Neurology Exam Questions PDF

A B C D E S.n Question Option1 Option2 Option3 Option4 Option5 o 1 Case...

A B C D E S.n Question Option1 Option2 Option3 Option4 Option5 o 1 Case of 40-year-old male presents with transient Retinal migraine Ophthalmoplegic Migraine sine migraine Focal migraine dysphagia, episodic headache and increased migraine senstivity to light. He also feels some weakness on the left side of body. What is your diagnosis? 2 A 60-year-old woman complains of a constant Temporal arteritis Migraine Tension-type headache Cluster headache Intracranial hypertension headache that is worse in the morning and improves throughout the day. She has a history of intermittent visual disturbances and reports recent episodes of scalp tenderness. Her ESR is elevated. What is the most likely diagnosis? 3 A 24-year-old female, Ms.Deepa, with a previous Amitriptyline Propranolol Sumatriptan Ergotamine history of recurrent headaches, originally diagnosed 12 months earlier as migraine without aura. The patient has returned to her primary care physician for medical follow-up of her migraines and to discuss options for therapy. Which of the following drug(s) can be used as a prophylaxis for migraine? 4 A 28-year-old female presents to her physician Migraine Cluster headache Tension-type headache Sinus headache Trigeminal neuralgia complaining of recurrent headaches. She describes them as throbbing, unilateral, and often accompanied by nausea, vomiting, and sensitivity to light and sound. These episodes typically last from 4 to 72 hours and are often preceded by visual disturbances such as flashing lights or blind spots. What is the most likely diagnosis for this patient? 5 A 35-year-old woman presents with a history of Migraine Cluster headache Tension-type headache Sinus headache Trigeminal neuralgia recurrent headaches, which are typically unilateral and throbbing. The headaches last between 4-72 hours and are associated with nausea, vomiting, and photophobia. She often notices visual disturbances (aura) before the headache starts. What is the most likely diagnosis? 6 A 40-year-old man presents with a severe headache Subarachnoid hemorrhage Tension-type Cluster headache Migraine Temporal arteritis that started suddenly while he was at work. He headache describes the pain as "the worst headache of his life." The pain is located around his neck and back of the head. He also reports nausea and photophobia. On examination, his blood pressure is elevated, and he has a stiff neck. What is the most likely diagnosis? 7 Pathology of which of the following system can Either pero-ipheral or Central nervous None Peripheral nervous system lead to disorders of autonomic nervous system? central nervous system system 8 All are examples of upper motor neuron lesion Anterior horn cell disease Multiple sclerosis Prion disease Tuberous sclerosis except 9 A 30-year-old man presents with rapid, involuntary Dystonia Tardive dyskinesia Parkinson’s disease Huntington’s disease Essential tremor muscle contractions that cause twisting and repetitive movements, particularly in his neck and shoulders. These movements are often worsened by stress. He has no history of trauma or neurological diseases. What is the most likely diagnosis? 10 Pseudotumor cerebri occurs due to which vitamin A B12 E D toxicity? 11 UMN lesion is characterized by Weakness & spasticity Fasciculations Rigidity Localized muscle atrophy 12 A 45-year-old woman presents with difficulty Parkinson's disease Huntington's disease Multiple sclerosis Amyotrophic lateral Wilson's disease initiating movement and a "shuffling" walk. She sclerosis (ALS) also reports stiffness in her arms and legs, particularly when trying to move. On examination, she has a mask-like facial expression, resting tremor in both hands, and rigidity. What is the most likely diagnosis? 13 A 55-year-old man presents with involuntary, jerky Huntington's disease Parkinson’s disease Essential tremor Myoclonus Tardive dyskinesia movements of his hands, legs, and face. These movements occur at irregular intervals and are worsened by stress. He has a family history of similar symptoms. Genetic testing reveals a mutation in the HTT gene. What is the most likely diagnosis? 14 A 60-year-old woman presents with difficulty Amyotrophic lateral Multiple sclerosis Guillain-Barré syndrome Myasthenia gravis Muscular dystrophy swallowing, slurred speech, and muscle weakness sclerosis (ALS) in her arms and legs. She has noticed progressive weakness over the last year. On examination, she has atrophy and fasciculations in her upper and lower limbs. What is the most likely diagnosis? 15 A 72-year-old lady presents with nausea and Glaucoma SUNCT Migraine with Aura Cluster headache vomiting and a headache for the one day. She describes the pain as one-sided and accompanied by a painful red eye, worse at night with blurring. What is the diagnosis? 16 A 61-year-old female patient presents to your clinic Trigeminal neuralgia SUNCT syndrome Giant cell arteritis paroxysmal hemicrania due to sudden episodes of left-sided facial pain for the last two days. She states that the pain feels like a 'sharp stabbing' and is a 9/10 in terms of  intensity. The pain lasts about 5-10 seconds and then dissipates rapidly. The pain is often brought on by talking and cold wind. Her past medical history is significant for depression and type 2 DM. What is the diagnosis? 17 A 40-year-old woman experiences a dull, bilateral Tension-type headache Cluster headache Migraine Trigeminal neuralgia Temporal arteritis headache that lasts for hours. She describes the pain as a "tight band" around her head. The headaches are not associated with nausea, vomiting, or light sensitivity. She often experiences them during periods of high stress. What is the most likely diagnosis? 18 A 60-year-old man presents with a new onset Temporal arteritis Migraine Tension-type headache Cluster headache Sinus headache headache that is persistent and located over the temples. The headache is associated with jaw claudication, fatigue, and weight loss. His erythrocyte sedimentation rate (ESR) is elevated. What is the most likely diagnosis? 19 A 33-year-old woman with no significant medical Acute aneurismal Brain stem Acute ischemia of mid Meningitis history presented with complaints of headache haemorrhage encephalitis brain which she described as a characteristic 'thunderclap headache'. All of the following are the differential diagnosis for 'thunderclap headache' except 20 A 22-years-old man presents with a history of a Analgesic abuse headache Migraine Depression associated Cluster headache headache for 6 months which is mainly in the headache frontal region, occasionally associated with nausea. He has been taking paracetamol 3g per day, Hydroxycodeine 50 mg 3 times a day and Aspirin 300 mg 3 times a day for a headache but only with temporary relief from symptoms no focal signs on neurological examinations. What is the diagnosis? 21 A 35-year-old woman presents with a headache Cluster headache Tension-type Migraine Sinus headache Trigeminal neuralgia that lasts for 30 minutes to an hour, occurring headache around the same time every day for several weeks. The pain is localized to the right eye and is associated with redness, tearing, and nasal congestion. She reports the pain often wakes her up at night. What is the most likely diagnosis? 22 A 45-year-old man presents with a headache that Cervicogenic headache Tension-type Migraine Sinus headache Temporal arteritis has been gradually worsening over the past few headache weeks. The pain is described as a constant, dull ache on both sides of the head. He also complains of neck stiffness and photophobia. What is the most likely diagnosis? 