Apea Pre-Predictor Actual Exam Test Bank
Questions And Correct Detailed Answers
With Rationales (Verified Answers) |Already
Graded A+
In myasthenia gravis, weakness is a result of insufficient acetylcholine
transmission at the neuromuscular junction; however, weakness can also occur
with overdosing of the cholinergic medications used to treat myasthenia. What
symptom helps differentiate a myasthenic crisis from a cholinergic crisis? -
answer-Muscle fasciculations
A 74-year-old man presents after his wife witnessed him grab his head in pain
and fall to the floor. He has not regained consciousness. His current blood
pressure is 150/96 mm Hg, and his heart rate is 65 bpm. Emergent head CT
shows a subarachnoid hemorrhage. - answer-Nimodipine (CCB)
A 75-year-old man is involved in a motor vehicle accident and strikes his
forehead on the windshield. He complains of neck pain and severe burning in
his shoulders and arms. His physical examination reveals weakness of his upper
extremities. What type of spinal cord injury does this patient have? - answer-
central cord syndrome
,A 4-month-old febrile infant presents with loss of appetite, irritability, seizures,
focal sensory and motor deficits, and an acute petechial rash. On physical
examination, a bulging fontanelle is noted; rectal temperature is 102.8°F. What
study would be most important in this child's evaluation? - answer-CSF analysis
A 46-year-old man presents with severe insomnia and anxiety. While
hospitalized, an overnight polysomnogram was performed over 2 consecutive
nights. Sleep latency was 60 minutes; REM latency was 45 minutes. He reports
feeling paresthesias deep within his legs while lying in bed, especially while
falling asleep. He denies recent illness or illicit drug use. His physical exam and
lab work were within normal limits. What is the most likely cause of the
patient's symptoms? - answer-Restless leg syndrome
A 32-year-old man presents with a severe headache; he has had 2 similar
headaches within the past week. He describes a burning, 'hot poker'-type of
pain located primarily behind his right eye. He notes that his eye waters
profusely with the headache; in addition, his nose is initially congested, then it
starts running. Only his right side is affected. The headache is so severe that he
cannot work or sleep through it, and he is unable to concentrate on anything
else. The headaches have been unresponsive to over- the-counter pain
medications. The episodes seem to last about 1 hour. He denies any other
symptoms. This patient has no chronic medical conditions, and he takes no
regular medications. What is the most likely underlying pathophysiology of this
patient's condition? - answer-Increased trigeminal nerve and parasympathetic
activity, leading to vasodilation
A 73-year-old man presents after a 15-minute episode of right eye vision loss,
which he described as being "like a shade being pulled down". What diagnostic
test is most likely to be abnormal? - answer-Carotid ultrasound
,A 42-year-old man presents to the emergency department with a severe
headache. He has been getting several of these headaches recently and has
tried all over-the-counter pain relievers and headache medicines with no relief.
His current headache started 15 minutes ago. He describes the pain as located
next to and behind his left eye and "stabbing/excruciating" in nature. He feels
like his left eye tears up profusely with these headaches. He denies recent
stressors that may have caused his headaches. On physical exam, the patient
appears slightly agitated and appears uncomfortable. Which of the following
aspects of patient history would be most consistent with this patient's
suspected condition? - answer-Rhinorrhea associated with HA
A 66-year-old English teacher is in the hospital. Her neurologist gives her a
magazine to read, and she is unable to do so. What is this phenomenon called?
