2020-06-29
258
Ischemic stroke * 1 * 1 * 1
# 76
*! THE MOST FREQUENT REASON FOR ISCHEMIC STROKE
*aneurysm
* + atherosclerosis
*malformation
* leukemia
*injury
Ischemic stroke * 2 * 5 * 1
# 77
*! The patient is 50 years old. Against the background of a rise in blood pressure to 200/100 mm RT. Art. weakness appeared in the left limbs, speech was disturbed. Objectively: central paresis of the facial muscles of the face, tongue on the left, dysarthria, spastic hemiparesis and hemianesthesia on the left. In the cerebrospinal fluid - unchanged.
Which of the following diagnoses is correct?.
* transient cerebrovascular accident
* ischemic stroke in the basin of the vertebral - basilar arteries
* hemorrhagic stroke in the basin of the anterior cerebral artery
* + ischemic stroke in the middle cerebral artery basin
* hemorrhagic stroke in the middle cerebral artery basin
# 78
*! Patient K., 62 years old. Weakness in the left arm and leg gradually developed, and the right eye stopped closing. Objectively: AD-200/100 mm RT. Art. Symptoms: lagophthalmos, sails, exclamation point on the right, spastic hemiparesis on the left. Liquor: colorless, pressure - 150 mm Hg, lymphocytes-3 cells.
Which of the following diagnoses is correct?
* transient cerebrovascular accident
* impaired spinal circulation
* hypertensive cerebral crisis
* + ischemic stroke
* hemorrhagic stroke
# 79
*! Patient A., 75 years old, developed hemiparesis, hemigipesthesia on the right, central paresis of the facial muscles and tongue on the right. Liquor - colorless, transparent, cytosis - 5 lymphocytes.
What is the clinical diagnosis?
* + ischemic stroke
* hemorrhagic stroke
* ventricular hemorrhage
* acute hypertensive encephalopathy
* transient ischemic attack
# 80
*! Patient A., 65 years old, developed hemiparesis in the morning after sleep, hemigipesthesia on the left, and peripheral paresis of the muscles of the tongue on the right.
Liquor - colorless, transparent, cytosis - 5 lymphocytes.
What is the most likely diagnosis?
* encephalitis
* subarachnoid hemorrhage
* + ischemic stroke in the vertebrobasilar basin
* ischemic stroke in the anterior cerebral artery basin
* acute spinal stroke
# 81
Ischemic stroke * 3 * 5 * 1
# 82
*! A man, 63 years old, gradually developed weakness in his right arm and leg, his left eye stopped closing. Objectively: AD-200/100 mm Hg, symptoms: lagophthalmos, sails, exclamation point on the left, spastic hemiparesis on the right. Liquor: colorless, pressure-140 mm water column, cytosis-lymphocytes-5.
Which of the research methods is most appropriate to carry out?
* REG
* EEG
* EMG
* Ultrasound of the vessels of the neck
* + MRI of the brain
# 83
*! A man, 70 years old, suffering from atherosclerosis, gradually developed weakness and numbness in his right limbs. Objectively: AD-170/90 mm. Hg. Art. Consciousness saved. The right nasolabial fold is smoothed, the tongue deviates to the right when protruding. Strength in the right limbs reduced to 3 points. The tone and reflexes are increased on the right.
Which of the following should be assigned?
* coagulants
* + anticoagulants
* antiserotonin
* antihistamines
* anticonvulsants
# 84
*! A woman, 75 years old, complains of weakness and numbness in her right limbs, speech has disappeared. Only one word "nonono" can be pronounced. Objectively: right-sided hemiparesis, hemianesthesia, hemianopsia.
What kind of specialist is needed for speech correction?
* + aphasiologist
* teacher
* kinesiotherapist
*masseur
*oculist
# 85
*! A 57-year-old man complained of headache, vomiting, weakness and numbness in the right limbs, speech disorders that developed in the morning against the background of increased blood pressure. Objectively AD-200/115 mm RT. Art., pulse - 94 beats per minute. Central paresis of facial muscles of the face and tongue on the right, right-sided hemiplegia and hemihypesthesia with increased tone and reflexes.
Which research method is most appropriate?
* radiography
* + MRI of the head mogu
* electroencephalography
* electromyography
* evoked potentials
Hemorrhagic stroke * 1 * 1 * 1
# 87
*! Meningeal syndrome develops with?
