Neurology Final Exam Questions PDF

1 Case of 40-year-old male presents with transient dysphagia, Retinal migraine Ophthalmopl Migraine Focal episodic headache and increased senstivity to light. He also egic migraine sine migraine feels some weakness on the left side of body. What is your migraine diagnosis? 2 A 60-year-old woman complains of a constant headache that Temporal arteritis Migraine Tension- Cluster Intracran is worse in the morning and improves throughout the day. She type headache ial has a history of intermittent visual disturbances and reports headache hyperten recent episodes of scalp tenderness. Her ESR is elevated. sion What is the most likely diagnosis? 3 A 24-year-old female, Ms.Deepa, with a previous history of Amitriptyline Propranolol Sumatriptan Ergotamine 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 complaining of Migraine Cluster Tension- Sinus Trigemin recurrent headaches. She describes them as throbbing, headache type headache al unilateral, and often accompanied by nausea, vomiting, and headache neuralgi sensitivity to light and sound. These episodes typically last a 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 recurrent Migraine Cluster Tension- Sinus Trigemin headaches, which are typically unilateral and throbbing. The headache type headache al headaches last between 4-72 hours and are associated with headache neuralgi nausea, vomiting, and photophobia. She often notices visual a disturbances (aura) before the headache starts. What is the most likely diagnosis? 6 A 40-year-old man presents with a severe headache that Subarachnoid Tension-type Cluster Migraine Tempora started suddenly while he was at work. He describes the pain hemorrhage headache headache l arteritis 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 lead to Either pero- Central None Peripheral disorders of autonomic nervous system? ipheral or central nervous nervous nervous system system system 8 All are examples of upper motor neuron lesion except Anterior horn cell Multiple Prion Tuberous disease sclerosis disease sclerosis 9 A 30-year-old man presents with rapid, involuntary muscle Dystonia Tardive Parkinson’s Huntington’s Essentia contractions that cause twisting and repetitive movements, dyskinesia disease disease l tremor 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 toxicity? A B12 E D 11 UMN lesion is characterized by Weakness & Fasciculation Rigidity Localized spasticity s muscle atrophy 12 A 45-year-old woman presents with diﬃculty initiating Parkinson's Huntington's Multiple Amyotrophi Wilson's movement and a "shuﬄing" walk. She also reports stiffness disease disease sclerosis c lateral disease in her arms and legs, particularly when trying to move. On sclerosis examination, she has a mask-like facial expression, resting (ALS) tremor in both hands, and rigidity. What is the most likely diagnosis? 13 A 55-year-old man presents with involuntary, jerky movements Huntington's Parkinson’s Essential Myoclonus Tardive of his hands, legs, and face. These movements occur at disease disease tremor dyskines irregular intervals and are worsened by stress. He has a ia 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 swallowing, Amyotrophic Multiple Guillain- Myasthenia Muscula slurred speech, and muscle weakness in her arms and legs. lateral sclerosis sclerosis Barré gravis r She has noticed progressive weakness over the last year. On (ALS) syndrome dystroph examination, she has atrophy and fasciculations in her upper y and lower limbs. What is the most likely diagnosis? 15 A 72-year-old lady presents with nausea and vomiting and a Glaucoma SUNCT Migraine Cluster headache for the one day. She describes the pain as one- with Aura headache 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 due to Trigeminal SUNCT Giant cell paroxysmal sudden episodes of left-sided facial pain for the last two neuralgia syndrome arteritis hemicrania 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 headache Tension-type Cluster Migraine Trigeminal Tempora that lasts for hours. She describes the pain as a "tight band" headache headache neuralgia l arteritis 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 headache that is Temporal arteritis Migraine Tension- Cluster Sinus persistent and located over the temples. The headache is type headache headach associated with jaw claudication, fatigue, and weight loss. headache e His erythrocyte sedimentation rate (ESR) is elevated. What is the most likely diagnosis? 19 A 33-year-old woman with no signiﬁcant medical history Acute aneurismal Brain stem Acute Meningitis presented with complaints of headache which she described haemorrhage encephalitis ischemia of as a characteristic 'thunderclap headache'. All of the mid brain following are the differential diagnosis for 'thunderclap headache' except 20 A 22-years-old man presents with a history of a headache for Analgesic abuse Migraine Depression Cluster 6 months which is mainly in the frontal region, occasionally headache associated headache associated with nausea. He has been taking paracetamol 3g headache 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 that lasts for Cluster headache Tension-type Migraine Sinus Trigemin 30 minutes to an hour, occurring around the same time every headache headache al day for several weeks. The pain is localized to the right eye neuralgi and is associated with redness, tearing, and nasal congestion. a 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 has been Cervicogenic Tension-type Migraine Sinus Tempora gradually worsening over the past few weeks. The pain is headache headache headache l arteritis 