Monday, 2 November 2015

Freshers Neurology Multiple Choice Questions And Answers

136- Which of the following would be expected features of a LEFT Posterior cerebral artery occlusion :
1) a right homonymous hemianopia
2) internuclear ophthalmoplegia
3) Wernicke's aphasia
4) pure aphasia (i.e. without alexia)
5) decerebrate state

137- A 70-year-old woman has a history of dyspnoea and palpitations for six months. An ECG at that time showed atrial fibrillation. She was given digoxin, diuretics and aspirin. She now presents with two short-lived episodes of altered sensation in the left face, left arm and leg. There is poor coordination of the left hand. ECHO was normal as was a CT head scan.
What is the most appropriate next step in management?
1) anticoagulation
2) carotid endarterectomy
3) clopidogrel
4) corticosteroid treatment
5) no action

138- A patient presented with a quadrantic hemianopia. Which of the following conditions is most likeley to cause such a presentation?
1) a lesion of the occipital cortex
2) a lesion of the optic chiasma
3) bilateral diabetic retinopathy
4) chloroquine poisoning
5) tobacco amblyopia

139- A 57-year-old man develops deep venous thrombosis during a hospitalization for prostatectomy. He exhibits decreased mental status with right hemiplegia, and a CT scan of the head suggests an acute cerebral infarction in the distribution of the left middle cerebral artery. A chest X-ray reveals cardiac enlargement and prominence of the main pulmonary arteries that suggests pulmonary hypertension. His serum troponin I is <0.4 ng/mL. Which of the following lesions is most likely to
be present on echocardiography?
1) Coarctation of the aorta
2) Dextrocardia
3) Pulmonary stenosis
4) Tetralogy of Fallot
5) Ventricular septal defect

140- A 55-year-old woman has had worsening shortness of breath for several years. She now has to sleep sitting up on two pillows. She has difficulty swallowing. There is no history of chest pain. She is afebrile. Recently, she suffered a stroke with left hemiparesis. A chest X-ray reveals a near-normal left ventricular size with a prominent left atrial border. Which of the following conditions is most likely to account for these findings?
1) Aortic coarctation
2) Cardiomyopathy
3) Essential hypertension
4) Left renal artery stenosis
5) Mitral valve stenosis

141- 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

142- 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

143- Which of the following would be expected features of a LEFT Posterior cerebral artery occlusion :
1) a right homonymous hemianopia
2) internuclear ophthalmoplegia
3) Wernicke's aphasia
4) pure aphasia (i.e. without alexia)
5) decerebrate state

144- Regarding pseudotumours cerebri (benign hypercranial hypertension) which is true?
1) A mildly increased CSF cell count is typical.
2) May be caused by prolonged steriod therapy.
3) Is occasionally associated with focal neurological signs.
4) Frequently presents with ataxia.
5) Is distinguished from hydrocephalus by the absence of suture separation.

145- 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

146- A complete unilateral facial hemiparesis may be caused by which of the following?
1) An intracranial tumour
2) Birth injury
3) Cerebellar atrophy
4) Myasthenia gravis
5) Phenothiazine toxicity

147-A 65-year-old male presents with bilateral leg pain. There is no relevant past medical history, and no excess alcohol use. Both knee reflexes are reduced. Fasting glucose is 6.5 mmol/L. Which is the next most likely investigation to confirm the diagnosis?
1) B12 and folate
2) Chest X-ray
3) CSF examination
4) MRI spine
5) Oral glucose tolerance test

148-A 45-year-old man presents with headaches and low libido. He is found to be hypopituitary. The CT scan shows a pituitary tumour with suprasellar extension. Which of the following structures is likely to be compressed?
1) Abducens nerve
2) Hypothalamus
3) Occulomotor nerve
4) 3rd Ventricle
5) Optic nerve

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