* + hemorrhagic stroke
* ischemic stroke
* myotonia
* multiple sclerosis
* myopathies
Hemorrhagic stroke * 2 * 5 * 1
# 88
*! Patient A., 55 years old, was admitted to the department with complaints of headache, vomiting, weakness and numbness in the right extremities, speech disorders that developed suddenly against the background of an increase in blood pressure to 170/100 mm Hg. Art. Objectively: the condition is serious, the face is hyperemic, tachycardia, Kernig and Brudzinsky symptoms on both sides. Central paresis of facial muscles of the face and tongue on the left, hemihypesthesia and hemiparesis on the right with increased tone and reflexes.
What is the most likely diagnosis?
* multiple sclerosis
* ischemic stroke
* + hemorrhagic stroke
* meningoencephalitis
* acute disseminated encephalomyelitis
# 8 9
*! Patient U., 59 years old, suffering from hypertension, developed severe headache, repeated vomiting. Objectively: stupor, pupils are dilated, pupil reactions to light are absent, meningeal syndrome. Left-sided spastic hemiplegia and hemigianesthesia.
* transient cerebrovascular accident
* impaired spinal circulation
* hypertensive cerebral crisis
* ischemic stroke
* + hemorrhagic stroke
# 91
*! A 35-year-old patient with high blood pressure, after stress appeared vomiting, psychomotor agitation, ptosis, divergent strabismus and mydriasis on the right, hemiparesis on the left, meningeal symptoms.
What type of stroke?
* transient cerebrovascular accident
* impaired spinal circulation
* hypertensive cerebral crisis
* ischemic stroke
* + hemorrhagic stroke
# 92
*! The patient is 35 years old. Suddenly a severe headache appeared, repeated vomiting. Objectively: meningeal syndrome, AD-200/120 mm. Hg. Art. The cerebrospinal fluid is stained with blood, red blood cells in large numbers, the cerebrospinal fluid pressure is increased.
Which of the following diagnoses?
* transient cerebrovascular accident
* impaired spinal circulation
* hypertensive cerebral crisis
* ischemic stroke
* + subarachnoid hemorrhage
Hemorrhagic stroke * 3 * 5 * 1
# 93
*! A 70-year-old man was admitted with complaints of headache, dizziness, vomiting, and instability when walking. The disease developed acutely against the background of an increase in blood pressure to 180/100 mm Hg. Art. Objectively: cerebellar ataxia, meningeal syndrome is pronounced. Reflexes are evenly revitalized, tone in the limbs is reduced. CSF emerges under pressure, cloudy, xantochromic color, red blood cells - 1000 in 1 mm3
Which of the following should be assigned?
* + coagulants
* anticoagulants
* antiserotonin
* antihistamines
* anticonvulsants
# 94
*! A 48-year-old man complained of severe headaches. In the afternoon, after physical overstrain, I felt a “blow to the head”, there was vomiting, and a short-term loss of consciousness. On examination: psychomotor agitation. There are no paresis of limbs. Meningeal syndrome is expressed: hyperesthesia to light and sounds, stiff neck 4 cm, cm Kernig at an angle of 100 ° on both sides, positive upper and lower Brudzinsky symptoms.
What is the first diagnostic method?
* radiography
* USDG
* REG
*EEG
* + lumbar puncture
# 95
*! A 70-year-old man was admitted with complaints of headache, dizziness, vomiting, instability when walking. The disease developed acutely against the background of an increase in blood pressure to 180/100 mm Hg. Art. Objectively: cerebellar ataxia, meningeal syndrome is pronounced. Reflexes are evenly revitalized, tone in the limbs is reduced. CSF emerges under pressure, cloudy, xantochromic color, red blood cells - 1000 in 1 mm3
What drugs are prescribed first?
* vascular
* + coagulants
* nootropic
* anticoagulants
* vitamins
# 97
*! A 32- year-old man has a headache, vomiting, stiff neck, Kernig and Brudzinsky symptom, bradycardia, fever up to 38 degrees, leukocytosis, cerebrospinal fluid is colored red or yellow.
What drug is most appropriate?
* hormones
* + coagulants
* nootropics
* anticoagulants
* vitamins
Transient ischemic attack. HIM * 1 * 1 * 1
# 98
*! What is the symptom of the initial manifestations of insufficient blood supply to the brain?
