NEURO EXAM MASTER ACTUAL QUESTIONS AND
ANSWERS |100% CORRECT |2026 UPDATE |ALREADY
GRADED A+
A 69-year-old woman suffered a massive stroke 6 weeks ago. She is now
recovering from the stroke, but she has residual paralysis and sensory impairment
of her right arm. She is also unable to speak and unable to turn her eyes to the
right.
The most likely site of her lesion is in the area that is supplied by what artery? -
ANSWER - L MCA (motor function of RUE and face, sometime RLE, speech, and
vision)
A 48-year-old woman presents after a seizure. Before the seizure, she
experienced confusion, disorientation, and poor coordination preceded by
nausea, dizziness, flushing, and weakness. Symptoms appeared after bird
watching several hours in her garden under the sun. Her medical history is
significant for the presence of schizophrenia, for which she takes chlorpromazine
at bedtime. Her temperature is 41°C, blood pressure 90/59, heart rate 110,
respiratory rate 25; BUN, creatinine, and transaminases are elevated, and there is
leukocytosis and lactic acidosis. There is normal urine myoglobin, PT, and PTT.
Question
What is the most likely diagnosis? - ANSWER - Non-exertional hyperthermia
A 23-year-old woman presents with increasing fatigability and muscle weakness.
On further questioning, she reveals that she has experienced difficulty swallowing
,over the past month, and there have been episodes of double vision as the day
progresses. Several of her professors have expressed concern because she looks
sleepy during the day. A CT of the chest reveals an anterior mediastinal mass.
What is the most likely diagnosis? - ANSWER - Myasthenia Gravis (mediastinal
mass is a thymoma)
A 42-year-old man presents to the emergency department with a severe
headache. He has been getting several of these headaches recently and has tried
all over-the-counter pain relievers and headache medicines with no relief. His
current headache started 15 minutes ago. He describes the pain as located next
to and behind his left eye and "stabbing/excruciating" in nature. He feels like his
left eye tears up profusely with these headaches. He reports he has been healthy
otherwise, with no chronic medical conditions, no history of surgery, no
medications, and no drug allergies. He denies recent stressors that may have
caused his headaches.
On physical exam, the patient appears slightly agitated and appears
uncomfortable. His left eye's conjunctiva is mildly injected, and lacrimation is
noted. His right eye is normal. Cranial nerves II-VII are intact, although the patient
expresses discomfort when the light is shown in hi - ANSWER - Verapamil (CCB's
TOC for prevention of Cluster HA's)
A 12-month-old girl presents with her parents after a 3-day history of intermittent
episodes of strange behavior. A neurologist is consulted because the parents are
concerned she is having some form of seizure activity. Her health history includes
2 episodes of otitis media, but she is otherwise healthy. Her initial vital signs and
physical exam by the emergency room staff are all normal.
Question
What description of the infant's strange behavior would lead the neurologist to
suspect a diagnosis of simple partial seizures? - ANSWER - Eye deviation with
facial twitching that lasts 1-2 minutes (No LOC with simple partial seizure)
,A 40-year-old woman presents with a 7-day history of pain in her right arm. The
patient denies any trauma or injury to this extremity just prior to the pain
starting, but she admits to having a Colles fracture in this arm about 2 months
ago. She denies any injury to her back, neck, or other components of the
musculoskeletal system prior to the event of pain. She describes the pain as
burning and throbbing with an extremely diffuse and uncomfortable ache
accompanying it. She further states that this limb has become extremely sensitive
to touch and cold; it appears somewhat more swollen than her left arm.
The patient is very upset because she does not know why her arm is so painful
when she has not done anything to it. She is a non-smoker. She does not drink
alcohol, and she exercises 3 times a week. Physical examination of the extremity
reveals a slightly cyanotic hue and generalized pain of the entire right upper ext -
ANSWER - Naprosyn (NSAID)
A 5-month-old male infant presents after a seizure involving all four limbs. His
mother tells you that he was born full term without any complications, and he
was well until 2 days ago when he developed a fever. He vomited multiple times
yesterday and was irritable. He has not had diarrhea or a cough. He was given
antipyretic medication for his fever. He has no known allergies. His immunizations
are up to date. His developmental milestones have been in accordance with his
age. On physical exam, temperature is 102.7°F, pulse is 154/min, BP is 90/50 mm
Hg, RR is 20/min. He is lethargic and pale; there are no focal neurological deficits.
