NBR 2 - Clinical Neurology Flashcards
1
Q
For questions 1 to 7. match the eye movement with the description. Each response may be used once. more than once. or not at all. A. convergence nystagmus B. dissociated nystagmus (internuclear ophthalmoplegia) C. downbeat nystagmus D. impairment of optokinetic nystagmus E. ocular bobbing F. seesaw nystagmus G. spasmus mutans
- a common sign of multiple sclerosis
A
B. dissociated nystagmus (internuclear ophthalmoplegia)
2
Q
For questions 1 to 7. match the eye movement with the description. Each response may be used once. more than once. or not at all. A. convergence nystagmus B. dissociated nystagmus (internuclear ophthalmoplegia) C. downbeat nystagmus D. impairment of optokinetic nystagmus E. ocular bobbing F. seesaw nystagmus G. spasmus mutans
- most often associated with large destructive lesions of the
A
E. ocular bobbing
3
Q
For questions 1 to 7. match the eye movement with the description. Each response may be used once. more than once. or not at all. A. convergence nystagmus B. dissociated nystagmus (internuclear ophthalmoplegia) C. downbeat nystagmus D. impairment of optokinetic nystagmus E. ocular bobbing F. seesaw nystagmus G. spasmus mutans
- seen exclusively in infants
A
G. spasmus mutans
4
Q
For questions 1 to 7. match the eye movement with the description. Each response may be used once. more than once. or not at all. A. convergence nystagmus B. dissociated nystagmus (internuclear ophthalmoplegia) C. downbeat nystagmus D. impairment of optokinetic nystagmus E. ocular bobbing F. seesaw nystagmus G. spasmus mutans
- associated with lesions of the cervicomedullary junction
A
C. downbeat nystagmus
5
Q
For questions 1 to 7. match the eye movement with the description. Each response may be used once. more than once. or not at all. A. convergence nystagmus B. dissociated nystagmus (internuclear ophthalmoplegia) C. downbeat nystagmus D. impairment of optokinetic nystagmus E. ocular bobbing F. seesaw nystagmus G. spasmus mutans
- associated with lesions of the parasellar region
A
F. seesaw nystagmus
6
Q
For questions 1 to 7. match the eye movement with the description. Each response may be used once. more than once. or not at all. A. convergence nystagmus B. dissociated nystagmus (internuclear ophthalmoplegia) C. downbeat nystagmus D. impairment of optokinetic nystagmus E. ocular bobbing F. seesaw nystagmus G. spasmus mutans
- associated with lesions of the parietal lobe
A
D. impairment of optokinetic nystagmus
7
Q
For questions 1 to 7. match the eye movement with the description. Each response may be used once. more than once. or not at all. A. convergence nystagmus B. dissociated nystagmus (internuclear ophthalmoplegia) C. downbeat nystagmus D. impairment of optokinetic nystagmus E. ocular bobbing F. seesaw nystagmus G. spasmus mutans
- associated with lesions of the pineal region
A
A. convergence nystagmus
8
Q
- Which of the following is false of seizure foci?
A. Epileptic foci are slower in binding and removing acetylcholine than normal cortex.
B. Firing of neurons in the focus is reflected by periodic spike discharges in the electroencephalogram (EEG).
C. If unchecked, cortical excitation may spread to the subcortical nuclei.
D. Neurons surrounding the focus are initially hyperpolarized and are GABAnergic.
E. The change in seizure discharge from the tonic phase to the clonic phase results from inhibition from the neurons surrounding the focus.
A
E. The change in seizure discharge from the tonic phase to the clonic phase results from inhibition from the neurons surrounding the focus.
9
Q
9. An abnormal optokinetic response is more likely to be obtained by rotating the optokinetic nystagmus drum A. away from an oCcipital lobe lesion B. away from a parietal lobe lesion C. toward an occipital lobe lesion D. toward a parietal lobe lesion E. toward a temporal lobe lesion
A
D. toward a parietal lobe lesion
10
Q
For questions 10 to 14, match the EEG wave with the description. Each response may be used once more than once or not at all. A. alpha B. beta C. delta D. theta E. 3-per-second spike and wave
- 4 to 7 Hz
A
D. theta
11
Q
For questions 10 to 14, match the EEG wave with the description. Each response may be used once more than once or not at all. A. alpha B. beta C. delta D. theta E. 3-per-second spike and wave
- normally may be present over the temporal lobes of the elderly
A
D. theta
12
Q
For questions 10 to 14, match the EEG wave with the description. Each response may be used once more than once or not at all. A. alpha B. beta C. delta D. theta E. 3-per-second spike and wave
- recorded from the frontal lobes symmetrically
A
B. beta
13
Q
For questions 10 to 14, match the EEG wave with the description. Each response may be used once more than once or not at all. A. alpha B. beta C. delta D. theta E. 3-per-second spike and wave
- associated with absence seizures
A
B. beta
14
Q
For questions 10 to 14, match the EEG wave with the description. Each response may be used once more than once or not at all. A. alpha B. beta C. delta D. theta E. 3-per-second spike and wave
- attenuated or abolished with eye opening or mental activity
A
A. alpha
15
Q
15. Which of the following drugs is least effective in the treatment of trigeminal neuralgia? A. baclofen B. carbamazepine C. clonazepam D. phenytoin E. ketorolac tromethamine (Toradol)
A
E. ketorolac tromethamine (Toradol)
16
Q
- Which of the following is true of papilledema?
