Monday, 2 November 2015

148 Top Neurology Objective Type Questions And Answers

1- A 23-year-old man presents with visual loss in the right eye, diagnosed as optic neuritis.
Which one of the following statements would be seen in an afferent pupillary defect?
1) accommodation response is unaffected
2) hypersensitive response to pilocarpine in the affected eye
3) irregular pupil of the affected eye
4) pupil of affected eye larger than the unaffected eye
5) pupil of affected eye smaller than the unaffected eye

2- A 75-year-old man presents with 12 months history of cognitive impairment, parkinsonism, intermittent confusion and generalised myoclonus. He was started on 62.5 tds of sinemet. In the following 2 months he was started experiencing visual hallucinations. The most likely diagnosis is:
1) Idiopathic Parkinson's disease
2) Alzheimer's disease
3) Diffuse Lewy body disease
4) Multiple system atrophy
5) Progressive supranuclear palsy

3-Which visual field defect is most likely to occur with multiple sclerosis?
1) bitemporal hemianopia
2) central scotoma
3) homonymous hemianopia
4) increased blind spot
5) tunnel vision

4- Which is true of herpes simplex encephalitis?
1) brain MRI is characteristically normal
2) fits are uncommon
3) genital herpes is usually present
4) temporal lobe involvement is common
5) viral identification using polymerase chain reaction on CSF is non-specific

5- Which of the following investigations best supports a diagnosis of new variant CJD:
1) CSF analysis
2) CT brain
3) EEG
4) EMG
5) MRI brain

6- Which of the following is a recognised cause of a phrenic nerve palsy?
1) Aortic aneurysm
2) Dermoid
3) Ganglioneuroma
4) Pericardial cyst
5) Sarcoidosis

7- A 33 year old epileptic female presents with visual problems. Examination reveals a constriction of visual fields to confrontation. Which of the following may be responsible for her visual deterioration?
1) Vigabatrin
2) Lamotrigine
3) Gabapentin
4) Phenytoin
5) Sodium Valproate

8- A 19 year old girl presents at the antenatal clinic. She is approximately six weeks pregnant and the pregnancy was unplanned. She has a two year history of grand mal epilepsy for which she takes carbamazepine. She has had no fits for approximately six months. She wants to continue with her pregnancy if it is safe to do so. She is worried about her anticonvulsant therapy and the effects on the baby and enquires how she should be managed?
1) Advise termination due to drug teratogenicity
2) Continue with carbamazepine
3) Stop carbamazepine until the second trimester
4) Switch therapy to phenytoin
5) Switch therapy to sodium valproate

9- A female patient aged 30 has a 5 years history of difficulty getting upstairs and out of a low chair and mild upper limb weakness but no pain. There is no family history. She presented with severe type 2 respiratory failure. EMG showed evidence of myopathy. The most likely diagnosis is:
1) Polymyositis
2) Inclusion body myositis
3) Acid Maltase Deficiency
4) Miller-Fisher Syndrome
5) Lambert-Eaton Myasthenic Syndrome

10- A 75 year-old woman with acute monocular visual loss. Fundoscopy reveals a swollen pale optic disc in the affected eye. What is the mose likely diagnosis?
1) Central retinal vein occlusion.
2) Closed angle glaucoma.
3) Giant cell arteritis.
4) Optic neuritis.
5) Raised intracranial pressure.

11- A 45-year-old man presents with an insidious onset of binocular horizontal diplopia and left sided facial pain. On examination ha has a left abducens nerve palsy and numbness over the maxillary division of the left trigeminal nerve. The most likely anatomical site of his neurological lesion is:
1) Cavernous sinus
2) Petrous apex
3) Superior orbital fissure
4) Cerebellopontine angle
5) Midbrain

12- An adloescent boy presents with unexplained neurological illness.Which one of the following would suggest substance abuse?
1) A history of low self-esteem.
2) A history of social isolation.
3) Deposits around the mouth.
4) A history of family conflict.
5) A history of attention deficit disorder.

13- A 45-year-old woman noticed tinnitus in her left ear which progressed over some weeks to hearing loss in that ear. On physical examination she is found to have a marked decrease in hearing on the left, with Rinne test indicating air conduction better than bone conduction. The other cranial nerves I - VII and IX - XII are intact. A brain MRI scan revealed a solitary, fairly discreet, 3 cm mass located in the region of the left cerebellopontine angle. Which of the following
statements is most appropriate to tell the patient regarding these findings?
1) A test for HIV-1 is likely to be positive
2) Other family members should undergo MR imaging of the brain
3) Remissions and exacerbations are likely to occur in coming years
4) The lesion can be resected with a good prognosis
5) You are unlikely to survive for more than a year

14- A 22-year-old man suffers a deep laceration to the forearm resulting in transection of the median nerve. Following this injury, the nerve will undergo which of the following pathological processes?
1) Chronic inflammation
2) Coagulative necrosis
3) Fibrinoid necrosis
4) Segmental demyelination
5) Wallerian degeneration

15- Which of the following features is characteristic of myasthenia gravis?
1) Diplopia
2) Equal sex incidence
3) Fasciculation
4) Lid lag
5) Loss of pupillary reflexes

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