Extrapyramidal system. Cerebellum

# 31

*! Does the extrapyramidal system regulate the following functions?

* sensitivity

* muscle strength

* + muscle tone

* rumor

* vision

 

Extrapyramidal system. Cerebellum 2 * 7 * 1

# 32

*! In a man, 56 years old, there is a coordination disorder, unsteadiness when walking. Intentional tremor with a finger-nasal and knee-calcaneal test on the right. In the Romberg position is unstable, tilts to the right.

If any of these structures are affected, is this symptom most likely?

* half diameter of the spinal cord on the right

* posterior spinal cord

* spinal cord diameter

* + cerebellum on the right

* cerebellar worm

# 33

*! A girl of 12 years old against the background of chronic sore throat, pain in the joints and heart appeared hyperkinesis in the form of a "dancing gait", muscle tone is reduced.

What is the most likely diagnosis?

* Huntington's chorea

* + rheumatic chorea

* Parkinson's disease

* dystonia

* tremor

# 35

*! A young man, 25 years old, had choreic hyperkinesis, a dancing gait, athetosis, mental degradation, the family had cases of this disease in almost every generation on the part of the father.

What is the most likely diagnosis?

* Thomson's disease

* Huntington's chorea

* rheumatic chorea

* Strumpel disease

* Wilson-Konovalov disease

# 36

*! A 45-year-old man complains of violent movements in his right hand; he makes movements resembling "throwing a nucleus or throwing a ball."

What is the name of the symptom?

* tics

* athetosis

* + hemiballism

* chorea

* torsion dystonia

# 37

*! The girl commits involuntary violent, smooth, circular movements with her body, like a cobra.

What is the name of the symptom?

* tics

* athetosis

* hemiballism

* chorea

* + torsion dystonia

# 38

*! A man, 66 years old, has a coordination disorder, unsteadiness when walking. Intentional tremor with a finger-nasal and knee-calcaneal test on the right. In the Romberg position is unstable, falls back and forth.

Which structures are affected by such symptoms?

* half the diameter of the spinal cord

spinal cord

* frontal lobe

* + cerebellar hemisphere

* + cerebellar worm

Extrapyramidal system 3 * 7 * 1

# 39

*! The young man has signs of liver failure, hyperkinesis, a change in the psyche, a Kaiser-Fleischer ring on the iris.

What medicine should be prescribed FIRST?

* + D-penicylamine

* cardiomagnyl

* acyclovir

* baclofen

* cavinton

# 40

*! The young man has signs of liver failure, hyperkinesis, muscle tone is reduced, a change in the psyche, on the iris, the Kaiser-Fleischer ring.

Which of the research methods is MOST appropriate?

* + blood test for cerulloplasmin

* X-ray of the skull

* lumbar puncture

* coagulogram

# 42

*! In a 48-year-old man, increased greasiness of the skin of the face, head, amimia, weakness of convergence, sharp stiffness in all limbs, muscle tone is increased as a “gear wheel”, more in the legs, tremor of the hands, slow speech, monotonous quiet voice, gait in small steps. From the anamnesis: 2 years ago I suffered an acute respiratory viral infection and expressed drowsiness, fever.

What are the most likely neurochemical changes in the brain?

* increased dopamine content

* + decrease in dopamine content

* increase in the content of norepinephrine

* decrease in glutamate content

* increase in serotonin content

# 43

*! The patient appeared unsteady when walking, chanted speech, horizontal nystagmus, a decrease in muscle tone in all limbs, intentional trembling with finger and knee-calcaneal tests.

Where is the hearth located?

* frontal lobe

* subcortical nuclei

* + cerebellum

* spinal cord

* pale ball

# 44

*! A man, 64 years old, was admitted with complaints of difficulty in walking and speaking, tremor at rest, objectively: amimia, bradylalia, quiet voice, muscle stiffness, tone increased in plastic type, hypokinesia.

What medicine should be prescribed?

* + L-Dopa preparations

* coagulants

* cytostatics

* antibiotics

* immunomodulators

# 45

*! In a 48-year-old man, increased greasiness of the skin of the face, head, amimia, weakness of convergence, sharp stiffness in all limbs, muscle tone is increased as a “gear wheel”, more in the legs, tremor of the hands, slow speech, monotonous quiet voice, gait in small steps. From the anamnesis: 2 years ago I suffered an acute respiratory viral infection and expressed drowsiness, fever.

What brain structures are affected in this patient?

* striatum

* brain stem

* dentate nucleus of cerebellum

* + palidonigral complex

* temporal parts of the cerebral cortex

Cranial Nerves 1 * 1 * 1

# 46

*! To diagnose the function, which nerve is used perimetry?

* + optic nerve

* oculomotor nerve

* vestibulocochleral nerve

* trigeminal nerve

* facial nerve

 

Cranial nerves 2 * 7 * 1

 

# 47

*! The examination revealed ptosis, mydriasis on the right, divergent strabismus. The pupil does not react to light. Which of the cranial nerves is involved in the process?