A. Absence of venous pulsations is a reliable indicator of papilledema.
B. Pupillary light reflexes remain normal.
C. The congested capillaries derive from the central retinal vein.
D. Unilateral edema of the optic disk is never seen.
E. Visual acuity usually decreases.
A
B. Pupillary light reflexes remain normal.
17
Q
neuralgia? I. pain in the throat II. syncope III. pain in the ear IV. bradycardia A. I, II, III B. I, III C. II, IV D. IV E. all of the above
A
E. all of the above
18
Q
18. Features of trisomy 13 (Patau's syndrome) include I. microcephaly II. hypertonia III. cleft lip and palate IV. dextrocardia A. I, II, III B. I, III C. II, IV D. IV E. all of the above
A
E. all of the above
19
Q
19. Which of the following is not a feature of Parinaud's syndrome? A. dissociated light-near response B. lid retraction C. nystagmus retractorius D. paralysis of upgaze E. third nerve palsy
A
E. third nerve palsy
20
Q
- Which of the following is true of tuberculous meningitis?
A. Headache is usually absent.
B. If untreated, the clinical course is self-limited.
C. The inflammatory exudate is confined to the subarachnoid space.
D. The inflammatory exudate is found mainly at the convexities.
E. The protein content ofthe cerebrospinal fluid (CSF) is almost always elevated.
A
E. The protein content ofthe cerebrospinal fluid (CSF) is almost always elevated.
21
Q
- Which ofthe following (SF findings is least suggestive of acute multiple sclerosis?
A. an IgG index greater than 1.7
B. increased myelin basic protein
C. increased protein to 200 mg/dL
D. presence of oligoclonal bands
E. slight to moderate monocytic pleocytosis
A
C. increased protein to 200 mg/dL
22
Q
- Each of the following is true of myasthenia gravis except
A. A decrementing response to peripheral nerve stimulation is typical.
B. Aminoglycoside antibiotics may worsen the symptoms.
C. Females are more frequently affected in the
A
D. Females predominate in the subset of patients with a thymoma.
23
Q
- A defect in mitochondrial DNA is found in each of the following disorders except
A. Kearns-Sayre syndrome
B. Leber’s hereditary optic atrophy
C. Leigh’s subacute necrotizing encephalopathy
D. Mitochondrial myopathy, encephalopathy,lactic acidosis, and stroke (MEIAS)
E. Menkes’ syndrome
A
E. Menkes’ syndrome
24
Q
24. Symptoms of spontaneous carotid artery dissection include I. dysgellisia II. eye pain III. tongue weakness IV. Horner's syndrome A. I, II, III B. I, III C. II, IV D. IV E. all of the above
A
E. all of the above
25
```
25. Memory impairment is caused by discrete bilateral lesions of which of the following structures?
I. amygdala
II. hippocampal formation
III. mammillary bodies
IV. dorsomedial nuclei of the thalamus
A. I, II, III
B. I, III
C. II, IV
D. IV
E. all of the above
```
C. II, IV
26
```
26. Genes responsible for cavernous malformations have been mapped to chromosomes
A. 1 and 3
B. 3 and 5
C. 3 and 7
D. 4and5
E. 5and7
```
C. 3 and 7
27
27. Each of the following is characteristic of a diabetic third nerve palsy except that
A. it develops over a few hours
B. it spares the pupil
C. it is usually painless
D. the lesion involves the center of the nerve
E. the prognosis for recovery is good
C. it is usually painless
28
```
For questions 28 to 36, provide the best match of the toxicities with the description. Each response may be used once, more than once, or not at all.
A. arsenic poisoning
B. lead poisoning
C. manganese poisoning
D. mercury poisoning
E. phosphorus poisoning
```
28. transverse white lines in the fingernails
A. arsenic poisoning
29
```
For questions 28 to 36, provide the best match of the toxicities with the description. Each response may be used once, more than once, or not at all.
A. arsenic poisoning
B. lead poisoning
C. manganese poisoning
D. mercury poisoning
E. phosphorus poisoning
```
29. black lines at the gingival margins
B. lead poisoning
30
```
For questions 28 to 36, provide the best match of the toxicities with the description. Each response may be used once, more than once, or not at all.
A. arsenic poisoning
B. lead poisoning
C. manganese poisoning
D. mercury poisoning
E. phosphorus poisoning
```
30. Later symptoms resemble those of Parkinson's disease.
C. manganese poisoning
31
```
For questions 28 to 36, provide the best match of the toxicities with the description. Each response may be used once, more than once, or not at all.
A. arsenic poisoning
B. lead poisoning
C. manganese poisoning
D. mercury poisoning
E. phosphorus poisoning
```
31. treated with atropine
E. phosphorus poisoning
32
```
For questions 28 to 36, provide the best match of the toxicities with the description. Each response may be used once, more than once, or not at all.
A. arsenic poisoning
B. lead poisoning
C. manganese poisoning
D. mercury poisoning
E. phosphorus poisoning
```
32. Pencillamine is the treatment of choice in the chronic form.
D. mercury poisoning
33
```
For questions 28 to 36, provide the best match of the toxicities with the description. Each response may be used once, more than once, or not at all.
