Monday, 2 November 2015

Neurology Objective Type Questions And Answers

16- A 25-year-old woman presents with a severe migraine. Which of the following is not a recognised feature of migraine?
1) Some symptoms improved by tricyclic antidepressants
2) Third nerve palsy
3) External opthalmoplegia
4) bilateral fortification spectra
5) precipitation by oral contraceptives

17- A 48-year-old female patient develops an acute, severe and isolated right C6 radiculopathy affecting both the motor and sensory roots. She is examined in an EMG clinic 3 weeks after the onset of symptoms. Which of the following statements is true?
1) Absent sensory nerve potentials would be expected on examination of the thumb and index finger on the right.
2) A repeat examination 12 months later is likely to reveal rapidly recruited low amplitude short duration motor units in the clinically involved muscle on EMG.
3) Fibrillation potentials would be expected in the right brachioradialis and abductor pollicus brevis.
4) Triceps tendon jerk is likely to be depressed or absent.
5) Voluntary motor unit activity may be absent in the right biceps.

18 - A 15 year old boy presents with tremor of both hands. Over the previous months he has eveloped a mild dysarthria. He has a history of behavioural problems, of a depressive/psychotic nature. The most likely diagnosis is:
1) Alzheimer's disease
2) Huntington's disease
3) Neuroacanthocytosis
4) variant Creutzfeldt-Jakob disease
5) Wilson's disease

19- A 24 year old female presents with vague frontal headaches and visual disturbance. She has a past history of acne for which she is receiving treatment. Examination reveals her to be obese with a blood pressure of 110/70 mmHg. There is absence of the central retinal vein pulsation on fundoscopic examination. Which of the following drugs account for these findings?
1) Isotretinoin
2) Ampicillin
3) Topical tetracycline
4) Dianette
5) Erythromycin

20- Which of the following is true of human neurons?
1) myelin sheaths extend across the nodes of Ranvier.
2) unmyelinated fibres have faster conduction.
3) sodium ion influx occurs during the action potential.
4) the action potential increases with increased stimulation.
5) increased extracellular calcium leads to increased neuronal excitability.

21- A 34 year old male presents with back-pain and weakness. Which of the following would support a diagnosis of prolapsed intervertebral disc?
1) bilateral symmetrical nerve involvement
2) Loss of sensation over the left outer upper thigh
3) no evidence of nerve compression
4) pain which is worse on resting
5) pain which is unremitting in character

22- The anticonvulsant Levetiracetecam
1) Is used as monotherapy for the treatment of generalised convulsions
2) Acts via the GABA receptor
3) Is associated with induction of hepatic cytochrome p450 enzymes
4) Is well absorbed via the oral route
5) Is associated with increased plasma concentrations of sodium valproate

23- Following factors decrease large intestinal motility:
1) Parasympathetic activity
2) Anticholinergic agents
3) Gastric Distension
5) Laxatives.

24- A 72 year old female presents with general slowness. Examination reveals a tremor of the hands. What frequency of tremor would you suspect in Parkinson's disease?
1) 1 Hz
2) 2 Hz
3) 5 Hz
4) 8 Hz
5) 10 Hz

25- Which statement is true regarding Gabapentin?
1) is a potent hepatic enzyme inducer
2) side effects typically include visual field defects with long-term use
3) therapy is best monitored through measuring plasma concentrations
4) is of particular value as monotherapy in absence attacks (petit mal)
5) requires dose adjustment in renal disease

26- A 62-year-old man presented with difficult walking. He had a past history of diabetes mellitus and cervical spondylosis, which had required surgical decompression eight years previously. He drank 40 units of alcohol weekly. On examination there was fasciculation, wasting and weakness in the left deltoid and biceps, with weakness in the shoulder girdle muscles bilaterally. There was fasciculation in the glutei and quadriceps bilaterally, weakness of hip flexion and foot dorsiflexion,
brisk reflexes in upper and lower limbs, and extensor plantar responses. There was no sensory impairment.What is the diagnosis?
1) alcoholic myopathy
2) diabetic amyotrophy
3) motor neurone disease
4) recurrent cervical cord compression
5) syringomyelia

27- Which of the following is least likely to cause choreiform movements?
1) polyarteritis nodosa
2) polycythaemia rubra vera
3) Rheumatic fever
4) systemic lupus erythematosus
5) thyrotoxicosis

28- A 24-year-old man presents with a five month history of low back pain, radiating to his buttocks, and back stiffness worse in the morning and worse after periods of inactivity. Which of the following signs is the most likely to be present?
1) exaggerated lumbar lordosis
2) positive femoral stretch test
3) positive Trendelenburg test
4) restricted straight leg raising
5) sacroiliac joint tenderness

29- A previously well 27-year-old woman presents with a history of transient ischaemic attack affecting her right side and speech. She had returned to the United Kingdom from a holiday in New Zealand two days previously. On examination there was nothing abnormal to find. An ECG, chest X-ray, CT brain scan and routine haematology and biochemistry were all normal. What is the most likely underlying abnormality?
1) atrial myxoma
2) carotid artery stenosis
3) embolus from paroxysmal atrial fibrillation
4) patent foramen ovale
5) subarachnoid haemorrhage

30- Which of the following factors is the most likely to account for this problem?
1) altered volume of distribution
2) delayed gastric emptying
3) first pass metabolism
4) hepatic enzyme induction
5) reduced gut blood flow

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