MD Central Nervous System Disorders 3

Question 1

A 60-year-old presents with resting tremor, bradykinesia, and cogwheel rigidity. He also has orthostatic hypotension, REM sleep behavior disorder, and anosmia. What is the unifying diagnosis?

Accepted Answer

Parkinson disease

Answer

The combination of motor parkinsonism with autonomic dysfunction, REM sleep behavior disorder, and anosmia is characteristic of Parkinson disease.

Question 2

Which medication mechanism is responsible for neuroleptic malignant syndrome?

Accepted Answer

Dopamine receptor blockade

Answer

Neuroleptic malignant syndrome results from dopamine receptor blockade by antipsychotics, causing hyperthermia, rigidity, and autonomic instability.

Question 3

A 25-year-old woman presents with new-onset focal-onset impaired awareness seizures. MRI shows a unilateral medial temporal sclerosis. What is the most likely seizure type?

Accepted Answer

Mesial temporal lobe epilepsy

Answer

Hippocampal sclerosis is the hallmark of mesial temporal lobe epilepsy, the most common focal epilepsy syndrome in adults.

Question 4

A patient with schizophrenia on haloperidol develops involuntary repetitive movements of the face, tongue, and extremities after 3 years of treatment. What is this condition?

Accepted Answer

Tardive dyskinesia

Answer

Tardive dyskinesia is a late-onset movement disorder from prolonged dopamine receptor blockade, typically presenting with oro-facial dyskinesias.

Question 5

A 40-year-old presents with behavioral disinhibition, hyperphagia, and executive dysfunction with preserved memory. MRI shows frontal and anterior temporal atrophy. What is the diagnosis?

Accepted Answer

Frontotemporal dementia

Answer

Behavioral variant frontotemporal dementia is characterized by frontal lobe disinhibition, hyperphagia, and executive dysfunction with relatively preserved memory.

MD - Doctor of Medicine Practice Test

MD - Doctor of Medicine Practice Test

MD Central Nervous System Disorders 3