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Neurology – Question & Answer Summary
A nurse is assessing a patient with myasthenia gravis who is experiencing a crisis. Which
symptom differentiates a myasthenic crisis from a cholinergic crisis?
a. Muscle fasciculations
b. Severe muscle weakness
c. Respiratory distress
d. Ptosis
✔️ Correct Answer: A
Rationale:
Muscle fasciculations are characteristic of a cholinergic crisis, which results from
excessive acetylcholine at the neuromuscular junction due to overmedication with
cholinesterase inhibitors. In a myasthenic crisis, the patient experiences severe muscle
weakness without fasciculations. Option A is correct. Severe muscle weakness, respiratory
distress, and ptosis can occur in both types of crises, making fasciculations the
distinguishing feature.
A patient has suffered a subarachnoid hemorrhage. Which medication should be
administered to prevent vasospasm?
a. Nimodipine
b. Nifedipine
c. Verapamil
d. Diltiazem
✔️ Correct Answer: A
Rationale:
Nimodipine is a calcium channel blocker specifically indicated to prevent cerebral
vasospasm following subarachnoid hemorrhage. It improves neurological outcomes by
reducing the severity of vasospasm. Option A is correct. Nifedipine, verapamil, and
diltiazem are calcium channel blockers but are not specifically indicated for this purpose.
,A patient presents with forehead trauma and exhibits arm weakness greater than leg
weakness. This clinical picture suggests which type of spinal cord injury?
a. Central cord syndrome
b. Anterior cord syndrome
c. Brown-Séquard syndrome
d. Cauda equina syndrome
✔️ Correct Answer: A
Rationale:
Central cord syndrome typically results from hyperextension injuries and presents with
greater motor weakness in the upper extremities compared to the lower extremities,
often with varying degrees of sensory loss. Option A is correct. Anterior cord syndrome
affects motor and pain/temperature sensation below the lesion. Brown-Séquard
syndrome is a hemisection injury. Cauda equina syndrome affects the lumbosacral nerve
roots.
A patient sustains a head injury, and a CT scan reveals a lens-shaped hyperdensity. This
finding is most consistent with which diagnosis?
a. Epidural hematoma
b. Subdural hematoma
c. Subarachnoid hemorrhage
d. Intracerebral hemorrhage
✔️ Correct Answer: A
Rationale:
An epidural hematoma typically appears as a biconvex (lens-shaped) hyperdensity on CT
scan, often associated with a skull fracture and middle meningeal artery injury. Option A
is correct. Subdural hematomas appear crescent-shaped, subarachnoid hemorrhage
appears as blood in the sulci/fissures, and intracerebral hemorrhage appears as a
hyperdense area within the brain parenchyma.
,What is the most common cause of non-traumatic altered consciousness in infants?
a. Infection
b. Seizure disorder
c. Metabolic disorder
d. Trauma
✔️ Correct Answer: A
Rationale:
Infection, particularly meningitis or encephalitis, is the most common cause of non-
traumatic altered consciousness in infants. Option A is correct. Seizure disorders,
metabolic disorders, and trauma are less common causes in this population.
What is the underlying pathophysiology in myasthenia gravis?
a. Antibodies against acetylcholine receptors
b. Demyelination of peripheral nerves
c. Degeneration of motor neurons
d. Impaired neurotransmitter release
✔️ Correct Answer: A
Rationale:
Myasthenia gravis is an autoimmune disorder caused by antibodies directed against
nicotinic acetylcholine receptors at the neuromuscular junction, leading to reduced
receptor function and fatigable muscle weakness. Option A is correct. Demyelination is
seen in Guillain-Barré and multiple sclerosis, motor neuron degeneration in ALS, and
impaired neurotransmitter release in Lambert-Eaton syndrome.
A patient with HIV presents with ring-enhancing brain lesions. What is the most likely
diagnosis?
a. Toxoplasma encephalitis
b. Primary CNS lymphoma
c. Progressive multifocal leukoencephalopathy
d. Tuberculoma
, ✔️ Correct Answer: A
Rationale:
Toxoplasma encephalitis is the most common cause of ring-enhancing brain lesions in
HIV patients with low CD4 counts. Option A is correct. Primary CNS lymphoma and
tuberculoma can also present with ring-enhancing lesions but are less common.
Progressive multifocal leukoencephalopathy typically presents with non-enhancing white
matter lesions.
A patient presents with acute unilateral facial weakness without fever. This presentation
is most consistent with:
a. Bell's palsy
b. Stroke
c. Ramsay Hunt syndrome
d. Lyme disease
✔️ Correct Answer: A
Rationale:
Bell's palsy is an idiopathic, acute, unilateral facial nerve paralysis that typically presents
without fever or other systemic symptoms. Option A is correct. Stroke may cause facial
weakness but usually with other neurological deficits. Ramsay Hunt syndrome presents
with facial weakness and a vesicular rash in the ear. Lyme disease may cause facial palsy
but is typically associated with other symptoms and exposure history.