* + headache
* hemigipesthesia
* spastic hemiparesis
*aphasia
* flaccid hemiparesis
Transient ischemic attack CHEM * 2 * 5 * 1
# 99
*! A woman, 40 years old, was admitted to the hospital with complaints of growing headache, nausea, vomiting, flickering of "flies before her eyes." Objectively: stunning, FMN - without features, reflexes are evenly increased, Babinsky symptom on both sides. MRI of the brain: the ventricles of the brain are dilated. Cerebro-spinal fluid: pressure — the cerebrospinal fluid is colorless, cerebrospinal fluid pressure is 300 mm of water, the composition of the cerebrospinal fluid is unchanged. Fundus: veins dilated
Put the CORRECT clinical diagnosis:
* hypertensive cerebral crisis
* + acute hypertensive encephalopathy
* ischemic stroke
* mixed stroke
* subarachnoid hemorrhage
#100
*! A woman, 68 years old, complains of a headache, shakiness when walking, memory impairment for current events, distraction, tearfulness. Suffers from arterial hypertension, diabetes. In neurological status: consciousness is clear, executes instructions, answers questions correctly. The nasolabial fold on the left is smoothed, reflexes of oral automatism are caused. HELL 180/100, on the R- graphy of the chest organs, aortic compaction, enlargement of the left ventricle.
What is the most likely diagnosis in a patient?
* Acute cerebrovascular accident according to ischemic type
* Acute hemorrhagic type of cerebral circulation
* Acute hypertensive encephalopathy
* + Chronic cerebral ischemia
* Cerebral hypertensive crisis
# 101
*! In a man, 55 years old, against the background of a rise in blood pressure to 180/100 mm Hg, headache, nausea, and dizziness appeared. Objectively: consciousness is preserved, the face is symmetrical, the tongue is in the midline. Reflexes are evenly increased. There are no coordinating violations. MRI of the brain - the ventricles of the brain are evenly widened.
What diagnosis can be made?
* ischemic stroke
* hypertensive crisis
* transient ischemic attack
* acute hypertensive encephalopathy
* initial manifestations of cerebrovascular insufficiency
# 103
*! A woman, 45 years old, is concerned about headaches of a diverse nature, dizziness, sleep disturbance, fatigue, which occur 1 time per week over the past 3 months. Objectively: cranial nerves without features, paresis, disorders of sensitivity and coordination no. MRI of the brain - without pathological changes.
What is the most likely diagnosis?
* + initial manifestations of cerebrovascular insufficiency
* transient ischemic attack
* chronic brain ischemia
* ischemic stroke
* lacunar stroke.
Transient ischemic attack. HIM 3 * 4 * 1
# 104
*! In a woman, 62 years old, against the background of a rise in blood pressure to 160/100, headache, dizziness, and limitation of visual fields appeared. Objectively: a concentric narrowing of the visual fields, instability in the Romberg position, no paresis. After 15 minutes, after taking antihypertensive therapy, the complaints regressed, the visual fields were restored, the staggering in the Romberg position disappeared.
Which of the additional methods for researching methods should be carried out first?
* electromyography
* + dopplerography
* echoencephalography
* X-ray of the skull
* electroencephalography
# 105
*! In a woman, 62 years old, against the background of a rise in blood pressure to 160/100, headache, dizziness, and weakness in the left extremities appeared. Objectively: left-side hemiparesis, symptoms of Babinsky and Oppenheim on the left. After taking antihypertensive therapy after 15 minutes, complaints and symptoms regressed.
Which of the additional research methods is most appropriate?
* electromyography
* + dopplerography
* echoencephalography
* X-ray of the skull
* electroencephalography
# 106
*! A man, 65 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 etiotropic therapy should be prescribed?
* nootropics
* coagulants
* + anticoagulants
* anticonvulsants
* anticholinesterase
# 107
*! A man, 40 years old, is concerned about headaches of a diverse nature, dizziness, sleep disturbance, fatigue, anxiety. Objectively: cranial-cerebral nerves without features, paresis, disorders of sensitivity and coordination no. MRI of the brain - without pathological changes.
Choose a drug suitable for the patient:
* antihypertensive
* diuretics
* antiplatelet agents
* antiviral
* + tranquilizers
Diseases of the peripheral nervous system 1 * 2 * 1
# 108
*! Signs of peripheral nerve damage:
* + muscle hypotrophy
* pathological reflexes
* protective reflexes
* hyperreflexia
* hypertension
# 109
*! What disease is demyelinating?
