Monday, 2 November 2015

Common Neurology Objective Type Questions And Answers

61- 54 year old female is admitted with progressive weakness following a trivial flu-like illness. Which of the following would exclude Guillain-Barre Syndrome as the diagnosis?
1) Autonomic dysfunction
2) Elevated protein on CSF examination
3) Evidence of muscle wasting
4) Ophthalmoplegia
5) Sensory level below D1

62- An 18 year old man presented with a history of a sudden onset of a frontal headache and photophobia. He had neck stiffness and a temperature of 38°C.
Which one of the following findings would suggest a diagnosis of subarachnoid haemorrhage rather than bacterial meningitis?
1) a blood neutrophil leucocytosis
2) a family history of polycystic renal disease
3) a fluctuating conscious level
4) a history of diabetes mellitus
5) a history of opiate abuse

63- A 45-year-old man has a history of progressive weakness for 5 weeks. He had particular difficulty getting out of the bath. On examination there was severe truncal and proximal limb weakness, without wasting or fasciculation. Tendon reflexes, plantar and sensation were all normal. The vital capacity was 1.8L. What is the most likely diagnosis?
1) cervical myelitis
2) Guillain-Barre syndrome
3) polio
4) polymyositis
5) syringiobulbia

64- Which is true regarding cerebral palsy?
1) The incidence is 2 per 100 live births.
2) Visual impairement occurs in 50%.
3) Hearing loss is present in 5%.
4) Epilepsy is present in 40%.
5) Learning impairment is present in 30%.

65- A right carotid artery stenosis could not account for:
1) Contralateral hemiplegia
2) Contralateral hemisensory loss
3) Drop attacks
4) Dysphasia
5) Right amaurosis fugax

66- Which of the following statements about the spinal cord is true?
1) A lesion of the left side of the spinal cord at C5 causes pyramidal weakness of the right leg
2) Centrally placed spinal cord lesions affect joint position sense before other modalities of sensation
3) Conus medullaris lesions characteristically cause mixed upper and lower motor neurone signs in the legs
4) The spinal cord ends at the lower border of the L3 vertebra
5) The spinothalamic tracts are supplied principally by the anterior spinal artery

67- A 50-year-old man presented with 18 months history of parasthesiae of his feet and hands. On examination there is numbness of glove and stocking distribution with generalised hyporeflexia. Nerve conduction studies revealed demyelinative sensory polyneuropathy. Which of the following conditions is the most likely diagnosis?
1) Alcohol abuse
2) Diabetes
3) Chronic inflammatory demyelinating polyneuropathy
4) Vasculitis
5) Vitamin B12 deficiency

68- Which of the following would be the result of a spinal lesion at the level of C8?
1) a reduced brachioradialis reflex
2) inability to abduct the shoulder
3) loss of sensation over the lateral aspect of the arm
4) winging of the scapula
5) weakness of finger flexion

69- Psychiatric illness rather than an organic brain disorder is suggested by:
1) Onset for the first time at the age of 55 years
2) A family history of major psychiatric illness
3) Impaired short term memory
4) No previous history of psychiatric illness
5) Clouding of conciousness

70- A 27 year-old male presents with 3 months of difficulty walking. Examination reveals motor weakness of left leg in a pyramidal distribution with increase in tone. Impaired pinprick sensation of right leg extending into the groin. What is the cause of these signs?
1) A central cauda equina lesion.
2) A cervical spinal cord lesion.
3) A foramen magnum lesion.
4) A left sided thoracic spinal cord lesion.
5) Bilateral cerebral hemisphere lesions.

71- Which of the following relate to Dopa-decarboxylase inhibitors?
1) enhance the effect of levodopa on the substantia nigra
2) reduce the extracerebral complications of L-dopa therapy
3) have anticholinergic activity
4) should not be given in combination with dopamine agonists
5) prevent L-dopa associated dyskinesias

72- Which of the following associations of muscles and nerve supply are NOT true:
1) Triceps and C7
2) Deltoid and C5
3) Gastroenemius and S1
4) Quadriceps and L3
5) Long flexors of fingers and C6

73- Which of the following would be expected following distal occlusion of the posterior cerebral artery?
1) cerebellar ataxia
2) contralateral hemiplegia
3) dysarthria
4) homonymous hemianopia
5) palatal palsy

74- A young teenager presents with fever and headache. He has received oral Amoxycillin for 3 days. Which of the following CSF findings would exclude a partially treated meningitis?
1) Negative gram stain
2) A CSF glucose of 45% of blood glucose
3) A white cell count of 50
4) A negative CSF culture
5) Negative Kernig's Sign

75- A 52 year old man has a slurring of his speech. Examination reveals bilateral partial ptosis and frontal balding, and difficulty releasing his grip after shaking hands. What is the most likely diagnosis?
1) myasthenia gravis
2) Eaton-Lambert syndrome
3) Myotonia dystrophica
4) Duchenne muscular dystrophy
5) Myotonia congenita

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