Neurology Quiz

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Neurology Quiz

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Quiz on Neurology

1. Which of the following is true of the ABC/2 method in intracerebral haemorrhage (ICH)?
(1) This is an accurate way to assess for the “spot sign”
(2) his is best done using T2 weighted MRI sequences
(3) Slices where the hematoma is <25% of the reference slice should not be counted in the calculation
(4) None of the above

2. An 8-year-old boy presents for evaluation of abnormal movements. For the past 6 months, he has experienced episodes suggestive of foot dystonia. He is unable to use his leg during an episode, which can last 1-2 minutes. The episodes always start when he stands up quickly. He does not lose consciousness. There is no reported worsening throughout the course of the day. Electroencephalogram during a spell is normal. His father had a similar problem as a child. Which of the following is true about his condition?
(1) Carbamazepine is contraindicated for treatment of his condition
(2) It is associated with mutations in the PRRT2 gene
(3) It is associated with mutations in the SCNIA gene
(4) It is inherited in an X-linked dominant fashion

3. A 17-year-old man with epilepsy describes seizures characterized by intermittent, brief arm jerking episodes after waking in the morning which have caused him to spill his coffee and break cups in the past. What type of seizure is this description most consistent with?
(1) Atonic
(2) Tonic
(3) Clonic
(4) Myoclonic

4. Which of the following tests are recommended as part of the standard evaluation when diagnosing epilepsy in adults?
(1) Electroencephalography only
(2) Brain imaging only
(3) Electroencephalography and brain imaging, preferably computerized tomography of the head
(4) Electroencephalography and brain imaging, preferably magnetic resonance imaging of the brain

5. What is the most common cause of neonatal seizures?
(1) Congenital malformation
(2) Hypoxic-ischemic encephalopathy
(3) Idiopathic
(4) Meningitis/sepsis

6. Which of the following is true regarding Cluster Headaches?
(1) It affects women more than men
(2) It is a holocranial headache disorder
(3) It is the most painful recurrent headache
(4) The majority of patients have the chronic form

7. A surgery resident is about to start working the night shift (7 PM to 7 AM) over the next 14 days. Which of the following measures may help her adjust to her new work schedule?
(1) Bright light in the morning on the way home from work
(2) Bright light at night on her way to work and during the beginning of the work period
(3) High dose melatonin before work
(4) Alcohol before bedtime

8. A 30 year old woman with migraine episodes 5-6 time per month is taking Naprosyn as and when required. What is the next best step in treatment?
(1) Add combination acetaminophen caffeine
(2) Admit the patient to the hospital for dihydroergotamine infusion
(3) Change to rizatriptan
(4) Start preventive therapy

9. Which of the following medications is approved for treatment of daytime sleepiness in narcolepsy-cataplexy?
(1) Eszopiclone
(2) Venlafaxine
(3) Imipramine
(4) Modafinil

10. Which statement is true about IIH?
(1) It occurs more frequently in obese women than men
(2) It occurs more frequently in men than women
(3) It occurs more frequently in children
(4) None of the above

11. A 30 year-old woman presents with 14 months of headaches. She has some degree of mild-moderate left temporal pain all the time which is tolerable, but 4-5 times per month she has exacerbations of severe pain in the same area associated with photophobia limited to the left eye and nausea. She also notices a foreign-body sensation in her left eye and that her left nostril feels stuffy during exacerbations. These attacks last up to 48 hours without treatment. Alcohol does not trigger her headaches. Which of the following headache disorders is this patient most likely suffering from?
(1) Cluster headache
(2) Migraine headache
(3) Hemicrania continua
(4) Trigeminal neuralgia

12. Brachycephaly is caused by premature fusion of which suture?
(1) Coronal
(2) Lambdoid
(3) Metopic
(4) Sagittat

13. Oral bioavailability of the following is high :
(1) Ethosuccimide
(2) Valproate
(3) Clobazam
(4) All of the above

14. Which of the following headache can also occur during sleep in addition to daytime?
(1) Cluster headache
(2) Migraine
(3) Chronic paroxysmal hemicranias
(4) All of the above

