WorksheetsCh. 11 Questions
Total questions: 10
Worksheet time: 5mins
A 63-year-old woman presents with progressive gait instability, blurred vision, and intermittent limb weakness over the past 3 years. Symptoms often resolve but then recur. MRI shows multiple periventricular white matter lesions. Which pathophysiologic mechanism best explains these findings?
Loss of acetylcholine receptors at neuromuscular junctions
Autoimmune-mediated demyelination of CNS axons with formation of sclerotic plaques
Degeneration of dopaminergic neurons in the substantia nigra
Deposition of β-amyloid plaques in cortical neurons
A 29-year-old man presents with acute onset of right-sided facial droop, inability to close his eye, and loss of taste on the anterior tongue. He can wrinkle his forehead symmetrically. Which is the most likely diagnosis?
Ischemic stroke in the middle cerebral artery distribution
Bell’s palsy due to inflammation of the facial nerve (CN VII)
Myasthenia gravis exacerbation causing facial weakness
Multiple sclerosis with cranial nerve involvement
A 72-year-old man has a sudden severe headache described as “the worst of my life,” followed by nausea, neck stiffness, and photophobia. CT scan shows blood in the subarachnoid space. Which condition is most likely?
Hemorrhagic stroke from hypertension
Ruptured saccular aneurysm causing subarachnoid hemorrhage
Arteriovenous malformation bleed
Ischemic stroke with hemorrhagic conversion
A 48-year-old woman with myasthenia gravis presents with worsening ptosis, dysphagia, and respiratory weakness after starting an aminoglycoside antibiotic. Which is the most likely mechanism of her current symptoms?
Excessive glutamate release at CNS synapses
Increased acetylcholine degradation by acetylcholinesterase
Impaired acetylcholine release from presynaptic terminals due to drug interference
Autoimmune attack on voltage-gated calcium channels in motor neurons
A 59-year-old man presents with resting tremor, bradykinesia, and cogwheel rigidity. Which neurotransmitter change is most characteristic of his disease?
Increased dopamine and decreased acetylcholine in the basal ganglia
Increased GABA and glutamate in the substantia nigra
Decreased dopamine and relative excess acetylcholine in the basal ganglia
Decreased serotonin and norepinephrine in the cortex
A 68-year-old woman has a 6-month history of progressive short-term memory loss, disorientation, and personality changes. MRI shows cortical atrophy; CSF analysis reveals decreased β-amyloid 42 and increased tau protein. Which is the most likely diagnosis?
Vascular dementia
Lewy body dementia
Alzheimer’s disease
Frontotemporal dementia
A 56-year-old man presents with sudden left-sided weakness and slurred speech for 3 hours. CT shows no hemorrhage. Which is the most appropriate next step?
Start aspirin immediately and arrange elective carotid endarterectomy
Administer IV alteplase after confirming no contraindications
Begin high-dose corticosteroids to reduce cerebral edema
Schedule MRI in 48 hours to confirm stroke subtype before treatment
A 34-year-old man presents with progressive muscle weakness, fasciculations, and atrophy. Sensory exam is normal. He dies from respiratory failure 2 years later. Which structure is primarily affected?
Neuromuscular junction
Upper and lower motor neurons
Myelin sheath of peripheral nerves
Basal ganglia nuclei
A 45-year-old woman reports daily headaches with photophobia and phonophobia, lasting 6–12 hours, sometimes preceded by flashing lights. Which pathophysiologic process best explains her headaches?
Sudden vasospasm of cerebral arteries
Increased ICP from CSF obstruction
Cortical spreading depression with trigeminovascular activation
Intracranial hemorrhage from small vessel rupture
A 70-year-old man presents with progressive visual hallucinations, fluctuating cognition, and parkinsonian symptoms. Which finding would most likely be seen on neuropathology?
Neurofibrillary tangles in the hippocampus
β-amyloid plaques in the cortex
α-synuclein–containing Lewy bodies in cortical neurons
Demyelination of periventricular white matter
