Neurology Practice Questions
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1. History & Physical/Neurology Explanations
A 73 year-old male presents to the (u) A. See C for explanation.
clinic with his wife. His wife has no- (u) B. See C for explanation.
ticed that he has developed a rest- (c) C. The patient symptoms are consistent with
ing tremor in his right hand and Parkinsonism. Physical exam findings include masked
a shuffling gait over the last year. facies, micrographia, decreased arm swing, and mo-
What finding on physical examina- notonous speech.
tion would support your suspected (u) D. See C for explanation.
diagnosis?
Answers
A. Chorea
B. Dystonia
C. Masked facies
D. Hyperreflexia
2. History & Physical/Neurology Explanations
A patient with an upper motor neu- (u) A. Fasciculations, areflexia and muscle atrophy are
ron lesion would exhibit which of the consistent with lower motor neuron lesions.
following findings? (u) B. See A for explanations.
Answers (u) C. See A for explanation.
A. Fasciculations (c) D. Spasticity is an upper motor neuron lesion
B. Areflexia finding.
C. Muscular atrophy
D. Spasticity
3. Diagnostic Studies/Neurology Explanations
What test is the single most useful (u) A. While cerebral spinal fluid cell count, protein
test in establishing the diagnosis of levels, and immunoglobins may be abnormal they are
multiple sclerosis? not specific for multiple sclerosis.
Answers (u) B. See A for explanation.
A. Cerebral spinal fluid cell count and (u) C. Evoked potentials are most useful in the detec-
protein level tion of subclinical involvement of neuropathways in
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B. Cerebral spinal fluid immunoglob- MS, but does not establish the diagnosis.
ulin studies (c) D. The presence of plaques on MRI is a key finding
C. Evoked potentials in establishing the diagnosis of MS.
D. Magnetic Resonance Imaging
4. Diagnostic Studies/Neurology Explanations
A 22 year-old male presents to the (u) A. See C for explanation.
clinic complaining of excessive day- (u) B. See C for explanation.
time somnolence and strong desires (c) C. Multiple sleep latency test is required to observe
to sleep at inappropriate times. He the abrupt transition to REM sleep and establish the
came in today because he had an diagnosis of narcolepsy.
episode of "feeling paralyzed" as he (u) D. See C for explanation.
was falling asleep yesterday. What is
the most appropriate diagnostic test
to confirm this patient's diagnosis?
Answers
A. MRI of the brain
B. Electroencephalogram
C. Multiple sleep latency test
D. Overnight polysomnography
5. Diagnosis/Neurology Explanations
A 54 year-old male smoker pre- (u) A. Cluster headaches can awaken patients, but are
sents to the clinic complaining of not usually "vague".
frequent vague headaches with as- (u) B. See C for explanation.
sociated vomiting that awaken him (c) C. Morning headaches associated with vomiting
from sleep occasionally and have are indicative of increased intracranial pressure and
been present upon awakening for raise concern of a CNS tumor such as a glioblastoma.
about two weeks. The headache typ- (u) D. Giant cell arteritis presents in the older patient
ically resolves about an hour into with headache in the temporal region and loss of
his morning routine. The patient vision.
is afebrile. What is the most likely
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cause of this patient's headaches?
Answers
A. Cluster headaches
B. Depression
C. Glioblastoma
D. Giant cell arteritis
6. Diagnosis/Neurology Explanations
A 28 year-old female presents to the (c) A. The pattern of sensory, motor and reflex findings
clinic complaining of a "prickly sen- is consistent with the pathophysiology of peripher-
sation" that started bilaterally in her al nerve demyelination that occurs in Guillain-Barré
feet two days ago and difficulty walk- syndrome.
ing. She now has the dysesthesia (u) B. Multiple sclerosis does not present as a sym-
from her mid-thigh down to her toes. metrical ascending paralysis.
On physical examination she has di- (u) C. Patients with myasthenia gravis tend to have in-
minished pain and temperature sen- termittent symptoms that affect proximal and extraoc-
sation, absent reflexes, loss of pro- ular muscles most notably and it also lacks sensory
prioception in her legs bilaterally, involvement.
and muscle strength is 1+/5+ in the (u) D. Although the exact type of cord transection
lower extremities and 5+/5+ in the can alter the pattern of motor and sensory findings
upper extremities. What is the most a patient with spinal cord compression who is not
likely diagnosis? in spinal shock would have hyperreflexia instead of
areflexia.
