Neurology Self-Assessment. A Companion to Bradley’s Neurology in Clinical Practice

218 Pages·2016·4.76 MB·English

by  Justin T. Jordan

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2015v1.0
Neurology Self-Assessment
Neurology Self-Assessment:
A Companion to Bradley’s
Neurology in Clinical Practice
JUSTIN T. JORDAN, MD
Assistant in Neurology, Massachusetts General Hospital;
Instructor in Neurology, Harvard Medical School,
Boston, MA
DAVID R. MAYANS, MD
Neurology Consultants of Kansas;
Clinical Assistant Professor, University of Kansas School of
Medicine, Wichita, KS
MICHAEL J. SOILEAU, MD
Director, Plummer Movement Disorder Center, Baylor Scott
& White Health, Temple, TX;
Clinical Assistant Professor and Assistant Program Director,
Neurology Residency, Texas A&M Health Science Center,
Temple, TX
Foreword by
JOHN C. MAZZIOTTA, MD, PHD
Vice Chancellor, UCLA Health Sciences;
Dean, David Geffen School of Medicine;
CEO, UCLA Health,
University of California, Los Angeles, CA
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Notices
Knowledge and best practice in this field are constantly changing. As new research and experience
broaden our understanding, changes in research methods, professional practices, or medical treatment
may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating
and using any information, methods, compounds, or experiments described herein. In using such
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including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the most
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to be administered, to verify the recommended dose or formula, the method and duration of
administration, and contraindications. It is the responsibility of practitioners, relying on their own
experience and knowledge of their patients, to make diagnoses, to determine dosages and the best
treatment for each individual patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume
any liability for any injury and/or damage to persons or property as a matter of products liability,
negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas
contained in the material herein.
ISBN: 978-0-323-37709-6
eISBN: 978-0-323-39221-1
Senior Content Strategist: Lotta Kryhl
Senior Content Development Specialist: Ailsa Laing
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Printed in China
Last digit is the print number: 9 8 7 6 5 4 3 2 1
Contents
Dedications,  vii
Foreword by John C. Mazziotta,  viii
Preface,  ix
Test One Questions,  1
Test One Answers,  17
Test Two Questions,  35
Test Two Answers,  53
Test Three Questions,  69
Test Three Answers,  86
Test Four Questions,  103
Test Four Answers,  120
Test Five Questions,  137
Test Five Answers,  152
Test Six Questions,  169
Test Six Answers,  185
Index,  201
v
To my father, who inspired my career, and my family
for their endless support.
JTJ
I want to thank Laura and Gabriella for their
patience with me while writing this book. I would like
to thank my mentors, particularly Nikhil
Balakrishnan, for his encouragement through this
process. Finally, I want to thank JJ for giving me the
opportunity to be part of this exceptional book.
DRM
I wish to thank my wife Janiece and son Mason for
supporting me throughout my career and for their
love each day. I’d also like to thank the many mentors
and colleagues along the way who have molded me
into the physician I am today and for igniting
excitement for the field of neurology.
MJS
Foreword
It is difficult to write self-assessment texts. They need to be The ability to examine a question, consider the answers,
comprehensive in scope and practical in usage. Neurology Self- make a selection, and then quickly refer to the answer is con-
Assessment by Drs. Jordan, Mayans, and Soileau accomplishes sistent with the long-known neuroscience principle that a
these goals admirably and is the perfect companion for stimulus and its response, when quickly rewarded, reinforces
Bradley’s Neurology in Clinical Practice, Seventh Edition. the information. This text provides exactly that stimulus-
Physicians, in general, and neurologists, in particular, are response exercise. That the answers are referenced to Bradley’s
always motivated to test their knowledge. A multiple-choice Neurology in Clinical Practice further provides the user with the
question is an opportunity to see how deep one’s knowledge opportunity to read in more depth about a topic, particularly
is. When I was preparing for my board examination in Psy- if that person has answered incorrectly.
chiatry and Neurology, I obtained a recent edition of one of The trio has done a masterful job in providing a compre-