* + Guillain-Bare
* tunnel syndrome
Huntington's chorea
* Duchenne myopathy
* myasthenia gravis
Diseases of the peripheral nervous system 2 * 7 * 1
# 110
*! A woman of 40 years old, works in a bank, began to notice aching pains in the neck area, aggravated by movements of the head, tension in the muscles of the neck and shoulder girdle, no paresis, no symptoms of root tension, no reflexes, no sensitive disorders. Which of the following diagnoses is most likely?
* radicular syndrome C4-C5
* + cervicalgia
* myelopathy
* brachialgia
* thoracalgia
# 111
A 50-year-old man complains of lower back pain radiating to his right leg. Objectively: soreness of Valle points, deflection of muscles in the lower back, specific posture with curvature of the spine
What is the name of this pose?
* + antalgic pose
* punching gait
* Wernicke-Mann pose
* flexor pose
* mannequin pose
# 112
*! A 45-year-old man notes pain in the lower back, pain in the right thigh along the front surface, a positive symptom of Matskevich and Wasserman on the right, there is no knee reflex on the right.
Which of the following diagnoses is MOST probable?
* vertebrogenic radiculopathy L5-S1
* + vertebrogenic radiculopathy L3-L4
* lumbalgia on the right
* lumbar ischialgia on the right
* transverse myelitis
# 114
*! A 45-year-old man, an athlete, is engaged in arm wrestling, after the performance, he felt numb and decreased strength in 1-3 fingers of his right hand. On examination, hypesthesia in 1-3 fingers of the right hand, anesthesia in the terminal phalanx of 2 fingers, Tinel's symptom is positive along the front surface of the middle third of the right forearm.
Which of the following syndromes is MOST probable in the patient?
* radicular
* mononeuritic
* plexus lesion
* + tunnel
*cerebral
# 115
*! A woman, 45 years old, was forced to use crutches in connection with a fracture of the bones of her right lower leg, weakness appeared in her right hand. On examination, weakness of extension of the right hand and fingers, hypesthesia in the rear of the first three fingers, and a symptom of a “hanging” hand were revealed.
Which nerve is most likely damaged in this syndrome?
* axillary
*subclavian
*median
* ulnar
* + radiation
# 116
*! A man suffering from diabetes began to notice weakness in his arms and legs, upon examination revealed a violation of sensitivity by the type of “gloves and socks”, decreased strength, hypotrophy and hypotension in the distal extremities.
What is the most likely diagnosis?
* neurosis
* neuralgia
* + polyneuropathy
* mononeuropathy
* tunnel syndrome
Diseases of the peripheral nervous system 3 * 8 * 1
# 117
*! The man is 32 years old, diagnosed with prolapse of the intervertebral disc with the development of severe pain and symptoms of prolapse of the root function.
What is the MOST important thing to do in this situation?
* Exercise therapy
*massage
* manual therapy
* + consultation of a neurosurgeon
* consultation of a vascular surgeon
# 118
A 37-year-old woman complained of “shooting” pains in the face area with irradiation to the lower jaw, manifested more often during the day and provoked by conversation, eating. This condition worries for a year.
What drug is most appropriate?
* antiplatelet therapy
* + anticonvulsants
* antiemetics
* g hypotensive drugs
* corticosteroids
# 119
*! A young man, 35 years old, a motorcyclist, was injured in an accident. He complained of pain and impaired movement in the right hand. On examination, the right hand is swollen, there are no movements in the right hand and fingers, hypesthesia on the palmar surface of the hand, Horner's symptom on the right.
What treatment is MOST appropriate for the patient?
* Exercise therapy
* massage
* mud therapy
* ultrasound
* + surgical treatment
# 121
*! A 30-year-old patient came to the emergency room with complaints of burning pain along the intercostal space on the right, general malaise. Ill acutely, associates with hypothermia. Objectively: the skin in the dermatome Th8-10 g is hyperemic, there are vesicles with serous-purulent contents. There are no paresis, reflexes are preserved.
What drug is most appropriate?
* antibiotics
* + antiviral
* antidepressants
* vascular
* Nootrotny
# 122
A 44-year-old man complains of back pain, which increases dramatically with the slightest movement. According to the words, the pain appeared after lifting weights. Objectively: an antalgic posture, pronounced tension of the muscles of the lower back with straightened lordosis, no Achilles reflex on the right.
What research method is needed?
* lumbar puncture
*electroencephalography
* + CT of the spine
* Ultrasound of the vessels of the limbs
* rheoencephalogaphia
# 123
*! A man, 24 years old, went to the clinic at the place of residence with complaints of burning pain and weakness in the hands and feet that appeared after SARS. An examination revealed a violation of sensitivity by the type of “gloves and socks”, flaccid tetraparesis in the distal extremities.