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 typically Low back pain Weakness of A preserved Diminution causes which among the following symptoms? and right sciatica dorsiﬂexion right ankle of of the right jerk sensation foot over themedial aspect of the right foot, including the great toe 24 A 55-year-old man presents with chronic neck pain that has Cervical Cervical Whiplash Thoracic Multiple been worsening over the past few months. He reports spondylosis radiculopathy injury outlet sclerosis stiffness and decreased range of motion in his neck. On syndrome 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 lower back Spinal stenosis Lumbar disc Spondylolist Ankylosing Sacroiliit pain and diﬃculty walking. The pain is worse with standing herniation hesis spondylitis is 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 neck pain Cervical Whiplash Thoracic Carpal Brachial that radiates to his right shoulder and arm. The pain began radiculopathy injury outlet tunnel plexus after a car accident where his head was jerked backward. He syndrome syndrome injury 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 history of Amygdalo Levetiraceta Primidone Vagus epilepsy. She had a history of focal impaired awareness with hippocampectom m nerve cognitive changes and behavioral arrest progressing to y stimulation 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 a pungent Focal seizures Hysteria Atonic Myoclonic odor, started sweating and loses consciousness. His family seizures seizures 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 seizures was Lamotrigine Carbamazepi Topiramate Phenytoin recently diagnosed as a case of complex partial seizures. ne 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 arm, with Jacksonian Generalized Epileptic Non- Focal progression to the left side of the face and left leg. He does seizure seizure seizure epileptic seizure not lose consciousness. What type of seizures does the seizure patient describe? 31 A patient had a head injury in road traﬃc accident and had Minor head injury Severe head Intermediate None of the lost consciousness instantaneously. After few minutes he injury severity above 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 consciousness after Initiate sodium B Administer Administer Neuromusc cocaine over-dosage. On examination BP= 200/100 with GCS nitroprusside to hypertonic mannitol at ular of 7 /15. The right-sided pupil is dilated and shows a sluggish achieve MAP ﬂuids to 1g/kg body paralysis reaction to light. Which is not recommended for this patient? below 130 mmHg maintain weight sodium of 145mEq/dl 33 A 60-year-old man is brought to the emergency department Drug overdose Stroke Hypoglycem Traumatic Subarac after being found unconscious at home. His blood pressure is ia brain injury hnoid 120/80 mmHg, heart rate is 80 bpm, and respiratory rate is hemorrh 12/min. On examination, the patient is unresponsive to verbal age 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 after a Hypoglycemia Brain tumor Meningitis Stroke Hepatic witnessed seizure followed by a prolonged period of encepha unconsciousness. On arrival, she is unresponsive, with a lopathy 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 of the Middle cerebral Anterior Posterior Anterior area of distribution of the artery cerebral cerebral communicat artery artery ing artery 36 Which of the following is the most common site of Anterior Basilar artery Posterior Middle aneurysmal subarachnoid hemorrhage? communicating communicat cerebral artery ing artery artery 37 A 68-year-old woman presents with sudden-onset right-sided Left hemispheric Transient Right Subarachno Intracere weakness and slurred speech. Her symptoms started ischemic stroke ischemic hemispheric id bral approximately 30 minutes ago while she was watching attack (TIA) ischemic hemorrhage hemorrh television. She has a history of hypertension and type 2 stroke age 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 ﬁbrillation Left-sided Right-sided Transient Subarachno Vestibul presents with sudden onset of visual disturbance in her right ischemic stroke ischemic ischemic id ar visual ﬁeld, diﬃculty speaking, and a right-sided hemiparesis. in the posterior stroke in the attack (TIA) hemorrhage migraine She also reports dizziness and diﬃculty maintaining balance. cerebral artery middle On examination, she has a left homonymous hemianopia and (PCA) territory cerebral dysarthria. Brain MRI reveals an infarct in the posterior artery (MCA) cerebral artery (PCA) distribution. What is the most likely territory diagnosis? 39 A patient had a head injury in road traﬃc accident and had Minor head injury Severe head Intermediate None of the lost consciousness instantaneously. After few minutes he injury severity above 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 Hypersexualit Metamorph Visual y opsia agnosia 41 A 60-year-old woman fell down the stairs. His face shows Score 9 Score 13 Score 15 Score 8 Score 3 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 sustained a CT of the brain MRI of the Electroneuro Electroence Lumbar moderate head injury. What kind of examination would you brain myography phalography puncture suggest? 43 Which of the following statement is false with respect to Involves More Multiple Multiple demyelinating disorders? biochemical common in sclerosis is Sclerosis is abnormality of females an most myelin autoimmune common disease of type of the central demyelinati nervous ng disorder system 44 A patient was treated for mantle cell Hodgkin lymphoma with Cervical spinal Cervical Multiple Spinal cord radiation therapy. After 6 months he develops an electric cord pathology arthritis sclerosis compressio shock-like pain along the spine on ﬂexing his neck. What is n the diagnosis? 