the most comprehensive texts in the field at that time. I went hensive set of 630 questions that will challenge the readers
through the book, page-by-page, table-by-table, and figure-by- and allow for a thorough self-assessment of their knowledge
figure and made mental multiple-choice questions out of its base. As one of the co-editors of Bradley’s Neurology in Clinical
content. This was a laborious but rewarding task. After that Practice, I speak on behalf of the four of us in complimenting
exercise, I felt I knew which areas required more study and Drs. Jordan, Mayans, and Soileau on their very successful self-
where I should be confident with my state of knowledge. This assessment text.
self-assessment text provides all of that for the readers with no
effort on their part. Its six 105-question examinations will test John C. Mazziotta, MD, PhD
the readers’ knowledge across a wide range of topics. Not only
for the editors of Bradley’s Neurology in Clinical Practice
does the self-assessment include all aspects of clinical neurol-
ogy but also basic science, ethics, and interpersonal skills.
Robert B. Daroff, MD
Such an offering is vital to high-quality patient care and pro-
fessional requirements such as in-service examinations, board Joseph Jankovic, MD
examinations, and maintenance of certification testing. The
Scott L. Pomeroy, MD, PhD
range of the questions’ difficulty will be valuable for everyone
interested in the field of neurology, from medical students to
seasoned practitioners.
viii
Preface
The field of neurology is more exciting and rapidly advancing explanations for both correct and incorrect answers, as well as
today than ever before, and as new light is shed on the etiology further reading suggestions from Bradley’s Neurology in Clinical
of disease, effective and revolutionary therapies follow close Practice. Questions are written in a style similar to full exami-
behind. This translates to improved quality of care for patients nations, with a strong representation of clinical vignettes and
and improved satisfaction for neurologists. images. The depth of knowledge required to perform well on
As our drive for scientific progress continues, neurologists these examinations is likely more than sufficient to pass pro-
should make every effort to maintain a firm understanding of fessional examinations, although should not be beyond the
available data in order to provide the best care possible for grasp of medical students.
patients. This necessity is not only apparent in daily practice, On the whole, we believe that Neurology Self-Assessment will
but also in professional requirements including in-service become a strong tool in the development and maintenance of
examinations, board examinations, and maintenance of certi- neurologic expertise for practitioners at all levels.
fication. It was in this context that we three approached Neu-
rology Self-Assessment. Justin T. Jordan, MD
Not only are the six 105-question examinations a tool for
David R. Mayans, MD
assessing one’s strengths and weaknesses, but they also provide
a valuable resource for exam studying, with in-depth Michael J. Soileau, MD
ix
Test One
QUESTIONS 2. In reference to the patient in the previous question,
which of the following would be the most appropriate
1. A 23-year-old female presents to the clinic for treatment?
evaluation of a headache. She is currently 14 weeks
A. Diamox
pregnant. She complains of a holocephalic headache
for the last week, which is worsening in intensity. The B. Acetaminophen and rest
headache is worse at night and causes blurry vision. C. Magnesium
Her neurological examination is remarkable for
D. Warfarin
bilateral papilledema. The sagittal T1 magnetic
E. Enoxaparin
resonance image (MRI) is shown here. Which of the
following is the most likely diagnosis? 3. Which of the following is not a means by which
A. Pseudotumor cerebri autoimmunity occurs?
B. Meningioma A. Genetic predisposition
C. Venous sinus thrombosis B. Failure of self-tolerance
D. Preeclampsia C. Molecular mimicry
E. Optic neuritis D. Major histocompatibility failure
E. Environmental factors
4. Dopamine beta hydroxylase converts dopamine to
which of the following?
A. Epinephrine
B. L-Dopa
C. Tyrosine
D. Serotonin
E. Norepinephrine
5. Which of the following is not a standard component of
a patient handoff between care providers?
A. Identification
B. Family history
C. Diagnoses
D. Treatment plan
E. Code status
6. Convulsive seizures during pregnancy can have all
of the following effects on the developing fetus
except?
A. Fetal bradycardia and asphyxia
B. Fetal increased risk of epilepsy
C. Increased risk of lower verbal IQ
Figure for Question 1.1. 
D. Blunt trauma to the fetus
E. Large for gestational age
1