NR 603 WEEK 1 EXAM(ACTUAL EXAM)
WITH CORRECT ACTUAL QUESTIONS AND
CORRECTLY WELL DEFINED ANSWERS
LATEST ALREADY GRADED A+ 2026
A 10-year-old boy is referred to you for being fidgety at
school, though he makes good grades. Prior history is
unremarkable, and there has been no recent illness. The
father had a similar history as a child. While speaking with
the patient, you notice that he clears his throat several
times per minute. Examination is otherwise normal, except
for rapid, nonrhythmic jerking movements of the face, neck,
and shoulders while at rest.
Question
What is true of this patient's case?
Answer Choices
1 Does not have Tourette syndrome due to the absence of
coprolalia
,2 Has a factitious disorder
3 Has a condition that clusters in families
4 Must start a regimen of levodopa
5 Suffers from Sydenham chorea - ANSWERS-Has a condition
that clusters in families
The combination of vocal tics (here, throat clearing) and
motor tics should suggest Gilles de la Tourette (Tourette)
syndrome, which is a common tic disorder that clusters in
families. Once thought to be a single gene, autosomal
dominant condition, it appears that multiple genes and
nongenetic factors may be at play.
Coprolalia is but one of many vocal tics seen in Tourette
syndrome (throat clearing, humming, whistling) and,
although a notorious one, is not a necessary feature.
The positive family history makes it unlikely that the
condition described is factitious.
Pimozide, SSRIs, and other agents have been used in the
treatment of Tourette syndrome, but levodopa is not used.
,The movement disorder of Sydenham chorea, as seen after
a streptococcal infection, is choreiform - that is, tends to be
slower and rhythmic, as opposed to the rapid, nonrhythmic
jerks seen in Tourette syndrome. Also, vocal tics are not
typically seen with Sydenham chorea.
A 28-year-old man presents following a road traffic accident
20 minutes prior. He states that it was just a "minor bump
from behind," but feels he might have whiplash. His neck is
stiff and sore, and he has developed numbness and tingling
on the lateral surface of his right arm extending into his
right fourth and fifth digits. On physical examination, his
bicep strength is +5/5 on the left and +5/5 on the right. His
biceps tendon reflex is 2+ on the left and 2+ on the right. In
addition, his triceps tendon reflex is 2+ on the left and 2+ on
the right. His grip strength on the right is diminished as
compared to the left. The remainder of the physical
examination is normal.
Question
Based on the above presentation, what is the cervical nerve
root most likely affected?
Answer Choices
1 C4
, 2 C5
3 C6
4 C7
5 C8 - ANSWERS-C8
Impingement of C8 may cause numbness and tingling
primarily on the medial surface of the arm and into the
lateral hand into the fourth and fifth digits. It may also
cause dysfunction of the hand as it innervates the small
hand muscles.
Impingement of the C4 nerve root may cause neck and
upper shoulder numbness and pain.
Impingement of C5 nerve root may cause deltoid and
shoulder numbness and pain, and biceps tendon reflex may
be diminished.
Impingement of the C6 nerve root can cause numbness and
tingling down the arm into the thumb, with weakness in the
bicep muscle and diminished brachioradialis tendon reflex
in the affected extremity.
WITH CORRECT ACTUAL QUESTIONS AND
CORRECTLY WELL DEFINED ANSWERS
LATEST ALREADY GRADED A+ 2026
A 10-year-old boy is referred to you for being fidgety at
school, though he makes good grades. Prior history is
unremarkable, and there has been no recent illness. The
father had a similar history as a child. While speaking with
the patient, you notice that he clears his throat several
times per minute. Examination is otherwise normal, except
for rapid, nonrhythmic jerking movements of the face, neck,
and shoulders while at rest.
Question
What is true of this patient's case?
Answer Choices
1 Does not have Tourette syndrome due to the absence of
coprolalia
,2 Has a factitious disorder
3 Has a condition that clusters in families
4 Must start a regimen of levodopa
5 Suffers from Sydenham chorea - ANSWERS-Has a condition
that clusters in families
The combination of vocal tics (here, throat clearing) and
motor tics should suggest Gilles de la Tourette (Tourette)
syndrome, which is a common tic disorder that clusters in
families. Once thought to be a single gene, autosomal
dominant condition, it appears that multiple genes and
nongenetic factors may be at play.
Coprolalia is but one of many vocal tics seen in Tourette
syndrome (throat clearing, humming, whistling) and,
although a notorious one, is not a necessary feature.
The positive family history makes it unlikely that the
condition described is factitious.
Pimozide, SSRIs, and other agents have been used in the
treatment of Tourette syndrome, but levodopa is not used.
,The movement disorder of Sydenham chorea, as seen after
a streptococcal infection, is choreiform - that is, tends to be
slower and rhythmic, as opposed to the rapid, nonrhythmic
jerks seen in Tourette syndrome. Also, vocal tics are not
typically seen with Sydenham chorea.
A 28-year-old man presents following a road traffic accident
20 minutes prior. He states that it was just a "minor bump
from behind," but feels he might have whiplash. His neck is
stiff and sore, and he has developed numbness and tingling
on the lateral surface of his right arm extending into his
right fourth and fifth digits. On physical examination, his
bicep strength is +5/5 on the left and +5/5 on the right. His
biceps tendon reflex is 2+ on the left and 2+ on the right. In
addition, his triceps tendon reflex is 2+ on the left and 2+ on
the right. His grip strength on the right is diminished as
compared to the left. The remainder of the physical
examination is normal.
Question
Based on the above presentation, what is the cervical nerve
root most likely affected?
Answer Choices
1 C4
, 2 C5
3 C6
4 C7
5 C8 - ANSWERS-C8
Impingement of C8 may cause numbness and tingling
primarily on the medial surface of the arm and into the
lateral hand into the fourth and fifth digits. It may also
cause dysfunction of the hand as it innervates the small
hand muscles.
Impingement of the C4 nerve root may cause neck and
upper shoulder numbness and pain.
Impingement of C5 nerve root may cause deltoid and
shoulder numbness and pain, and biceps tendon reflex may
be diminished.
Impingement of the C6 nerve root can cause numbness and
tingling down the arm into the thumb, with weakness in the
bicep muscle and diminished brachioradialis tendon reflex
in the affected extremity.