45 A 65-year-old woman is brought to the clinic for memory Decreased Enlarged Increased Cerebellar Frontal problems. On examination, she displays diﬃculty recalling hippocampal ventricles brain atrophy lobe recent events and exhibits poor short-term memory. What volume glucose atrophy brain abnormality is most likely to be found in Alzheimer’s metabolism disease? 46 A 71-year-old male with a family history of Alzheimer’s Presence of Hyperlipidemi Hypertensio Age Physical disease is diagnosed with mild cognitive impairment (MCI). APOE ε4 allele a n activity 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 disease. Donepezil Levodopa Lithium Sertraline Haloperi Which of the following medications would most likely be dol prescribed for managing his cognitive symptoms? 48 A 33-year male with numbness from the lower trunk to the Optic neuritis in Incomplete Length of Frequency distal extremities was diagnosed with multiple sclerosis. He the ﬁrst 2 years recovery intervals of relapses was started with glucocorticoids with some improvement in from relapses between his symptoms. Which one of the following is not predictive of relapses long-term disability in such patients? 49 A 38-year-old woman with sensory disturbances, muscle Patient is Death of Patient is Patient weakness & visual disturbances was diagnosed with Multiple bedridden, can patient due bedridden, walks Sclerosis recently. The physician is evaluating her talk, can drink to multiple can't talk, normally, neurological status with Expanded disability severity score sclerosis can’t drink shows no (EDSS). What does a score of 9 in EDSS signify? disability 50 A 58-year-old woman presenting with right arm weakness, Neuroﬁbromatosi Neuroﬁbroma Turcot Li - paraparesis, and increased reﬂexes. T1w MRI with contrast, s 1 tosis 2 syndrome Fraumeni coronal view showed dumbbell schwannoma at C3-C4 level syndrome 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, diﬃculty Alzheimer’s Depression Vascular Frontotemp Parkinso recalling recent events, and confusion. She becomes easily disease dementia oral n’s agitated and occasionally gets lost in familiar places. Which dementia disease of the following is the most likely diagnosis? dementi a 52 A 72-year-old man presents with diﬃculty remembering Montreal Mini-Mental Clock Trail Neurops names of familiar people and forgetting appointments. He Cognitive State Drawing Making Test ychologi has no diﬃculty performing daily tasks. What cognitive test Assessment Examination Test cal would be most appropriate to assess his memory? (MoCA) (MMSE) testing 53 Blood supply area of the middle cerebral artery: Most of the The medial Occipital Brainstem Cerebell internal capsule surface of lobes um the frontal and parietal lobes 54 Triple H therapy is done in? SAH SDH EDH Intraparench ymal bleed 55 A 69-year-old hypertensive patient suddenly developed facial Left middle Right internal Right Left Left muscle weakness, slurred speech, and weakness in the right cerebral artery carotid artery middle posterior internal extremities after sleeping. Select the vascular basin most cerebral cerebral carotid likely to be affected: artery artery artery 56 Lateral medullary syndrome is caused by thrombosis of Anterior inferior PCA Anterior Basilar cerebral artery inferior artery cerebral artery 57 Mr X is a 70-year-old male who presents with a one-year Normal pressure Cerebellar Lewy body Multiple history of progressive ataxia, urinary incontinence and hydrocephalus astrocytoma dementia sclerosis 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 Alzheimer's Parkinson's Vascular Creutzfel hypertension presents with memory impairment, apathy, and dementia disease disease dementia dt- diﬃculty with language. His wife notes that he has become Jakob more impulsive and socially inappropriate. MRI reveals disease 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 history of Frontal lobe Occipital Temporal Parietal 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 rigidity, Lewy body Progressive Frontotemp Parkinson's Alzheim bradykinesia, and resting tremor. He also has a signiﬁcant dementia supranuclear oral disease er's cognitive decline, with diﬃculty in memory and problem- palsy dementia dementia disease 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 multiple Absence of Bilateral Complete Poor sclerosis oligoclonal visual loss tranaction recovery bands in CSF of cord 62 A study without which a diagnosis of multiple sclerosis MRI of the brain. CT of the Electroneuro Electroence Lumbar cannot be conﬁrmed: brain myography phalography puncture 63 A 30-year-old woman presented with double vision, divergent Multiple sclerosis Myasthenia Aneurysm Diabetic Acute strabismus, right-sided ptosis. Administration of proserin did gravis of the neuropathy cerebral not change the clinical picture; ENMG without abnormalities. internal circulati MR angiography: no pathology was revealed. MRI of the carotid on brain: multiple foci of demyelination paraventricularly and in artery disorder the area of the brain stem. Blood sugar analysis: 4.2 mmol/l. of Choose the most likely diagnosis: ischemic nature in the brainste m 64 A 32-year-old patient shows signs of spastic paraparesis, Multiple sclerosis Tumor of the Spinal cord Ischemic Encepha impaired coordination in the left limbs, pelvic organ left cerebellar tumor stroke litis dysfunction, and pallor of the temporal halves of the optic hemisphere discs. Choose the most likely diagnosis: 65 A 25-year-old female patient came to the doctor