MD Central Nervous System Disorders 2

Question 1

A 45-year-old man presents with sudden onset of thunderclap headache reaching maximal intensity within seconds. CT head is negative. What is the next best step?

Accepted Answer

Lumbar puncture for xanthochromia

Answer

A negative CT with thunderclap headache requires lumbar puncture to detect xanthochromia, indicating subarachnoid hemorrhage.

Question 2

Which demyelinating disease is characterized by optic neuritis, transverse myelitis, and area postrema syndrome, with seropositivity for AQP4-IgG?

Accepted Answer

Neuromyelitis optica spectrum disorder

Answer

AQP4-IgG (anti-aquaporin-4) antibodies are the hallmark of neuromyelitis optica spectrum disorder (NMOSD).

Question 3

A 70-year-old presents with progressive gait instability, urinary incontinence, and cognitive decline. MRI shows enlarged ventricles disproportionate to sulcal atrophy. What is the diagnosis?

Accepted Answer

Normal pressure hydrocephalus

Answer

The classic triad of gait apraxia, urinary incontinence, and dementia with ventriculomegaly suggests normal pressure hydrocephalus.

Question 4

A patient develops ascending paralysis 2 weeks after a GI infection with Campylobacter jejuni. CSF shows albuminocytologic dissociation. Which antibody is associated with this variant?

Accepted Answer

Anti-GM1

Answer

Anti-GM1 antibodies are associated with the acute motor axonal neuropathy (AMAN) variant of Guillain-Barré syndrome linked to Campylobacter.

Question 5

Which feature best distinguishes a Todd's paralysis from an acute ischemic stroke?

Accepted Answer

Gradual resolution over minutes to hours after a seizure

Answer

Todd's paralysis is postictal focal weakness that resolves spontaneously within minutes to hours following a seizure.

MD - Doctor of Medicine Practice Test

MD - Doctor of Medicine Practice Test

MD Central Nervous System Disorders 2