- answer-Alexia
A 35-year-old man presents with unusual sensations in his legs. He describes
the sensation as an uncomfortable crawly sensation deep within his legs. If he
tries to ignore them, the feeling worsens. He has brief relief with movement,
but the feelings return as soon as he is still again. He was given a trial of a
benzodiazepine to take at bedtime, but it did not really help. In addition, he
complains of being sleepy during the day as a result of the medication. He also
tried leg massages and exercise without much relief. The patient denies
snoring, vivid dreams, or cataplexy. He states that he has a depressed mood
and reduced energy and concentration, but he denies suicidal ideation. His
physical exam is normal. Complete blood cell count and chemistry panels are
normal. Question What is true regarding the patient's condition? - answer-An
abnormal electrical impulse conduction study is frequently seen
A 70-year-old man presents with memory loss that has been worsening over
the past few months. He also has history of slurred speech and walking
difficulty. There is a history of getting lost in familiar surroundings. His history
is also significant for a stroke 2 years ago. On examination, there are focal
, neurological signs including plantar response, gait abnormalities, exaggeration
of deep tendon reflexes, and weakness of the right lower limb. Brain imaging
studies show multiple large-vessel infarcts and extensive periventricular white
matter lesion. What is indicated by evidence of relevant cerebrovascular
disease? - answer-Vascular dementia
A 60-year-old man presents for evaluation of loss of recent and remote
memory, psychomotor slowing, and difficulty with complex tasks. On exam,
the patient also shows some tremor tics, dystonia, and impaired coordination.
Family history reveals he had 2 brothers who both died of a strange
"movement" disorder. What is the provisional diagnosis? - answer-
Huntington's disease
A 9-year-old boy presents to a neurologist's office accompanied by his mother.
She reports that he has had 3 episodes of what she thinks are seizures. She
describes these episodes in detail to the neurologist. What would lead the
neurologist to consider the diagnosis of tonic-clonic seizures? - answer-Sudden
loss of consciousness with convulsions and confusion that lasts about 15
minutes each time, then resolves spontaneously
A 32-year-old man is admitted to the hospital following loss of consciousness.
The patient had been ill with fever and headache for several days, then
developed double vision, confusion, and loss of consciousness. He has been
otherwise healthy with no past medical conditions. Imaging reveals edema of
the frontal lobe. Which virus most commonly causes the patient's infection? -
answer-HSV
A 44-year-old man presents after an episode what is described as "passing
out". He has a past medical history of hypertension, diabetes mellitus type II,
and osteoarthritis. Earlier in the day, the patient visited his primary care
physician for routine blood work. During his blood draw, the patient had an
Questions And Correct Detailed Answers
With Rationales (Verified Answers) |Already
Graded A+
In myasthenia gravis, weakness is a result of insufficient acetylcholine
transmission at the neuromuscular junction; however, weakness can also occur
with overdosing of the cholinergic medications used to treat myasthenia. What
symptom helps differentiate a myasthenic crisis from a cholinergic crisis? -
answer-Muscle fasciculations
A 74-year-old man presents after his wife witnessed him grab his head in pain
and fall to the floor. He has not regained consciousness. His current blood
pressure is 150/96 mm Hg, and his heart rate is 65 bpm. Emergent head CT
shows a subarachnoid hemorrhage. - answer-Nimodipine (CCB)
A 75-year-old man is involved in a motor vehicle accident and strikes his
forehead on the windshield. He complains of neck pain and severe burning in
his shoulders and arms. His physical examination reveals weakness of his upper
extremities. What type of spinal cord injury does this patient have? - answer-
central cord syndrome
,A 4-month-old febrile infant presents with loss of appetite, irritability, seizures,
focal sensory and motor deficits, and an acute petechial rash. On physical
examination, a bulging fontanelle is noted; rectal temperature is 102.8°F. What
study would be most important in this child's evaluation? - answer-CSF analysis
A 46-year-old man presents with severe insomnia and anxiety. While
hospitalized, an overnight polysomnogram was performed over 2 consecutive
nights. Sleep latency was 60 minutes; REM latency was 45 minutes. He reports
feeling paresthesias deep within his legs while lying in bed, especially while
falling asleep. He denies recent illness or illicit drug use. His physical exam and
lab work were within normal limits. What is the most likely cause of the
patient's symptoms? - answer-Restless leg syndrome
A 32-year-old man presents with a severe headache; he has had 2 similar
headaches within the past week. He describes a burning, 'hot poker'-type of
pain located primarily behind his right eye. He notes that his eye waters
profusely with the headache; in addition, his nose is initially congested, then it
starts running. Only his right side is affected. The headache is so severe that he
cannot work or sleep through it, and he is unable to concentrate on anything
else. The headaches have been unresponsive to over- the-counter pain
medications. The episodes seem to last about 1 hour. He denies any other
symptoms. This patient has no chronic medical conditions, and he takes no
regular medications. What is the most likely underlying pathophysiology of this
patient's condition? - answer-Increased trigeminal nerve and parasympathetic
activity, leading to vasodilation
A 73-year-old man presents after a 15-minute episode of right eye vision loss,
which he described as being "like a shade being pulled down". What diagnostic
test is most likely to be abnormal? - answer-Carotid ultrasound
,A 42-year-old man presents to the emergency department with a severe
headache. He has been getting several of these headaches recently and has
tried all over-the-counter pain relievers and headache medicines with no relief.
