Module Neurology and Psychiatry

Discipline: Neurology

Sensitivity and its disorders * 1 * 1 * 1

#1

*! Cortical representation of a sensitive analyzer?

* + posterior central gyrus

* Geshlya gyrus

* occipital lobe

* temporal lobe

* frontal lobe

 

Sensitivity and its disorders * 2 * 7 * 1

# 2

*! A 52-year-old woman with diabetes complains of pain in her arms and legs. Examination revealed hypoesthesia of the type of “long gloves and golfs”.

What type of sensory disorder in this case?

* + peripheral

* radicular

* spinal segmental

* conductor

* segmental

# 3

*! A man, 35 years old, with a history of neurosyphilis, complains of shooting back pain. An examination revealed a disorder of deep sensitivity on the right arm and leg.

Which structures are affected by this symptom?

* + bundle of Burdach and Gaulle

* back spine

* back horn

* spinothalamic pathway

* * spinal ganglion

#4

*! A man, 40 years old, after a stroke cannot recognize objects by touch with his eyes closed.

What kind of sensitivity is impaired?

* + stereognostic feeling

* joint-muscle feeling

* vibration sensitivity

* temperature sensitivity

* pain sensitivity

#5

*! A patient, 20 years old, suffering from drug addiction, revealed the absence of all types of sensitivity according to the peripheral polyneuric type of “gloves and socks”.

What is this sensory disorder called?

* dysesthesia

* hypesthesia

* + anesthesia

* hyperesthesia

* dissociation

# 6

*! A 20-year-old patient suffering from drug addiction began to be bothered by a feeling of numbness and a decrease in sensitivity in the distal extremities.

What is the name of this syndrome?

 

*spinal

*cortical

* + peripheral

* rear pillar

* conductor

 

#8

*! A woman, 45 years old, has a history of numerous burns, she lost surface sensitivity as a “half jacket” on the left from the level of the clavicle to the level of the navel.

What type of sensitivity disorder does the patient have?

* + posterior segmental

* mononeuritic

* polyneuritic

* capsular

* radicular

 

Sensitivity and its disorders * 3 * 7 * 1

#9

*! A 58-year-old man, a teacher, gradually developed severe pain in his left limbs, and his gait in the dark was disturbed. Objectively: hemigipesthesia, hyperpathy, hemianopsia.

Where is the pathological focus located?

* Varoliev bridge

* + visual tubercle

* medulla

* inner capsule

* frontal lobe of the brain

#10

*! A woman, 30 years old, when examined in a hospital, revealed a violation of surface sensitivity in the form of a belt at the level of Th8-Th10 with a dermatome, and deep sensitivity was preserved.

Where is the pathological focus located?

* + front gray commissure

* rear pillar

* front horn

* spine

* bark

#eleven

*! A woman, 30 years old, when examined at the clinic revealed a violation of surface sensitivity in the form of a belt at the level of D8-D10 with a dermatome, deep sensitivity is preserved.

What kind of research is needed?

* EEG

* REG

* USDG

* + MRI of the spinal cord

* MRI of the brain

#12

*! A man complains of pain and rashes in the form of vesicles in the forehead and keratitis on the right.

Which drug is most appropriate?

*antibiotic

* + antiviral

*hormone

*vascular

* nootropic

#thirteen

The patient does not recognize objects to the touch with his right hand with his eyes closed, but can describe their properties. Simple types of sensitivity are not disturbed. What is the name of the symptom?

* apraxia

* whirlpool

* + astereognosis

* agnosia

*aphasia

#fifteen

*! During the examination, the patient revealed a disorder of deep sensitivity, uncertainty when walking. When closing the eyes, the severity of gait disturbances increases dramatically.

Which research method is most appropriate?

* lumbar puncture

* MRI of the brain

* + MRI of the spinal cord

* electromyography

*electroencephalography

 

Arbitrary movements and their disorders * 1 * 1 * 1

# 1 6

*! Where does the pyramidal path in the spinal cord go after crossover?

* + lateral columns of the spinal cord

* thalamus

* back columns of the spinal cord

* front thigh of the inner capsule.

* posterior horns of the spinal cord.

Arbitrary movements and their disorders * 2 * 7 * 1

 

# 1 7

*! A man, 45 years old, has complaints of clonic convulsions in his left leg starting from the foot. When examined in the clinic, paresis of the left leg with increased tone and pathological foot reflexes.

What is the MOST likely process localization?

* inner capsule on the left

* lower part of the front central gyrus on the left

* upper part of the anterior central gyrus on the left

* lower part of the front central gyrus on the right

* + upper part of the front central gyrus on the right

#eighteen

*! In a patient K., 89 years old, suffering from hypertension, movements in the right extremities disappeared. Objectively: right-sided spastic hemiplegia and hemianesthesia.

What syndrome can be distinguished in a patient?