23 A right-sided disc herniation at the LS-51 level Low back pain and right Weakness of A preserved right ankle jerk Diminution of sensation typically causes which among the following sciatica dorsiflexion of the over themedial aspect of symptoms? right foot the right foot, including the great toe 24 A 55-year-old man presents with chronic neck pain Cervical spondylosis Cervical Whiplash injury Thoracic outlet syndrome Multiple sclerosis that has been worsening over the past few months. radiculopathy He reports stiffness and decreased range of motion in his neck. On examination, there is tenderness over the cervical spine, and radiographs show degenerative changes at C5-C6. He also complains of tingling in his fingers. What is the most likely diagnosis? 25 A 70-year-old woman presents with progressive Spinal stenosis Lumbar disc Spondylolisthesis Ankylosing spondylitis Sacroiliitis lower back pain and difficulty walking. The pain is herniation worse with standing and walking, but improves when she bends forward or sits down. She also complains of numbness and weakness in her legs. MRI of the lumbar spine reveals narrowing of the spinal canal. What is the most likely diagnosis? 26 A 45-year-old man presents with severe, localized Cervical radiculopathy Whiplash injury Thoracic outlet syndrome Carpal tunnel syndrome Brachial plexus injury neck pain that radiates to his right shoulder and arm. The pain began after a car accident where his head was jerked backward. He also reports weakness and tingling in his right hand. On examination, there is decreased sensation over the C6 dermatome, and reflexes are diminished in the right upper limb. What is the most likely diagnosis? 27 A 46-year-old woman presented with a 25-year Amygdalo Levetiracetam Primidone Vagus nerve stimulation history of epilepsy. She had a history of focal hippocampectomy impaired awareness with cognitive changes and behavioral arrest progressing to bilateral tonic- clonic seizures. Magnetic resonance imaging displayed asymmetry of the hippocampus, with a prominent right temporal horn of the lateral ventricle. Which of the following is the most efficacious treatment for this patient? 28 A 35-year patient recalls episodes where he smells Focal seizures Hysteria Atonic seizures Myoclonic seizures a pungent odor, started sweating and loses consciousness. His family member says while unconscious he was having facial twitching with lip smacking movements. What is the most probable diagnosis? 29 A 24-year-old, married woman with history of Lamotrigine Carbamazepine Topiramate Phenytoin seizures was recently diagnosed as a case of complex partial seizures. Which of the following  anticonvulsive agent would be the MOST appropriate agent as first-line therapy in such patients? 30 A 21-year-old man complains of seizures in the left Jacksonian seizure Generalized seizure Epileptic seizure Non-epileptic seizure Focal seizure arm, with progression to the left side of the face and left leg. He does not lose consciousness. What type of seizures does the patient describe? 31 A patient had a head injury in road traffic accident Minor head injury Severe head injury Intermediate severity None of the above and had lost consciousness instantaneously. After few minutes he regains consciousness. Spontaneous eye opening without any muscular weakness and is fully aware of his surroundings. GCS score is E4V5M6. However, the patient continues to complain headache, dizziness, nausea, faintness and an episode of emesis. What is the severity of his head injury? 32 A 25-year-old is admitted with loss of Initiate sodium B Administer Administer mannitol at Neuromuscular paralysis consciousness after cocaine over-dosage. On nitroprusside to achieve hypertonic fluids to 1g/kg body weight examination BP= 200/100 with GCS of 7 /15. The MAP below 130 mmHg maintain sodium of right-sided pupil is dilated and shows a sluggish 145mEq/dl reaction to light. Which is not recommended for this patient? 33 A 60-year-old man is brought to the emergency Drug overdose Stroke Hypoglycemia Traumatic brain injury Subarachnoid department after being found unconscious at home. hemorrhage His blood pressure is 120/80 mmHg, heart rate is 80 bpm, and respiratory rate is 12/min. On examination, the patient is unresponsive to verbal stimuli but opens his eyes in response to pain (Glasgow Coma Scale of 8). His pupils are 3 mm and react to light. CT scan of the brain reveals no acute abnormalities. What is the most likely cause of his coma? 34 A 50-year-old woman is brought to the hospital Hypoglycemia Brain tumor Meningitis Stroke Hepatic encephalopathy after a witnessed seizure followed by a prolonged period of unconsciousness. On arrival, she is unresponsive, with a Glasgow Coma Scale score of 7. She has a history of hypertension and diabetes. Blood tests show a blood glucose level of 30 mg/dL. What is the most likely cause of her coma? 35 Hemiplegia is commonly associated with infarction Middle cerebral artery Anterior cerebral Posterior cerebral artery Anterior communicating of the area of distribution of the artery artery 36 Which of the following is the most common site of Anterior communicating Basilar artery Posterior communicating Middle cerebral artery aneurysmal subarachnoid hemorrhage? artery artery 37 A 68-year-old woman presents with sudden-onset Left hemispheric ischemic Transient ischemic Right hemispheric ischemic Subarachnoid hemorrhage Intracerebral hemorrhage right-sided weakness and slurred speech. Her stroke attack (TIA) stroke symptoms started approximately 30 minutes ago while she was watching television. She has a history of hypertension and type 2 diabetes mellitus. On examination, she has right-sided hemiparesis and dysarthria. Her MRI of the brain reveals a hyperintense lesion in the left middle cerebral artery (MCA) territory. What is the most likely diagnosis? 38 A 50-year-old woman with a history of atrial Left-sided ischemic stroke Right-sided ischemic Transient ischemic attack Subarachnoid hemorrhage Vestibular migraine fibrillation presents with sudden onset of visual in the posterior cerebral stroke in the middle (TIA) disturbance in her right visual field, difficulty artery (PCA) territory cerebral artery speaking, and a right-sided hemiparesis. She also (MCA) territory reports dizziness and difficulty maintaining balance. On examination, she has a left homonymous hemianopia and dysarthria. Brain MRI reveals an infarct in the posterior cerebral artery (PCA) distribution. What is the most likely diagnosis? 39 A patient had a head injury in road traffic accident Minor head injury Severe head injury Intermediate severity None of the above and had lost consciousness instantaneously. After few minutes he regains consciousness. Spontaneous eye opening without any muscular weakness and is fully aware of his surroundings. GCS score is E4V5M6. However, the patient continues to complain headache, dizziness, nausea, faintness and an episode of emesis. What is the severity of his head injury? 40 All are seen in Kluver Bucy syndrome except Seizures Hypersexuality Metamorphopsia Visual agnosia 41 A 60-year-old woman fell down the stairs. His face Score 9 Score 13 Score 15 Score 8 Score 3 shows abrasions and wounds. You have determined that she opens her eyes only when presented with a painful stimulus, responds slurred to questions, makes isolated sounds and does not follow your instructions, but localizes pain when presented with a painful stimulus. Calculate level of consciousness on the Glasgow Coma Scale. 42 A 60-year-old woman fell down the stairs. She CT of the brain MRI of the brain Electroneuromyography Electroencephalography Lumbar puncture sustained a moderate head injury. What kind of examination would you suggest? 43 Which of the following statement is false with Involves biochemical More common in Multiple sclerosis is an Multiple Sclerosis is most respect to demyelinating disorders? abnormality of myelin females autoimmune disease of the common type of central nervous system demyelinating disorder 44 A patient was treated for mantle cell Hodgkin Cervical spinal cord Cervical arthritis Multiple sclerosis Spinal cord compression lymphoma with radiation therapy. After 6 months pathology  he develops an electric shock-like pain along the spine on flexing his neck. What is the diagnosis? 