15. A. ten-year-old girl has malignant hyperthermia during a routine surgical procedure. Her grandparents report that several family members, both male and female, have had muscle weakness since childhood. What disease are these family members most likely to have?
(1) Nemaline rod myopathy
(2) Centronuclear myopathy
(3) Central core myopathy
(4) Becker muscular dystrophy

16. Cortex remains smooth in which of the developmental disorder?
(1) Lissencephaly
(2) Microcephaly
(3) Schizencephaly
(4) None of the above

17. Which of the following are paroxysmal movement disorders that can be confused with epilepsy?
(1) Hyperekplexia
(2) Paraoxysmal dyskinesia
(3) Non epileptic myoclonus
(4) All of the above

18. Which of the following is associated with medication induced intracranial hypertension?
(1) Initiation of high-dose corticosteroids
(2) Tetracycline
(3) Fluoxetine
(4) Topiramate

19. When evaluating a patient with a spell of loss of consciousness differentiating between seizures and syncope can present a clinical challenge. Which of the following features would typically argue in favor of seizure (as opposed to syncope) in any given case?
(1) Staring with cry
(2) Prodromal pallor and diaphoresis
(3) Being preceded by a feeling lightheaded
(4) Biting of the tip of the tongue

20. Acetylcholinesterase inhibitors have been shown to reduce psychosis in which of the following neurodegenerative disorders?
(1) Alzheimer disease (AD)
(2) Parkinson disease (PD)
(3) Dementia with Lewy bodies (DLB)
(4) All of the above

Practice Set MCQs
Quiz Questions and Answers

21. What is true about prion diseases?
(1) A group of uniformly fatal neurodegenerative diseases
(2) Most patients survive
(3) Few patients die
(4) None of the above

22. What is not true about palatal myoclonus?
(1) It is also classified as segmental myoclonus
(2) Affects man & women equally
(3) Patients complain of audible ear clicks
(4) Easy to treat

23. Cerebellar ataxia can be caused by
(1) Alcohol
(2) Hypothyroidism
(3) anticonvulsants drug toxicity
(4) All of the above

24. A 62-year-old gentleman presents to the emergency department after a 20-minute episode of left sided weakness which completely resolved prior to arrival. An MRI of the brain demonstrates a punctate area of restricted-diffusion in the right internal capsule. Which of the following is the correct diagnosis in this case?
(1) Transient ischemic attack
(2) Hemorrhagic stroke
(3) Ischemic stroke
(4) Complicated migraine

25. Which of the following are autosomal recessive ataxias?
(1) Friedreich ataxia
(2) Abetalipoproteinemia
(3) Ataxia telangiectasia
(4) All of the above

26. All of the following are arboviruses associated with neurologic disease in humans except
(1) West Nile virus
(2) Dengue virus
(3) Zika virus
(4) Poliovirus

27. Which of the following is most common malignancy associated with paraneoplastic neuropathies?
(1) Small cell carcinoma of lung
(2) Carcinoma of breast
(3) Carcinoma of ovaries
(4) Hodgkin and non-hodgkin lymphoma

28. Which of the following genes is not linked to autosomal recessive Parkinson disease?
(1) PRKN
(2) PINK1
(3) DJ-I
(4) MAPT

29. A twelve-year-old girl loses control of her bicycle while riding downhill and reaches for a tree branch with her right arm to stop herself. She is sent by her neurosurgeon for EMG four weeks later with a suspected Klumpke brachial plexus injury. All the following would be consistent with this diagnosis, except
(1) right Horner’s syndrome
(2) absent ulnar sensory nerve action potential
(3) fibrillations and positive sharp waves in the brachioradialis
(4) fibrillations and positive sharp waves in the abductor pollicis brevis

30. Beyond genetic testing, which of the following diagnostic tests is often used when considering a diagnosis of | Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL)?
(1) Liver biopsy
(2) Skin biopsy
(3) Muscle biopsy
(4) Nerve biopsy