 

* + central hemiparesis

* peripheral type of sensitivity disorder

* flaccid hemiparesis

* peripheral hemiparesis

* alternating syndrome

#nineteen

*! Patient D., 48 years old, gradually developed severe pain in the left extremities, the gait in the dark was disturbed. Objectively: hemigipesthesia, hyperpathy, hemianopsia.

Determine the location of the topical focus:

* + visual tubercle

* medulla

* inner capsule

* Varoliev bridge

* frontal lobe of the brain

#twenty

*! Patient D., 48 years old, gradually developed weakness and numbness in the right limbs, speech impairment. Objectively: the right nasolabial fold is smoothed, the tongue deviates to the right, dysarthria, tone and reflexes are increased in the right extremities, hemianesthesia and hemianopsia.

Indicate the level of brain damage:

* visual tubercle

* medulla

* + internal capsule

* Varoliev bridge

* frontal lobe of the brain

# 21

*! A woman, 55 years old, a janitor, complains of weakness in the limbs, upon examination: hypotrophy of the muscles of the upper extremities, decreased tendon reflexes, muscle strength and fibrillar twitching in the muscles of the hands. The gait has been changed, while walking it “pulls” its legs. A sharp increase in tendon reflexes from the legs, pathological reflexes of Babinsky and Oppenheim on both sides.

What level of spinal cord should be examined?

* + cervical thickening

* above the cervical thickening

* thoracic

* lumbar

* lower thoracic region

# 22

*! Patient K., 39 years old, suffering from hypertension, developed repeated vomiting. Objectively: coma, pupils are dilated, pupil reactions to light are absent, right-sided spastic hemiplegia and hemigipesthesia.

Identify the syndrome?

* + capsular

* thalamic

* Brown-Secar syndrome

* alternating syndrome

* stem syndrome

 

Arbitrary movements and their disorders. 3 * 7 * 1

 

# 24

! The patient has weakness in all limbs, walking and self-care are difficult. On examination, the restriction of active movements in the upper and lower extremities, an increase in their muscle tone and tendon reflexes, pathological reflexes on the hands and feet are revealed. The functions of the cranial nerves are not impaired.

Where is the pathological focus located?

* at the level of the upper thoracic segments

* at the level of the lower thoracic segments

* + at the level of the upper cervical segments

* at the level of lumbar segments

* at the level of the lower cervical segments

 

# 25

! A man, 45 years old, against the background of a rise in blood pressure to 140/90 mmHg, developed weakness in his right leg, and sloppiness, which lasted 20 minutes. Objectively upon admission: the face is symmetrical, the tongue is in the midline. Monoparesis of the right leg with increased reflex and Babinsky symptom. After 20 minutes, the strength in the leg was restored, the reflexes were uniform, there were no pathological signs.

What therapy is appropriate to prescribe?

* + neuroprotectors

* coagulants

* tranquilizers

* anticonvulsants

* anticholinesterase

 

# 26

* A woman of 59 years old, complained of bursting headaches, vomiting, weakness in the left limbs, impaired walking. From the anamnesis: for six months it is observed and treated by an oncologist with a diagnosis of Breast cancer. Neurological status: there are no meningeal symptoms, a decrease in muscle strength in the left limbs to 2 points, muscle tone is increased on the left. Deep reflexes on the left are increased, hemihypesthesia on the left, Babinsky symptom on the left. Liquor - protein-cell dissociation. MRI of the brain - metastases in the frontotoparietal parts on the right.

The use of which of the following medications is MOST appropriate:

* antioxidants

* antifungal

* decongestant +

* anti-inflammatory

* immunostimulatory

 

 

# 27

A man, 67 years old, suffering from hypertension, complains of weakness in the left limbs. Objectively: on the right, a decrease in muscle strength to 3-4 points, increased tone, hyperreflexia, pathological foot reflexes on the right.

What research method is needed?

* EEG

* EMG

* MRI of the spine

* + MRI of the brain

* X-ray of the spine

# 28

*! A 56-year-old woman suffering from atherosclerosis has complaints of weakness and numbness in her right limbs. Objectively: AD-170/90 mm Hg central paresis of facial muscles of the face and tongue on the right, hemiparesis with increased tone and hyperreflexia on the right.

What research method is needed?

* MRI of the cervical spine

* MRI of the chest

* + MRI of the brain

* MRI of the lumbar

* X-ray of the spine

# 29

*! A 32-year-old man, an athlete, after falling from the bars, complained of pain and impaired movement and sensitivity in his left hand. On examination, the left arm hangs down, is rotated inwards, there are no movements in the shoulder and elbow joints, the hand and fingers are bent.

What instrumental study is MOST appropriate to assign to the patient?

* Echoencephalography

* Rheoencephalography

*Electroencephalography

* + Electroneuromyography

* Doppler ultrasound

#thirty