45 A 65-year-old woman is brought to the clinic for Decreased hippocampal Enlarged ventricles Increased brain glucose Cerebellar atrophy Frontal lobe atrophy memory problems. On examination, she displays volume metabolism difficulty recalling recent events and exhibits poor short-term memory. What brain abnormality is most likely to be found in Alzheimer’s disease? 46 A 71-year-old male with a family history of Presence of APOE ε4 Hyperlipidemia Hypertension Age Physical activity Alzheimer’s disease is diagnosed with mild allele cognitive impairment (MCI). Which of the following is most associated with progression from MCI to Alzheimer’s disease? 47 A 68-year-old man is diagnosed with Alzheimer’s Donepezil Levodopa Lithium Sertraline Haloperidol disease. Which of the following medications would most likely be prescribed for managing his cognitive symptoms? 48 A 33-year male with numbness from the lower Optic neuritis in the first 2 Incomplete recovery Length of intervals between Frequency of relapses trunk to the distal extremities was diagnosed with years from relapses relapses multiple sclerosis. He was started with glucocorticoids with some improvement in his symptoms. Which one of the following is not predictive of long-term disability in such patients? 49 A 38-year-old woman with sensory disturbances, Patient is bedridden, can Death of patient due Patient is bedridden, can't Patient walks normally, muscle weakness & visual disturbances was talk, can drink to multiple sclerosis talk, can’t drink shows no disability diagnosed with Multiple Sclerosis recently. The physician is evaluating her neurological status with Expanded disability severity score (EDSS). What does a score of 9 in EDSS signify? 50 A 58-year-old woman presenting with right arm Neurofibromatosis 1 Neurofibromatosis 2 Turcot syndrome Li - Fraumeni syndrome weakness, paraparesis, and increased reflexes. T1w MRI with contrast, coronal view showed dumbbell schwannoma at C3-C4 level with bone erosion of the vertebral body. The characteristic 'Schwannoma of spinal nerve roots' is associated with? 51 A 68-year-old female presents with memory loss, Alzheimer’s disease Depression Vascular dementia Frontotemporal dementia Parkinson’s disease difficulty recalling recent events, and confusion. dementia She becomes easily agitated and occasionally gets lost in familiar places. Which of the following is the most likely diagnosis? 52 A 72-year-old man presents with difficulty Montreal Cognitive Mini-Mental State Clock Drawing Test Trail Making Test Neuropsychological remembering names of familiar people and Assessment (MoCA) Examination testing forgetting appointments. He has no difficulty (MMSE) performing daily tasks. What cognitive test would be most appropriate to assess his memory? 53 Blood supply area of the middle cerebral artery: Most of the internal The medial surface of Occipital lobes Brainstem Cerebellum capsule the frontal and parietal lobes 54 Triple H therapy is done in? SAH SDH EDH Intraparenchymal bleed 55 A 69-year-old hypertensive patient suddenly Left middle cerebral artery Right internal carotid Right middle cerebral artery Left posterior cerebral Left internal carotid developed facial muscle weakness, slurred speech, artery artery artery and weakness in the right extremities after sleeping. Select the vascular basin most likely to be affected: 56 Lateral medullary syndrome is caused by Anterior inferior cerebral PCA Anterior inferior cerebral Basilar artery thrombosis of artery artery 57 Mr X is a 70-year-old male who presents with a Normal pressure Cerebellar Lewy body dementia Multiple sclerosis one-year history of progressive ataxia, urinary hydrocephalus astrocytoma incontinence and memory loss. He is otherwise asymptomatic. He has no significant past medical history and is not on any medication. What is the most likely diagnosis? 58 A 72-year-old male with a history of diabetes and Frontotemporal dementia Alzheimer's disease Parkinson's disease Vascular dementia Creutzfeldt-Jakob disease hypertension presents with memory impairment, apathy, and difficulty with language. His wife notes that he has become more impulsive and socially inappropriate. MRI reveals significant atrophy of the frontal and temporal lobes. Which condition is most likely? 59 29 yrs male was brought to OPD by his wife giving Frontal lobe Occipital Temporal Parietal history of aggressive behaviour with decreased social interaction and lack of self-care. O/E grasp reflex present, CT scan would be showing lesion of which lobe? 60 A 55-year-old man presents with symptoms of Lewy body dementia Progressive Frontotemporal dementia Parkinson's disease Alzheimer's disease rigidity, bradykinesia, and resting tremor. He also supranuclear palsy dementia has a significant cognitive decline, with difficulty in memory and problem-solving. An MRI of the brain is unremarkable. His symptoms do not meet the criteria for Alzheimer’s disease, but they are suggestive of a movement disorder with cognitive dysfunction. What is the most likely diagnosis? 61 Which of the following is least likely to occur in Absence of oligoclonal Bilateral visual loss Complete tranaction of cord Poor recovery multiple sclerosis bands in CSF 62 A study without which a diagnosis of multiple MRI of the brain. CT of the brain Electroneuromyography Electroencephalography Lumbar puncture sclerosis cannot be confirmed: 63 A 30-year-old woman presented with double Multiple sclerosis Myasthenia gravis Aneurysm of the internal Diabetic neuropathy Acute cerebral circulation vision, divergent strabismus, right-sided ptosis. carotid artery disorder of ischemic Administration of proserin did not change the nature in the brainstem  clinical picture; ENMG without abnormalities. MR angiography: no pathology was revealed. MRI of the brain: multiple foci of demyelination paraventricularly and in the area of the brain stem. Blood sugar analysis: 4.2 mmol/l. Choose the most likely diagnosis: 64 A 32-year-old patient shows signs of spastic Multiple sclerosis Tumor of the left Spinal cord tumor Ischemic stroke Encephalitis paraparesis, impaired coordination in the left limbs, cerebellar pelvic organ dysfunction, and pallor of the hemisphere temporal halves of the optic discs. Choose the most likely diagnosis: 65 A 25-year-old female patient came to the doctor Cerebellar tumor Tumor of cranio- Multiple sclerosis Encephalitis Ischemic stroke because she felt unsteady when walking. She had a vertebral junction history of retrobulbar neuritis twice. The neurologist found evidence of cerebellar lesions and 2-sided lesions of the pyramidal pathways. Choose the most likely diagnosis: 66 Which of the following will manifest as Subdural hematoma Epidural hematoma Subarachnoid haemorrhage Brain infraction "pachymeningitis hemorrhagica interna"? 67 A 12-year-old patient was admitted to the clinic Antiedema Anticoagulants Antibiotics Anticonvulsants Antiretroviral drugs with a high body temporeatura of 39.5 g, headache, vomiting, consciousness of 10 points on the Glasgow Coma Scale, occipital muscle rigidity, and positive Kernig's symptom. The general blood count shows an inflammatory reaction due to a high neutrophil count. What treatment should be performed? 68 A 20 year old patient presents with headache, Liquor analysis MRI Urinanalysis EEG Blood analysis vomiting, Glasgow coma scale consciousness of 12 points, occipital muscle rigidity and positive Kernig's symptom, what investigation should be performed? 69 Which nerve is most commonly involved in uncal IIIrd Vith Ixth XIIth herniation? 