A. Transient ischemic attack is:

1. Temporary symptoms of neurological dysfunction caused by regional ischemia of brain tissue, but not leading to the development of infarction lesion on CT or MRI

2. Clinical syndrome, represented by focal and/or general cerebral disorders, developing suddenly, as a result of acute cerebrovascular accident

3. Syndrome caused by blood entering the subarachnoid space due to rupture of blood vessels of the brain or its membranes

4. Autoimmune disease of the blood vessels of the brain, leading to the development of focal and/or general cerebral disorders

5. Intracranial hemorrhages due to acquired changes and/or malformations of blood vessels

 

B. The patient complaints for shooting pain in the lumbar region, irradiating to the left leg, increasing with movement and sneezing. Examination is positive for hypoesthesia of the lateral side of the foot, loss of the Achilles reflex. Possible diagnosis:

1. Myelopathy of the lower thoracic spine

2. Herniation, radiculopathy S1

3. Herniation, radiculopathy L1

4. Neuropathy of the tibial nerve

5. Neuropathy of the femoral nerve

 

C. The patient complains about dull pain in the cervical region increasing in movement. The symptoms last more than 10 years with episodes of remission. Neurological examination detects pain during palpation in the cervical region, limitation of movement in the cervical part. Tendon reflexes are normal, equal, there are no sensory disturbances. Possible diagnosis:

1. Myelopathy of the cervical spinal cord

2. Herniation, radiculopathy C1

3. Nonspecific vertebral pain

4. Neuropathy of the occipital nerve

5. Herniated disc, radiculopathy C5

 

D. Which symptom is characteristic of stroke in the posterior cerebral artery:

1) monoplegia or monoparesis of the leg

2) motor aphasia

3) hemianopsia

4) astereognosis

5) grasping reflex

 

E. That’s investigation is mandatory if the patient has wake up or night headache:

1. Electroencephalography

2. Electromyography

3. Evoked potentials

4. Cerebral MRI

5. X-ray of the cervical spine

 

F. The initial treatment of migraine attacks is:

1) Immunoglobulins

2) Anticonvulsants

3) Nonsteroidal anti-inflammatory drugs or analgesics

4) Antibiotics

5) Opioid analgesics

 

G. A 23-year-old female patient complains of shooting pain in the lumbar region, which increases with movement, radiates down to the left leg to the popliteal fossa, limps on the left leg. She fell ill a week ago after lifting heavy goods. She has been suffering from lumbar pain for about 2 years with periodic exacerbation. She is currently 20 weeks pregnant. Objectively: the cranial nerves are normal. There are no sensory disturbances. Tendon reflexes are physiological and equal. The strength in all muscle groups is 5 points. There is palpable pain in the lumbar spine in the area of ​​the spinous processes and paravertebrally with muscle tension. Lasegue's symptom is weakly positive on the left. The range of motion in the spine is limited then knees to the right and forward.

1.       Your possible diagnosis and its justification.

2.       What diagnostic methods will you use to confirm your assumption?

3.       What treatment will you prescribe for the patient?