vitamin d

How are congenital anomalies described in relation to neuromuscular diseases?. a.They always present with seizures. b.They are infrequent causes of neuromuscular disease. c.They are the most common cause of neuromuscular disease. d.They exclusively affect the cerebellum.

Which set of electrolyte abnormalities is explicitly listed in the notes as potentially causing neurological signs?. a. Only hyperkalemia. b. Only hypocalcemia. c. Hypercholesterolemia, hypertriglyceridemia and hyperbilirubinemia. d. Hypo-/hypernatremia, hypo-/hyperkalemia, hypo-/hypercalcemia and hypophosphatemia.

Which of the following is listed as a secondary (metastatic) tumor affecting the nervous system?. a. Medulloblastoma. b. Astrocytoma. c. Hemangiosarcoma. d. Oligodendroglioma.

Which clinical course for ischemic myelopathy is stated in the notes?. a. Acute and non-progressive. b. Intermittent episodes only during exercise. c. Chronic and progressively worsening. d. Static deficits from birth.

Which statement best matches the notes regarding inflammatory/infectious neurological disease?. a. Multiple agents can enter via blood, nerves, or direct extension from surrounding tissue. b. Inflammation is always idiopathic and cannot be infectious. c. Only bacteria cause inflammatory CNS disease and only via CSF. d. Only viruses cause inflammatory CNS disease and only via lymphatics.

According to the notes, what is the correct order for approaching a neurological case before building a VITAMIN D differential list?. a. Define the problem → localize neuroanatomically → generate differentials (VITAMIN D). b. Generate VITAMIN D list → localize → examine. c. Localize → treat → define the problem. d. Choose treatment → take history → localize.

Which combination is typical of lower motor neuron (LMN) dysfunction?. a. Decreased reflexes, decreased tone and muscle atrophy. b. Head pressing only. c. Wide-based stance with tremor. d. Hyperreflexia with increased tone.

What is the main purpose of using the acronym VITAMIN D in neurological case work-up?. a. To classify only infectious diseases. b. To calculate drug dosages for treatment. c. To create a comprehensive differential diagnosis list. d. To replace the neurological examination.

Which CSF change is described in the notes for subarachnoid hemorrhage?. a. Always normal CSF. b. Increased protein and increased cell content. c. Only decreased glucose. d. Low protein with no cells.

Gradually progressive focal neurological signs are most consistent with which mechanism?. a. Metabolic encephalopathy. b. Neoplastic mass effect. c. Acute vascular infarction. d. Idiopathic vestibular disease.

In the notes, brain injury related to sudden acceleration or deceleration is explained by: a. Exclusive vascular embolism from the heart. b. Thiamine deficiency. c. Primary autoimmune inflammation. d. Brain displacement producing coup and countercoup lesions.

In the notes, toxic neurological disease is defined as: a. A congenital malformation present at birth. b. A progressive inherited neuronal degeneration. c. A space-occupying mass lesion. d. A disturbance of neurological function without observable CNS tissue morphological changes.

Which electrolyte abnormality listed in the notes can produce neurological signs?. a. Hypercholesterolemia only. b. Hypertriglyceridemia exclusively. c. Elevated liver enzymes without electrolyte change. d. Hypo- or hypercalcemia.

According to the notes, differential diagnoses should be generated after defining the neurological problem and determining which of the following?. a. Owner’s preferred treatment option. b. Neuroanatomical localisation. c. Housing and feeding plan. d. Breed club recommendations.

Which CSF pattern is most consistent with inflammatory CNS disease?. a. Only decreased glucose. b. Always completely normal CSF. c. Low protein and acellular CSF. d. Increased cells and protein in CSF.

Pelvic limb hyporeflexia with decreased tone and muscle atrophy localizes to: a. Cerebellum. b. Prosencephalon. c. L4–S3 spinal cord segment. d. T3–L3 spinal cord segment.

Hypoadrenocorticism (Addison) is associated in the notes with: a. Static deficits from birth. b. Intention tremor with preserved strength. c. Depression and hyponatremia. d. Hyperactivity and circling.