because she Cerebellar tumor Tumor of Multiple Encephalitis Ischemic felt unsteady when walking. She had a history of retrobulbar cranio- sclerosis stroke neuritis twice. The neurologist found evidence of cerebellar vertebral lesions and 2-sided lesions of the pyramidal pathways. junction Choose the most likely diagnosis: 66 Which of the following will manifest as "pachymeningitis Subdural Epidural Subarachnoi Brain hemorrhagica interna"? hematoma hematoma d infraction haemorrhag e 67 A 12-year-old patient was admitted to the clinic with a high Antiedema Anticoagulant Antibiotics Anticonvuls Antiretro body temporeatura of 39.5 g, headache, vomiting, s ants viral consciousness of 10 points on the Glasgow Coma Scale, drugs 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, vomiting, Liquor analysis MRI Urinanalysis EEG Blood Glasgow coma scale consciousness of 12 points, occipital analysis muscle rigidity and positive Kernig's symptom, what investigation should be performed? 69 Which nerve is most commonly involved in uncal herniation? IIIrd Vith Ixth XIIth 70 Which is not affected in lesion of posterior column of spinal Temperature Romberg's Vibration Ataxia cord? sense sign sense 71 Brown Séquard syndrome, not involved is Contralateral Ipsilateral Contralatera Ipsilateral posterior column pyramidal l planter tract spinothalam extensor ic 72 A 59-year-old patient gradually develops spastic tetraparesis Amyotrophic Multiple Myasthenia Myasthenic Multiple with 2-sided Babinski's pathologic symptoms, marked muscle lateral sclerosis sclerosis, gravis syndrome sclerosis hypotrophy and ﬁbrillary twitches. Choose the disease that spinal form , should be excluded ﬁrst of all: cerebral form 73 If Wernicke’s area is damaged in the dominant hemisphere, it Irrelevant and No effect on Speech with Incomprehe will result in? rapid speech speech diﬃculty in nsion of articulation written language 74 Dose of methylprednisolone following spine injury: 30mg/kg within 45mg/kg 50mg/kg 60mg/kg 3 hrs of injury within 6 hrs within 9 hrs within 12 of injury of injury hrs of injury 75 Hypotension in Acute Spinal Cord Injury is due to? Loss of Orthostatic Orthostatic loss of Sympathetic tone Hypotension Hypotension parasympar hic tone 76 A 45-year-old patient felt marked weakness in the legs, pain MRI X-ray CT Liquor EEG on the inner surface of the thigh at the moment of weight analysis 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-Barré Peripheral Central Peripheral Central Central syndrome: tetraparesis tetraparesis monoparesi hemiparesis monopa s resis 78 Guillain-Baret polyneuropathy is characterized by an Viruses Bacteria Fungi Trauma Vascular inﬂammatory lesion caused by (choose the correct answer) ischemi a 79 Select the mechanisms underlying the pathogenesis of Vascular Peripheral Lesion of Muscle Lesion diabetic polyneuropathy: damage to nerve spinal cord damage of the peripheral nerves damage roots anterior horn of the spinal cord 80 A 48-year-old patient complains of a sensation of irritation on Extramedullary Intramedullar Spinal cord Epiduritis Multiple the skin of the legs, which began with the feet and over 6 spinal cord tumor y tumor of abscess sclerosis months progressed to the shins, knees thighs. What diagnosis the spinal do you suggest? cord 81 A 68-year-old woman had an elevated t to 38.5, severe Meningitis Subarachnoid Intraventricu Encephalitis Brain headache, photophobia. Meningeal symptom complex was hemorrhage lar tumor detected in an infectious disease hospital and liquor was hemorrhage 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 Cyto Flaccidity paralysis albumen disassociati on 83 Best Treatment of GBS is Plasmapheresis Intravenous Dialysis Vancomycin Steroids 84 Select a symptom NOT characteristic of polyneuropathy: High tendon Peripheral Dpecreased Vegetative Pain reﬂexes paresis of sensitivity disorders in along hands, feet in the distal the distal the parts of the parts of the course limbs limbs of nerves 85 Duchenne muscular dystrophy is an X-linked recessive Boys only Girls only More boys More girls Same disease that most commonly affects: than girls than boys for girls and boys 86 What does the concept of treatment for muscular dystrophy Physical and Thymectomy Immunosup Immunoglo Plasmap include? orthopedic pressants bulin heresis therapy therapy 87 Gene for myotonic dystrophy is coded on chromosome 19 20 21 24 number 88 Duchenne muscular dystrophy is а... Lesion of a Lesion of the Lesion of Lesion of Lesion muscle anterior root the nerve the anterior of the of the spinal horn of the neuromu cord spinal cord scular transmis sion 89 A patient present with unilateral painful ophthalmoplegia. Tolosa-Hunt Cavernous Gradenigo Orbital Imaging revealed an enlargement of cavernous sinus on the syndrome sinus syndrome Pseudotum affected side. The likely diagnosis is: thrombosis or 90 A patient's visual ﬁeld is being tested by confrontation ﬁeld Visual inattention Homonymou Simultanag Somatopara testing,during which you noticed an abnormality. On wiggling s hemianopia nosia phrenia 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 with 9th cranial nerve 8 10 12 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 manifested by facial Trigeminal Oculomotor Facial Accessory Olfactor pain: y 93 A 12-year-old female patient complains of weakness in the Peroneal Ulnar Sciatic Tibial Radial left leg. She is acutely ill, does not know the cause. But she neuropathy neuropathy neuropathy neuropathy nerve notes that before the onset of complaints, she was picking neuropat berries while sitting on her knees. In the neurological status, hy 