A. arsenic poisoning
B. lead poisoning
C. manganese poisoning
D. mercury poisoning
E. phosphorus poisoning
```
33. characterized by mood changes, tremors, and a cerebellar syndrome
D. mercury poisoning
34
```
For questions 28 to 36, provide the best match of the toxicities with the description. Each response may be used once, more than once, or not at all.
A. arsenic poisoning
B. lead poisoning
C. manganese poisoning
D. mercury poisoning
E. phosphorus poisoning
```
34. treated with ethylenediaminetetraacetic acid (EDTA) and dimercaprol (BAL)
B. lead poisoning
35
```
For questions 28 to 36, provide the best match of the toxicities with the description. Each response may be used once, more than once, or not at all.
A. arsenic poisoning
B. lead poisoning
C. manganese poisoning
D. mercury poisoning
E. phosphorus poisoning
```
35. increased excretion of urinary coproporphyrin
B. lead poisoning
36
```
For questions 28 to 36, provide the best match of the toxicities with the description. Each response may be used once, more than once, or not at all.
A. arsenic poisoning
B. lead poisoning
C. manganese poisoning
D. mercury poisoning
E. phosphorus poisoning
```
36. Diagnosis can be made by the examination of hair samples.
A. arsenic poisoning
37
37. Which of the following is not a characteristic of Adie's syndrome?
A. degeneration of the ciliary ganglia and postganglionic parasympathetics
B. more common in women than in men
C. no reaction to 0.1% pilocarpine solution
D. paralysis of segments of the pupillary sphincter
E. Pupil responds better to near than to light.
C. no reaction to 0.1% pilocarpine solution
38
```
38. Characteristics of infantile seizures include
I. lip smacking
II. hypsarrythmia
III. generalized tonic-clonic activity
IV. myoclonic head jerks
A. I, II, III
B. I, III
C. II, IV
D. IV
E. all of the above
```
C. II, IV
39
```
For questions 39 to 42, match the disease with the description. Each response may be used once, more than once, or not at all.
A. myasthenia gravis
B. myasthenic syndrome of Eaton-Lambert
C. both
D. neither
```
39. Muscles of the trunk and lower extremities are more frequently involved than the extraocular muscles.
B. myasthenic syndrome of Eaton-Lambert
40
```
For questions 39 to 42, match the disease with the description. Each response may be used once, more than once, or not at all.
A. myasthenia gravis
B. myasthenic syndrome of Eaton-Lambert
C. both
D. neither
```
40. Poor response to anticholinesterase drugs
B. myasthenic syndrome of Eaton-Lambert
41
```
For questions 39 to 42, match the disease with the description. Each response may be used once, more than once, or not at all.
A. myasthenia gravis
B. myasthenic syndrome of Eaton-Lambert
C. both
D. neither
```
41. An incrementing response (marked increase in the amplitude of the action potential with.,fast rates of nerve stimulation) is typical.
B. myasthenic syndrome of Eaton-Lambert
42
```
For questions 39 to 42, match the disease with the description. Each response may be used once, more than once, or not at all.
A. myasthenia gravis
B. myasthenic syndrome of Eaton-Lambert
C. both
D. neither
```
42. associated with antibodies to the presynaptic voltage-dependent calcium channel
B. myasthenic syndrome of Eaton-Lambert
43
```
43. The dorsal scapular nerve innervates the
I. supraspinatus
II. rhomboids
III. subscapularis
IV. levator scapulae
A. I, II, III
B. I, III
C. II, IV
D. IV
E. all of the above
```
C. II, IV
44
```
For questions 44 to 50, match the peripheral nerve with the muscle it innervates. Each response may be used once, more than once, or not at all.
A. axillary nerve
B. dorsal scapular nerve
C. subscapular nerve
D. suprascapular nerve
E. none of the above
```
44. teres major
C. subscapular nerve
45
```
For questions 44 to 50, match the peripheral nerve with the muscle it innervates. Each response may be used once, more than once, or not at all.
A. axillary nerve
B. dorsal scapular nerve
C. subscapular nerve
D. suprascapular nerve
E. none of the above
```
45. teres minor
A. axillary nerve
46
```
For questions 44 to 50, match the peripheral nerve with the muscle it innervates. Each response may be used once, more than once, or not at all.
A. axillary nerve
B. dorsal scapular nerve
C. subscapular nerve
D. suprascapular nerve
E. none of the above
```
46. subscapularis
C. subscapular nerve
47
```
For questions 44 to 50, match the peripheral nerve with the muscle it innervates. Each response may be used once, more than once, or not at all.
A. axillary nerve
B. dorsal scapular nerve
C. subscapular nerve
D. suprascapular nerve
E. none of the above
```
47. levator scapulae
B. dorsal scapular nerve
48
```
For questions 44 to 50, match the peripheral nerve with the muscle it innervates. Each response may be used once, more than once, or not at all.
A. axillary nerve
B. dorsal scapular nerve
C. subscapular nerve
D. suprascapular nerve
E. none of the above
```
48. supraspinatus
D. suprascapular nerve
49
```
For questions 44 to 50, match the peripheral nerve with the muscle it innervates. Each response may be used once, more than once, or not at all.
A. axillary nerve
B. dorsal scapular nerve
C. subscapular nerve
D. suprascapular nerve
E. none of the above
```
49. infraspinatus
D. suprascapular nerve
50
```
For questions 44 to 50, match the peripheral nerve with the muscle it innervates. Each response may be used once, more than once, or not at all.
