NEURO NBME EXAM NEWEST 2026 TEST BANK|
COMPLETE 300 ACTUAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+|| BRAND NEW!!
Question 1
A 65-year-old man presents with right-sided weakness and loss
of pain/temperature sensation on the left side of the body.
Where is the most likely lesion?
A. Right cerebral cortex
B. Left cerebral cortex
C. Right brainstem
D. Left brainstem
Answer: C
Rationale: Lateral medullary (Wallenberg) syndrome or any
1
,brainstem lesion affecting the spinothalamic tract (contralateral)
and corticospinal tract (ipsilateral before decussation). Right
brainstem lesion causes ipsilateral (right) body weakness
(corticospinal tract above decussation? Wait—corticospinal tract
decussates at medulla; above decussation, weakness is
contralateral; below decussation, ipsilateral. For brainstem, it
depends. Classic “crossed findings” = ipsilateral cranial nerve +
contralateral body weakness/sensory.
Question 2
A patient has loss of vibration and proprioception in the left
lower extremity, with an ipsilateral Babinski sign. Where is the
lesion?
A. Left dorsal root ganglion
B. Left spinothalamic tract
2
,C. Left dorsal column
D. Left corticospinal tract
Answer: C
*Rationale: Dorsal columns carry ipsilateral
vibration/proprioception. Corticospinal tract (also ipsilateral
below decussation) runs with dorsal columns in the spinal cord.
Combined dorsal column + corticospinal tract lesion suggests
posterior cord syndrome (e.g., tabes dorsalis, B12 deficiency).*
Question 3
A 45-year-old woman has binocular diplopia worse with lateral
gaze. On exam, the left eye cannot abduct past midline, and
nystagmus is present in the right eye when looking left.
Convergence is intact. This is:
A. Left medial longitudinal fasciculus (MLF) lesion (INO)
B. Left CN VI palsy
3
, C. Left CN III palsy
D. Myasthenia gravis
Answer: A
Rationale: Internuclear ophthalmoplegia (INO) from MLF lesion
(multiple sclerosis most common in young adults). Adduction failure
on side of lesion (left eye cannot adduct) with contralateral
abducting nystagmus. Convergence intact (CN III spared).
Question 4
A patient has right-sided facial weakness (lower face, forehead
spared) and right arm weakness. No sensory findings. Where is
the lesion?
A. Right facial nerve
B. Left facial nerve
C. Left frontal lobe (motor cortex)
D. Right pontine tegmentum
4
COMPLETE 300 ACTUAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+|| BRAND NEW!!
Question 1
A 65-year-old man presents with right-sided weakness and loss
of pain/temperature sensation on the left side of the body.
Where is the most likely lesion?
A. Right cerebral cortex
B. Left cerebral cortex
C. Right brainstem
D. Left brainstem
Answer: C
Rationale: Lateral medullary (Wallenberg) syndrome or any
1
,brainstem lesion affecting the spinothalamic tract (contralateral)
and corticospinal tract (ipsilateral before decussation). Right
brainstem lesion causes ipsilateral (right) body weakness
(corticospinal tract above decussation? Wait—corticospinal tract
decussates at medulla; above decussation, weakness is
contralateral; below decussation, ipsilateral. For brainstem, it
depends. Classic “crossed findings” = ipsilateral cranial nerve +
contralateral body weakness/sensory.
Question 2
A patient has loss of vibration and proprioception in the left
lower extremity, with an ipsilateral Babinski sign. Where is the
lesion?
A. Left dorsal root ganglion
B. Left spinothalamic tract
2
,C. Left dorsal column
D. Left corticospinal tract
Answer: C
*Rationale: Dorsal columns carry ipsilateral
vibration/proprioception. Corticospinal tract (also ipsilateral
below decussation) runs with dorsal columns in the spinal cord.
Combined dorsal column + corticospinal tract lesion suggests
posterior cord syndrome (e.g., tabes dorsalis, B12 deficiency).*
Question 3
A 45-year-old woman has binocular diplopia worse with lateral
gaze. On exam, the left eye cannot abduct past midline, and
nystagmus is present in the right eye when looking left.
Convergence is intact. This is:
A. Left medial longitudinal fasciculus (MLF) lesion (INO)
B. Left CN VI palsy
3
, C. Left CN III palsy
D. Myasthenia gravis
Answer: A
Rationale: Internuclear ophthalmoplegia (INO) from MLF lesion
(multiple sclerosis most common in young adults). Adduction failure
on side of lesion (left eye cannot adduct) with contralateral
abducting nystagmus. Convergence intact (CN III spared).
Question 4
A patient has right-sided facial weakness (lower face, forehead
spared) and right arm weakness. No sensory findings. Where is
the lesion?
A. Right facial nerve
B. Left facial nerve
C. Left frontal lobe (motor cortex)
D. Right pontine tegmentum
4