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 neurological Flaccid Central Central Flaccid Polyneur status revealed the following signs: muscle strength in the left monoparesis monoparesis diparalysis diparesis opathy 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 spilling of ﬂuids Otoscopy CT EEG ENMG MRI 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 weakness Thymoma Retrosternal Hilar Hilar and muscle fatigue which worsened with activity was goiter Lymphaden Lymphaden diagnosed as a case of Myasthenia Gravis. She presented opathy opathy 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 of ongoing Myasthenia GBS Amitriptyline Methysergid double vision which is worse when he is watching TV in the gravis e 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 is impaired Lesion of the Lesion of the Lesion of Lesion of a Lesion in any form of myasthenia? neuromuscular anterior root the nerve muscle of the transmission of the spinal anterior cord horn of the spinal cord 99 A 63-year-old woman with T2DM, hypertension presented to Voltage gated Lambert Paraneoplas Multiple your hospital with complaints of sudden onset right eye calcium channel Eaton tic system ptosis and diplopia, worse at the end of the day. She also had antibodies syndrome cerebellar atrophy history of fatigue, intermittent muscle weakness for the past 1 degeneratio month. Initial investigations were done. A probable diagnosis n 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 myasthenia 12 tablets per day 1 tablets per 24 tablets 48 tablets 50 gravis. She weighs 60 kg. You've prescribed prednisolone in day per day per day tablets tablet form. The dosage is 0.005 g in 1 tablet. Choose the per day correct daily dose. 101 Case of 36-year-old female presents with Diplopia and ptosis, Focal migraine Retinal Migraine Ophthalmop which usually develops after the headache. She had multiple migraine sine legic such attacks in the past. What is your diagnosis? migraine migraine 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 morning hours. What is the most likely Tension-type Trigeminal Tempora diagnosis? Cluster headache headache Migraine neuralgia l arteritis 103 What is drug of choice for acute attack of migraine Sumatriptan Caffeine Amitriptyline Methysergid e 104 Types of migraine: Case of 46-year-old female comes to you Migraine sine Retinal Ophthalmop Focal with history of visual disturbances without headache. She migraine migraine legic migraine also has nausea, vomiting and aura. What is your diagnosis? migraine 105 A 55-year-old woman presents with a dull, bilateral headache that has been gradually worsening over the past 6 months. The headache is constant and typically worsens in the Cervicog morning, and she reports associated symptoms of nausea Tension- enic and visual disturbances. Her medical history includes Temporal type headach hypertension. What is the most likely diagnosis? Brain tumor arteritis headache Migraine e 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. Tension- He also reports restlessness during the attacks. What is the Sinus type Trigeminal Migraine most likely diagnosis? Cluster headache headache headache neuralgia s 107 You are working as a palliative medicine resident in a tertiary Cerebellar Brainstem Craniophary Pineal body institution. A group of children diagnosed with cancers came astrocytoma glioma ngioma tumor to you for follow-up. Which of the following brain tumor has the worst prognosis in children? 108 Medulloblastoma most commonly occurs in the Cerebellum Medulla Cerebral Spinal cord hemisphere 109 A patient with dermatomyositis reports improvement of Continue the Raise dose Start Perform symptoms on steroids for last 6 months. Labs did today same dose of of steroids mycophenol muscle show Creatine kinase of 1300 Units/L. What is the next step steroids ate biopsy 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 Tardive Essential Huntington’s Hemiball diagnosis? Myoclonus dyskinesia tremor disease ismus 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 Parkinson’s Cerebellar Resting likely diagnosis? Essential tremor disease tremor Dystonia tremor 112 A 50-year-old man with a history of diabetes presents with sudden-onset weakness in his right arm and leg. On Amyotrophi examination, he has spasticity, hyperreﬂexia, and a positive Guillain- c lateral Parkinso Babinski sign on the right side. The weakness does not Stroke Multiple Barré sclerosis n’s improve with rest. What is the most likely diagnosis? (hemiparetic) sclerosis syndrome (ALS) disease 113 A 70-year-old woman presents with diﬃculty walking and Progress frequent falls. She has rigidity in her neck and arms, along ive with a shuﬄing gait. There is no tremor. On examination, she supranu has diﬃculty turning in bed and making small, quick steps. Normal pressure Parkinson’s Cerebellar Huntington’s clear What is the most likely diagnosis? hydrocephalus disease ataxia disease palsy 114 A 45-year-old man presents to emergency room with Weakness and Fasciculation' Rigidity Muscle Progressive atrophy and weakness of hands. On further spasticity s atrophy examination he is found to have brisk jaw jerk, Fasciculations, 115 Which drug can you use for acute attack of migraine Sumatriptan Caffeine Amitriptyline Methysergid e 116 Case of 36-year-old female presents with Diplopia and ptosis, Ophthalmoplegic Retinal Migraine Focal which usually develops after the headache. She had multiple migraine migraine sine migraine such attacks in the past. What is your diagnosis? migraine 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 Tension- Sinus headaches are sometimes preceded by visual disturbances, Cluster