Which set of neuroanatomical locations is explicitly listed in the notes as targets for localisation before creating a differential list?. a. Only spinal cord and muscles. b. Only cerebrum and cerebellum. c. Cerebrum, cerebellum, brain stem, spinal cord and peripheral nerves. d. Liver, kidney, spleen and pancreas.

Which condition is listed in the notes as an idiopathic neurological disease?. a. Subarachnoid hemorrhage. b. Porencephaly. c. Idiopathic vestibular disease. d. Intervertebral disc herniation.

According to the notes, infectious agents may reach the nervous system via which routes?. a. Only via lymphatic vessels. b. Only via CSF circulation. c. Blood, nerves, or direct extension from surrounding tissues. d. Only after cranial surgery.

According to the notes, vascular neurological diseases can occur in which age group?. a. At every age. b. Only in geriatric patients. c. Only in neonatal patients. d. Only in young animals under 1 year.

Which option lists only inflammatory/infectious nervous system disease terms explicitly named in the notes?. a. Encephalitis, Myelitis, Neuritis, Meningitis, Ependymitis. b. Myopathy, cardiomyopathy, nephropathy, hepatopathy, enteropathy. c. Neoplasia, anomalies, metabolic disease, trauma, vascular disease. d. Arthritis, dermatitis, pancreatitis, hepatitis, cystitis.

Rapid and severe muscle atrophy is most characteristic of which mechanism?. a. Cerebellar dysfunction. b. Neurogenic (LMN/peripheral nerve) disease. c. Metabolic encephalopathy. d. Forebrain lesion.

Which combination of signs is characteristic of peripheral nerve dysfunction?. a. Decreased/absent reflexes, reduced muscle tone, rapid neurogenic atrophy. b. Increased reflexes and increased tone without atrophy. c. Only behavioral changes. d. Normal reflexes and pure cerebellar tremor.

Which statement is correct regarding meningiomas in small animals?. a. They originate from glial cells and are most common in brachycephalic dogs. b. They are exclusively spinal tumors in young animals. c. They are secondary metastatic tumors more common in dogs. d. They are primary meningeal tumors more common in cats than dogs.

Which neurological signs are associated with hyperthyroidism in the notes?. a. Only intention tremor and hypermetria. b. Static deficits from birth. c. Hyperactivity, pacing, circling and seizures. d. Only LMN paresis with absent reflexes.

According to the notes, vascular lesions of the nervous system are typically described as: a. Restricted to peripheral nerves only. b. Always bilateral and progressive. c. Well demarcated and extremely focal. d. Diffuse and symmetrical.

Which combination of signs is typical of cerebellar dysfunction?. a. Intention tremor, wide-based stance and ipsilateral menace deficit with normal vision. b. Flaccid paralysis with muscle atrophy. c. Head pressing with compulsive circling. d. Depression with hyponatremia.

According to the table on onset and progression of brain diseases, which group should be prioritized in acute, progressive and asymmetrical signs?. a. Degenerative and congenital anomalies only. b. Metabolic and toxic causes exclusively. c. Meningoencephalitis/encephalitis, neoplasia and trauma. d. Idiopathic epilepsy only.

What distinction regarding tumors of the nervous system is made in the notes?. a. Inflammatory versus metabolic tumors. b. Primary versus secondary (metastatic) tumors. c. Benign versus traumatic tumors. d. Congenital versus infectious tumors.

Which pattern is most consistent with a C1–C5 myelopathy?. a. Tetraparesis with normal or increased spinal reflexes in all limbs. b. Exercise-induced weakness only. c. Pelvic limb hyporeflexia with thoracic limb hyperreflexia. d. Pure cranial nerve deficits without gait abnormality.

In the VITAMIN D acronym, what does the letter "N" represent?. a. Neuritis exclusively. b. Neuromuscular junction. c. Nutritional only. d. Neoplastic.

