NU 518 – NEUROLOGICAL & HEAD/NECK
ASSESSMENT | UNIVERSITY OF SOUTH
ALABAMA.
EXAM 2: NEUROLOGICAL & HEAD/NECK ASSESSMENT
Keywords
cranial nerves, neurological assessment, vertigo, dizziness,
nystagmus, Romberg test, headache evaluation, red flags, visual
acuity, pupillary reflexes, fundoscopic exam, thyroid examination,
,lymph node assessment, carotid bruit, geriatric assessment, stroke
assessment, NIHSS, meningeal signs, seizure evaluation
Question 1
A 35-year-old archaeologist comes to your office for a regular skin
check-up. She has just returned from her annual dig site in Greece.
She has fair skin and reddish-blonde hair. She has a family history of
melanoma. She has many freckles scattered across her skin. From
this description, which of the following is NOT a risk factor for
melanoma in this patient?
A) Age
B) Hair color
C) Actinic lentigines
D) Heavy sun exposure
Correct Answer: A
Rationale:
✅Correct (A): Age is not a significant risk factor for melanoma in
this patient because she is only 35 years old. Melanoma risk
increases with age, but younger patients can still develop melanoma.
Her fair skin, reddish-blonde hair (red hair gene variant), actinic
,lentigines (sun-induced freckles), family history of melanoma, and
heavy sun exposure (archaeologist working in Greece) are all
established risk factors .
✅Incorrect (B): Red or blonde hair (MC1R gene variants) increases
melanoma risk.
✅Incorrect (C): Actinic lentigines (sun-induced freckles) indicate
UV damage and increased risk.
✅Incorrect (D): Heavy sun exposure is a major risk factor for
melanoma.
Study Tip: "Melanoma risk factors: fair skin, red/blonde hair,
freckles, family history, sun exposure, atypical moles."
Question 2
A patient presents with acute onset of vertigo, nausea, and vomiting.
The vertigo is described as a sensation that the room is spinning. It
began suddenly 2 hours ago and is associated with nystagmus.
Which of the following is the most likely diagnosis?
A) Benign paroxysmal positional vertigo (BPPV)
B) Vestibular neuritis
, C) Ménière's disease
D) Cerebellar stroke
Correct Answer: B
Rationale:
✅Correct (B): Vestibular neuritis presents with acute, prolonged
(hours to days) vertigo, nausea, vomiting, and nystagmus, typically
following a viral illness. It is caused by inflammation of the
vestibular nerve. BPPV (A) presents with brief (seconds) episodes
triggered by head position changes. Ménière's (C) includes
fluctuating hearing loss and tinnitus. Cerebellar stroke (D) would
have additional neurological findings (ataxia, dysmetria) .
✅Incorrect (A): BPPV has brief (seconds) episodes triggered by
positional changes.
✅Incorrect (C): Ménière's includes hearing loss and tinnitus.
✅Incorrect (D): Cerebellar stroke would have ataxia, dysmetria, or
other focal deficits.
StudyTip: "Vestibular neuritis = acute, prolonged vertigo +
nystagmus (post-viral). BPPV = brief, positional."
ASSESSMENT | UNIVERSITY OF SOUTH
ALABAMA.
EXAM 2: NEUROLOGICAL & HEAD/NECK ASSESSMENT
Keywords
cranial nerves, neurological assessment, vertigo, dizziness,
nystagmus, Romberg test, headache evaluation, red flags, visual
acuity, pupillary reflexes, fundoscopic exam, thyroid examination,
,lymph node assessment, carotid bruit, geriatric assessment, stroke
assessment, NIHSS, meningeal signs, seizure evaluation
Question 1
A 35-year-old archaeologist comes to your office for a regular skin
check-up. She has just returned from her annual dig site in Greece.
She has fair skin and reddish-blonde hair. She has a family history of
melanoma. She has many freckles scattered across her skin. From
this description, which of the following is NOT a risk factor for
melanoma in this patient?
A) Age
B) Hair color
C) Actinic lentigines
D) Heavy sun exposure
Correct Answer: A
Rationale:
✅Correct (A): Age is not a significant risk factor for melanoma in
this patient because she is only 35 years old. Melanoma risk
increases with age, but younger patients can still develop melanoma.
Her fair skin, reddish-blonde hair (red hair gene variant), actinic
,lentigines (sun-induced freckles), family history of melanoma, and
heavy sun exposure (archaeologist working in Greece) are all
established risk factors .
✅Incorrect (B): Red or blonde hair (MC1R gene variants) increases
melanoma risk.
✅Incorrect (C): Actinic lentigines (sun-induced freckles) indicate
UV damage and increased risk.
✅Incorrect (D): Heavy sun exposure is a major risk factor for
melanoma.
Study Tip: "Melanoma risk factors: fair skin, red/blonde hair,
freckles, family history, sun exposure, atypical moles."
Question 2
A patient presents with acute onset of vertigo, nausea, and vomiting.
The vertigo is described as a sensation that the room is spinning. It
began suddenly 2 hours ago and is associated with nystagmus.
Which of the following is the most likely diagnosis?
A) Benign paroxysmal positional vertigo (BPPV)
B) Vestibular neuritis
, C) Ménière's disease
D) Cerebellar stroke
Correct Answer: B
Rationale:
✅Correct (B): Vestibular neuritis presents with acute, prolonged
(hours to days) vertigo, nausea, vomiting, and nystagmus, typically
following a viral illness. It is caused by inflammation of the
vestibular nerve. BPPV (A) presents with brief (seconds) episodes
triggered by head position changes. Ménière's (C) includes
fluctuating hearing loss and tinnitus. Cerebellar stroke (D) would
have additional neurological findings (ataxia, dysmetria) .
✅Incorrect (A): BPPV has brief (seconds) episodes triggered by
positional changes.
✅Incorrect (C): Ménière's includes hearing loss and tinnitus.
✅Incorrect (D): Cerebellar stroke would have ataxia, dysmetria, or
other focal deficits.
StudyTip: "Vestibular neuritis = acute, prolonged vertigo +
nystagmus (post-viral). BPPV = brief, positional."