type Temporal headach such as ﬂashing lights. What is the most likely diagnosis? Migraine headache headache arteritis e 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 Sinus 30 minutes to 2 hours, and typically occur at night. He has a Tension-type Cervicogeni headach history of similar episodes. What is the most likely diagnosis? Cluster headache headache Migraine c headache e 119 A 35-year-old woman presented with complaints of sudden Acute aneurismal Brain stem Acute Meningitis onset headache which she described as a characteristic haemorrhage encephalitis ischemia of 'thunderclap headache'. She has no \signiﬁcant medical mid brain 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 complaints of Acetazolamide Glycerol Mannitol Dexamethas headache associated with nausea & 2episodes of vomiting one 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, Trigemin vomiting, and visual disturbances (auras). The headaches are Tension- al typically triggered by bright lights or strong odors. What is the Cluster Sinus type neuralgi most likely diagnosis? Migraine headache headache headache a 122 A 50-year-old woman experiences recurrent headaches with a sensation of pressure in her face and forehead. She reports Cervicog nasal congestion and facial tenderness. The headaches are enic worse when she bends over. What is the most likely Tension-type Cluster headach diagnosis? Sinus headache headache Migraine headache e 123 A 48-year-old woman has a lower back pain and hypoesthesia A lesion at the Pathology A lesion at Compressio in the left 51 dermatomal distribution (left calf and lateral left right L4-LS where the the right L4- n by the LS foot). What is the most likely cause? interspace nerve exits LS lamina the spinal interspace canal immediately above the pedicle of S3 vertebra 124 Which of the following tests is abnormal in patients with ALS Electromyograph MRI whole CT whole V.E.P (Amyotrophic Lateral Sclerosis)? y spine Spine 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 Sacroiliac Osteoarthriti in her left foot. Physical examination reveals a positive Lumbar disc Spinal joint s of the Fibromy straight leg raise test. What is the most likely diagnosis? herniation stenosis dysfunction spine algia 126 A 46-year-old woman presented with a 25-year history of Medial temporal. Lennox Rolandic Epilepsia epilepsy. She had a history of focal impaired awareness with lobe epilepsy Gastaut epilepsy Partialis cognitive changes and behavioral arrest progressing to syndrome Continua 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 develop long- 5 10 15 20 term epilepsy? 128 Commonest presentation of neurocysticercosis is Seizures Focal Dementia Radiculopat neurological hy 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 Hysteric region on the right side. MRI of the brain shows no Epileptic Ischemic Hemorrhagi al abnormalities. What happened to the patient after the seizure? Todd's palsy seizure stroke c stroke 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 Electroencephalo CT of the Electroneuro MRI of the Lumbar for about an hour. What investigation should be performed? graphy brain myography brain puncture 131 A 64-year-old, male unconscious patient was brought in with Brain stem lesion Cerebellar Thalamic Internal a history of high-grade fever. The attender recalls history of lesion lesions capsule double vision, dysphagia, and unsteady gait in the patient. lesio 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 Periodic meetings or while watching TV. He also describes vivid limb dreams and muscle weakness in his legs during these moveme episodes, especially after laughing or during emotional stress. Restless leg nt What is the most likely diagnosis? Narcolepsy Insomnia Sleep apnea syndrome disorder 133 A 60-year-old male diabetic and hypertensive patient was Check blood Order CT Give Immediately found unconscious in the morning. On examination pulse rate glucose scan intravenous reduce BP is 120/min, BP=160/100 mm Hg. What is the next step to be mannitol with anti- done for management? hypertensiv es 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 REM interrupted by frequent nocturnal awakenings. She has a sleep history of depression and often worries about her sleep Obstructive Sleepwalkin behavior patterns. What is the most likely diagnosis? Insomnia sleep apnea Narcolepsy g disorder 135 The most common cause of subarachnoid haemorrhage is Hypertension Cavernous Aneurysm Arterio- angioma venous malformatio n 136 Which of the following will manifest as "pachymeningitis Subdural Epidural Subarachnoi Brain hemorrhagica interna"? hematoma hematoma d infraction 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 Cerebell scan of the brain reveals an intracerebral hemorrhage in the Hypertensive Embolic Subarachnoi Transient ar right frontal lobe. What is the most likely cause of this intracerebral ischemic d ischemic infarctio patient's condition? hemorrhage stroke hemorrhage attack (TIA) n 138 Right-sided A 60-year-old man presents with sudden-onset left-sided ischemic weakness and diﬃculty understanding speech. He reports stroke in that the symptoms started about 45 minutes ago. He has a Left-sided the anterior history of smoking and hyperlipidemia. On examination, he ischemic stroke cerebral has left-sided hemiparesis and Wernicke's aphasia. A CT scan in the middle Transient artery of the brain shows no acute hemorrhage. What is the most cerebral artery Subarachnoid ischemic (ACA) Multiple likely diagnosis? (MCA) territory hemorrhage attack (TIA) territory 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 Severe consciousness on the