Which disease is listed in the notes as an idiopathic inflammatory condition?. a. Portosystemic shunt. b. Ischemic myelopathy. c. Steroid Responsive Meningitis-Arteritis (SRMA). d. Intervertebral disc disease.

According to the notes, infectious agents can penetrate the nervous system via which routes?. a. Blood, nerves, or direct expansion from surrounding tissues. b. Only via lymphatics. c. Only after trauma. d. Only via cerebrospinal fluid circulation.

Which condition is listed as an endogenous form of spinal trauma in the notes?. a. Hypoglycemia. b. Intervertebral disc herniation. c. Idiopathic epilepsy. d. Granulomatous meningoencephalitis.

Which list matches the neurolocation regions explicitly used to organize differentials in the notes?. a. Retina, optic nerve, hypothalamus, pituitary, cerebellum. b. Cardiac, respiratory, gastrointestinal, endocrine, urinary systems. c. Forelimbs, hindlimbs, tail, larynx, diaphragm. d. Cerebrum, Cerebellum, Brain stem, Spinal cord, Peripheral nerves.

Which CSF finding is described for subarachnoid hemorrhage in the notes?. a. Bacteria consistently visible on cytology. b. Normal CSF with no abnormalities. c. Low protein and low cell count. d. Increased protein and increased cell content.

Ischemic myelopathy is described in the notes as typically being: a. Chronic and progressive. b. Congenital and static. c. Non-painful. d. Severely painful in all cases.

Marked lateralization of neurological signs strongly supports which differential category?. a. Vascular. b. Metabolic. c. Diffuse degenerative. d. Nutritional.

Which of the following is listed in the notes as an example of a secondary (metastatic) tumor affecting the nervous system?. a. Lymphoma. b. Porencephaly. c. Intervertebral disc herniation. d. Idiopathic vestibular disease.

Hyperthyroidism is associated in the notes with which neurological signs?. a. Flaccid paralysis with severe muscle atrophy. b. Behavioral changes (hyperactivity), pacing, circling and seizures. c. Pure cerebellar intention tremor only. d. Only decreased menace response with normal vision.

Which finding strongly supports a brainstem localization?. a. Altered mentation with cranial nerve III–XII deficits. b. Normal mentation with isolated menace deficit and intention tremor. c. Pure behavioral hyperactivity without neurological deficits. d. Only lower motor neuron signs in pelvic limbs.

When neurological signs are diffuse and symmetrical, which category should be strongly considered first?. a. Focal vascular infarction. b. Localized trauma. c. Metabolic/Nutritional. d. Peripheral nerve transection.

Which pattern is typical of a C6–T2 (cervical intumescence) lesion?. a. Only intention tremor and wide-based stance. b. Normal reflexes in thoracic limbs and decreased in pelvic limbs only. c. Decreased thoracic limb reflexes with normal/increased pelvic limb reflexes. d. Only behavioral changes.

A peracute onset of neurological signs that remain stable over time is most suggestive of which category?. a. Nutritional deficiency. b. Degenerative. c. Vascular. d. Congenital anomaly.

Which secondary consequences of traumatic brain injury are emphasized in the notes?. a. Primary demyelination of peripheral nerves. b. Exclusive endocrine dysfunction. c. Bleeding/hematoma, edema, compression and increased intracranial pressure. d. Immediate infectious meningitis in all cases.

Which descriptor for ischemic myelopathy is explicitly stated in the notes?. a. Acute and non-progressive. b. Congenital and static. c. Intermittent only during exercise. d. Chronic and progressive.

Lower motor neuron signs in the thoracic limbs with upper motor neuron signs in pelvic limbs localize the lesion to which region?. a. C1–C5 spinal cord segment. b. T3–L3 spinal cord segment. c. C6–T2 spinal cord segment. d. Peripheral nerve.

The most frequent differential diagnoses for peripheral neuromuscular disorders include which categories?. a. Degenerative/hereditary, metabolic, neoplastic, inflammatory, infectious, immune-mediated, vascular and traumatic. b. Only congenital anomalies. c. Only vascular and metabolic. d. Only idiopathic epilepsy.