70 Which is not affected in lesion of posterior column Temperature sense Romberg's sign Vibration sense Ataxia of spinal cord? 71 Brown Séquard syndrome, not involved is Contralateral posterior Ipsilateral pyramidal Contralateral spinothalamic Ipsilateral planter extensor column tract 72 A 59-year-old patient gradually develops spastic Amyotrophic lateral Multiple sclerosis, Myasthenia gravis Myasthenic syndrome Multiple sclerosis, tetraparesis with 2-sided Babinski's pathologic sclerosis spinal form cerebral form symptoms, marked muscle hypotrophy and fibrillary twitches. Choose the disease that should be excluded first of all: 73 If Wernicke’s area is damaged in the dominant Irrelevant and rapid No effect on speech Speech with difficulty in Incomprehension of hemisphere, it will result in? speech articulation written language 74 Dose of methylprednisolone following spine 30mg/kg within 3 hrs of 45mg/kg within 6 hrs 50mg/kg within 9 hrs of 60mg/kg within 12 hrs of injury: injury of injury injury injury 75 Hypotension in Acute Spinal Cord Injury is due to? Loss of Sympathetic tone Orthostatic Orthostatic Hypotension loss of parasymparhic tone Hypotension 76 A 45-year-old patient felt marked weakness in the MRI X-ray CT Liquor analysis EEG legs, pain on the inner surface of the thigh at the moment of weight lifting, urinary disturbance occurred. On examination: peripheral asymmetric inferior paraparesis, hypoesthesia in the area of the perineum and on the inner surface of the thighs. Choose the most informative methods of examination: 77 Select the symptoms characteristic of Guillain- Peripheral tetraparesis Central tetraparesis Peripheral monoparesis Central hemiparesis Central monoparesis Barré syndrome: 78 Guillain-Baret polyneuropathy is characterized by Viruses Bacteria Fungi Trauma Vascular ischemia an inflammatory lesion caused by (choose the correct answer) 79 Select the mechanisms underlying the pathogenesis Vascular damage to Peripheral nerve Lesion of spinal cord roots Muscle damage Lesion of the anterior of diabetic polyneuropathy: peripheral nerves damage horn of the spinal cord 80 A 48-year-old patient complains of a sensation of Extramedullary spinal Intramedullary tumor Spinal cord abscess Epiduritis Multiple sclerosis irritation on the skin of the legs, which began with cord tumor of the spinal cord the feet and over 6 months progressed to the shins, knees thighs. What diagnosis do you suggest? 81 A 68-year-old woman had an elevated t to 38.5, Meningitis Subarachnoid Intraventricular hemorrhage Encephalitis Brain tumor severe headache, photophobia. Meningeal hemorrhage symptom complex was detected in an infectious disease hospital and liquor was analyzed. In the liquor analysis: turbid, 1200 kl/mL, neutrophils predominate, protein-0.99 g/L. Choose the most likely diagnosis: 82 True about GBS are all except Sensory loss Ascending paralysis Cyto albumen Flaccidity disassociation 83 Best Treatment of GBS is Plasmapheresis Intravenous Steroids Dialysis Vancomycin 84 Select a symptom NOT characteristic of High tendon reflexes Peripheral paresis of Dpecreased sensitivity in Vegetative disorders in the Pain along the course of polyneuropathy: hands, feet the distal parts of the limbs distal parts of the limbs nerves 85 Duchenne muscular dystrophy is an X-linked Boys only Girls only More boys than girls More girls than boys Same for girls and boys recessive disease that most commonly affects: 86 What does the concept of treatment for muscular Physical and orthopedic Thymectomy Immunosuppressants Immunoglobulin therapy Plasmapheresis dystrophy include? therapy 87 Gene for myotonic dystrophy is coded on 19 20 21 24 chromosome number 88 Duchenne muscular dystrophy is а... Lesion of a muscle Lesion of the anterior Lesion of the nerve Lesion of the anterior horn Lesion of the root of the spinal of the spinal cord neuromuscular cord transmission 89 A patient present with unilateral painful Tolosa-Hunt syndrome Cavernous sinus Gradenigo syndrome Orbital Pseudotumor ophthalmoplegia. Imaging revealed an enlargement thrombosis of cavernous sinus on the affected side. The likely diagnosis is: 90 A patient's visual field is being tested by Visual inattention Homonymous Simultanagnosia Somatoparaphrenia confrontation field testing,during which you hemianopia noticed an abnormality. On wiggling one finger of one hand, patient is able see normally and can tell the correct side, but when fingers of both hands on both sides are wiggled simultaneously, patient is able to appreciate the movement of only right side and the left hand appears to him as stationary.This phenomenon is called? 91 The gag reflex is checked in a 65-year-old woman 9th cranial nerve 8 10 12 with diabetes mellitus. When the right side of the pharynx is touched with a tongue blade, the palate elevates symmetrically. When the left side of the pharynx is touched, the palate does not elevate at all.Which of the following cranial nerves is most likely to be responsible for this? 92 A lesion of the following cranial nerve is Trigeminal Oculomotor Facial Accessory Olfactory manifested by facial pain: 93 A 12-year-old female patient complains of Peroneal neuropathy Ulnar neuropathy Sciatic neuropathy Tibial neuropathy Radial nerve neuropathy weakness in the left leg. She is acutely ill, does not know the cause. But she notes that before the onset of complaints, she was picking berries while sitting on her knees. In the neurological status, the left Achilles reflex is preserved. Left-sided steppage gait. What's your presumptive diagnosis? 94 In a 30-year-old male patient, examination of Flaccid monoparesis Central monoparesis Central diparalysis Flaccid diparesis Polyneuropathy neurological status revealed the following signs: muscle strength in the left hand 3 points, areflexia in the left hand, decreased muscle tone in the left hand, trophic disorders on the skin of the fingers of the left hand. Highlight the correct syndrome from the suggested answers. 95 A 12 year old girl, complains of drooling and Otoscopy CT EEG ENMG MRI spilling of fluids from the mouth, from the right corner of the mouth, right eye not closing and right eyebrow drooping. No paresis or paralysis has been detected in the arms and legs. What investigation should be performed? 96 A 46-year-old woman with history of intermittent Thymoma Retrosternal goiter Hilar Lymphadenopathy Hilar Lymphadenopathy weakness and muscle fatigue which worsened with activity was diagnosed as a case of Myasthenia Gravis. She presented with complaints of persistent cough associated with shortness of breath. On workup, CT Chest shows anterior mediastinal mass. What could be the possible diagnosis? 97 A 65-year-old male comes to the OPD complaining Myasthenia gravis GBS Amitriptyline Methysergide of ongoing double vision which is worse when he is watching TV in the evening. He has also noticed that he feels weaker towards the end of the day and that his face is slightly puffy. On inspection, there is a partial ptosis of the left eye lid and his mouth hangs slightly open at rest. On examination, there are visibly distended neck veins. What is the most likely diagnosis? 98 Myasthenia refers to peripheral disorders of. What Lesion of the Lesion of the anterior Lesion of the nerve Lesion of a muscle Lesion of the anterior is impaired in any form of myasthenia? neuromuscular root of the spinal horn of the spinal cord transmission cord 99 A 63-year-old woman with T2DM, hypertension Voltage gated calcium Lambert Eaton Paraneoplastic cerebellar Multiple system atrophy presented to your hospital with complaints of channel antibodies syndrome degeneration sudden onset right eye ptosis and diplopia, worse at the end of the day. She also had history of fatigue, intermittent muscle weakness for the past 1 month. Initial investigations were done. A probable diagnosis of Myasthenia Gravis made. Which of the following is not useful for the above diagnosis? 100 A 30-year-old woman is diagnosed with ocular 12 tablets per day 1 tablets per day 24 tablets per day 48 tablets per day 50 tablets per day myasthenia gravis. She weighs 60 kg. You've prescribed prednisolone in tablet form. The dosage is 0.005 g in 1 tablet. Choose the correct daily dose. 101 Case of 36-year-old female presents with Diplopia Focal migraine Retinal migraine Migraine sine migraine Ophthalmoplegic migraine and ptosis, which usually develops after the headache. She had multiple such attacks in the past. What is your diagnosis? 