A. Guillain-Barré syndrome
B. Multiple sclerosis
C. Myasthenia gravis
D. Spinal cord compression
7. Diagnosis/Neurology Explanations
A 51 year-old female presents to (u) A. See D for explanation.
the clinic complaining of intermittent (u) B. See D for explanation.
sharp pain that originates at the cor- (u) C. See D for explanation.
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ner of her mouth and radiates to- (c) D. This is the classic presentation for trigeminal
ward her ipsilateral eye. She notes neuralgia (tic douloureux).
"everything makes it worse" includ-
ing touching the area, talking and
eating. What is the most likely diag-
nosis?
Answers
A. Bell's palsy
B. Cluster headache
C. Post-herpetic neuralgia
D. Trigeminal neuralgia
8. Health Maintenance/Neurology Explanations
A 45 year-old man presents for a (u) A. The main risk factor assessed by ECG is atrial
routine appointment. He tells you fibrillation and this patient's regular pulse confirms
his mother and father have both he is currently not in atrial fibrillation
had ischemic strokes in their 70's. (c) B. Hyperlipidemia is a known risk factors for stroke
He does not smoke. His blood pres- that can be modified with treatment.
sure is 128/80 mmHg, pulse 78/min- (u) C. The patient does not have signs or symptoms
utes and regular, respiratory rate of of carotid stenosis at this point.
12/minute. What diagnostic studies (u) D. An MRI with gadolinium would be useful in
would you order to further evaluate evaluating for the presence of Berry aneurysms, but
this patient's risk of stroke? the history of ischemic strokes does not raise the
Answers concern of an aneurysm.
A. Electrocardiogram
B. Fasting lipid profile
C. Carotid Doppler ultrasound
D. MRI with gadolinium
9. Clinical Intervention/Neurology Explanations
Which of the following interventions (u) A. Although caregiver burnout is often encoun-
is most effective during the early tered, consistency is beneficial to a patient having
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1. History & Physical/Neurology Explanations
A 73 year-old male presents to the (u) A. See C for explanation.
clinic with his wife. His wife has no- (u) B. See C for explanation.
ticed that he has developed a rest- (c) C. The patient symptoms are consistent with
ing tremor in his right hand and Parkinsonism. Physical exam findings include masked
a shuffling gait over the last year. facies, micrographia, decreased arm swing, and mo-
What finding on physical examina- notonous speech.
tion would support your suspected (u) D. See C for explanation.
diagnosis?
Answers
A. Chorea
B. Dystonia
C. Masked facies
D. Hyperreflexia
2. History & Physical/Neurology Explanations
A patient with an upper motor neu- (u) A. Fasciculations, areflexia and muscle atrophy are
ron lesion would exhibit which of the consistent with lower motor neuron lesions.
following findings? (u) B. See A for explanations.
Answers (u) C. See A for explanation.
A. Fasciculations (c) D. Spasticity is an upper motor neuron lesion
B. Areflexia finding.
C. Muscular atrophy
D. Spasticity
3. Diagnostic Studies/Neurology Explanations
What test is the single most useful (u) A. While cerebral spinal fluid cell count, protein
test in establishing the diagnosis of levels, and immunoglobins may be abnormal they are
multiple sclerosis? not specific for multiple sclerosis.
Answers (u) B. See A for explanation.
A. Cerebral spinal fluid cell count and (u) C. Evoked potentials are most useful in the detec-
protein level tion of subclinical involvement of neuropathways in
Actualstudy 1
, Neurology Practice Questions
Neurology Practice Questions.pdf answer keys
Study online at https://quizlet.com/_16q0x3
B. Cerebral spinal fluid immunoglob- MS, but does not establish the diagnosis.
ulin studies (c) D. The presence of plaques on MRI is a key finding
C. Evoked potentials in establishing the diagnosis of MS.
D. Magnetic Resonance Imaging
4. Diagnostic Studies/Neurology Explanations
A 22 year-old male presents to the (u) A. See C for explanation.
clinic complaining of excessive day- (u) B. See C for explanation.
time somnolence and strong desires (c) C. Multiple sleep latency test is required to observe
to sleep at inappropriate times. He the abrupt transition to REM sleep and establish the
came in today because he had an diagnosis of narcolepsy.
episode of "feeling paralyzed" as he (u) D. See C for explanation.
was falling asleep yesterday. What is
the most appropriate diagnostic test
to confirm this patient's diagnosis?