Non-contrast CT of the head is unremarkable. You suspect that he has bacterial
meningitis.
Question
After drawing blood samples for investigations, what is the most appropriate next
step? - ANSWER - LP (and then empiric abx)
A 48-year-old HIV-positive man starts to develop headaches. At first, he attributes
the headaches to stress, but they persist and become worse over the next few
, weeks. He develops nausea and vomiting, and he thinks he has a fever. He starts
to become confused, so he seeks medical attention. On physical examination, his
temperature is 100°F.
Question
What special maneuver of the neurological exam should be performed to support
your diagnosis? - ANSWER - Kernig's Sign (pt has evidence of meningitis caused by
cryptococcus which is an opportunistic infection in IM pts)
A 70-year-old woman is brought to your attention because of a slowly progressive
gait disorder. She has also been experiencing forgetfulness and problems with
micturition. About 1 year ago, she started having weakness and tiredness in her
legs, followed by unsteadiness; her steps became shorter and shorter. She
occasionally forgets where she put things and she has forgotten to turn off the
oven on 2 occasions. Over the last month, she has started experiencing urinary
urgency, the need for frequent urination, and the involuntary leaking of urine. She
is worried about these symptoms.
Question
What is the most likely cause of her urinary problems? - ANSWER - Detrusor
muscle instability (Normal Pressure Hydrocephalus)
An 82-year-old woman presents with her anxious daughter who lives with her.
The daughter has noticed recent "lapses in memory" and feels that her mother
has become forgetful lately. Her lapses in memory usually relate to people's
names and recollection of past events and recent conversations. According to her,
she is otherwise healthy; she takes calcium and vitamin D for osteoporosis, aspirin
for her heart, and vitamin B complex. She has no history of trauma, strokes, or
CNS infections. Her lapses in memory mostly affect short-term memory. She is
able to carry out activities of daily living and is well oriented to time, place, and
person. Her husband passed away 18 months ago, and she sometimes finds it
difficult to sleep when she remembers his death. She feels "lonely" and
"desperate" at times. Her BP is 130/80 mm Hg, and other vitals are normal.
ANSWERS |100% CORRECT |2026 UPDATE |ALREADY
GRADED A+
A 69-year-old woman suffered a massive stroke 6 weeks ago. She is now
recovering from the stroke, but she has residual paralysis and sensory impairment
of her right arm. She is also unable to speak and unable to turn her eyes to the
right.
The most likely site of her lesion is in the area that is supplied by what artery? -
ANSWER - L MCA (motor function of RUE and face, sometime RLE, speech, and
vision)
A 48-year-old woman presents after a seizure. Before the seizure, she
experienced confusion, disorientation, and poor coordination preceded by
nausea, dizziness, flushing, and weakness. Symptoms appeared after bird
watching several hours in her garden under the sun. Her medical history is
significant for the presence of schizophrenia, for which she takes chlorpromazine
at bedtime. Her temperature is 41°C, blood pressure 90/59, heart rate 110,
respiratory rate 25; BUN, creatinine, and transaminases are elevated, and there is
leukocytosis and lactic acidosis. There is normal urine myoglobin, PT, and PTT.
Question
What is the most likely diagnosis? - ANSWER - Non-exertional hyperthermia
A 23-year-old woman presents with increasing fatigability and muscle weakness.
On further questioning, she reveals that she has experienced difficulty swallowing
,over the past month, and there have been episodes of double vision as the day
progresses. Several of her professors have expressed concern because she looks
sleepy during the day. A CT of the chest reveals an anterior mediastinal mass.
What is the most likely diagnosis? - ANSWER - Myasthenia Gravis (mediastinal
mass is a thymoma)
A 42-year-old man presents to the emergency department with a severe
headache. He has been getting several of these headaches recently and has tried
all over-the-counter pain relievers and headache medicines with no relief. His
current headache started 15 minutes ago. He describes the pain as located next
to and behind his left eye and "stabbing/excruciating" in nature. He feels like his
left eye tears up profusely with these headaches. He reports he has been healthy
otherwise, with no chronic medical conditions, no history of surgery, no
medications, and no drug allergies. He denies recent stressors that may have
caused his headaches.