102 A 35-year-old man presents with a severe, unilateral headache that is described as stabbing and is associated with lacrimation, rhinorrhea, and ptosis. The headaches typically occur in the early Tension-type morning hours. What is the most likely diagnosis? Cluster headache headache Migraine Trigeminal neuralgia Temporal arteritis 103 What is drug of choice for acute attack of migraine Sumatriptan Caffeine Amitriptyline Methysergide 104 Types of migraine: Case of 46-year-old female Migraine sine migraine Retinal migraine Ophthalmoplegic migraine Focal migraine comes to you with history of visual disturbances without headache. She also has nausea, vomiting and aura. What is your diagnosis? 105 A 55-year-old woman presents with a dull, bilateral headache that has been gradually worsening over Brain tumor Temporal arteritis Tension-type headache Migraine Cervicogenic headache  the past 6 months. The headache is constant and typically worsens in the morning, and she reports associated symptoms of nausea and visual disturbances. Her medical history includes hypertension. What is the most likely diagnosis? 106 A 30-year-old man presents with sudden-onset excruciating pain around his right eye, associated with tearing, redness, and nasal congestion. The headache episodes last for 30-60 minutes and occur multiple times a day, especially at night. He also reports restlessness during the attacks. What is the most likely diagnosis? Cluster headache Sinus headache Tension-type headache Trigeminal neuralgia Migraines 107 You are working as a palliative medicine Cerebellar astrocytoma Brainstem glioma Craniopharyngioma Pineal body tumor resident in a tertiary institution. A group of children diagnosed with cancers came to you for follow-up. Which of the following brain tumor has the worst prognosis in children? 108 Medulloblastoma most commonly occurs in Cerebellum Medulla Cerebral hemisphere Spinal cord the 109 A patient with dermatomyositis reports Continue the same dose Raise dose of Start mycophenolate Perform muscle biopsy improvement of symptoms on steroids for last of steroids steroids 6 months. Labs did today show Creatine kinase of 1300 Units/L. What is the next step in the management? 110 A 40-year-old man presents with sudden, involuntary jerking movements of his upper limbs that occur in episodes. These movements are not rhythmic and are sometimes associated with a feeling of muscle stiffness. The patient has no family history of neurological disease. What is the most likely diagnosis? Myoclonus Tardive dyskinesia Essential tremor Huntington’s disease Hemiballismus 111 A 25-year-old woman presents with difficulty holding objects, particularly when she is stressed. She has noticed that her hands shake when she reaches for items, but her tremor improves when she is at rest. On examination, the tremor is most prominent when she extends her arms. What is the most likely diagnosis? Essential tremor Parkinson’s disease Cerebellar tremor Dystonia Resting tremor 112 A 50-year-old man with a history of diabetes presents with sudden-onset weakness in his right arm and leg. On examination, he has spasticity, hyperreflexia, and a positive Babinski sign on the right side. The weakness does not improve with rest. What is the most Amyotrophic lateral likely diagnosis? Stroke (hemiparetic) Multiple sclerosis Guillain-Barré syndrome sclerosis (ALS) Parkinson’s disease 113 A 70-year-old woman presents with difficulty walking and frequent falls. She has rigidity in her neck and arms, along with a shuffling gait. There is no tremor. On examination, she has difficulty turning in bed and making small, Normal pressure Progressive quick steps. What is the most likely diagnosis? hydrocephalus Parkinson’s disease Cerebellar ataxia Huntington’s disease supranuclear palsy 114 A 45-year-old man presents to emergency Weakness and spasticity Fasciculation's Rigidity Muscle atrophy room with Progressive atrophy and weakness of hands. On further examination he is found to have brisk jaw jerk, Fasciculations, 115 Which drug can you use for acute attack of Sumatriptan Caffeine Amitriptyline Methysergide migraine 116 Case of 36-year-old female presents with Ophthalmoplegic Retinal migraine Migraine sine migraine Focal migraine Diplopia and ptosis, which usually develops migraine after the headache. She had multiple such attacks in the past. What is your diagnosis? 117 A 29-year-old woman presents with recurrent headaches that typically last for 4-72 hours. The pain is described as pulsating and unilateral. She reports nausea, vomiting, and a sensitivity to light and sound during these episodes. The headaches are sometimes preceded by visual disturbances, such as flashing lights. What is the most likely diagnosis? Migraine Cluster headache Tension-type headache Temporal arteritis Sinus headache 118 A 55-year-old man reports having a severe headache behind his right eye, accompanied by tearing, nasal congestion, and redness of the eye. The headaches occur in clusters, lasting 30 minutes to 2 hours, and typically occur at night. He has a history of similar Tension-type episodes. What is the most likely diagnosis? Cluster headache headache Migraine Cervicogenic headache Sinus headache 119 A 35-year-old woman presented with Acute aneurismal Brain stem Acute ischemia of mid Meningitis complaints of sudden onset headache which haemorrhage encephalitis brain she described as a characteristic 'thunderclap headache'. She has no \significant medical  history. On examination, her pupils were dilated bilaterally. These findings are consistent with the diagnosis of? 120 A 32-year-old obese woman presented with Acetazolamide Glycerol Mannitol Dexamethasone complaints of headache associated with nausea & 2episodes of vomiting over 1 week duration. She also complained of pulsatile tinnitus & transient visual changes. Fundoscopic examination revealed features of papilledema. The physician suspected this as a case of idiopathic intracranial hypertension. What is the drug of choice for the above diagnosis? 121 A 24-year-old woman presents with a history of recurrent, severe, unilateral headaches associated with nausea, vomiting, and visual disturbances (auras). The headaches are typically triggered by bright lights or strong odors. What is the most likely diagnosis? Migraine Cluster headache Sinus headache Tension-type headache Trigeminal neuralgia 122 A 50-year-old woman experiences recurrent headaches with a sensation of pressure in her face and forehead. She reports nasal congestion and facial tenderness. The headaches are worse when she bends over. Tension-type What is the most likely diagnosis? Sinus headache headache Migraine Cluster headache Cervicogenic headache 123 A 48-year-old woman has a lower back pain A lesion at the right L4- Pathology where A lesion at the right L4- Compression by the LS and hypoesthesia in the left 51 dermatomal LS interspace the nerve exits the LS interspace lamina distribution (left calf and lateral left foot). spinal canal What is the most likely cause? immediately above the pedicle of S3 vertebra 124 Which of the following tests is abnormal in Electromyography MRI whole spine CT whole Spine V.E.P patients with ALS (Amyotrophic Lateral Sclerosis)? 125 A 40-year-old woman presents with a sudden onset of severe lower back pain radiating down her left leg. The pain started after she lifted a heavy box at work. She describes the pain as sharp and stabbing, with occasional numbness and tingling in her left foot. Physical examination reveals a positive straight leg raise test. What is the most likely Sacroiliac joint Osteoarthritis of the diagnosis? Lumbar disc herniation Spinal stenosis dysfunction spine Fibromyalgia 126 A 46-year-old woman presented with a 25- Medial temporal lobe. Lennox Gastaut Rolandic epilepsy Epilepsia Partialis year history of epilepsy. She had a history of epilepsy syndrome Continua focal impaired awareness with cognitive changes and behavioral arrest progressing to bilateral tonic-clonic seizures. Magnetic resonance imaging displayed asymmetry of the hippocampus, with a prominent right temporal horn of lateral ventricle. Which of the following is the probable diagnosis? 