A. axillary nerve
B. dorsal scapular nerve
C. subscapular nerve
D. suprascapular nerve
E. none of the above
```
50. rhomboids
B. dorsal scapular nerve
51
51. The motor unit potential in myopathy is of
A. decreased voltage and decreased duration
B. decreased voltage and increased duration
C. decreased voltage and normal duration
D. normal voltage and decreased duration
E. normal voltage and increased duration
A. decreased voltage and decreased duration
52
52. Which is true of myotonic dystrophy?
A. Frontal balding occurs only in men.
B. Lens abnormalities are rare.
C. The congenital form is inherited only from the maternal line.
D. The inheritance is autosomal recessive.
E. Weakness always predates the myotonia.
C. The congenital form is inherited only from the maternal line.
53
```
53. Subacute combined degeneration of the spinal cord is caused by a deficiency of
A. cobalamin
B. folic acid
C. nicotinic acid
D. pyridoxine
E. thiamine
```
A. cobalamin
54
```
54. The marker linked to the Huntington gene is localized to the short arm of chromosome
A. 4
B. 11
C. 17
D. 22
E. none of the above
```
A. 4
55
55. Alexia without agraphia is most likely to occur with a lesion involving the
A. left geniculocalcarine tract and corpus callosum
B. left geniculocalcarine tract and Wernicke's area
C. left geniculocalcarine tract, corpus callosum, and Wernicke's area
D. right geniculocalcarine tract and corpus callosum
E. right geniculocalcarine tract and Wernicke's area
A. left geniculocalcarine tract and corpus callosum
56
56. Deviation of the eyes to the right is most likely to occur with occlusion of the
A. calcarine artery bilaterally
B. calcarine artery on the contralateral side
C. contralateral paramedian branch of the basilar artery
D. ipsilateral superior cerebellar artery
E. superior division of the contralateral middle cerebral artery
C. contralateral paramedian branch of the basilar artery
57
```
57. Which of the following antiepileptic drugs has the shortest half-life?
A. carbamazepine
B. ethosuximide
C. phenobarbital
D. phenytoin
E. valproate
```
E. valproate
58
```
For questions 58 to 60, match the description with the disease.
A. amyotrophic lateral sclerosis
B. syringomyelia
C. both
D. neither
```
58. weakness and atrophy of the hands
C. both
59
```
For questions 58 to 60, match the description with the disease.
A. amyotrophic lateral sclerosis
B. syringomyelia
C. both
D. neither
```
59. hypo- or arettexia
B. syringomyelia
60
```
For questions 58 to 60, match the description with the disease.
A. amyotrophic lateral sclerosis
B. syringomyelia
C. both
D. neither
```
60. absence of sensory changes
A. amyotrophic lateral sclerosis
61
61. Biochemical studies of neurons from a seizure focus have shown all of the following except
A. increased levels of extracellular potassium in glial scars near seizure foci
B. decreased rate of binding and removing acetylcholine in the foci
C. deficiency of r-aminobutyric acid (CABA)
D. decreased glycine levels
E. decreased taurine levels
D. decreased glycine levels
62
62. The most reliable indicator of an intracellular cobalamin (vitamin B12) deficiency is
A. low vitamin B12 on a microbiologic assay
B. low vitamin B12 on a radioisotope dilution assay
C. low vitamin B12 on a Schilling test
D. the finding of hypersegmented polymorphonuclear neutrophil leukocytes (PMN) in bone marrow smears
E. the finding of increased serum concentration of methylmalonic acid and homocysteine
E. the finding of increased serum concentration of methylmalonic acid and homocysteine
63
63. Each of the following is true of radiation myelopathy (delayed progressive type) except
A. Absence of pain is typical early in the course.
B. It occurs 12 to 15 months after radiation.
C. Magnetic resonance imaging (MRI) shows abnormal signal intensity; decreased on T1 and increased on T2.
D. Sensory changes usually develop after motor changes.
E. The most severe parenchymal changes are typical of infarction.
D. Sensory changes usually develop after motor changes.
64
```
64. Fasciculation potentials indicate
A. motor nerve fiber irritability
B. motor nerve fiber destruction
C. motor unit denervation
D. muscle atrophy
E. reinnervation of muscle units
```
A. motor nerve fiber irritability
65
```
For questions 65 to 70, match the description with the potential.
A. fasciculation potential
B. fibrillation potential
C. both
D. neither
```
65. di- or triphasic pattern
B. fibrillation potential
66
```
For questions 65 to 70, match the description with the potential.
A. fasciculation potential
B. fibrillation potential
C. both
D. neither
```
66. 5 to 15 ms in duration
A. fasciculation potential
67
```
For questions 65 to 70, match the description with the potential.
A. fasciculation potential
B. fibrillation potential
C. both
D. neither
```
67. may take the form of positive sharp waves
B. fibrillation potential
68
```
For questions 65 to 70, match the description with the potential.
A. fasciculation potential
B. fibrillation potential
C. both
D. neither
```
68. seen in poliomyelitis
C. both
69
```
For questions 65 to 70, match the description with the potential.
A. fasciculation potential
B. fibrillation potential
C. both
D. neither
```
69. usually develops 24 to 36 hours after the death of an axon
D. neither
70
```
For questions 65 to 70, match the description with the potential.