Which cerebrospinal fluid (CSF) finding is characteristic of Guillain-Barré syndrome?
a. Elevated protein with normal cell count
b. Elevated protein with elevated cell count
c. Normal protein with elevated cell count
d. Low glucose with elevated protein
✔️ Correct Answer: A
Rationale:
Guillain-Barré syndrome is characterized by albuminocytologic dissociation: elevated CSF
protein with a normal white blood cell count. Option A is correct. Elevated protein with
Answers & Rationales Approved For Better Grades
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Neurology – Question & Answer Summary
A nurse is assessing a patient with myasthenia gravis who is experiencing a crisis. Which
symptom differentiates a myasthenic crisis from a cholinergic crisis?
a. Muscle fasciculations
b. Severe muscle weakness
c. Respiratory distress
d. Ptosis
✔️ Correct Answer: A
Rationale:
Muscle fasciculations are characteristic of a cholinergic crisis, which results from
excessive acetylcholine at the neuromuscular junction due to overmedication with
cholinesterase inhibitors. In a myasthenic crisis, the patient experiences severe muscle
weakness without fasciculations. Option A is correct. Severe muscle weakness, respiratory
distress, and ptosis can occur in both types of crises, making fasciculations the
distinguishing feature.
A patient has suffered a subarachnoid hemorrhage. Which medication should be
administered to prevent vasospasm?
a. Nimodipine
b. Nifedipine
c. Verapamil
d. Diltiazem
✔️ Correct Answer: A
Rationale:
Nimodipine is a calcium channel blocker specifically indicated to prevent cerebral
vasospasm following subarachnoid hemorrhage. It improves neurological outcomes by
reducing the severity of vasospasm. Option A is correct. Nifedipine, verapamil, and
diltiazem are calcium channel blockers but are not specifically indicated for this purpose.
,A patient presents with forehead trauma and exhibits arm weakness greater than leg
weakness. This clinical picture suggests which type of spinal cord injury?
a. Central cord syndrome
b. Anterior cord syndrome
c. Brown-Séquard syndrome
d. Cauda equina syndrome
✔️ Correct Answer: A
Rationale:
Central cord syndrome typically results from hyperextension injuries and presents with
greater motor weakness in the upper extremities compared to the lower extremities,
often with varying degrees of sensory loss. Option A is correct. Anterior cord syndrome
affects motor and pain/temperature sensation below the lesion. Brown-Séquard
syndrome is a hemisection injury. Cauda equina syndrome affects the lumbosacral nerve
roots.
A patient sustains a head injury, and a CT scan reveals a lens-shaped hyperdensity. This
finding is most consistent with which diagnosis?
a. Epidural hematoma
b. Subdural hematoma
c. Subarachnoid hemorrhage
d. Intracerebral hemorrhage
✔️ Correct Answer: A
Rationale:
An epidural hematoma typically appears as a biconvex (lens-shaped) hyperdensity on CT
scan, often associated with a skull fracture and middle meningeal artery injury. Option A
is correct. Subdural hematomas appear crescent-shaped, subarachnoid hemorrhage
appears as blood in the sulci/fissures, and intracerebral hemorrhage appears as a
hyperdense area within the brain parenchyma.
,What is the most common cause of non-traumatic altered consciousness in infants?
a. Infection
b. Seizure disorder
c. Metabolic disorder
d. Trauma
✔️ Correct Answer: A
Rationale:
Infection, particularly meningitis or encephalitis, is the most common cause of non-
traumatic altered consciousness in infants. Option A is correct. Seizure disorders,
metabolic disorders, and trauma are less common causes in this population.
What is the underlying pathophysiology in myasthenia gravis?
a. Antibodies against acetylcholine receptors
b. Demyelination of peripheral nerves
c. Degeneration of motor neurons
d. Impaired neurotransmitter release
✔️ Correct Answer: A
Rationale:
Myasthenia gravis is an autoimmune disorder caused by antibodies directed against
nicotinic acetylcholine receptors at the neuromuscular junction, leading to reduced
receptor function and fatigable muscle weakness. Option A is correct. Demyelination is
seen in Guillain-Barré and multiple sclerosis, motor neuron degeneration in ALS, and
impaired neurotransmitter release in Lambert-Eaton syndrome.
A patient with HIV presents with ring-enhancing brain lesions. What is the most likely
diagnosis?
a. Toxoplasma encephalitis
b. Primary CNS lymphoma
c. Progressive multifocal leukoencephalopathy
d. Tuberculoma
, ✔️ Correct Answer: A
Rationale:
Toxoplasma encephalitis is the most common cause of ring-enhancing brain lesions in
HIV patients with low CD4 counts. Option A is correct. Primary CNS lymphoma and
tuberculoma can also present with ring-enhancing lesions but are less common.
Progressive multifocal leukoencephalopathy typically presents with non-enhancing white
matter lesions.
A patient presents with acute unilateral facial weakness without fever. This presentation
is most consistent with:
a. Bell's palsy
b. Stroke
c. Ramsay Hunt syndrome
d. Lyme disease
✔️ Correct Answer: A
Rationale:
Bell's palsy is an idiopathic, acute, unilateral facial nerve paralysis that typically presents
without fever or other systemic symptoms. Option A is correct. Stroke may cause facial
weakness but usually with other neurological deficits. Ramsay Hunt syndrome presents
with facial weakness and a vesicular rash in the ear. Lyme disease may cause facial palsy
but is typically associated with other symptoms and exposure history.
Which cerebrospinal fluid (CSF) finding is characteristic of Guillain-Barré syndrome?
a. Elevated protein with normal cell count
b. Elevated protein with elevated cell count
c. Normal protein with elevated cell count
d. Low glucose with elevated protein
✔️ Correct Answer: A
Rationale:
Guillain-Barré syndrome is characterized by albuminocytologic dissociation: elevated CSF
protein with a normal white blood cell count. Option A is correct. Elevated protein with