127 What percentage of patients with head injury 5 10 15 20 develop long-term epilepsy? 128 Commonest presentation of neurocysticercosis Seizures Focal neurological Dementia Radiculopathy is deficits 129 A 18-year-old man complains of cramps in his left arm and leg. He then loses consciousness and does not remember anything. After the seizure, when he regains consciousness, he notices that his left arm and leg do not move for about an hour. EEG showed epileptiform activity in the frontal-central region on the right side. MRI of the brain shows no abnormalities. What happened to the patient after the seizure? Todd's palsy Epileptic seizure Ischemic stroke Hemorrhagic stroke Hysterical seizure 130 A woman complains that her sister, who is 18 years old, has already fallen 3 times, lost consciousness, had cramps in her limbs, bit her tongue, foamed at the mouth and wet herself. The seizure lasts 2 minutes; after the seizure, the sister sleeps for about an hour. Electroencephalograph What investigation should be performed? y CT of the brain Electroneuromyography MRI of the brain Lumbar puncture 131 A 64-year-old, male unconscious patient was Brain stem lesion Cerebellar lesion Thalamic lesions Internal capsule lesio brought in with a history of high-grade fever. The attender recalls history of double vision, dysphagia, and unsteady gait in the patient. The medical history of the patient was hypertension for the past 13years & he is on antihypertensives. On examination, his temperature was 102.8 degrees Fahrenheit & bilateral pinpoint pupils are noted. What would be the probable diagnosis? 132 A 45-year-old man presents with excessive daytime sleepiness, despite having a full 8 hours of sleep at night. He reports episodes of falling asleep uncontrollably during meetings or while watching TV. He also describes vivid dreams and muscle weakness in his legs during these episodes, especially after laughing or during emotional stress. What is Periodic limb the most likely diagnosis? Narcolepsy Insomnia Sleep apnea Restless leg syndrome movement disorder 133 A 60-year-old male diabetic and hypertensive Check blood glucose Order CT scan Give intravenous Immediately reduce BP patient was found unconscious in the morning. mannitol with anti-hypertensives On examination pulse rate is 120/min, BP=160/100 mm Hg. What is the next step to be done for management? 134 A 60-year-old woman presents with difficulty falling asleep and staying asleep, particularly in the early morning hours. She frequently wakes up feeling unrested, and her sleep is interrupted by frequent nocturnal awakenings. She has a history of depression and often worries about her sleep patterns. What is the Obstructive sleep REM sleep behavior most likely diagnosis? Insomnia apnea Narcolepsy Sleepwalking disorder 135 The most common cause of subarachnoid Hypertension Cavernous angioma Aneurysm Arterio-venous haemorrhage is malformation 136 Which of the following will manifest as Subdural hematoma Epidural hematoma Subarachnoid Brain infraction "pachymeningitis hemorrhagica interna"? hemorrhage 137 A 72-year-old man presents with sudden onset of severe headache, nausea, and vomiting, followed by confusion and right-sided weakness. His blood pressure is elevated, and he has a history of atrial fibrillation. On examination, he has right-sided hemiplegia and a Glasgow Coma Scale (GCS) of 14. CT scan of the brain reveals an intracerebral hemorrhage in the right frontal lobe. What is Hypertensive the most likely cause of this patient's intracerebral Embolic ischemic Subarachnoid Transient ischemic condition? hemorrhage stroke hemorrhage attack (TIA) Cerebellar infarction 138 A 60-year-old man presents with sudden-onset left-sided weakness and difficulty understanding speech. He reports that the symptoms started about 45 minutes ago. He has a history of smoking and hyperlipidemia. On examination, he has left-sided hemiparesis Left-sided ischemic Right-sided ischemic and Wernicke's aphasia. A CT scan of the stroke in the middle stroke in the anterior brain shows no acute hemorrhage. What is the cerebral artery (MCA) Subarachnoid Transient ischemic attack cerebral artery (ACA) most likely diagnosis? territory hemorrhage (TIA) territory Multiple sclerosis 139 An 18-year-old male was involved in a traffic accident and was found on the road near a crosswalk. His face shows abrasions and wounds. You have determined he is opening his eyes (eye opening), responding to questions (speech), and following your instructions (movements). The level of consciousness on the Glasgow Coma Scale is a score of 13. What kind of head trauma did Superficial head the man suffer? Moderate head trauma trauma Mild head trauma No head trauma Severe head trauma 140 A 25-year-old man was involved in a traffic accident and was found on the road near a crosswalk. There are visible abrasions and wounds on his face. You have determined that he opens his eyes independently, he responds to questions, but is confused about the present date and year. When you ask him to raise his hands, he does not comply. However, he localizes pain well. Calculate the level of consciousness on the Glasgow Coma Scale. Score 13 Score 15 Score 10 Score 8 Score 3 141 A head injured patient, who opens eyes to 11 9 7 13 painful stimulus, is confused and localizes to pain. What is the Glasgow coma score 142 Cortical blindness is seen in lesion of which Occipital Parietal Frontal Temporal lobe? 143 Which of the following statement is false with Involves biochemical More common in Multiple sclerosis is an Multiple Sclerosis is respect to demyelinating disorders? abnormality of myelin females autoimmune disease of most common type of the central nervous demyelinating disorder system 144 A 40yr old male presented with altered mental Urgent parenteral Placement of ICP Lumbar puncture Craniotomy status, seizures, and vomiting. He has no h/o antibiotics monitor fever, neck stiffness. On CECT ring- enhancing lesion at gray-white interface is seen. General hygiene was poor and he has multiple dental caries. What is the next best step in the management of this patient? 145 A 33-year male with numbness from the lower Optic neuritis in the Incomplete Length of intervals Frequency of relapses trunk to the distal extremities was diagnosed first 2 years recovery from between relapses with multiple sclerosis. He was started with relapses glucocorticoids with some improvement in his symptoms. Which one of the following is not predictive of long-term disability in such patients? 146 A patient has had recurrent optic neuritis Neuromyelitis Optica Subacute combined Post cerebral artery Neuro-syphilis bilaterally with transverse myelitis. Visual degeneration of stroke acuity in right eye is 6/60 and left eye is 6/18. spinal cord Patient showed a 50°'1 response to steroids. (SACD) Diagnosis is? 147 A 38-year-old woman with sensory Patient is bedridden, Death of patient Patient is bedridden, can't Patient walks normally, disturbances, muscle weakness & visual can talk, can drink due to multiple talk, can’t drink shows no disability disturbances was diagnosed with Multiple sclerosis Sclerosis recently. The physician is evaluating her neurological status with Expanded disability severity score (EDSS). What does a score of 9 in EDSS signify? 