A. fasciculation potential
B. fibrillation potential
C. both
D. neither
```
70. may be visible through the skin
A. fasciculation potential
71
71. What characteristics of motor unit potentials are typical soon after reinnervation?
A. prolonged, high amplitude, and polyphasic
B. prolonged, low amplitude, and polyphasic
C. shortened, high amplitude, and polyphasic
D. shortened, low amplitude, and polyphasic
E. none of the above
B. prolonged, low amplitude, and polyphasic
72
72. Which of the following ocular findings is not seen in myasthenia gravis?
A. abnormal pupillary response to accommodation
B. normal pupillary response to light
C. weakness of extraocular muscles
D. weakness of eye closure
E. weakness of eye opening
A. abnormal pupillary response to accommodation
73
```
73. Risk factors for carpal tunnel syndrome include
I. acromegaly
II. amyloidosis
III. hypothyroidism
IV. pregnancy
A. I, II, III
B. I, III
C. II, IV
D. IV
E. all of the above
```
E. all of the above
74
74. Which of the following is true of neurologic findings in sarcoidosis?
A. Cranial nerve VI is most frequently involved.
B. Sarcoidosis occurs in 25% of cases of sarcoid.
C. Polydipsia, polyuria, somnolence, and obesity are common features.
D. The granulomatous infiltration is most prominent over the hemispheres.
E. Visual disturbances are usually secondary to lesions in the occipital cortex.
C. Polydipsia, polyuria, somnolence, and obesity are common features.
75
75. All of the following are associated with narcolepsy except
A. increased total number of hours per day spent sleeping
B. cataplexy.
C. hypnagogic hallucinations
D. sleep paralysis
E. sleep patterns beginning with the rapid eye movements (REM) stage
A. increased total number of hours per day spent sleeping
76
76. Which of the following signs or symptoms occurring in a young person is the most suggestive of multiple sclerosis?
A. bilateral internuclear ophthalmoplegia
B. gait ataxia
C. Lhermitte's sign
D. optic neuritis
E. vertigo
A. bilateral internuclear ophthalmoplegia
77
```
77. The muscles most often involved in thyroid ophthalmopathy are the
A. inferior, superior, and medial recti
B. inferior rectus and superior oblique
C. lateral and superior recti
D. lateral rectus and superior oblique
E. medial rectus and inferior oblique
```
A. inferior, superior, and medial recti
78
```
78. Most cases of "idiopathic" hemifacial spasm are thought to result from
A. ephaptic transmission
B. hypersensitivity of facial muscles
C. hypocalcemia
D. psychiatric disorders
E. recurrence of latent viral infection
```
A. ephaptic transmission
79
79. The diagnosis of neurosarcoidosis is based on
A. biopsy evidence of sarcoid granulomas in non-central nervous system (CNS) tissue and neurologic findings
B. computed tomography (CT) scan showing meningeal involvement
C. increased sedimentation rate and hyperglobulinemia
D. increased serum levels of angiotensin-converting enzyme
E. MRl findings of periventricular and white matter changes
A. biopsy evidence of sarcoid granulomas in non-central nervous system (CNS) tissue and neurologic findings
80
```
For questions 80 to 84, match the paraneoplastic syndrome with the description. Each response may be used once, more than once, or not at all.
A. limbic encephalitis
B. Eaton-Lambert syndrome
C. Moersch-Woltman (stiff-man) syndrome
D. opsoclonus-myoclonus
E. sensory neuropathy
```
80. seen most often in children with neuroblastoma
D. opsoclonus-myoclonus
81
```
For questions 80 to 84, match the paraneoplastic syndrome with the description. Each response may be used once, more than once, or not at all.
A. limbic encephalitis
B. Eaton-Lambert syndrome
C. Moersch-Woltman (stiff-man) syndrome
D. opsoclonus-myoclonus
E. sensory neuropathy
```
81. anti-Hu antibodies
E. sensory neuropathy
82
```
For questions 80 to 84, match the paraneoplastic syndrome with the description. Each response may be used once, more than once, or not at all.
A. limbic encephalitis
B. Eaton-Lambert syndrome
C. Moersch-Woltman (stiff-man) syndrome
D. opsoclonus-myoclonus
E. sensory neuropathy
```
82. anti-Ri antibodies
D. opsoclonus-myoclonus
83
```
For questions 80 to 84, match the paraneoplastic syndrome with the description. Each response may be used once, more than once, or not at all.
A. limbic encephalitis
B. Eaton-Lambert syndrome
C. Moersch-Woltman (stiff-man) syndrome
D. opsoclonus-myoclonus
E. sensory neuropathy
```
83. autoantibodies to voltage-gated calcium channels
B. Eaton-Lambert syndrome
84
```
For questions 80 to 84, match the paraneoplastic syndrome with the description. Each response may be used once, more than once, or not at all.
A. limbic encephalitis
B. Eaton-Lambert syndrome
C. Moersch-Woltman (stiff-man) syndrome
D. opsoclonus-myoclonus
E. sensory neuropathy
```
84. autoantibodies to glutamic acid decaboxylase
C. Moersch-Woltman (stiff-man) syndrome
85
For questions 85 to 88, match the vascular syndrome with the description. Each response may be used once, more than once, or not at all.