What tactics are most appropriate?
* prescribe outpatient treatment
* appoint a day hospital
* + hospitalize in hospital
* recommend thermometry
* recommend massage
# 124
*! A man of 25 years, a bus driver, for 1 month, complains of pain in the lumbar spine, radiating to the outer surface of his right leg. Objectively: movements in the lumbar spine are limited, left scoliosis, hypesthesia in the 1-2 interdigital space of the right foot, weak back flexion of the big toe of the right foot. Tendon reflexes on the legs D = S. Symptom Lasega is positive on the right up to 60 degrees, on the left - negative.
What instrumental study is MOST appropriate to assign to the patient
* electroencephalography
* electroneuromyography
* + MRI of the lumbar
* radiography of the lumbar
* lumbar contrast myelography
Inflammatory diseases of the central nervous system 1 * 1 * 1
# 125
*! What are the meningeal symptoms?
* Neri symptom
* Rossolimo symptom
* Babinsky symptom
* + Brudzinsky symptom
* Lassega.
Meningitis 2 * 4 * 1
# 126
*! The condition of patient M., who is in the pulmonology department for bronchiectasis, has deteriorated sharply: cerebral symptoms have significantly increased, meningeal signs have appeared. Neutrophilic pleocytosis in the cerebrospinal fluid, leukocytosis in the blood, increased ESR.
Make a clinical diagnosis
* + secondary purulent meningitis
* subarachnoid hemorrhage
* tuberculous meningitis
* tuberculous meningitis
* lymphocytic meningitis
# 127
*! The patient has severe headache, diarrhea, repeated vomiting, hyperthermia, the patient's face is hyperemic. The cerebrospinal fluid is transparent, flows under pressure, lymphocytic pleocytosis. Sick family members and employees at work.
Preliminary diagnosis?
* polyradiculoneuritis
* transverse myelitis
* + enterovirus meningitis
* meningococcal meningitis
* Q fever
# 128
*! The patient has the following symptoms: headache, dizziness, tinnitus, stiff neck, Kernig symptom, general intoxication, positive Wasserman reaction in the blood, cerebrospinal fluid, cerebrospinal lymphocytic pleocytosis. Make a diagnosis.
* + syphilitic meningitis
* syphilitic neuritis
* syphilitic meningomyelitis
* spinal cord
* progressive paralysis
# 129
*! A 42-year-old man, became ill sharply, suffered severe headache and repeated vomiting, increased body temperature to 40 °, a heartbeat, shortness of breath, cramps, an ambulance was called during the day, and the patient was taken to a rural outpatient clinic. On examination: the consciousness is upset by the type of stupor, pulse 110 beats per min., Blood pressure 100/60 mm RT. Art. A hemorrhagic rash was found in the buttocks, thighs and lower legs. Tendon reflexes are evenly enlivened. Stiff neck 4 cm, Kernig symptom at an angle of 90 °. Positive lower symptom of Brudzinski.
What is the most likely diagnosis?
* Serous meningitis
* Tuberculous meningitis
* + Meningococcal meningitis
* Neurorematism
* Back dry
Meningitis 3 * 4 * 1
# 130
*! A 32-year-old man has a headache, vomiting, stiff neck, Kernig and Brudzinsky symptom, bradycardia, fever up to 38 degrees, leukocytosis, cerebrospinal fluid is yellowish.
What drug is most appropriate?
* anticonvulsant
* + antibiotic
*vascular
* antihypoxant
*anticoagulant
# 132
*! The patient complains of a headache, fever, nausea and vomiting. Objectively: Stiff neck muscles, Kernig and Brudzinsky symptoms from 2 sides, the reflexes are evenly animated, Babinsky symptom from 2 sides.
The main diagnostic method is:
* Ultrasound of the vessels of the neck
* EMG
* EMG
* + lumbar puncture
* EEG
# 133
*! A 34-year-old man complained of fever up to 37.5 °, severe headache, dizziness, lack of appetite, and sleep disturbance. Symptoms appeared within 2 weeks and gradually increased. In neurological status: converging strabismus on the left, diplopia when looking to the left, stiff neck 3cm, symptom of Kernig at an angle of 120 °, no paresis of limbs. In the cerebrospinal fluid - fibrin film.
What treatment tactics are most appropriate in this case?
* Hospitalize in the therapeutic department.