148 A 78-year-old female is diagnosed with Alzheimer's disease and experiences occasional aggression and agitation. What is the most appropriate initial management for Family education and Cholinesterase Cognitive-behavioral Antipsychotic these behavioral symptoms? behavioral interventions inhibitors therapy Antidepressants medication 149 A 72-year-old woman with Alzheimer's disease begins to show signs of paranoia and delusions. What is the most appropriate Administer Provide family Start a cholinesterase Initiate an Refer for cognitive- intervention for these symptoms? antipsychotics counseling inhibitor antidepressant behavioral therapy 150 A 70-year-old female with AlA 70-year-old female with Alzheimer’s disease is found to have significantly reduced levels of acetylcholine in the brain. Which of the Selective serotonin following drug classes would likely be most Cholinesterase reuptake inhibitors NMDA receptor effective in this patient? inhibitors (SSRIs) antagonists Benzodiazepines Dopamine agonists 151 A 78-year-old woman with Alzheimer’s disease exhibits difficulty recognizing faces and understanding visual-spatial relationships. Which cognitive domain is primarily affected in her case? Visuospatial ability Executive function Attention Language Memory 152 A 67-year-old man with a family history of Alzheimer’s disease has been diagnosed with mild cognitive impairment. He expresses concern about developing Alzheimer's. What Recommend lifestyle Perform Begin antipsychotic Perform genetic testing Start cholinesterase would be the most appropriate next step? changes neuroimaging medication for APOE inhibitors 153 29 yrs male was brought to OPD by his wife Frontal lobe Occipital Temporal Parietal giving history of aggressive behaviour with decreased social interaction and lack of self- care. O/E grasp reflex present, CT scan would be showing lesion of which lobe? 154 Right-sided Focal symptom characteristic of right middle Right-sided homonymous cerebral artery occlusion: Left-sided hemiparesis hemiparesis hemianopsia Ataxia Nystagmus 155 The patient is 72 years old, suffers from arterial hypertension, she does not take permanent hypotensive therapy. This morning there appeared awkwardness and numbness in the left upper extremity, facial asymmetry (lowering of the left corner of the mouth). Select the vascular basin most likely to be Right middle cerebral Left posterior Right posterior cerebral Right middle cerebral affected: artery cerebral artery artery artery Basic artery 156 A 28-year-old woman presented with Posterior choroidal Tuberothalamic. Recurrent artery of Lenticulostriate artery headaches and difficulty with gait. The arteries artery Heubner physical examination was notable for bilateral papilledema. Sagittal MRI showed the lesion located in the posterior third ventricle that strongly enhances with gadolinium. Surgical excision showed that the lesion was a pinealoma. The gland involved is supplied by? 157 A patient is unable to solve mathematical Parietal lobe Frontal lobe Temporale lobe Occipital lobe calculations, which part of his brain is damaged? 158 A 70-year-old woman with a history of progressive memory loss, difficulty recognizing familiar faces, and changes in personality presents for evaluation. Neuroimaging shows atrophy in the temporal and parietal lobes. Which of the following findings is most likely to be present in her Tau tangles and brain tissue? amyloid plaques Lewy bodies Huntington inclusions Prion plaques Glial cell tumors 159 A 47yrs old female c/o headache, changes in Surgical excision Chemotherapy with Cerebral angiography Preoperative radiation vision, seizures from past 2yrs. Now she has Adriamycin with tumor embolization therapy followed by developed weakness rt. side of body. A CT surgical excision  scan was being ordered by the physician which showed well circumscribed mass abutting the skull in left hemisphere. On contrast enhanced MRI shows -What is the next step in management of this patient? 160 A 72-year-old woman presents with progressive memory loss, difficulty with spatial orientation, and frequent disorientation. Her family reports that she has become increasingly repetitive in conversation and has difficulty recalling recent events. On examination, she appears disheveled and is unaware of the time or place. Which of the Frontotemporal Amyotrophic lateral following is the most likely diagnosis? Alzheimer's disease dementia Parkinson's disease Huntington's disease sclerosis 161 What treatments are not used for myasthenia Immunoglobulin gravis? Immunosuppressants Thymectomy Plasmapheresis therapy Antiretroviral therapy 162 A 13-year-old adolescent has been diagnosed with Finlepsin Depakine (Convulex) Levetiracetam (Keppra) Phenobarbital (Luminal Diazepam (Relanium) structural epilepsy, focal tonic-clonic seizures, and (Carbamazepine) Todd's palsy. What type of medication should be offered to the patient? 163 All are clinical features of myasthenia gravis, Absent deep tendon Spontaneus Proximal muscle Worsen by exertion EXCEPT reflexes remission involvement 164 A 38-year-old woman with sensory Patient is bedridden, Death of patient Patient is bedridden, can't Patient walks normally, disturbances, muscle weakness & visual can talk, can drink due to multiple talk, can’t drink shows no disability disturbances was diagnosed with Multiple sclerosis Sclerosis recently. The physician is evaluating her neurological status with Expanded disability severity score (EDSS). What does a score of 9 in EDSS signify? 165 Best predictor in the GCS Motor response Eye opening Eye opening All 166 The number of cells in the normal composition of the liquor (in 1 mm3): 01-May Oct-15 20-30 40-50 60-70 167 This condition is the primary indication for a Occlusive cerebrospinal fluid study (choose one intracranial Inflammation of cerebral Herniation of the condition): Brain tumor hypertension membranes Ischemic stroke intervertebral disk 168 In case of muscular dystrophy it is necessary to Tissue biopsy CT EEG ENMG MRI examine the patient using the method 169 Which of the following is not a feature of Knee reflex Absent Ankle reflex Bladder / bowel Early & Root involved S3, S4, conus medullaris syndrome? Absent marked S5 170 Which of the following tests is abnormal in Electromyography MRI whole spine CT whole Spine V.E.P patients with ALS (Amyotrophic Lateral Sclerosis)? 171 If Broun-Sekar syndrome is detected, a neuroimaging study of the following section of the neural system should be performed: Spinal cord Cerebellum Brain Peripheral nerves Muscles 172 A 5O-year-old woman complains of Syringomyelia Subacute combined ALS Tabes dorsalis clumsiness in her hands while working in the degeneration kitchen. She recently burned her hands on the stove without experiencing any pain. Neurologic examination reveals bilateral weakness of the shoulder girdles, arms, and hands as well as a loss of pain and temperature sensation covering the shoulder and upper limb in a cape-like distribution. Severe atrophy is present in the intrinsic muscles of the hands. The most likely diagnosis is: 173 A 35-year-old patient presents with numbness Neuro-syphilis An intramedullary Amyotrophic lateral A.I.D.P over the neck. On examination decreased pain tumor sclerosis and temperature sensation is found in the distribution of C4, CS. Scalp sensation, cranial nerve function and limb examination are normal. Bladder and bowel sphincter control are normal. What is the diagnosis? 174 A 5O-year-old woman complains of Syringomyelia Subacute combined ALS Tabes dorsalis clumsiness in her hands while working in the degeneration kitchen. She recently burned her hands on the stove without experiencing any pain. Neurologic examination reveals bilateral weakness of the shoulder girdles, arms, and hands as well as a loss of pain and temperature sensation covering the shoulder and upper limb in a cape-like distribution. Severe atrophy is present in the intrinsic muscles of the hands. The most likely diagnosis is 175 Transtentorial uncal heriniation causes all lpsilateral hemiplegia Decorticate rigidity Cheyne stokes respiration lpsilateral dilated pupils except 176 A 2-year-old girl, from an endemic area, unvaccinated, became acutely ill with runny nose, cough, body temperature of 38 degrees Celsius. On the 5th day of the disease she could not stand on her feet. Examination of the neurological status revealed a lower flaccid Polio Diphtheria Tetanus Whooping cough Measles  paralysis. 