A. basilar syndrome
B. lateral medullary syndrome (vertebral or posteroinferior cerebellar artery [PICA] occlusion)
C. lateral superior pontine syndrome (superior cerebellar artery occlusion)
D. medial medullary occlusion
E. none of the above
85. contralateral hemiparesis sparing the face, contralateral loss of position and vibration sense, ipsilateral paralysis, and atrophy of the tongue
D. medial medullary occlusion
86
For questions 85 to 88, match the vascular syndrome with the description. Each response may be used once, more than once, or not at all.
A. basilar syndrome
B. lateral medullary syndrome (vertebral or posteroinferior cerebellar artery [PICA] occlusion)
C. lateral superior pontine syndrome (superior cerebellar artery occlusion)
D. medial medullary occlusion
E. none of the above
86. contralateral pain and temperature loss in the body, ipsilateral Homer's syndrome, ipsilateral ataxia, ipsilateral paralysis of the palate and vocal cords, and ipsilateral pain and numbness in the face
B. lateral medullary syndrome (vertebral or posteroinferior cerebellar artery [PICA] occlusion)
87
For questions 85 to 88, match the vascular syndrome with the description. Each response may be used once, more than once, or not at all.
A. basilar syndrome
B. lateral medullary syndrome (vertebral or posteroinferior cerebellar artery [PICA] occlusion)
C. lateral superior pontine syndrome (superior cerebellar artery occlusion)
D. medial medullary occlusion
E. none of the above
87. ipsilateral cerebellar ataxia, contralateral loss of pain and temperature in the body, partial deafness, and nausea and vomiting
C. lateral superior pontine syndrome (superior cerebellar artery occlusion)
88
For questions 85 to 88, match the vascular syndrome with the description. Each response may be used once, more than once, or not at all.
A. basilar syndrome
B. lateral medullary syndrome (vertebral or posteroinferior cerebellar artery [PICA] occlusion)
C. lateral superior pontine syndrome (superior cerebellar artery occlusion)
D. medial medullary occlusion
E. none of the above
88. bilateral motor weakness in all extremities, bilateral cerebellar ataxia, and diplopia
A. basilar syndrome
89
```
89. The lesion in hemiballismus is localized to the contralateral
A. brachium conjunctivum
B. caudate nucleus
C. dorsomedial nucleus of the thalamus
D. substantia nigra
E. subthalamic nucleus
```
E. subthalamic nucleus
90
```
90. The long thoracic nerve innervates the
A. latissimus dorsi
B. levator scapulae
C. rhomboids
D. serratus anterior
E. teres minor
```
D. serratus anterior
91
91. Which of the following is most consistent with the Eaton-Lambert syndrome?
A. abnormal presynaptic vesicles
B. antibodies to the acetylcholine receptor
C. decreased numbers of acetylcholine receptors
D. defect in release of acetylcholine quanta
E. none ofthe above
D. defect in release of acetylcholine quanta
92
```
92. The von Hippel-Undau disease has been associated with all of the following except
A. a defect on chromosome 3
B. dominant inheritance
C. iris hamartomas
D. pancreatic cysts
E. renal cell carcinoma
```
C. iris hamartomas
93
```
93. Gerstmann's syndrome classically involves a lesion in the
A. dominant frontal lobe
B. dominant parietal lobe
C. dominant temporal lobe
D. nondominant parietal lobe
E. nondominant temporal lobe
```
B. dominant parietal lobe
94
94. Each of the following is true of dopamine pharmacology except the following:
A. Homovanillic acid is a metabolite.
B. It is derived from phenylalanine.
C. It is metabolized by monoamine oxidase (MAO).
D. The activation of the D2 receptor decreases the release of transmitter at synaptic terminals.
E. The rate-limiting step in its synthesis is dopa decarboxylase.
E. The rate-limiting step in its synthesis is dopa decarboxylase.
95
```
For questions 95 to 99, match the anti parkinsonian drug with the description. Each response may be used once, more than once, or not at all.
A. amantadine
B. Artane (trihexyphenidyl)
C. bromocriptine
D. Eldepryl (selegiline)
E. Sinemet (carbidopa-Ievidopa)
```
95. contains a dopa decarboxylase inhibitor
E. Sinemet (carbidopa-Ievidopa)
96
```
For questions 95 to 99, match the anti parkinsonian drug with the description. Each response may be used once, more than once, or not at all.
A. amantadine
B. Artane (trihexyphenidyl)
C. bromocriptine
D. Eldepryl (selegiline)
E. Sinemet (carbidopa-Ievidopa)
```
96. slows progression of the disease in its early stages
D. Eldepryl (selegiline)
97
```
For questions 95 to 99, match the anti parkinsonian drug with the description. Each response may be used once, more than once, or not at all.
A. amantadine
B. Artane (trihexyphenidyl)
C. bromocriptine
D. Eldepryl (selegiline)
E. Sinemet (carbidopa-Ievidopa)
```
97. stimulates D2 receptors
C. bromocriptine
98
```
For questions 95 to 99, match the anti parkinsonian drug with the description. Each response may be used once, more than once, or not at all.
A. amantadine
B. Artane (trihexyphenidyl)
C. bromocriptine
D. Eldepryl (selegiline)
E. Sinemet (carbidopa-Ievidopa)
```
98. Dryness of the mouth and blurred vision are some of the side effects.
B. Artane (trihexyphenidyl)
99
```
For questions 95 to 99, match the anti parkinsonian drug with the description. Each response may be used once, more than once, or not at all.