Glasgow Coma Scale is a score of 13. Moderate head Superﬁcial Mild head No head head What kind of head trauma did the man suffer? trauma head trauma trauma trauma 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 painful stimulus, is 11 9 7 13 confused and localizes to pain. What is the Glasgow coma score 142 Cortical blindness is seen in lesion of which lobe? Occipital Parietal Frontal Temporal 143 Which of the following statement is false with respect to Involves More Multiple Multiple demyelinating disorders? biochemical common in sclerosis is Sclerosis is abnormality of females an most myelin autoimmune common disease of type of the central demyelinati nervous ng disorder system 144 A 40yr old male presented with altered mental status, Urgent parenteral Placement of Lumbar Craniotomy seizures, and vomiting. He has no h/o fever, neck stiffness. antibiotics ICP monitor puncture 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 trunk to the Optic neuritis in Incomplete Length of Frequency distal extremities was diagnosed with multiple sclerosis. He the ﬁrst 2 years recovery intervals of relapses was started with glucocorticoids with some improvement in from relapses between his symptoms. Which one of the following is not predictive of relapses long-term disability in such patients? 146 A patient has had recurrent optic neuritis bilaterally with Neuromyelitis Subacute Post Neuro- transverse myelitis. Visual acuity in right eye is 6/60 and left Optica combined cerebral syphilis eye is 6/18. Patient showed a 50°'1 response to steroids. degeneration artery stroke Diagnosis is? of spinal cord (SACD) 147 A 38-year-old woman with sensory disturbances, muscle Patient is Death of Patient is Patient weakness & visual disturbances was diagnosed with Multiple bedridden, can patient due bedridden, walks Sclerosis recently. The physician is evaluating her talk, can drink to multiple can't talk, normally, neurological status with Expanded disability severity score sclerosis can’t drink shows no (EDSS). What does a score of 9 in EDSS signify? disability 148 A 78-year-old female is diagnosed with Alzheimer's disease Antipsyc and experiences occasional aggression and agitation. What is Family education Cognitive- hotic the most appropriate initial management for these behavioral and behavioral Cholinesteras behavioral Antidepress medicati symptoms? interventions e inhibitors therapy ants on 149 Refer for cognitiv e- A 72-year-old woman with Alzheimer's disease begins to Provide Start a Initiate an behavior show signs of paranoia and delusions. What is the most Administer family cholinestera antidepress al appropriate intervention for these symptoms? antipsychotics counseling se inhibitor ant therapy 150 Selective A 70-year-old female with AlA 70-year-old female with serotonin Alzheimer’s disease is found to have signiﬁcantly reduced reuptake NMDA Dopami levels of acetylcholine in the brain. Which of the following Cholinesterase inhibitors receptor Benzodiaze ne drug classes would likely be most effective in this patient? inhibitors (SSRIs) antagonists pines 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 Visuospatial Executive her case? ability function Attention Language Memory 152 Start A 67-year-old man with a family history of Alzheimer’s Begin Perform cholines disease has been diagnosed with mild cognitive impairment. antipsychoti genetic terase He expresses concern about developing Alzheimer's. What Recommend Perform c testing for inhibitor would be the most appropriate next step? lifestyle changes neuroimaging medication APOE s 153 29 yrs male was brought to OPD by his wife giving history of Frontal lobe Occipital Temporal Parietal 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 homonymou s Focal symptom characteristic of right middle cerebral artery Left-sided Right-sided hemianopsi Nystag occlusion: hemiparesis hemiparesis a Ataxia mus 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 Right Right left upper extremity, facial asymmetry (lowering of the left Left posterior posterior middle corner of the mouth). Select the vascular basin most likely to Right middle cerebral cerebral cerebral Basic be affected: cerebral artery artery artery artery artery 156 A 28-year-old woman presented with headaches and diﬃculty Posterior Tuberothala. Recurrent Lenticulostri with gait. The physical examination was notable for bilateral choroidal arteries mic artery artery of ate artery papilledema. Sagittal MRI showed the lesion located in the Heubner 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 calculations, which Parietal lobe Frontal lobe Temporale Occipital part of his brain is damaged? lobe lobe 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 Glial following ﬁndings is most likely to be present in her brain Tau tangles and Huntington Prion cell tissue? amyloid plaques Lewy bodies inclusions plaques tumors 159 A 47yrs old female c/o headache, changes in vision, seizures Surgical excision Chemotherap Cerebral Preoperative from past 2yrs. Now she has developed weakness rt. side of y with angiography radiation body. A CT scan was being ordered by the physician which Adriamycin with tumor therapy showed well circumscribed mass abutting the skull in left embolizatio followed by hemisphere. On contrast enhanced MRI shows -What is the n surgical next step in management of this patient? excision 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 Amyotro examination, she appears disheveled and is unaware of the phic time or place. Which of the following is the most likely Alzheimer's Frontotempor Parkinson's Huntington's lateral diagnosis? disease al dementia disease