His current headache started 15 minutes ago. He describes the pain as located
next to and behind his left eye and "stabbing/excruciating" in nature. He feels
like his left eye tears up profusely with these headaches. He denies recent
stressors that may have caused his headaches. On physical exam, the patient
appears slightly agitated and appears uncomfortable. Which of the following
aspects of patient history would be most consistent with this patient's
suspected condition? - answer-Rhinorrhea associated with HA
A 66-year-old English teacher is in the hospital. Her neurologist gives her a
magazine to read, and she is unable to do so. What is this phenomenon called?
- answer-Alexia
A 35-year-old man presents with unusual sensations in his legs. He describes
the sensation as an uncomfortable crawly sensation deep within his legs. If he
tries to ignore them, the feeling worsens. He has brief relief with movement,
but the feelings return as soon as he is still again. He was given a trial of a
benzodiazepine to take at bedtime, but it did not really help. In addition, he
complains of being sleepy during the day as a result of the medication. He also
tried leg massages and exercise without much relief. The patient denies
snoring, vivid dreams, or cataplexy. He states that he has a depressed mood
and reduced energy and concentration, but he denies suicidal ideation. His
physical exam is normal. Complete blood cell count and chemistry panels are
normal. Question What is true regarding the patient's condition? - answer-An
abnormal electrical impulse conduction study is frequently seen
A 70-year-old man presents with memory loss that has been worsening over
the past few months. He also has history of slurred speech and walking
difficulty. There is a history of getting lost in familiar surroundings. His history
is also significant for a stroke 2 years ago. On examination, there are focal
, neurological signs including plantar response, gait abnormalities, exaggeration
of deep tendon reflexes, and weakness of the right lower limb. Brain imaging
studies show multiple large-vessel infarcts and extensive periventricular white
matter lesion. What is indicated by evidence of relevant cerebrovascular
disease? - answer-Vascular dementia
A 60-year-old man presents for evaluation of loss of recent and remote
memory, psychomotor slowing, and difficulty with complex tasks. On exam,
the patient also shows some tremor tics, dystonia, and impaired coordination.
Family history reveals he had 2 brothers who both died of a strange
"movement" disorder. What is the provisional diagnosis? - answer-
Huntington's disease
A 9-year-old boy presents to a neurologist's office accompanied by his mother.
She reports that he has had 3 episodes of what she thinks are seizures. She
describes these episodes in detail to the neurologist. What would lead the
neurologist to consider the diagnosis of tonic-clonic seizures? - answer-Sudden
loss of consciousness with convulsions and confusion that lasts about 15
minutes each time, then resolves spontaneously
A 32-year-old man is admitted to the hospital following loss of consciousness.
The patient had been ill with fever and headache for several days, then
developed double vision, confusion, and loss of consciousness. He has been
otherwise healthy with no past medical conditions. Imaging reveals edema of
the frontal lobe. Which virus most commonly causes the patient's infection? -
answer-HSV
A 44-year-old man presents after an episode what is described as "passing
out". He has a past medical history of hypertension, diabetes mellitus type II,
and osteoarthritis. Earlier in the day, the patient visited his primary care
physician for routine blood work. During his blood draw, the patient had an