The notes emphasize that VITAMIN D should be used after: a. Choosing a vaccine protocol. b. Defining the problem and localizing the lesion. c. Completing surgery. d. Starting treatment.

Which condition is listed in the notes as an example of a nutritional neurological disorder?. a. Thiamine (vitamin B1) deficiency. b. Intervertebral disc herniation. c. Ischemic myelopathy. d. Granulomatous meningoencephalitis (GME).

Inflammatory neurological diseases are generally associated with what CSF change according to the notes?. a. Low protein and low cell count only. b. Always completely normal CSF. c. No possible CSF alteration. d. Inflammatory changes in CSF.

Degenerative neurological diseases are typically characterized by which time course?. a. Immediate full recovery. b. Progressive worsening over time. c. Peracute onset with stabilization. d. Intermittent signs only during exercise.

What is the main purpose of using the VITAMIN D acronym in neurological case work-up, as described in the notes?. a. To decide the surgical approach without localisation. b. To select the anesthetic protocol before examination. c. To replace the neurological examination. d. To structure and broaden the differential diagnosis list after localisation.

According to the notes, lysosomal storage diseases typically affect the brain in which pattern?. a. Only peripheral nerve involvement. b. Only spinal gray matter. c. Strictly unilateral focal lesion. d. Diffuse pattern of brain involvement.

Which of the following is listed in the notes as a metabolic cause of neurological dysfunction?. a. Portosystemic shunt. b. Porencephaly. c. Intervertebral disc herniation. d. Countercoup lesion.

Neoplastic disease causes neurological dysfunction primarily through: a. Space-occupying compression of nervous tissue. b. Immediate congenital malformation. c. Primary electrolyte imbalance only. d. Exclusive metabolic encephalopathy.

Which finding is most consistent with a T3–L3 myelopathy?. a. Pure cranial nerve deficits. b. Thoracic limb LMN signs only. c. Exercise-induced weakness with normal reflexes. d. Paraparesis with normal or increased pelvic limb reflexes.

Which condition is listed in the notes as an endogenous spinal cord compression considered a special form of trauma?. a. Hypoglycemia. b. Thiamine deficiency. c. Addison disease. d. Intervertebral disc herniation.

Why can spinal cord disease be painful even though the spinal cord itself has no pain receptors?. a. Because the white matter contains nociceptors. b. Because the conus medullaris is highly sensitive. c. Because motor neurons transmit pain. d. Because the meninges surrounding the spinal cord have pain receptors.

Which pattern is most consistent with an L4–S3 (lumbosacral intumescence) lesion?. a. Only altered mentation and seizures. b. Pelvic limb hyporeflexia with decreased tone and possible atrophy. c. Wide-based stance and intention tremor only. d. Hyperreflexia and increased extensor tone in pelvic limbs.

Which condition is listed in the notes as an idiopathic neurological disease?. a. Intervertebral disc herniation. b. Porencephaly. c. Subarachnoid hemorrhage. d. Idiopathic cerebellitis (White Dog Shaker Syndrome).

Selective serotonin reuptake inhibitor (SSRI) exposure can result in serotonin syndrome. Which set of signs is listed in the notes?. a. Only orthopedic pain and lameness. b. Only dermatological pruritus and otitis. c. Cardiovascular, gastrointestinal, and neurological signs (e.g., tachycardia; vomiting/diarrhea; sedation/agitation/ataxia/tremors/seizures). d. Only polyuria and polydipsia without neurological involvement.

Vascular disease is described in the notes as producing lesions that are typically: a. Well demarcated and extremely focal. b. Always diffuse and bilateral. c. Restricted to cranial nerves only. d. Always symmetrical and generalized.

Portosystemic shunt is listed in the notes as a metabolic cause primarily related to which organ system?. a. Primary bone disease. b. Primary cardiac arrhythmia only. c. Hepatic (liver) disease. d. Primary skeletal muscle disorder.

