Monday, 2 November 2015

Latest Neurology Multiple Choice Questions And Answers

106- A 24-year-old man presents with a headache that has been present for nine months. He has headache almost every day, mainly frontal, sometimes with nausea. Current medication includes paracetamol, brufen and codeine with only transient relief of symptoms. He has a history of depression. Examination was normal.
What is the most likely diagnosis?
1) analgesic misuse headache
2) cluster headache
3) frontal brain tumour
4) headache due to depression
5) migraine

107- A 60-year-old man awakens with painless loss of vision of his left eye. Three years earlier he had suffered a similar episode involving the right eye. Visual loss in that eye has been stationary. He does not complain of any systemic symptoms. What is the most likely diagnosis?
1) Optic neuritis
2) Nonarteritic ischaemic optic neuropathy
3) Arteritic ischaemic optic neuropathy
4) Acute angle-closure glaucoma
5) Compressive optic neuropathy

108- A 67-year-old man has drunk 8 units of alcohol a day for most of his adult life. He has worsening symptoms of poor memory, a wide-based gait and urinary incontinence for ten months. What is the most likely diagnosis?
1) HIV encephalitis
2) meningovascular syphilis
3) normal pressure hydrocephalus
4) syringomyelia
5) Wernicke-Korsakoff syndrome

109- A 40 year old male is diagnosed with Dystrophia myotonica. Which one of the following features would be expected in this patient?
1) Autosomal recessive inheritance
2) Cataracts
3) Fasiculations would predominate
4) Progressive external ophthalmoplegia
5) Preserved tendon reflexes despite muscle wasting

110- A 40-year-old man presents with 2 years history of intermittent strictly unilateral headaches. The pain is excruciating severe. It is located around the orbital region. The headache usually lasts 45-60 minutes. It usually appears early hours in the morning. There is associated ptosis and lacrimation on the side of the headache. The most likely diagnosis is:
1) Cluster headaches
2) Migraine
3) Tension type headache
4) Giant cell arteritis
5) Trigeminal neuralgia

111- A 50 year old female presents with a 4 month history of progressive distal sensory loss and weakness. On examination positive neurological findings include moderate proximal and distal weakness of arms and legs, glove and stocking sensory loss and areflexia. Planter responses were mute. The following conditions could give a similar picture:-
1) Guillian-Barre syndrome
2) Chronic inflammatory demyelinating neuropathy(CIDP)
3) Cervical spondylosis
4) Hereditary motor and sensory neuropathy(HMSN)
5) Myasthenia Gravis

112- Which one of the following would support a diagnosis of subacute combined degeneration of the cord rather than multiple sclerosis?
1) absent ankle jerks
2) autonomic symptoms
3) cerebellar signs
4) extensor plantars
5) visual problems

113- A 65-year-old woman has a one month history of malaise, weight loss, right sided pain around the eye and headaches. She has also noticed intermittent diplopia.
Five years previously she had a mastectomy for carcinoma of the breast. On examination, temperature was 37.5°C, there was tenderness of the scalp on the right forehead and temple, and some minor weakness of abduction of the right eye. ESR 55 mm/hour.
What is the most likely diagnosis?
1) thyroid eye disease
2) frontal sinusitis
3) giant cell arteritis
4) meningeal metastastatic disease
5) posterior communicating artery aneurysm

114- A sixty year old male presents with a six month history of a gradually increasing burning sensation in his feet. Examination revealed normal cranial nerves and higher mental function. Normal bulk, tone, power, light touch and pinprick sensation, co-ordination and reflexes in upper and lower limbs. The clinical findings are consistent with:-
1) Large fibre sensory neuropathy
2) Small fibre sensory neuropathy
3) Diabetic Amyotrophy
4) Motor neurone disease
5) Sjogrens syndrome

115-Which of the following anatomical considerations is correct:
1) optic chiasm lesions characteristically produce a bitemporal hemianopia
2) central scotoma occurs early in papilloedema
3) in cortical blindness pupillary reactions are abnormal
4) optic tract lesions produce an ipsilateral homonymous hemianopia
5) opticokinetic nystagmus is found with bilateral infarction of the parieto-occipital lobes

116- A 62 year old male is noted to have a broad-based ataxic gait.This is characteristic of which of the following?
1) A basal ganglia lesion
2) Cerebellar vermis lesion
3) Osteomalacia
4) phenytoin toxicity
5) Right-sided cerebral infarction

117- A lesion of the facial nerve in the internal auditory meatus will NOT affect
1) taste
2) sweating over the cheek
3) lacrimation
4) hearing
5) blinking

118- Which of the following is a form of generalised seizure?
1) Aversive seizures
2) Epilepsia partialis continua
3) Automatisms
4) Lennox Gastaut Syndrome
5) Benign rolandic epilepsy

119- A 21-year-old female presented with a sudden onset of left sided head and neck pain. 24 hours later she presents with sudden onset of right hemiparesis, facial weakness and homonymous hemianopia and left horner's syndrome. A CT brain showed a left middle cerebral artery territory infarction. The most likely diagnosis is:
1) Cardiac embolism
2) Migraine
3) Left Carotid artery dissection
4) Antiphospholipid syndrome
5) Systemic vasculitis

120- A 25 year-old man presents with 24 hours blurred vision in left eye and mild frontal headache. He has a 10 year history of Diabetes Mellitus. Examination reveals a central scotoma. What is the diagnosis?
1) Central retinal artery occlusion.
2) Diabetic retinopathy.
3) Optic neuritis.
4) Pituitary tumour.
5) Migraine.

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