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USMLE Step 2 – Neurology | 2025 High-Yield Clinical Q&A for Stroke, Seizures, Myopathies & Neuro Emergencies (160+ Questions and Answers).

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This focused neurology Q&A document for USMLE Step 2 contains over 350 high-yield clinical questions and answers covering core neuro topics, including stroke syndromes, spinal cord and cauda equina compression, cerebellar lesions, cranial nerve palsies, neurodegenerative diseases, neuromuscular disorders, and seizure syndromes. Each question is formatted for rapid Step 2 CK-style recall and includes diagnostic criteria, physical signs, imaging findings, and treatment protocols. Perfect for shelf exam prep, Step 2 review, and last-minute neurology reinforcement.

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,USMLE Step 2 – Neurology | 2025 High-Yield
Clinical Q&A for Stroke, Seizures, Myopathies
& Neuro Emergencies (160+ Questions and
Answers).
Progressively worsening focal back pain that is WORSENED in recumbent position

Spinal cord Compression (epidural) --> due to distension of epidural venous plexus when lying down

Progressively worsening focal back pain that is IMPROVED in recumbent position

Degenerative joint disease

Best way to diagnos for Spinal Cord Compression

Emergent MRI

Treatment of Epidural Spinal Cord Compression

Glucocorticoids

Work up for back pain + myelopathy symptoms

MRI

Work up for back pain without myelopathy symptoms

X-ray

Low back pain with tenderness at affected level and decreased spinal mobility.
Pain worsened with standing, walking, or lying on back

Acute Vertebral compression fracture

What condition is indicated with spinal apophyseal (facet) joint arthritis

Spondyloarthropathy

, Low back pain in paraspinal area without significant tenderness to palpation that worsens with
movement and improves with rest

Ligmentous back sprain

- Gradually worsening, severe, local back pain
- Back pain worse in recumbent position/at night
- LE weakness/LE paresis
- Loss of rectal tone
- Complete Sensory loss of LE
- Urinary retention
- Hyper-reflexia, (+) Babinksi, weakness w/o fasciculations

Spinal Cord Compression

- Severe radicular pain
- Saddle anesthesia
- Asymmetric motor weakness
- Hyporeflexia
- Late-onset bowel and bladder dysfxn

Cauda equina syndrome

- Sudden onset severe back pain
- Perianal anesthesia
- Symmetric motor weakness
- Hyperreflexia
- Early-onset bowel and bladder dysfxn

Conus medullaris syndrome

What part of nervous system is injured with Cauda Equina Syndrome

Sacral spinal roots

What is underlying cause with signs of Spinal cord compression and fever

Epidural abscess

Risk factors for Epidural Abscess

- Vertebral body osteo --> continguous tisse infxn
- Steroid injections/ Epidural anesthesia --> direct inoculation
- IV drug use
- Immunocompromised = DM, HIV, alcoholism

Most common bug with Epidural Abscess

Staph aureus

Best way to confirm diagnosis of Epidural abscess
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