* Hospitalize in the pulmonary ward.
* + Hospitalize in a specialized medical institution.
* Conduct outpatient treatment
* Hospitalize in the neurosurgical department
Encephalitis * 1 * 1 * 1
# 134
*! SYNDROME DISTINCTING Encephalitis from Meningitis
*fever
* cerebrospinal fluid syndrome
* + focal syndrome
* cerebral syndrome
* meningeal
Encephalitis * 2 * 3 * 1
# 135
*! Patient S. felt general weakness, dizziness, drowsiness, restriction of eye movement, euphoria, talkativeness followed by apathy or delirium, salivation, profuse hyperhidrosis was noted, then there was a period of drowsiness for 2 days.
What is the most likely diagnosis?
*polio
* tick-borne encephalitis
* mosquito encephalitis
* + epidemic encephalitis Economo
* herpetic encephalitis
# 137
*! A young man, 18 years old, became ill sharply after SARS, was admitted to the hospital with complaints of a headache, fever up to 39-40 degrees, a convulsive attack with loss of consciousness was noted. Objectively: labial herpes, weak convergence, tendon reflexes D> S are enlivened, muscle strength on the right is reduced, meningeal symptoms. Liquor - a clear, lymphocytic pleocytosis, an increase in protein content.
What is the most likely diagnosis?
* tuberculous meningitis
* enteroviral meningitis
* hemorrhagic stroke
* + herpetic encephalitis
* epidemic encephalitis Economo
Encephalitis * 3 * 3 * 1
# 138
*! Patient S., 42 years old, has severe headache, repeated vomiting, hyperthermia, the patient’s face is hyperemic, herpetic eruptions on the lips, herpetic sore throat, right-sided hemiparesis. The cerebrospinal fluid is transparent, flows under pressure, lymphocytic pleocytosis.
What research method should be carried out?
* + IFA
* Mantoux test
* Wasserman reaction
* Wright's reaction
* Thorne test
# 139
*! A man, 53 years old, was admitted to the hospital with complaints of headache, weakness, fever up to 39 degrees, pain in the muscles of the neck, limbs. Objectively: stiff neck muscles, soreness when moving eyeballs, paresis of the upper shoulder girdle. From the anamnesis: Liquor - transparent, lymphocytic pleocytosis.
What group of drugs is most appropriate for etiotropic therapy?
* nootropics
* vascular
* antibiotics
* + antiviral
* anticonvulsants
# 140
*! A man, 53 years old, was admitted to the hospital with complaints of headache, weakness, fever up to 39 degrees, pain in the muscles of the neck, limbs. Objectively: stiff neck muscles, soreness when moving eyeballs, paresis of the upper shoulder girdle. From the anamnesis: 3 days ago I was relaxing in the mountains. Liquor - a transparent, lymphocytic pleocytosis.
What group of drugs is most appropriate?
* nootropics
* vascular
* antibiotics
* anticonvulsants
* + immunoglobulin
Demyelinating and degenerative diseases * 1 * 3 * 1
# 141
*! With magnetic resonance imaging of the brain, foci of demyelination are detected with?
purulent meningitis
* amyotrophic lateral sclerosis
* stroke
* + multiple sclerosis
* brain tumors
# 142
*! What pathomorphological changes characterize multiple sclerosis?
* + demyelination
* microhemorrhage
* stenosis of small arterioles
* perivascular infiltration
* degeneration
# 143
*! Foci of demyelination are detected with:
* + multiple sclerosis, acute multiple disseminated encephalomyelitis
* amyotrophic lateral sclerosis
purulent meningitis
* syringobulbia
* brain tumors
Demyelinating and degenerative diseases * 2 * 6 * 1 *
# 144
*! In patient S., 40 years old, an objective examination revealed: Charcot's triad, blanching of the temporal halves of the nipples of the optic nerves, the absence of abdominal reflexes.
What is the most likely clinical diagnosis?
* Schilder encephalitis
* + multiple sclerosis
* acute disseminated encephalomyelitis
* Pick disease
* Pierre Marie's disease
# 146
*! Woman 30 years old. The disease began a year ago with a sharp decrease in vision in the right eye. Within a month, she was treated by ophthalmologists about retrobulbar optic neuritis. Vision has improved. Six months later, doubling appeared in the eyes, weakness of the legs, shakiness when walking; difficulty urinating.
What is the most likely diagnosis?
