Question

Question 1

In this movement disorder, excessive or inappropriate contraction of muscles (often agonists and antagonists) leads to sustained abnormal postures of the affected region of the body. The abnormal movements and postures may be generalized (involving the trunk and at least two other sites) or restricted in distribution, such as to the neck, hand and forearm, or mouth.

1. dystonia
2. chorea
3. athetosis
4. asterixis

Question 2

Small vessel occlusion affecting penetrating arteries deep in the brain may cause infarcts in the putamen, thalamus, caudate nucleus, pons, posterior limb of the internal capsule, or other sites. These are rarely fatal but may be noted at autopsy. They are referred to as

1. lacunar infarcts or lacunes.
2. macroangiopathic lesions.
3. dissection infarcts.
4. Moya-moya

Question 3

A person who does not know who and where he or she is and the approximate date or time is said to be

1. obtunded.
2. stuporous.
3. disoriented.
4. amnestic.

Question 4

The sudden onset of "the worst headache I've ever had in my life" is classically due to

1. subarachnoid hemorrhage.
2. brain tumor
3. giant cell arteritis
4. medication-withdrawal headache

Question 5

Two contraindications for a lumbar puncture are

1. coagulopathy and increased intracranial pressure.
2. subarachnoid hemorrhage and increased intracranial pressure.
3. coagulopathy and subarachnoid hemorrhage.
4. None of the above.

Answer 1

1.dysyonias

These are abnormal movement disorder caused by sustained contraction of a particular muscle group. These may be idiopathic or secondary to drugs like antipsychotic medication.

Chorea and athetosis are less severe and in those rapid movement occurs but no sustained contraction.

Asterexis is a sign seen in hepatic encephalopathy

2. Lacunar infarcts

These are small infarcts in the deeper brain structures due to the occlusion of the small vessels. This occurs mostly secondary to atherosclerosis.

Dissection infarcts occits due to vessel dissection and involves a large area

Moyamoya disease is due to carotid vessel pathology and it mainly involve the basal ganglia

3. Disoriented

A person who is disoriented can't know their place or time of location and their orientation to the surroundings are lost

Stupor is near coma where a patient can't be responded until a severe painful stimuli

Amnesia means loss of memory

4. Subarachnoid hemorrhage

It always presents with severe headache and is often called by the patients - worst headache of my life

5. Caogulopathy and raised ICT

Lumbar puncture is contraindicated in caogulopathy which causes excessive bleeding and in raised ICT where lumbar puncture can causes sudden pressure drop and can lead to brainstem herniation

Hope this helps... Thank you!!!