disease sclerosis 161 Immunoglo Antiretro Immunosuppress Plasmapher bulin viral What treatments are not used for myasthenia gravis? ants Thymectomy esis therapy therapy 162 A 13-year-old adolescent has been diagnosed with structural Finlepsin Depakine Levetiraceta Phenobarbit Diazepa epilepsy, focal tonic-clonic seizures, and Todd's palsy. What (Carbamazepine) (Convulex) m (Keppra) al (Luminal m type of medication should be offered to the patient? (Relaniu m) 163 All are clinical features of myasthenia gravis, EXCEPT Absent deep Spontaneus Proximal Worsen by tendon reﬂexes remission muscle exertion involvement 164 A 38-year-old woman with sensory disturbances, muscle Patient is Death of Patient is Patient weakness & visual disturbances was diagnosed with Multiple bedridden, can patient due bedridden, walks Sclerosis recently. The physician is evaluating her talk, can drink to multiple can't talk, normally, neurological status with Expanded disability severity score sclerosis can’t drink shows no (EDSS). What does a score of 9 in EDSS signify? disability 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 Herniati on of Inﬂammatio the Occlusive n of intervert This condition is the primary indication for a cerebrospinal intracranial cerebral Ischemic ebral ﬂuid study (choose one condition): Brain tumor hypertension membranes stroke disk 168 In case of muscular dystrophy it is necessary to examine the Tissue biopsy CT EEG ENMG MRI patient using the method 169 Which of the following is not a feature of conus medullaris Knee reﬂex Ankle reﬂex Bladder / Root syndrome? Absent Absent bowel Early involved S3, & marked S4, S5 170 Which of the following tests is abnormal in patients with ALS Electromyograph MRI whole CT whole V.E.P (Amyotrophic Lateral Sclerosis)? y spine Spine 171 If Broun-Sekar syndrome is detected, a neuroimaging study of the following section of the neural system should be Peripheral performed: Spinal cord Cerebellum Brain nerves Muscles 172 A 5O-year-old woman complains of clumsiness in her hands Syringomyelia Subacute ALS Tabes while working in the kitchen. She recently burned her hands combined dorsalis on the stove without experiencing any pain. Neurologic degeneration 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 over the neck. Neuro-syphilis An Amyotrophic A.I.D.P On examination decreased pain and temperature sensation is intramedullar lateral found in the distribution of C4, CS. Scalp sensation, cranial y tumor sclerosis 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 clumsiness in her hands Syringomyelia Subacute ALS Tabes while working in the kitchen. She recently burned her hands combined dorsalis on the stove without experiencing any pain. Neurologic degeneration 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 except lpsilateral Decorticate Cheyne lpsilateral hemiplegia rigidity stokes dilated respiration pupils 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 paralysis. 6 months after the illness, the paralysis had not recovered and she needed supportive Whooping devices. What infectious disease did she have? Polio Diphtheria Tetanus cough Measles 177 Which of the following is not a Channelopathy Tay Sachs Periodic Cystic Liddle disease paralysis ﬁbrosis syndrome 178 A 60 yr old woman presents with tingling, numbness, and ALS lpsilateral Cheyne Polyneuropa weakness of extremities for the past year. she also noted and hemiplegia stokes thy lack of bowel control. What is the most likely diagnosis? respiration 179 Guillain-Baret polyneuropathy is characterized by impairment of the following nervous system functions (choose one Coordin correct answer) Motor Protective Temperature Sensory ator 180 Cranial Disorder of Bilateral Nerve nerve Select the symptoms characteristic of Guillain-Baret Lesions of all pelvic pyramidal involvement involve polyneuropathy nerves functions symptoms in one limb ment 181 A 52-year-old woman has been suffering from type II diabetes mellitus for 10 years; she complains of severe itching and Acute pain in the right foot. On examination: the joints of the feet demyelinati Guillain- Diphther are deformed, the skin on the feet is thin, Achilles reﬂexes are Alcoholic ng Baret ia absent, knee reﬂexes are very low. Hypesthesia in the legs - up Diabetic polyneuropat polyradiculo polyneuropa polyneur to the middle third of the tibia. polyneuropathy hy neuropathy thy opathy 182 Thymectom Antibiotics / Plasmapheresis / Steroids / y/ Immuno Immunoglobu Immunoglob Immunoglo globulin Choose the most likely diagnosis: Immunoglobulins lins ulins bulins s only 183 A child attending a nursery suddenly increased t to 39 C, developed convulsions and confusion. The doctor diagnosed Subarac meningeal symptom complex. In the analysis of the liquor: hnoid turbid, cytosis-820 kl in ml, neutrophils predominate. Choose Bacterial Viral Serous hemorrh the most probable diagnosis: meningitis meningitis meningitis Epiduritis age 184 1000 12 month old child is diagnosed with meningitis, calculate the 50 mg per 100 mg per 500 mg per mg per daily dose of ceftriaxone for the patient: 10 mg per day day day day day 185 Which of the following drugs can cause muscle weakness? All of the above Zidovudine Chloropine Statin 186 A 65-year-old, male with hypertension develops sudden onset Abducens nerve Trochlear Trigeminal Facial nerve 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 Transfer Reducing A sharp A sharp an excessive from the their number decrease in decrease dose of mother the number in the acetylcholinester through the of number ase inhibitors placental functioning of

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