A. amantadine
B. Artane (trihexyphenidyl)
C. bromocriptine
D. Eldepryl (selegiline)
E. Sinemet (carbidopa-Ievidopa)
```
99. inhibits intracerebral metabolic degradation of dopamine
B. Artane (trihexyphenidyl)
100
```
100. Wernicke's area corresponds most closely to Brodmann's area(s)
A. 17
B. 19
C. 22
D. 41 and 42
E. 44
```
C. 22
101
```
101. Complications of diabetes generally thought to be vascular in origin include
I. ophthalmoplegia
II. acute mononeuropathy
III. mononeuritis multiplex
IV. distal sensorimotor polyneuropathy
A. I, II, III
B. I, III
C. II, IV
D. IV
E. all of the above
```
A. I, II, III
102
102. Each of the following is consistent with a cholinergic crisis in a patient with myasthenia gravis being treated with pyridostigmine (Mestinon) except
A. bradycardia
B. diarrhea
C. increased strength after the Tensilon test
D. miosis
E. sweating
C. increased strength after the Tensilon test
103
```
103. The genetic transmission of the MELAS syndrome is
A. autosomal dominant
B. autosomal recessive
C. maternal inheritance
D. sporadic
E. X-linked recessive
```
C. maternal inheritance
104
```
For questions 104 to 107, match the cord syndrome with the description. Each response may be used once, more than once, or not at all.
A. anterior cord syndrome
B. Brown-Sequard syndrome
C. central cord syndrome
D. AandB
E. none of the above
```
104. acute hyperextension
C. central cord syndrome
105
```
For questions 104 to 107, match the cord syndrome with the description. Each response may be used once, more than once, or not at all.
A. anterior cord syndrome
B. Brown-Sequard syndrome
C. central cord syndrome
D. AandB
E. none of the above
```
105. flexion injury
A. anterior cord syndrome
106
```
For questions 104 to 107, match the cord syndrome with the description. Each response may be used once, more than once, or not at all.
A. anterior cord syndrome
B. Brown-Sequard syndrome
C. central cord syndrome
D. AandB
E. none of the above
```
106. dissociated sensory loss
A. anterior cord syndrome
107
```
For questions 104 to 107, match the cord syndrome with the description. Each response may be used once, more than once, or not at all.
A. anterior cord syndrome
B. Brown-Sequard syndrome
C. central cord syndrome
D. AandB
E. none of the above
```
107. Among the incomplete syndromes, this has the best prognosis.
B. Brown-Sequard syndrome
108
```
For questions 108 to 113, match the description with the sleep stage.
A. REM sleep
B. non-rapid eye movement (NREM) sleep
C. both
D. neither·
```
108. dreaming
C. both
109
```
For questions 108 to 113, match the description with the sleep stage.
A. REM sleep
B. non-rapid eye movement (NREM) sleep
C. both
D. neither·
```
109. adult somnambulism
B. non-rapid eye movement (NREM) sleep
110
```
For questions 108 to 113, match the description with the sleep stage.
A. REM sleep
B. non-rapid eye movement (NREM) sleep
C. both
D. neither·
```
110. desynchronization of the EEG
A. REM sleep
111
```
For questions 108 to 113, match the description with the sleep stage.
A. REM sleep
B. non-rapid eye movement (NREM) sleep
C. both
D. neither·
```
111. K complexes
B. non-rapid eye movement (NREM) sleep
112
```
For questions 108 to 113, match the description with the sleep stage.
A. REM sleep
B. non-rapid eye movement (NREM) sleep
C. both
D. neither·
```
112. sleep spindles
B. non-rapid eye movement (NREM) sleep
113
```
For questions 108 to 113, match the description with the sleep stage.
A. REM sleep
B. non-rapid eye movement (NREM) sleep
C. both
D. neither·
```
113. Glucose metabolism in the brain is increased in comparison to the waking state.
A. REM sleep
114
For questions 114 to 117, match the description with the disease.
A. glycogen storage disease type II (acid maltase deficiency)
B. glycogen storage disease type V (McArdle's disease)
C. both
D. neither
114. myophosphorylase deficiency
B. glycogen storage disease type V (McArdle's disease)
115
For questions 114 to 117, match the description with the disease.
A. glycogen storage disease type II (acid maltase deficiency)
B. glycogen storage disease type V (McArdle's disease)
C. both
D. neither
115. Large amounts of glycogen are deposited in various organs.
A. glycogen storage disease type II (acid maltase deficiency)
116
For questions 114 to 117, match the description with the disease.
A. glycogen storage disease type II (acid maltase deficiency)
B. glycogen storage disease type V (McArdle's disease)
C. both
D. neither
116. Three clinical forms are noted.
A. glycogen storage disease type II (acid maltase deficiency)
117
For questions 114 to 117, match the description with the disease.
A. glycogen storage disease type II (acid maltase deficiency)
B. glycogen storage disease type V (McArdle's disease)
C. both
D. neither
117. X-linked recessive inheritance
D. neither
118
```
118. Wilson's disease is characterized by
I. high urinary copper excretion
II. high serum copper
Ill. low ceruloplasmin levels
IV. hyperdensity of the globus pallid us and putamen on cr
A. I, II, III
B. I, III
C. II, IV
D. IV
E. all of the above
```
B. I, III
119
119. Each of the following is true of central pontine myelinolysis except
A. A marked inflammatory response with destruction of nerve cells in the pons is seen.
B. It is associated with rapid correction of hyponatremia.
C. It is associated with chronic alcoholism.
D. Quadriplegia, pseudobulbar palsy, and a locked in syndrome can occur.
E. Some patients have no signs or symptoms referable to the pontine lesion.
A. A marked inflammatory response with destruction of nerve cells in the pons is seen.
120
```
For questions 120 to 122, match the description with the disease.
