Monday, 2 November 2015

Best Neurology Objective Type Questions And Answers

46- A lesion of the occipital lobe causes:
1) Acalculia
2) Astereogenesis
3) Constructional apraxia
4) Cortical blindness
5) Visuospatial neglect

47- A 17-year-old man has been diagnosed with schizophrenia 4 weeks ago. He was started on haloperidol. Two weeks later he was found confused and drowsy. On examination he was pyrexial (40.7 C), rigid with blood pressure of 200/100. Which of the following treatment will you initiate?
1) phenytoin
2) diazepam
3) cefuroxime
4) acyclovir
5) dantrolene

48- A 50 year-old male epileptic presents with paraesthesia of hands and feet. He also has unsteadiness when walking. On examination he has Dupytren's contracture in his left hand, a peripheral sensory neuropathy and palpable lymph nodes in his neck and axillae.
Which of the following drugs is the most likely cause of these features?
1) Carbamazepine.
2) Clonazepam
3) Lamotrigine.
4) Phenytoin.
5) Sodium valproate.

49- An 80-year-old woman has a three month history of progressive numbness and unsteadiness of her gait. On examination, there is a mild spastic paraparesis, with brisk knee reflexes, ankle reflexes are present with reinforcement, extensor plantars, sensory loss in the legs with a sensory level at T10, impaired joint position sense in the toes, and loss of vibration sense below the iliac crests.
Investigations were as follows:-
haemoglobin 12.0 g/dl
MCV 99 fl
What is the most likely diagnosis?
1) anterior spinal artery occlusion
2) dorsal meningioma
3) multiple sclerosis
4) subacute combined degeneration of the cord
5) tabes dorsalis

50- A 16 year old girl presented with a three week history of headache and horizontal diplopia on far right lateral gaze. On two separate occasions she noted dimmed vision whilst bending forwards. Over the last year she had gained 12 kilograms in weight. On examination, her weight was 95 kg, and height 162cms. Neurological examination revealed bilateral papilloedema and a partial right sixth cranial nerve palsy. What is the most likely diagnosis?
1) Benign intracranial hypertension.
2) Multiple sclerosis.
3) Pituitary tumour
4) Superior sagittal vein thrombosis.
5) Thyroid eye disease.

51- Which of the following clinical manifestations suggests Guillain Barré Syndrome?
1) Weakness beginning in the arms
2) Asymmetrical involvement of distal muscles
3) Bulbar involvement in about 50% of cases
4) Brisk tendon reflexes
5) Normal CSF protein

52- In herpes simplex encephalitis which of the following statements is correct?
1) brain MRI is characteristically normal
2) temporal lobe involvement is common
3) fits are uncommon
4) cold sores or genital herpes are usually present
5) viral identification by PCR on cerebrospinal fluid is non-specific

53- A 25 year-old lady recently diagnosed with rheumatoid arthritis. She has developed weakness, double vision and tiredness. Examination reveals bilateral weakness of eye abduction, bilateral ptosis, slightly reduced proximal motor power in the limbs, normal reflexes and sensation. What is the diagnosis?
1) Chronic progressive external opthalmoplegia.
2) Guillain-Barre syndrome.
3) Multiple sclerosis.
4) Myasthenia gravis.
5) Polymyositis

54- A 63 year old male is admitted with acute onset unsteadiness of gait, dizziness and dysphagia. Examination revealed a right-sided Horner's syndrome, nystagmus, loss of pain and temperature sensation on the left side of the trunk and in the left arm and leg, and gait ataxia.
What is the most likely diagnosis?
1) leaking posterior communicating artery aneurysm
2) left sided acoustic neuroma
3) posterior inferior cerebellar artery occlusion
4) right sided pontine infarct
5) spontaneous left sided cerebellar haemorrhage

55- Which of the following features are not compatible with the diagnosis of motor neuron disease?
1) Dementia
2) Dysphagia
3) Muscle cramps
4) Neck weakness
5) Optic atrophy

56- A 35-year-old man has wrist drop of his right hand. Examination reveals a small area of sensory loss on the dorsum of the hand. Which of the following nerves is likely to be involved?
1) Median nerve
2) Ulnar nerve
3) Long thoracic nerve
4) Radial nerve
5) T1 nerve root

57- A 92-year-old man was admitted in a confused state. He has a history of immobility due to severe lower back pain. He had been losing weight for three months and had complains of weakness, urinary frequency, thirst, poor urinary stream and constipation. Lumbar spine Xrays show severe osteopenia and collapse of the body of the vertebra at L3.
Investigations show:
haemoglobin 9.6 g/dl
sodium 144 mmol/l
potassium 3.9
urea 10.4
creatinine 120
glucose 8
dip stick urine blood ++, protein +
What is the most important immediate investigation?
1) Chest X-ray
2) MSU
3) prostate specific antigen
4) serum calcium
5) serum protein electrophoresis

58- A 25-year-old old woman presents with 2 hrs of a unilateral temporal headache increasing in severity. The Pain is of a throbbing character and is exacerbated by light. There are no abnormal signs on examination. What is the diagnosis?
1) Acute Subarachnoid haemorrhage.
2) Cluster headache.
3) Intracranial Tumour.
4) Migraine.
5) Tension headaches.

59- 50-year-old old man is admitted to hospital unconsious, and smelling of alcohol. One hour after admission, he becomes suddenly sweaty with a regular tachycardia of 110 bpm and a BP of 100/50. What is the diagnosis?
1) Alcohol withdrawal.
2) Hepatic encephalopathy.
3) Hypoglycaemia.
4) Subdural haematoma.
5) Wernicke's encephalopathy.

60- A 70-year-old man presents with weight loss, lower limb weakness and dry mouth. He has been a heavy smoker. On examination, he looks cachectic; he has proximal lower limb weakness, areflexia (reflexes normalise with repetitive muscle contraction). There is no wasting or fasciculations. Sensory examination is normal. Which of the following blood test is the most likely to confirm the diagnosis?
1) Acetylcholine receptors
2) Voltage gated calcium channels antibodies
3) Anti GM1 antibody
4) Antinuclear antibody
5) Anti Ro/La antibodies

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