31. A 27 year-old previously healthy woman presents to the emergency room complaining of right-sided headache and neck pain which started suddenly during her yoga class. On examination she appears in pain but the exam is otherwise notable only for ptosis and miosis on her right side. Which of the following diagnoses is most likely in this case? b
(1) Cerebral venous sinus thrombosis
(2) Subarachnoid hemorrhage
(3) Migraine with brainstem aura
(4) Carotid artery dissection

32. Which nucleus innervates the left superior rectus muscle and which nucleus innervates the left superior oblique muscle (respectively)?
(1) The right 3rd nerve nucleus the right 4th nerve nucleus
(2) The left 3rd nerve nucleus; the left 4th nerve nucleus
(3) The right 3rd nerve nucleus; the left 4th nerve nucleus
(4) The left 3rd nerve nucleus; the right 4th nerve nucleus

33. The ICH score was designed as a clinical grading tool to estimate which of the following?
(1) 90-day modified Rankin score
(2) probability of herniation
(3) risk for hematoma expansion
(4) 30-day mortality

34. What is the mechanism of action of Tetanus toxin?
(1) Disinhibition of anterior horn cells and autonomic neurons
(2) Anterior horn cell destruction/dysfunction
(3) Inhibition of intracellular protein production
(4) Direct myotoxicity with secondary inflammation

35. Brief episodes of vertigo lasting for seconds to minutes occurring suddenly without any apparent trigger are known as
(1) Vestibular paroxysmia
(2) BPPV
(3) Menieres disease
(4) None of the above

36. Which of the following are variants of Guillian Barre syndrome?
(1) Miller Fisher syndrome
(2) Acute ataxic neuropathy
(3) Acute pandysautonomia
(4) All of the above

37. A 20-year-old male with a history of hypertension and bilateral carpal tunnel : syndrome presents to the sleep clinic for evaluation of suspected sleep apnea based on symptoms of loud snoring, waking up gasping during the night and daytime sleepiness. His examination is notable for frontal bossing, an enlarged | tongue, enlarged thyroid and large hands and feet. Which of the following tests would be most appropriate in the evaluation of this patient?
(1) Insulin like growth factor
(2) Prolactin
(3) Cortisol
(4) Thyroid stimulating hormone

38. Antibodies targeting the aquaporin-4 (AQP4) protein have been implicated in the pathogenesis of neuromyelitis optica. AQP4 is thought to be primarily localized to which cell type of the central nervous system?
(1) Neurons
(2) Oligodendrocytes
(3) Astrocytes
(4) Endothelial cells

39. Damage to the MLF results into
(1) INO
(2) 6th nerve palsy
(3) 3 nerve palsy
(4) lateral gaze palsy

40. Which is the most common antecedent event of Guillian Barre syndrome?
(1) Respiratory illness
(2) Gastro intestinal illness
(3) Surgery
(4) Vaccination

41. Everolimus is approved for, and has demonstrated efficacy in treating, which type of tumor?
(1) Epithelioma
(2) Cortical tuber
(3) Subependymal giant cell astrocytoma
(4) Plexiform neurofibroma

42. Indications for cEEG monitoring in the ICU are
(1) Status epilepticus
(2) Screening for NCSE among high risk patients
(3) To characterize ‘spells’ suspected to represent seizures
(4) All of the above

43. 3Hz spike & wave paroxysms on EEG occur In
(1) absence epilepsy
(2) myoclonic epilepsy
(3) complex partial epilepsy
(4) all of the above

44. If 30-year-old lady presents with recurrent episodes of dizziness and vertigo. The episodes come on gradually over a period of approximately 15 minutes, last 4-5 hours, then spontaneously resolve. Which of the ; following additional symptoms would most strongly suggest a diagnosis of vestibular migraine?
(1) Photophobia with throbbing unilateral headache
(2) Ataxia with tinnitus and headache
(3) Aural fullness with low-frequency hearing impairment
(4) Unilateral spontaneously-resolving weakness

45. Which one of the following medications potentiates GAB A effects?
(1) Carbamazepine
(2) Perampanel
(3) Lacosamide
(4) Clobazam