* + oculomotor

* trigeminal

*facial

*visual

*olfactory

# 48

*! A 37-year-old man complained of hearing loss, tinnitus, hard of hearing whispering, with good perception of colloquial speech, periodic headaches, dizziness. In the period of 9 years working aircraft mechanic. On examination: moderate hearing loss (perception of whispering speech at a distance of two meters. No other disorders were found.

Which research method is MOST needed?

* + MRI of the brain

* encephalography

* echocardiography

* radiography

* echoencephaloscopy

 

 

#fifty

*! The girl is 19 years old, the last 4 weeks several times a day there are bouts of diplopia, which continue for several days with the joining of stupid ones. pain behind the right eye. The doctor asked her to look at the lamp blinking on the left, closing her right eye with a red light. At the same time, the girl saw 2 lights: white and red to his left. The right pupil was wider than the left and weakly reacted to light.

What cranial nerve lesion most likely caused this condition?

*visual

* deflecting

* + oculomotor

*facial

*vestibular

# 51

*! The patient was urgently admitted to the hospital with complaints of weakness in the left limbs, choking, swallowing disorders, tongue atrophy, hoarseness. When taking liquid food notes pouring out through the nose. The speech is fuzzy, the pronunciation of the words is nasal. What is the syndrome identified in the patient.

* capsular

* alternating

* pseudobulbar

* + bulbar

* Horner syndromes

 

# 52

*! The patient was admitted with complaints of bouts of pain in the left half of the face. Pain occurs suddenly for 15-20 seconds, aggravated by chewing, during a conversation, with coughing. During the attack, hyperemia of the face appears on the left and discharge from the nose. The pain radiates to the zygomatic bone and upper jaw, the teeth of the upper jaw on the left. Pain on palpation in the infraorbital foramen on the left. The superciliary and corneal reflexes are preserved.

What nerve is involved in the pathological process?

* 1st branch of the V nerve

* + 2nd, 3rd branch of the V nerve

* X nerve

* VII nerve

* XII nerve

 

# 53

*! Examination of the patient revealed a deviation of the tongue to the right, atrophy of the muscles of the right half of the tongue, slurred speech, a positive test of Barre in the left extremities, decreased strength to 2 points, high reflexes from the left extremities, increased muscle tone in them, a positive Babinsky reflex is invoked from the left foot.

What is the syndrome identified in the patient.

* bulbar syndrome

* capsular

* pseudobulbar

* + alternating

* cerebrospinal

 

 

Cranial nerves * 3 * 7 * 1

 

# 54

*! In a woman, 44 years old, when examined in the clinic, there is a central paresis of the facial muscles of the face and tongue on the left, dysarthria, spastic hemiplegia and hemianesthesia on the left.

Which research method is MOST needed?

* EEG

* Echo EEG

* Ultrasound of vessels

* MRI of the cervical spine

* + MRI of the brain

# 55

*! The patient on the right noted inconsistency of the eyelids, the inability to raise an eyebrow, the lag of the corner of the mouth with a smile. On the left is central hemiplegia. What is the syndrome?

* Argyll-Robertson syndrome

* + alternating

* cerebrospinal

* capsule

*cortical

# 56

*! Patient K., 72 years old, was delivered to the NSO with complaints of “skewed” faces, weakness and numbness of the left extremities, which developed suddenly against the background of an increase in blood pressure to 160/100 mm Hg. Art. Objectively: symptoms of “lagophthalmos, sails, exclamation mark” on the right, tongue in the midline, convergent strabismus, restriction of the movement of the right eyeball outside, reflexes are increased in the left limbs.

How are cranial nerves involved in the process?

* sublingual and additional

* + abducent nerve and facial

* trigeminal

* trigeminal, abducent

* oculomotor

# 58

*! A woman, 66 years old, has a pensioner, complaints at admission to the clinic for headaches, fatigue, visual impairment. When examining the visual fields, quadrant hemianopsia on the left was noted.

Which research method is MOST needed?

* EEG

* Echo EEG

* Ultrasound of vessels

* MRI of the spinal cord

* + MRI of the brain

# 59

*! A man, 44 years old, suffers for 2 years with bouts of severe, “dagger” pain in the right half of his face, in the forehead, orbit, cheek, and nose wings. The pains are felt like an electric shock and are provoked by touching the face, eating, talking.

What is the most appropriate medication listed?

* analgin

* ergotamine

* indomethacin

* + carbamazepine

* pentoxifylline

# 60

*! A woman, 62 years old, suddenly developed weakness in her right extremities, her face “skewed”. Objectively: a convergent squint on the left, the left eye does not close, the nasolabial fold is smoothed on the left, the symptom is “sail”, the left corner of the mouth lags behind, the tongue is midline, spastic hemiparesis is on the right.

Which research method is MOST needed?

* EE G

* Echo EEG

* Ultrasound of vessels

* MRI of the spinal cord

* + MRI of the brain

Higher brain functions. ANS. 1 * 1 * 1

# 61

*! Which of the following is a clinically m sign th lesion center Wernicke?

