to be given to the index case
C)it should include all household contact where there has been close contact eg. Share eating utensils
D)it should be given to the attending medical staff only if they did mouth to mouth
E)rifampicin or ceftriaxone or ciprofloxacin are in the drugs involved

Answer 3

it does not need to be given to the index case

Question 4

Which of the signs or symptoms below would concern you that the cause of a patients vertigo was central?

A)associated vomiting
B)worsens with position change
C)associated tinnitus
D)vertical nystagmus
E)sudden onset

Question 5

Which of these is not consistent with vestibular neuronitis?

A)horizontal nystagmus
B)dysarthria
C)vomiting
D)constant for eight hours
E)vertigo

Question 6

What is NOT true of Guillian Barre Syndrome?

A)frequently patients report an antecedent viral illness
B)classical motor weakness is greater and earliest in the legs
C)there is a lack of deep tendon reflexes
D)there is peripheral sensory loss greater in the arms than the legs
E)There may be autonomic disturbances

Question 7

Which statement is false regarding Bells Palsy?

A)The use of steroids is well proven to decrease duration of illness
B)Steroids are definitely not of use if the presentation is one week post symptom onset
C)The feature that excludes it from an upper motor nerve lesion is the inability to furrow the forehead
D)Other cranial nerves are always normal
E)It involves the 7th cranial nerve

Question 8

Which of the drugs below is not known to cause an exacerbation of myasthenia gravis?

A)prednisolone
B)lignocaine
C)chlorpromazine
D)lithium
E)penicillin

Question 9

Which is not a feature of myasthenia gravis?

A)motor weakness is usually of proximal extremities and bulbar
B)there is usually no sensory loss
C)there is usually no reflex loss
D)symptoms are often worse as the day progresses
E)it is due to anitibodies formed against acetylcholineesterase

Question 10

Which statement is FALSE about MS?

A)30% of patients will initially present with optic neuritis
B)CSF protein and gammaglobulin levels are reduced in MS
C)nearly all patients will demonstrate some abnormality on MRI
D)the overall life expectancy is not usually reduced with MS
E)MS symptoms will often worsen with fever and exercise

Question 11

A patient presents with right sided arm weakeness and a R facial droop with aphasia. Which artery distribution is the likely to be the cause of her stoke?

A)right MCA
B)left MCA
C)right anterior cerebral artery
D)left anterior cerebral artery
E)left vertebrobasilar system

Question 12

Which CSF finding is incorrect?

A)antigenic studies are useful where partial treatment with antibiotics renders the CSF sterile on culture
B)antigenic studies are more sensitive when urine and serum are used as opposed to CSF
C)in viral meningitis the main white cells usually seen are monocytes
D)you would expect to see a raised CSF pressure in bacterial meningitis
E)in viral meningitis you would expect to see a low glucose and a high protein

Question 13

Which of the signs or symptoms below would concern you that the cause of a patients vertigo was central?

A)associated vomiting
B)worsens with position change
C)associated tinnitus
D)vertical nystagmus
E)sudden onset