* Amyotrophic lateral sclerosis
* + Multiple sclerosis
*A brain tumor
* Guillain-Barré Syndrome
* Myodystrophy
# 147
*! The man is 28 years old. He complained that with both hands he could not distinguish between hot and cold, weight loss of the muscles of the hands, awkwardness when performing fine, precise movements with his fingers. On examination, Claude Bernard-Horner syndrome on the right, atrophy of the interosseous muscles of both hands, more on the right. Tendon and periosteal reflexes on the hands are not caused. Knee and Achilles reflexes high S — D. Clonuses of the feet. Babinsky from 2 sides. Loss of pain and temperature sensitivity on both hands. The nail phalanges are thickened, the nails are dull, brittle, the skin is dry
What is the most likely diagnosis?
* Neurosyphilis
* Multiple sclerosis
* + Syringomyelia
* Guillain-Barré Syndrome
* Acute myelitis
# 148
A 45-year-old man complains of weakness and weight loss. These phenomena appeared 6-8 months ago and are gradually progressing.
On examination: dysphagia, dysphonia, dysarthria, pharyngeal and palatine reflexes, hypotrophy of the muscles of the tongue, fibrillar twitching in the tongue, upper flaccid paraparesis, more pronounced in the hands, are reduced. The tendon reflexes on the arms and legs are high.
What is the most likely diagnosis?
* + Amyotrophic lateral sclerosis
* Syringomyelia
* Acute disseminated encephalomyelitis.
*Parkinson's disease
* Multiple sclerosis
# 149
*! In a man, 44 years old, a neurological examination revealed: bilateral amaurosis, lower spastic paraplegia, pelvic disorders of the central type.
What structures in the nervous system are affected:
* brain
* + spinal cord and optic nerves
* facial nerve
* plexus
* cerebral cortex
Demyelinating and degenerative diseases * 3 * 6 * 1 *
# 151
*! During a neurological examination, a man revealed: bilateral amaurosis, lower spastic paraplegia, pelvic disorders of the central type.
What diagnostic method should be prescribed to clarify the diagnosis?
* Echoencephalography
*Electroencephalography
* + Magnetic resonance imaging
* rheoencephalography
*CT scan
# 152
*! The patient consulted a doctor with complaints of swallowing disorder, decreased voicing, twitching in the muscles of the hands, weight loss, weakness in the hands, and speech impairment. The doctor revealed he had bulbar syndrome, peripheral paresis of the hands and central paresis of the legs
Which of the examination methods is most justified for making a diagnosis?
* + electroneuromyography
* neurosonography
* rheoencephalography
*electroencephalography
* ultrasound dopplerography
# 153
*! On examination, a woman, 35 years old, found: horizontal nystagmus, dysarthria, euphoria, imperative urination, paresthesia in the legs, spastic paresis of the lower extremities, lack of abdominal reflexes. After treatment, all symptoms disappeared.
In the phase of remission, treatment is necessary
* alpha interferon
* + beta interferon
* hormonal drugs
* antihypertensive drugs
* antiplatelet agents
# 154
*! When examining a young man, 20 years old, revealed: horizontal nystagmus, atactic gait, instability in the Romberg position, lack of abdominal reflexes, intentional trembling, revitalization of knee reflexes, clonus of the feet.
What drugs are most appropriate to prescribe?
* cytostatics
* + glucocorticoids
* tranquilizers
* antibiotics
* estrogenic steroid agents
# 155
*! On examination, a woman, 35 years old, found: horizontal nystagmus, dysarthria, euphoria, imperative urination, paresthesia in the legs, spastic paresis of the lower extremities, lack of abdominal reflexes.
What is the most reliable diagnostic method?
* EEG
* myelography
* angiography
* CT scan of the brain
* + MRI of the brain
# 156
*! A 32-year-old woman has complaints of decreased vision and double vision, fatigue, distraction, headaches, dizziness, poor sleep, irritability, and tearfulness. On examination, it was found: the absence of abdominal reflexes, vestibular disorders. On the fundus: blanching of the temporal halves of the nipples of the optic nerves.
What form of suspected multiple sclerosis is appropriate for this patient?
cerebellar
* + optical
* spinal
* cerebrospinal
* stem
Epilepsy. Migraine * 1 * 2 * 1 *
# 157
*! When epilepsy is genetically predetermined:
* cell energy balance
* demyelination of nerve fibers
* + brain spasmodic readiness
* state of cell membranes
* hypoxia
# 158
*! What disease does symptomatic epilepsy occur in?
