Soal Neurologi Seleksi Imo

SOAL NEUROLOGI SELEKSI IMO : 1. A 45 –years–years- old female female is i!ol!ed i!ol!ed i a mo"or mo"or !e#i$le !e#i$le a$$ide" a$$ide" i %#i$# s#e s"ri&es i "#e side of #er #ead a'ais" "#e %ids#ield. S#e is "rasie"ly ($os$io(s. )#e e*amied i "#e emer'e$y room s#e is fel" "o +e f(lly $os$io(s. O #er re"(r from "#e Radio Radiolo' lo'y y ,ear" ,ear"me me" " "#o('# "#o('# s# s#e e aro(s aro(ses es oly oly "o !i'or !i'oro( o(s s s"im(la"io. /#e 0l($id i"er!al s#e #as e*erie$ed is MOS/ $#ara$"eris"i$ of %#i$# of "#e follo%i'2 A. S(+ara$#oid #aemorr#a'e 3. Eid(ral #aemorr#a'e . S(+d(ral #aemorr#a'e ,. /ra(ma"i$ i"rasere+ral #aemorr#a'e E. aemorr#a'i$ s"ro&e 6. Seora Seora' ' la&i-l la&i-la&i a&i 67 "a#( "a#( di+a%a di+a%a &e (i" (i" 'a%a" 'a%a" dar(ra" dar(ra" r(ma# sa&i sa&i"" a&i+ a&i+a" a" "er8 "er8a" a"(# (# dari dari a"a a"a se"i se"i' ''i 'i lim lima me"er e"er.. 9ada ada eme emeri ri&s &saa aa  dida didaa a"& "&a a &el(m el(m(# (#a a &ed(a ed(a a'' a''o" o"a a 'era 'era& & +a%a# +a%a# 'a''( 'a''(a a sesi+ sesi+ili" ili"as as #ies #ies"es "esi; i; #i''a #i''a daera daera# # &(li" &(li" se"i''i papilla se"i''i papilla mammae mammae di$(ri'ai a&i+a" adaya fra&"(r "(la' !er"e+ra. ,idaa"&a 8('a +e8ola s(rasym#isis s(rasym#isis ya' did('a did('a &area &ad(' &e$i' "erisi e(#. Aa&a# dia'osis "ois ada &as(s ii2 A. !er"e+ra $er!i$alis I< 3. !er"e+ra "#ora$alis I< . !er"e+ra "#ora$alis4-year >4-year-old -old %oma rese"s "o "#e emer'e$y dear"me" $omlaii' of a 0is-ad-eedles sesa"io i #er fee" ad le's %#i$# +e'a yes"erday. yes"erday. Ii"ially "#is sesa"io i!ol!ed oly #er fee" +(" i" #as 'rad(ally mo!ed ( "o i!ol!e #er a&les $al!es ad "#i'#s. S#e #as #ad di?$(l"y %al&i' for "#e as" fe% #o(rs. S#e re$alls a re$e" eisode of +loody diarr#ea +(" o"#er%ise s#e #as +ee i 'ood #eal"#. O e*amia"io "#ere "#ere is %ea&ess of "#e foo" ad le' m(s$les i a symme"ri$al dis"ri+("io. ,ee "edo re@e*es re@e*es are a+se" a" "#e &ees ad a&les. 9la"ar re@e* is @e*or. as$i$(la"ios are o" see. I$osis"e" res(l"s are o+"aied o sesory e*am. raial er!es are i"a$". /#e res" of "#e #ysi$al e*am is ormal. S e*amia"io is ormal e*$e" for a ele!a"ed ro"ei le!el.

)#i$# of "#e follo%i' is "#e mos" li&ely dia'osis for "#is a"ie"2 A. 3o"(lism 3. Mo"or e(ro disease . G(illai-3arre sydrome ,. 9oliomyeli"is  E. A$("e I< ife$"io

4. A 65-year-old %oma $omes "o yo(r $lii$ $omlaii' of #eada$#es. S#eBs +ee #a!i' (ila"eral #eada$#es for a+o(" a year a" a ra"e of aro*ima"ely "%o "o "#ree eisodes a mo"#.  /#e #eada$#es las" for C "o D #o(rs are (lsa"i' ad are a$$omaied +y a(sea !omi"i' ad #o"o#o+ia. S#e also #as +ee e*erie$i' some r#iorr#ea %i"# "#e #eada$#es. /#e ai is modera"e i i"esi"y ad 'e"s %orse %i"# ro("ie #ysi$al a$"i!i"y. S#e (s(ally 'e"s relief +y "a&i' o!er-"#e$o("er i+(rofe. er medi$al #is"ory is osi"i!e for si(s aller'ies. S#e #as a family #is"ory of #eada$#es. er #ysi$al e*amia"io i$l(di' a e(rolo'i$ e*amia"io is (remar&a+le. S#e #as #eard o "#e e%s "#a" #eada$#es $a +e a si' of a "(mor ad s#e is $o$ered a+o(" "#is ossi+ili"y. On the basis of this patient’s history and physical examination, what is the most likely diagnosis, and how would you evaluate her?  A. /esio-"ye #eada$#e f(r"#er %or&( is o" idi$a"ed a" "#is "ime  3. Si(s #eada$#e o+"ai a si(s $om("ed "omo'ra#i$ s$a  . Mi'raie %i"#o(" a(ra o f(r"#er %or&( is idi$a"ed a" "#is "ime  ,. Mi'raie %i"#o(" a(ra ma'e"i$ resoa$e ima'i' is idi$a"ed "o r(le o(" i"ra$raial a"#olo'y E. Red mi'raie o f(r"#er %or&( is idi$a"ed a" "#is "ime 5. A 76-year-old %oma is referred "o yo( for e!al(a"io of 6 "o > years of 'rad(al memory loss. Al"#o('# s#e $learly #as si'iF$a" di?$(l"ies %i"# memory ad slo%ed see$# s#e seems s(rrisi'ly aa"#e"i$ "o%ard #er $odi"io. S#e #as #yer"esio ad mild os"eoeia +(" is o"#er%ise #eal"#y s#e #as o #is"ory of #ead "ra(ma. er oly medi$a"io is 16.5 m' of #ydro$#loro"#iaide o$e daily. er Mii-Me"al S"a"e E*am MMSE; s$ore is 61H> #er e(rolo'i$ e*am is ormal.

Ne(rosy$#olo'i$al "es"i' $oFrms $o'i"i!e dysf($"io. La+ora"ory e!al(a"io for o"#er $a(ses of deme"ia is e'a"i!e. Which of the following is the most appropriate diagnosis for this patient? A. ,eFi"e Al#eimer disease 3. 9ro+a+le Al#eimer disease . 9ro'ressi!e s(ra($lear alsy ,. Normal-ress(re $omm(i$a"i'; #ydro$e#al(s E. 9oly#arma$y

C. Seora' %ai"a da"a' &e RS de'a &el(#a yeri &eala +ada meria'  s(da# +erla's(' 5 #ari m(al da m("a# -;. S(da# +ero+a" &e ,o&"er "ai +el(m ada er(+a#a. Se%a&"( dieri&sa &esadara me(r( lema# a''o"a 'era& searo# sisi -; &e8a' -;emeri&saa asie di8(mai &a&( &(d(& aresis er!(s .  4.  5. 3 C. E 7. A D. E J. ,

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