6 months after the illness, the paralysis had not recovered and she needed supportive devices. What infectious disease did she have? 177 Which of the following is not a Channelopathy Tay Sachs disease Periodic paralysis Cystic fibrosis Liddle syndrome 178 A 60 yr old woman presents with tingling, ALS lpsilateral Cheyne stokes respiration Polyneuropathy numbness, and weakness of extremities for the hemiplegia past year. she also noted and lack of bowel control. What is the most likely diagnosis? 179 Guillain-Baret polyneuropathy is characterized by impairment of the following nervous system functions (choose one correct answer) Motor Protective Temperature Sensory Coordinator 180 Select the symptoms characteristic of Guillain- Disorder of pelvic Bilateral pyramidal Nerve involvement in Cranial nerve Baret polyneuropathy Lesions of all nerves functions symptoms one limb involvement 181 A 52-year-old woman has been suffering from type II diabetes mellitus for 10 years; she complains of severe itching and pain in the right foot. On examination: the joints of the feet are deformed, the skin on the feet is thin, Achilles reflexes are absent, knee reflexes are very low. Hypesthesia in the legs - up to the Diabetic Alcoholic Acute demyelinating Guillain-Baret Diphtheria middle third of the tibia. polyneuropathy polyneuropathy polyradiculoneuropathy polyneuropathy polyneuropathy 182 Plasmapheresis / Steroids / Thymectomy / Antibiotics / Choose the most likely diagnosis: Immunoglobulins Immunoglobulins Immunoglobulins Immunoglobulins Immunoglobulins only 183 A child attending a nursery suddenly increased t to 39 C, developed convulsions and confusion. The doctor diagnosed meningeal symptom complex. In the analysis of the liquor: turbid, cytosis-820 kl in ml, neutrophils predominate. Choose the most probable Subarachnoid diagnosis: Bacterial meningitis Viral meningitis Serous meningitis Epiduritis hemorrhage 184 12 month old child is diagnosed with meningitis, calculate the daily dose of ceftriaxone for the patient: 10 mg per day 50 mg per day 100 mg per day 500 mg per day 1000 mg per day 185 Which of the following drugs can cause All of the above Zidovudine Chloropine Statin muscle weakness? 186 A 65-year-old, male with hypertension Abducens nerve Trochlear Trigeminal Facial nerve develops sudden onset weakness on the right side of the face & arm. His attender recalls history of headache, blurred vision in the patient which leads to the suspicion of increased ICP. Which is the most common cranial nerve involved in raised ICP? 187 Neonatal myasthenia develops as a result of: Administration of an Transfer from the Reducing their number A sharp decrease in the A sharp decrease in the excessive dose of mother through the number of functioning number of functioning acetylcholinesterase placental barrier of AChRs due to a massive ryanodine receptors inhibitors AT to the attack by their acetylcholine autoantibodies receptor 188 Myasthenic crisis can be provoked by: Bronchopulmonary Skin diseases Food allergies Increasing A/D Gymnastics infection 189 The patient complains of visual impairment, on optic nerve testing, the patient was found to have visual field limitation on the outer side of the right eye and on the nasal side of the left Loss of the central Partial atrophy of the eye. What is the syndrome called? Hemianopsia visual field Blindness in one eye optic nerve Different pupil size 190 To test this nerve, you use, spices, flavors, perfume. I II III X XII 191 A 55-year-old female presents with 3-years Trigeminal neuralgia Maxillary sinusitis Maxillary osteomyelitis Gradenigo's syndrome history of severe lancinating pain extending from left ear to her maxillary area. Pain is triggered by chewing and brushing teeth. She was treated by otolaryngologist for sinus infection a year ago and undergone multiple dental work and teeth extraction with transient or no improvement. The most likely diagnosis is 192 A 22-year-old obese female experiences right Idiopathic lntracranial Craniopharyngiom Optic neuritis Sagittal sinus eye diplopia. She had weight gain in last year Hypertension a thrombosis and her current BMI is 35. Her fundus examination reveals papilledema on the right side. The most likely cause of her symptoms is? 193 You are an intern, posted in the neurology Myasthenia gravis GBS Transverse myelitis Traumatic neuritis ward in the Department of Internal Medicine. A 48-year-old woman was admitted with a history of muscle weakness. Investigations & examination revealed normal nerve conduction but flaccidity is seen. Which of the following would be the possible diagnosis? 194 A 63-year-old woman with T2DM, Voltage gated calcium AChR antibodies Muscle-specific kinase Edrophonium test hypertension presented to your hospital with channel antibodies antibodies  complaints of sudden onset right eye ptosis and diplopia, worse at the end of the day. She also had history of fatigue, intermittent muscle weakness for the past 1 month. Initial investigations were done. A probable diagnosis of Myasthenia Gravis made. Which of the following is not useful for the above diagnosis? 195 A 10-year-old female patient complains of weakness and pain in her right leg. She fell ill acutely and does not know the cause. However, she notes that before the complaints appeared, she was running and hit her knee on the ground while playing on a football field. In her neurological status, the Achilles reflex on the right is absent. Dorsal flexion is impossible. She cannot stand on her toes on Radial nerve the right. Which nerve is affected? Tibial neuropathy Ulnar neuropathy Sciatic neuropathy neuropathy Peroneal neuropathy 196 A 10-year-old female patient complains of weakness in her left leg. She fell ill acutely and does not know the cause. However, she notes that before the complaints appeared, she picked berries while sitting on her knees. The neurological status shows that the left Achilles reflex is preserved. Left-sided steppage gait. What examination should be performed? Tissue biopsy CT EEG ENMG MRI 197 A 41-year-old man is diagnosed with myasthenia gravis. His weight is 80 kilograms. You have prescribed treatment. Of the steroids, you have suggested prednisolone 0.005 g in 1 tablet. Choose the correct Steroids 16 tablet per Steroids 6 tablets Steroids 10 tablets per Steroids 1 tablets per Steroids 26 tablets per treatment option. day. per day. day. day. day. 198 Patient D., 12 years old, complains of rapid fatigue Brain MRI Proserine test CT scan of the brain EEG Holter MRI with angiography of the masticatory muscles and eyelid muscles. Neurological status: hemiptosis on both sides and weakness of the masticatory muscles. There were no obvious signs of damage to the central and peripheral nervous system. After performing stress tests (sit down and stand up 20 times), weakness of the orbicularis oculi muscles, muscles that lift the upper eyelid, and masticatory muscles was revealed. Your tactics to clarify the diagnosis: 199 In a child with suspected myasthenia gravis, what general blood test blood for CPK LDH proserine test test with atropine MRI with angiography laboratory examination should be done first to clarify the diagnosis? 200 A 16-year-old patient, according to her mother, Spinal muscular atrophy Duchenne myopathy Shoulder-scapular Myasthenia gravis Guillain-Barré syndrome complains of rapid fatigue of the masticatory myodystrophy Landouzy- muscles and eyelid muscles (“in the afternoon, the Dejerine girl cannot open her eyes, they close and that’s it…”). Neurological status: hemiptosis on both sides and weakness of the masticatory muscles. After performing stress tests (sit down and stand up 20 times), weakness of the orbicularis oculi muscles, muscles that lift the upper eyelid, and masticatory muscles was revealed. Preliminary diagnosis?