* myelitis
* radiculopathy
* polyneuropathy
* + brain tumors
* Charcot-Marie neural amyotrophy
Epilepsy. Migraine * 2 * 7 * 1 *
# 159
*! A girl, 17 years old, for 2 years marks attacks with a frequency of 2 times a month, loses consciousness, falls, tonic and clonic convulsions occur, while the pupils are dilated, light reflection, eyes roll up, hypersalivation, tongue bite, after the attack comes a dream.
What type of attack is most likely?
* + generalized tonic-clonic
* generalized myoclonic
* generalized tonic
* complex abscess
* simple abscess
# 160
*! A woman, 37 years old, went to the clinic with complaints of bouts of headaches, pulsating in one half of the head, lasting several hours or 2 days, fatigue, irritability, and weather dependence. Before the attack, there are t stars in front of the eyes, fogging. Objectively: vegetative lability, no paresis, no meningeal signs.
What is the most likely option for a headache in this case?
* simple migraine
* + classic migraine
* acute post-traumatic
* + chronic post-traumatic
* tension headache
# 161
*! A young man, 17 years old, complains of seizures that he doesn’t remember when contacting the clinic, feels pain in his stomach before the seizures, during chewing seizures from his mother’s words, swallows, repeats certain sounds and incoherent words, doesn’t respond to others, pupils are wide, salivation, attacks last about 3 minutes, after which he is disoriented.
What type of seizure is most likely?
* generalized tonic-clonic seizure
* + complex partial seizure
* myoclonic seizure
* atonic abscess
* typical absance
# 162
*! In a 45-year-old man suffering from chronic alcoholism, generalized tonic-clonic seizures occurred in series of up to 6 times during withdrawal.
What type of epilepsy is MOST likely in this patient?
* Todd's postictal palsy
* Lennox-Gastaut syndrome
* myoclonic
* West syndrome
* + Kozhevnikova
# 164
*! A 45-year-old man complains 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
# 165
*! A 38-year-old woman complained of pain localized in the left temporal region, pulsating, and lasting several hours. On examination, organic lesions were not detected.
What is the most likely diagnosis?
* classic migraine.
* Migraine without aura.
* trigeminal neuralgia.
* sinusitis.
* bundle headache
Epilepsy. Migraine * 3 * 5 * 1 *
# 166
*! A young man, 29 years old, turned to the clinic with complaints of attacks of loss of consciousness 1-2 times a month. During an attack, the patient falls, the body strains, then cramps occur in the limbs, a bite of the tongue, involuntary urination are noted. Objectively: no focal symptoms were detected.
Which drug is most appropriate for a long time?
* diazepam
* phenobarbital
* + depakine
* encephabol
* luminal
# 167
*! A woman, 42 years old, a teacher, complains when contacting the clinic about headaches, constricting nature, the feeling of a "helmet" on the head. In the anamnesis of ZHMT, a concussion half a year ago, headaches disturbed since then. Objectively: there are no meningeal signs, no paresis, vegetative lability, after acupressure of the head and cervical-collar zone notes marked relief
Which drug is most appropriate to prescribe?
* vasoactive drugs;
* hormonal drugs
* nootropic drugs;
* antidepressants;
* + muscle relaxants
# 168
*! A girl, 27 years old, complains of bouts of pulsating unilateral headaches, accompanied by intolerance to light and sounds, nausea, vomiting, drowsiness, visual disturbances in the form of photopsies and scotomas precede the headache.
What drugs are most prescribed?
* opiates
* + triptans
* analgesics
* vitamins
* coagulants
# 169
*! A girl, 12 years old, from the words of her mother periodically 5-7 times a month, is likened to a statue with an empty look, at times she is not in contact, does not respond to the environment, the attack lasts 10-20 seconds
Which of the drugs is MOST appropriate to prescribe?
* coagulants
* vascular
* + anticonvulsants
* nootropic
* vitamins
# 170
*! A 38-year-old man, an engineer, turned to the clinic complaining of a sharp decrease in memory and attention, “failure of thoughts”, “violent thinking”, followed by loss of consciousness and convulsive prigups lasting up to 3-4 minutes (according to his wife). The beginning is observed in the last 4 months, after a head injury and a brain injury 2 years ago. In the neurostatus, minimal diffuse neurological symptoms.
Which of the following instrumental studies is MOST
* Echoencephalography
* Rheoencephalography
* + Electroencephalography
* Electroneuromyography
* Doppler ultrasound
#1
*! Palimpsest is-