Paraparesis with increased pelvic limb reflexes and normal thoracic limbs localizes most likely to: a. Peripheral nerve. b. Brainstem. c. L4–S3 spinal cord segment. d. T3–L3 spinal cord segment.

What does the acronym VITAMIN D represent in the classification of neurological diseases?. a. Viral, Ischemic, Traumatic, Acquired, Myopathic, Idiopathic, Neoplastic and Demyelinating diseases. b. Viral, Immune-mediated, Traumatic, Autoimmune, Metastatic, Iatrogenic, Neoplastic and Degenerative diseases. c. Vascular, Inflammation/Infection, Trauma/Toxicity, Anomalies, Metabolic, Idiopathic, Neoplasia/Nutritional and Degenerative diseases. d. Vascular, Inherited, Toxic, Autoimmune, Metabolic, Inflammatory, Neoplastic and Developmental diseases.

In a suspected subarachnoid hemorrhage of vascular origin, what CSF finding is expected?. a. Marked increase in protein and cell content. b. Severe hypoglycorrhachia without pleocytosis. c. Completely normal CSF. d. Only decreased protein concentration.

The typical time course of degenerative neurological disease in the notes is: a. Peracute and static. b. Intermittent only during exercise. c. Progressive worsening. d. Immediate spontaneous resolution.

Before performing an atlanto-occipital CSF tap in a patient with suspected vascular disease, what should be investigated first?. a. Serum thyroid hormone levels. b. Blood glucose concentration. c. Presence of a coagulopathy. d. Renal function.

After a vascular event, the notes describe neurological signs as often remaining stable and then: a. Progressively worsening until death within hours. b. Partially regressing over the next days or weeks. c. Immediately resolving within minutes. d. Never improving at any time.

Decreased spinal reflexes are indicative of dysfunction at which level?. a. Upper motor neuron. b. Lower motor neuron. c. Forebrain. d. Cerebellum.

In the notes, why do many nervous system tumors cause neurological signs?. a. They only cause electrolyte abnormalities. b. They produce a space-occupying effect and compress nervous tissue. c. They can be diagnosed only by CSF cell counts. d. They always cause symmetric diffuse encephalopathy.

The notes state that intoxications may show neurological signs together with: a. Extraneuronal systemic symptoms. b. Only unilateral blindness. c. No systemic signs ever. d. Only seizures without other signs.

In the VITAMIN D acronym, what does the first "I" represent?. a. Ischemic only. b. Inherited exclusively. c. Inflammatory/Infectious. d. Idiopathic.

In the notes, "coup" and "countercoup" lesions are used to explain injury from: a. Inherited degenerative storage disease. b. Only direct penetrating trauma. c. Sudden acceleration/deceleration with brain displacement in the skull. d. Chronic metabolic encephalopathy.

According to the notes, infectious agents may penetrate the nervous system via: a. Blood, nerves, or direct expansion from surrounding tissues. b. Only via CSF flow from the ventricles. c. Only via lymphatic vessels. d. Only after penetrating trauma.

Degenerative diseases in the notes are often described as affecting which patient group?. a. Only neonatal patients. b. Young or young adult animals. c. Only geriatric animals. d. Only animals with trauma.

An acute and painful spinal cord syndrome should strongly raise suspicion for which category?. a. Degenerative storage disease. b. Peripheral neuropathy only. c. Traumatic. d. Idiopathic epilepsy.

Cerebellar lesions cause incoordination but typically do not cause: a. Intention tremor. b. True muscle weakness. c. Hypermetria. d. Wide-based stance.

Which VITAMIN D categories should be prioritized in acute, progressive and symmetrical neurological signs?. a. Degenerative and Congenital. b. Neoplastic and Vascular. c. Metabolic/Nutritional and Toxic. d. Idiopathic and Traumatic.

Diffuse bilateral neurological signs without clear lateralization should first suggest which mechanism?. a. Focal vascular infarction. b. Single cranial nerve lesion. c. Localized disc herniation. d. Metabolic/Nutritional disorder.

