6- 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?
A. anterior spinal artery occlusion
B. dorsal meningioma
C. multiple sclerosis
D. subacute combined degeneration of the cord
E. tabes dorsalis
Ans: B
7- Which of the following anatomical considerations is correct:
A. optic chiasm lesions characteristically produce a bitemporal hemianopia
B. central scotoma occurs early in papilloedema
C. in cortical blindness pupillary reactions are abnormal
D. optic tract lesions produce an ipsilateral homonymous hemianopia
E. opticokinetic nystagmus is found with bilateral infarction of the parieto-occipital lobes
Ans: A
8- Which of the following would be expected following distal occlusion of the posterior cerebral artery?
A. cerebellar ataxia
B. contralateral hemiplegia
C. dysarthria
D. homonymous hemianopia
E. palatal palsy
Ans: D
9- 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?
A. Absent sensory nerve potentials would be expected on examination of the thumb and index finger on the right.
B. 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.
C. Fibrillation potentials would be expected in the right brachioradialis and abductor pollicus brevis.
D. Triceps tendon jerk is likely to be depressed or absent.
E. Voluntary motor unit activity may be absent in the right biceps.
Ans: A
10- Which of the following anatomical considerations is correct:
A. optic chiasm lesions characteristically produce a bitemporal hemianopia
B. central scotoma occurs early in papilloedema
C. in cortical blindness pupillary reactions are abnormal
D. optic tract lesions produce an ipsilateral homonymous hemianopia
E. opticokinetic nystagmus is found with bilateral infarction of the parieto-occipital lobes
Ans: A
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Investigations were as follows:- haemoglobin 12.0 g/dl MCV 99 fl
What is the most likely diagnosis?
A. anterior spinal artery occlusion
B. dorsal meningioma
C. multiple sclerosis
D. subacute combined degeneration of the cord
E. tabes dorsalis
Ans: B
7- Which of the following anatomical considerations is correct:
A. optic chiasm lesions characteristically produce a bitemporal hemianopia
B. central scotoma occurs early in papilloedema
C. in cortical blindness pupillary reactions are abnormal
D. optic tract lesions produce an ipsilateral homonymous hemianopia
E. opticokinetic nystagmus is found with bilateral infarction of the parieto-occipital lobes
Ans: A
8- Which of the following would be expected following distal occlusion of the posterior cerebral artery?
A. cerebellar ataxia
B. contralateral hemiplegia
C. dysarthria
D. homonymous hemianopia
E. palatal palsy
Ans: D
9- 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?
A. Absent sensory nerve potentials would be expected on examination of the thumb and index finger on the right.
B. 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.
C. Fibrillation potentials would be expected in the right brachioradialis and abductor pollicus brevis.
D. Triceps tendon jerk is likely to be depressed or absent.
E. Voluntary motor unit activity may be absent in the right biceps.
Ans: A
10- Which of the following anatomical considerations is correct:
A. optic chiasm lesions characteristically produce a bitemporal hemianopia
B. central scotoma occurs early in papilloedema
C. in cortical blindness pupillary reactions are abnormal
D. optic tract lesions produce an ipsilateral homonymous hemianopia
E. opticokinetic nystagmus is found with bilateral infarction of the parieto-occipital lobes
Ans: A
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