On physical exam, the patient appears slightly agitated and appears
uncomfortable. His left eye's conjunctiva is mildly injected, and lacrimation is
noted. His right eye is normal. Cranial nerves II-VII are intact, although the patient
expresses discomfort when the light is shown in hi - ANSWER - Verapamil (CCB's
TOC for prevention of Cluster HA's)
A 12-month-old girl presents with her parents after a 3-day history of intermittent
episodes of strange behavior. A neurologist is consulted because the parents are
concerned she is having some form of seizure activity. Her health history includes
2 episodes of otitis media, but she is otherwise healthy. Her initial vital signs and
physical exam by the emergency room staff are all normal.
Question
What description of the infant's strange behavior would lead the neurologist to
suspect a diagnosis of simple partial seizures? - ANSWER - Eye deviation with
facial twitching that lasts 1-2 minutes (No LOC with simple partial seizure)
,A 40-year-old woman presents with a 7-day history of pain in her right arm. The
patient denies any trauma or injury to this extremity just prior to the pain
starting, but she admits to having a Colles fracture in this arm about 2 months
ago. She denies any injury to her back, neck, or other components of the
musculoskeletal system prior to the event of pain. She describes the pain as
burning and throbbing with an extremely diffuse and uncomfortable ache
accompanying it. She further states that this limb has become extremely sensitive
to touch and cold; it appears somewhat more swollen than her left arm.
The patient is very upset because she does not know why her arm is so painful
when she has not done anything to it. She is a non-smoker. She does not drink
alcohol, and she exercises 3 times a week. Physical examination of the extremity
reveals a slightly cyanotic hue and generalized pain of the entire right upper ext -
ANSWER - Naprosyn (NSAID)
A 5-month-old male infant presents after a seizure involving all four limbs. His
mother tells you that he was born full term without any complications, and he
was well until 2 days ago when he developed a fever. He vomited multiple times
yesterday and was irritable. He has not had diarrhea or a cough. He was given
antipyretic medication for his fever. He has no known allergies. His immunizations
are up to date. His developmental milestones have been in accordance with his
age. On physical exam, temperature is 102.7°F, pulse is 154/min, BP is 90/50 mm
Hg, RR is 20/min. He is lethargic and pale; there are no focal neurological deficits.
Non-contrast CT of the head is unremarkable. You suspect that he has bacterial
meningitis.
Question
After drawing blood samples for investigations, what is the most appropriate next
step? - ANSWER - LP (and then empiric abx)
A 48-year-old HIV-positive man starts to develop headaches. At first, he attributes
the headaches to stress, but they persist and become worse over the next few
, weeks. He develops nausea and vomiting, and he thinks he has a fever. He starts
to become confused, so he seeks medical attention. On physical examination, his
temperature is 100°F.
Question
What special maneuver of the neurological exam should be performed to support
your diagnosis? - ANSWER - Kernig's Sign (pt has evidence of meningitis caused by
cryptococcus which is an opportunistic infection in IM pts)
A 70-year-old woman is brought to your attention because of a slowly progressive
gait disorder. She has also been experiencing forgetfulness and problems with
micturition. About 1 year ago, she started having weakness and tiredness in her
legs, followed by unsteadiness; her steps became shorter and shorter. She
occasionally forgets where she put things and she has forgotten to turn off the
oven on 2 occasions. Over the last month, she has started experiencing urinary
urgency, the need for frequent urination, and the involuntary leaking of urine. She
is worried about these symptoms.
Question
What is the most likely cause of her urinary problems? - ANSWER - Detrusor
muscle instability (Normal Pressure Hydrocephalus)
An 82-year-old woman presents with her anxious daughter who lives with her.
The daughter has noticed recent "lapses in memory" and feels that her mother
has become forgetful lately. Her lapses in memory usually relate to people's
names and recollection of past events and recent conversations. According to her,
she is otherwise healthy; she takes calcium and vitamin D for osteoporosis, aspirin
for her heart, and vitamin B complex. She has no history of trauma, strokes, or
CNS infections. Her lapses in memory mostly affect short-term memory. She is
able to carry out activities of daily living and is well oriented to time, place, and
person. Her husband passed away 18 months ago, and she sometimes finds it
difficult to sleep when she remembers his death. She feels "lonely" and
"desperate" at times. Her BP is 130/80 mm Hg, and other vitals are normal.