Answers
A. MRI of the brain
B. Electroencephalogram
C. Multiple sleep latency test
D. Overnight polysomnography
5. Diagnosis/Neurology Explanations
A 54 year-old male smoker pre- (u) A. Cluster headaches can awaken patients, but are
sents to the clinic complaining of not usually "vague".
frequent vague headaches with as- (u) B. See C for explanation.
sociated vomiting that awaken him (c) C. Morning headaches associated with vomiting
from sleep occasionally and have are indicative of increased intracranial pressure and
been present upon awakening for raise concern of a CNS tumor such as a glioblastoma.
about two weeks. The headache typ- (u) D. Giant cell arteritis presents in the older patient
ically resolves about an hour into with headache in the temporal region and loss of
his morning routine. The patient vision.
is afebrile. What is the most likely
Actualstudy 2
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Neurology Practice Questions.pdf answer keys
Study online at https://quizlet.com/_16q0x3
cause of this patient's headaches?
Answers
A. Cluster headaches
B. Depression
C. Glioblastoma
D. Giant cell arteritis
6. Diagnosis/Neurology Explanations
A 28 year-old female presents to the (c) A. The pattern of sensory, motor and reflex findings
clinic complaining of a "prickly sen- is consistent with the pathophysiology of peripher-
sation" that started bilaterally in her al nerve demyelination that occurs in Guillain-Barré
feet two days ago and difficulty walk- syndrome.
ing. She now has the dysesthesia (u) B. Multiple sclerosis does not present as a sym-
from her mid-thigh down to her toes. metrical ascending paralysis.
On physical examination she has di- (u) C. Patients with myasthenia gravis tend to have in-
minished pain and temperature sen- termittent symptoms that affect proximal and extraoc-
sation, absent reflexes, loss of pro- ular muscles most notably and it also lacks sensory
prioception in her legs bilaterally, involvement.
and muscle strength is 1+/5+ in the (u) D. Although the exact type of cord transection
lower extremities and 5+/5+ in the can alter the pattern of motor and sensory findings
upper extremities. What is the most a patient with spinal cord compression who is not
likely diagnosis? in spinal shock would have hyperreflexia instead of
areflexia.
A. Guillain-Barré syndrome
B. Multiple sclerosis
C. Myasthenia gravis
D. Spinal cord compression
7. Diagnosis/Neurology Explanations
A 51 year-old female presents to (u) A. See D for explanation.
the clinic complaining of intermittent (u) B. See D for explanation.
sharp pain that originates at the cor- (u) C. See D for explanation.
Actualstudy 3
, Neurology Practice Questions
Neurology Practice Questions.pdf answer keys
Study online at https://quizlet.com/_16q0x3
ner of her mouth and radiates to- (c) D. This is the classic presentation for trigeminal
ward her ipsilateral eye. She notes neuralgia (tic douloureux).
"everything makes it worse" includ-
ing touching the area, talking and
eating. What is the most likely diag-
nosis?
Answers
A. Bell's palsy
B. Cluster headache
C. Post-herpetic neuralgia
D. Trigeminal neuralgia
8. Health Maintenance/Neurology Explanations
A 45 year-old man presents for a (u) A. The main risk factor assessed by ECG is atrial
routine appointment. He tells you fibrillation and this patient's regular pulse confirms
his mother and father have both he is currently not in atrial fibrillation
had ischemic strokes in their 70's. (c) B. Hyperlipidemia is a known risk factors for stroke
He does not smoke. His blood pres- that can be modified with treatment.
sure is 128/80 mmHg, pulse 78/min- (u) C. The patient does not have signs or symptoms
utes and regular, respiratory rate of of carotid stenosis at this point.
12/minute. What diagnostic studies (u) D. An MRI with gadolinium would be useful in
would you order to further evaluate evaluating for the presence of Berry aneurysms, but
this patient's risk of stroke? the history of ischemic strokes does not raise the
Answers concern of an aneurysm.
A. Electrocardiogram
B. Fasting lipid profile
C. Carotid Doppler ultrasound
D. MRI with gadolinium
9. Clinical Intervention/Neurology Explanations
Which of the following interventions (u) A. Although caregiver burnout is often encoun-
is most effective during the early tered, consistency is beneficial to a patient having
Actualstudy 4