* motor aphasia

* apraxia

* amnestic aphasia

* dysarthria

* + sensory aphasia

Higher brain functions. ANS. 2 * 7 * 1

 

# 62

*! A 44-year-old man complained of visual impairment, objects seem distorted, of irregular shape.

What are the described visual disorders called?

* amaurosis

* amblyopia

* hemianopsia

* diplopia

* + metamorphopsies

# 63

*! A 55-year-old man, against the background of diabetes mellitus, gradually developed sloppy behavior, inadequate behavior, euphoricity, and a tendency to flat jokes.

What is the name of the described syndrome?

* + frontal psyche

* anosognosia

* autotopnosia

* astereognosis

* ataxia

# 64

*! A 32-year-old woman suffering from systemic lupus erythematosus complains of attacks of pale fingertips with numbness and crawling, accompanied by a throbbing pain in them under the influence of cold.

What syndrome is MOST likely in this patient? /

* + Raynaud's syndrome

* Horner's syndrome

* Guillain-Barré syndrome

* Lambert-Eaton syndrome

* Miller-Fisher syndrome

# 65

*! The patient is in serious condition delivered to the clinic.

In the anamnesis: about 10 years suffers from ischemic heart disease (coronary heart disease). In the morning after waking up after sleep, weakness appeared in the right limbs, headache, and vomiting.

In neurological status: in consciousness, oriented. There are no meningeal symptoms. The patient speaks, but does not understand the addressed speech. The reaction of the pupils to the light is saved. The nasolabial fold on the right is smoothed, the tongue deviates to the right. Right foot rotated outwards. Hemiplegia on the right.

What kind of speech impairment

* + sensory aphasia

* motor aphasia

* semantic aphasia

* amnestic aphasia

* dysarthria

# 67

*! A woman, 50 years old, was admitted to the hospital with complaints of headache, speech impairment According to relatives, she has been sick for a year. On examination: euphoric, untidy, flat jokes, partial motor aphasia, right-sided hemiparesis is more pronounced in the leg. In cerebrospinal fluid: protein-cell-cell x -nd dissociation. On the fundus are stagnant discs.

What is the most likely localization of the tumor?

* + frontal lobe

* temporal lobe

* parietal lobe

* wings of the main bone

* olfactory fossa

# 68

*! The patient has constant pain, numbness in the hands, feet. On examination: acrocyanosis of the hands, feet, acrohyperhidrosis, hyperkeratosis of the palms, increased fragility of the nails and hypesthesia of the type of “gloves”, “socks”.

What is the most likely diagnosis?

* Ganglionitis.

* Sympatho-adrenal crisis.

* + Vegetative polyneuritis

. * Hypothalamic syndrome.

* Claude Bernard-Horner Syndrome

Higher brain functions. ANS. 3 * 7 * 1

 

# 69

*! A man, 30 years old, complains of frequent attacks with seizures of a tonic and clonic nature, which begin in the left leg, then the left arm, then in the left half of the face.

Which research method is most needed?

* Echo EEG

* Ultrasound of vessels

* REG

* + EEG

* Lumbar puncture

# 70

*! A 49-year-old man who has suffered a stroke does not realize his disease, if he has severe hemiplegia, plans unrealistic plans for his condition, is going to work, claims to be completely healthy.

Which research method is most needed?

*EEG

* MRI of the spinal cord

* lumbar puncture

* Ultrasound of vessels

* + MRI of the brain

# 71

*! A girl of 1–3 years old had a chill at the school lesson, cooling hands and feet, dry mouth, pain in the heart, palpitations, and a sense of fear. The school doctor noted a pulse of 100 beats per minute, blood pressure of 160/100 mm Hg. Art., the skin is clean, vesicular breathing, heart sounds are clean and sonorous. What is the most likely diagnosis?

* Sympatho-adrenal crisis

* vago-insular crisis

* vegetative polyneuritis

*Epilepsy.

*A brain tumor

# 72

*! The patient cannot stand and sit. In neurological status: astasia, abasia, anosognosia, flat jokes, does not adequately assess the severity of his condition.

Specify the lesion focus?

* parietal lobe

* temporal lobe

* occipital lobe

* + frontal lobe

* parietal-temporal lobe

 

# 73

*! The patient has headaches, frequent “deja vu”, dizziness, there are attacks of generalized tonic-clonic seizures with an aura in the form of auditory hallucinations. In the fundus: congestive disks of the optic nerves.

Which research method is most likely to be carried out?

* + MRI of the brain

* MRI of the spinal cord

* Lumbar puncture

* Ultrasound of vessels

* MRI angiography of cerebral vessels

 

 

# 75

*! A woman, 34 years old, manager, periodically experiences bouts of unmotivated anxiety, a feeling of lack of air, lightheadedness, palpitations, chills-like tremors, dizziness, and frequent urination. When examining the pathology of the internal organs was not detected.

What drugs are MOST indicated for this patient?

* antibiotics

* antiarrhythmics

* + sedatives

* anticonvulsants

* antihypertensive

 

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