Neurology Rosh Review
A 32-year-old man with suspected carbon monoxide poisoning is evaluated in the emergency
department. He is unarousable and unresponsive. Which of the following terms accurately
describes this patient's condition?
A Comatose
B Lethargic
C Obtunded
D Stuporous - ANS-A Comatose
During trauma to the anterior skull, rapid acceleration and declaration of the brain can cause
tissue damage in the region closest to the point of impact. What is this mechanism of injury
called?
A Axonal
B Contrecoup
C Coup
D Le Fort - ANS-C Coup
A 78-year-old man presents to the emergency department after being involved in a motor
vehicle collision. He was the restrained driver in a car that was rear-ended, and he describes a
"whiplash" injury in which his head went suddenly forward and then backward. He reports pain
in his neck and has difficulty grasping things with both hands. Physical examination reveals
weakness and loss of deep tendon reflexes in both upper extremities and normal strength in
both lower extremities. On questioning, he reports having intermittent neck pain, tingling in his
hands, and feeling "clumsy" prior to the injury, but it was much less severe. Which of the
following is the most likely diagnosis?
A Anterior cord syndrome
B Brown-Séquard syndrome
C Central cord syndrome
D Posterior cord syndrome - ANS-C Central cord syndrome
What is the best treatment for a patient with severe Bells Palsy?
A Carbamazepine and valacyclovir
B Prednisone and valacyclovir
C Prednisone monotherapy
D Valacyclovir monotherapy - ANS-B Prednisone and valacyclovir
Which of the following interventions is recommended in all patients for secondary prevention
after a transient ischemic attack?
A Anticoagulant therapy
B Antihyperglycemic therapy
C Antihypertensive therapy
, D Statin therapy - ANS-D Statin therapy
Which of the following is part of the initial evaluation of syncope in all patients?
A Carotid Doppler ultrasound
B Echocardiogram
C Electrocardiogram
D MRI of the brain - ANS-C Electrocardiogram
A 28-year-old man presents to the clinic with a bilateral, moderate-intensity headache for the
past eight hours. He describes the pain as a tightness around his head. He denies nausea,
vomiting, and photophobia, and his neurological examination reveals no abnormalities. Which of
the following is the most likely diagnosis?
A Cluster headache
B Migraine headache
C Subarachnoid hemorrhage
D Tension headache - ANS-D Tension headache
A 65-year-old man is brought in by ambulance after being found unresponsive. A CT scan of the
head demonstrates an acute hemorrhage in the left putamen. Which of the following is the most
common risk factor of hemorrhagic stroke?
A Antiplatelet therapy
B Cocaine use
C Hypertension
D Trauma - ANS-C Hypertension
A 79-year-old woman presents with a gradual onset of jaw claudication and temporal
headaches. Past medical history is significant for polymyalgia rheumatica. She reports transient
episodes of monocular vision loss. Physical examination reveals normal fundoscopy. Laboratory
studies show an erythrocyte sedimentation rate of 129 mm/H and an elevated C-reactive
protein. Which of the following is the most appropriate diagnostic test?
A Biopsy
B Computed tomography
C Magnetic resonance imaging
D Positron emission tomography - ANS-A Biopsy *looking for giant cell arteritis*
A 55-year-old man presents with new-onset seizures and frontal headaches. Past medical
history is significant for neurofibromatosis. Physical examination reveals papilledema and motor
weakness. Magnetic resonance imaging shows a calcified tumor in the white matter of the
frontal lobe. Biopsy of the tumor reveals a "fried-egg" appearance on histology. Which of the
following is the most likely diagnosis?
A Ependymoma
B Glioblastoma multiforme
C Medulloblastoma
D Oligodendroglioma - ANS-D Oligodendroglioma
A 32-year-old man with suspected carbon monoxide poisoning is evaluated in the emergency
department. He is unarousable and unresponsive. Which of the following terms accurately
describes this patient's condition?
A Comatose
B Lethargic
C Obtunded
D Stuporous - ANS-A Comatose
During trauma to the anterior skull, rapid acceleration and declaration of the brain can cause
tissue damage in the region closest to the point of impact. What is this mechanism of injury
called?
A Axonal
B Contrecoup
C Coup
D Le Fort - ANS-C Coup
A 78-year-old man presents to the emergency department after being involved in a motor
vehicle collision. He was the restrained driver in a car that was rear-ended, and he describes a
"whiplash" injury in which his head went suddenly forward and then backward. He reports pain
in his neck and has difficulty grasping things with both hands. Physical examination reveals
weakness and loss of deep tendon reflexes in both upper extremities and normal strength in
both lower extremities. On questioning, he reports having intermittent neck pain, tingling in his
hands, and feeling "clumsy" prior to the injury, but it was much less severe. Which of the
following is the most likely diagnosis?
A Anterior cord syndrome
B Brown-Séquard syndrome
C Central cord syndrome
D Posterior cord syndrome - ANS-C Central cord syndrome
What is the best treatment for a patient with severe Bells Palsy?
A Carbamazepine and valacyclovir
B Prednisone and valacyclovir
C Prednisone monotherapy
D Valacyclovir monotherapy - ANS-B Prednisone and valacyclovir
Which of the following interventions is recommended in all patients for secondary prevention
after a transient ischemic attack?
A Anticoagulant therapy
B Antihyperglycemic therapy
C Antihypertensive therapy
, D Statin therapy - ANS-D Statin therapy
Which of the following is part of the initial evaluation of syncope in all patients?
A Carotid Doppler ultrasound
B Echocardiogram
C Electrocardiogram
D MRI of the brain - ANS-C Electrocardiogram
A 28-year-old man presents to the clinic with a bilateral, moderate-intensity headache for the
past eight hours. He describes the pain as a tightness around his head. He denies nausea,
vomiting, and photophobia, and his neurological examination reveals no abnormalities. Which of
the following is the most likely diagnosis?
A Cluster headache
B Migraine headache
C Subarachnoid hemorrhage
D Tension headache - ANS-D Tension headache
A 65-year-old man is brought in by ambulance after being found unresponsive. A CT scan of the
head demonstrates an acute hemorrhage in the left putamen. Which of the following is the most
common risk factor of hemorrhagic stroke?
A Antiplatelet therapy
B Cocaine use
C Hypertension
D Trauma - ANS-C Hypertension
A 79-year-old woman presents with a gradual onset of jaw claudication and temporal
headaches. Past medical history is significant for polymyalgia rheumatica. She reports transient
episodes of monocular vision loss. Physical examination reveals normal fundoscopy. Laboratory
studies show an erythrocyte sedimentation rate of 129 mm/H and an elevated C-reactive
protein. Which of the following is the most appropriate diagnostic test?
A Biopsy
B Computed tomography
C Magnetic resonance imaging
D Positron emission tomography - ANS-A Biopsy *looking for giant cell arteritis*
A 55-year-old man presents with new-onset seizures and frontal headaches. Past medical
history is significant for neurofibromatosis. Physical examination reveals papilledema and motor
weakness. Magnetic resonance imaging shows a calcified tumor in the white matter of the
frontal lobe. Biopsy of the tumor reveals a "fried-egg" appearance on histology. Which of the
following is the most likely diagnosis?
A Ependymoma
B Glioblastoma multiforme
C Medulloblastoma
D Oligodendroglioma - ANS-D Oligodendroglioma