According to the notes, intoxications often produce neurological signs together with: a. Only unilateral blindness. b. Extraneuronal (systemic) symptoms. c. Only seizures without any other signs. d. Only spinal pain.

In the VITAMIN D acronym, what does the second "I" represent?. a. Infectious only. b. Idiopathic. c. Inherited exclusively. d. Isolated spinal disease.

Neurological damage after trauma may worsen due to which secondary mechanisms described in the notes?. a. Bleeding, edema and increased intracranial pressure. b. Electrolyte imbalance only. c. Immediate genetic mutation. d. Exclusive peripheral nerve demyelination.

After a vascular event, neurological deficits may: a. Partially regress over days to weeks. b. Remain static for life without change. c. Resolve immediately within minutes. d. Always worsen progressively.

The ascending reticular activating system (ARAS) is responsible for which function according to the notes?. a. Peripheral proprioception. b. Coordination of fine motor movement. c. Primary control of muscle contraction at the neuromuscular junction. d. Regulation of the state of consciousness.

Which distinction is made in the notes regarding neoplastic disease affecting the nervous system?. a. Primary versus secondary (metastatic) tumors. b. Central versus peripheral only. c. Benign versus infectious. d. Acute versus chronic only.

Hypoglycemia can cause neurological dysfunction primarily because the brain: a. Functions independently of energy supply. b. Uses calcium as its only fuel. c. Depends on glucose as a primary energy source. d. Stores large glucose reserves.

Which primary brain tumor is described as more common in dogs, especially Boxer, Boston Terriers and English Bulldogs?. a. Schwannomas. b. Pituitary adenomas (sellar region). c. Meningiomas. d. Gliomas.

Progressive neurological deterioration in a young animal should raise suspicion for which category?. a. Idiopathic vestibular disease. b. Acute vascular disease. c. Traumatic compression only. d. Degenerative disease.

The notes include an MRI example showing a wedge-shaped cerebellar infarct in which breed?. a. German Shepherd Dog. b. Beagle. c. Boxer. d. Cavalier King Charles Spaniel (CKCS).

In the notes, vascular neurological disease is described as having an onset that is typically: a. Always slowly progressive over months. c. Peracute (within minutes). b. Always congenital and present at birth. d. Always intermittent only during exercise.

Hypoxia is listed in the notes as a metabolic cause of neurological dysfunction secondary to: a. Only spinal cord compression. b. Only cerebellar malformations. c. Only peripheral nerve trauma. d. Severe anemia and respiratory or cardiovascular disease.

Which statement best describes degenerative neurological diseases in the notes?. a. Peracute onset with marked lateralization and rapid stabilization. b. Disturbance without observable morphological CNS changes. c. Progressive neuronal tissue destruction, often inheritable and breed-associated. d. Always caused by bacterial infection.

Which clinical picture is described for neuromuscular junction dysfunction?. a. Marked unilateral postural reaction deficits only. b. Severe hyperreflexia and increased extensor tone. c. Exercise-induced weakness with normal proprioception. d. Central vestibular ataxia with altered mentation.

In the VITAMIN D acronym, what does the letter "V" represent?. a. Vestibular. b. Viral only. c. Vascular. d. Voluntary.

Loss of vision ipsilateral and rostral to the optic chiasm, and contralateral and caudal to the optic chiasm, is associated with lesions in which region?. a. Cervical spinal cord. b. Prosencephalon (cerebrum/diencephalon). c. Peripheral nerve. d. Lumbosacral intumescence.

Which secondary mechanism following trauma is emphasized in the notes as worsening neurological damage?. a. Edema causing compression and increased intracranial pressure. b. Immediate metabolic storage disease. c. Exclusive peripheral neuropathy. d. Primary demyelination only.

In the context of VITAMIN D, idiopathic diseases are defined as: a. Diseases caused by trauma. b. Diseases with no identifiable underlying cause. c. Diseases due to congenital malformations. d. Diseases exclusively due to metabolic disorders.