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Coma MCQs
Neurology · MBBS / Medicine · 27 practice questions
- Pupillary Findings in Coma
- Causes of Coma - Supratentorial vs Subtentorial vs Diffuse
- Emergency Management of Coma
- History - Time Course of Coma Onset
- Blood Pressure in Coma
- Emergency Management - Flumazenil Contraindications
- Neurologic Examination - Eye Movements
- Temperature Abnormalities in Coma
1. A 60-year-old woman develops sudden hemiparesis and aphasia that progresses to coma within 30 minutes. Which underlying process is most characteristic of this time course?
- AChronic subdural hematoma
- BIntracerebral hemorrhage
- CBrain abscess
- DBrain tumor
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B. Intracerebral hemorrhage The chapter states that rapid progression from hemispheric signs to coma within minutes to hours is characteristic of intracerebral hemorrhage, distinguishing it from the more protracted courses of tumor, abscess, or chronic subdural hematoma.
2. During a routine exam, a healthy 25-year-old's pupils are noted to differ in diameter by 0.5 mm. Both pupils constrict briskly and symmetrically to light, and extraocular movements are normal. How should this finding be interpreted?
- APathologic anisocoria requiring urgent CT head
- BEarly sign of transtentorial herniation
- CSign of oculomotor nerve compression
- DPhysiologic anisocoria, a normal variant present in about 20% of the population
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D. Physiologic anisocoria, a normal variant present in about 20% of the population The text specifies that anisocoria of 1 mm or less with symmetric light reactivity and normal extraocular movements is physiologic and occurs in 20% of the population.
3. A previously normotensive 30-year-old woman develops acute renal failure and is found comatose with a blood pressure of 200/120 mm Hg. According to the chapter, why might hypertensive encephalopathy be suspected at this blood pressure, which is lower than the typical threshold?
- AThis blood pressure is too low to cause hypertensive encephalopathy in any patient
- BHypertensive encephalopathy always requires blood pressure over 250/150 regardless of chronicity
- CThe threshold is lower in previously normotensive patients with acute blood pressure elevation
- DOnly children can develop hypertensive encephalopathy at lower blood pressures
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C. The threshold is lower in previously normotensive patients with acute blood pressure elevation The text states that in hypertensive encephalopathy, blood pressure exceeds 250/150 in chronically hypertensive patients but may be lower in children or after acute elevation in previously normotensive patients such as with acute renal failure.
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