A. homocystinuria
B. Marfan's syndrome
C. both
D. neither
```
120. arachnodactyly
C. both
121
```
For questions 120 to 122, match the description with the disease.
A. homocystinuria
B. Marfan's syndrome
C. both
D. neither
```
121. mental retardation
A. homocystinuria
122
```
For questions 120 to 122, match the description with the disease.
A. homocystinuria
B. Marfan's syndrome
C. both
D. neither
```
122. brain infarcts
A. homocystinuria
123
```
123. Dressing apraxia is associated with a lesion in the
A. dominant frontal lobe
B. dominant parietal lobe
C. nondominant frontal lobe
D. nondominant parietal lobe
E. nondominant temporal lobe
```
D. nondominant parietal lobe
124
```
124. The axillary nerve innervates the
A. coracobrachialis
B. rhomboids
C. supraspinatus
D. teres major
E. teres minor
```
E. teres minor
125
125. All ofthe following are seen in Sturge-Weber syndrome except
A. calcified cortical vessels
B. facial nlPVus contralateral to seizure activity
C. hemisensory deficit contralateral to facial nevus
D. meningeal venous angiomas
E. tramline calcifications outlining the convolution of the parieto-occipital cortex
A. calcified cortical vessels
126
```
126. The normal sensory nerve conduction velocity in the median and ulnar nerves is approximately
A. 10 meters per second (m/s)
B. 25 mls
C. 50 mls
D. 100 m/s'
E. 150 mls
```
C. 50 mls
127
127. Each of these statements is true of Charcot-Mar ie-Tooth disease except
A. Autosomal dominance is the usual mode of inheritance.
B. Distal muscle atrophy is prominent.
C. It can affect the upper extremities.
D. Steroids have no effect on disease progression.
E. The autonomic nervous system is usually involved.
E. The autonomic nervous system is usually involved.
128
```
128. Cranial nerves that may be affected by a c1ival chordoma include
I. cranial nerve XII
II. cranial nerve V
Ill. cranial nerve X
IV. cranial nerve II
A. I, II, III
B. I, III
C. II,IV
D. IV
E. all of the above
```
E. all of the above
129
129. Which of the following CSF findings is least consistent with tuberculous meningitis?
A. glucose of 30 mg/dL
B. lymphocytic predomination after 1 week of illness
C. opening pressure of 200 mm CSF
D. protein of 35 mg%
E. white blood cell count (WBC) of200 cells/mm3
D. protein of 35 mg%
130
130. The syndrome of PICA occlusion results in all of the following except
A. contralateral Horner's syndrome
B. contralateral loss of pain and temperature over the body
C. ipsilateral ataxia
D. ipsilateral numbness of the limbs
E. ipsilateral paralysis of the palate
A. contralateral Horner's syndrome
131
```
131. Stage 2 sleep is characterized by
A. K complexes
B. delta waves
C. desynchronization of the EEG
D. REM sleep
E. somnambulism
```
A. K complexes
132
For questions 132 to 141, match the muscular dystrophy with the description. Each response may be used once, more than once, or not at all.
A. Becker's muscular dystrophy
B. Duchenne's muscular dystrophy
C. Emery-Dreifuss muscular dystrophy
D. Landouzy-Dejerine (fascioscapulohumeral) dystrophy
E. myotonic dystrophy
132. The protein dystrophin is absent.
B. Duchenne's muscular dystrophy
133
For questions 132 to 141, match the muscular dystrophy with the description. Each response may be used once, more than once, or not at all.
A. Becker's muscular dystrophy
B. Duchenne's muscular dystrophy
C. Emery-Dreifuss muscular dystrophy
D. Landouzy-Dejerine (fascioscapulohumeral) dystrophy
E. myotonic dystrophy
133. The protein dystrophin is structurally abnormal.
A. Becker's muscular dystrophy
134
For questions 132 to 141, match the muscular dystrophy with the description. Each response may be used once, more than once, or not at all.
A. Becker's muscular dystrophy
B. Duchenne's muscular dystrophy
C. Emery-Dreifuss muscular dystrophy
D. Landouzy-Dejerine (fascioscapulohumeral) dystrophy
E. myotonic dystrophy
134. the most common adult form of muscular dystrophy
E. myotonic dystrophy
135
For questions 132 to 141, match the muscular dystrophy with the description. Each response may be used once, more than once, or not at all.
A. Becker's muscular dystrophy
B. Duchenne's muscular dystrophy
C. Emery-Dreifuss muscular dystrophy
D. Landouzy-Dejerine (fascioscapulohumeral) dystrophy
E. myotonic dystrophy
135. Prominent pseudohypertrophy of the calves is seen in Becker and in this type.
B. Duchenne's muscular dystrophy
136
For questions 132 to 141, match the muscular dystrophy with the description. Each response may be used once, more than once, or not at all.
A. Becker's muscular dystrophy
B. Duchenne's muscular dystrophy
C. Emery-Dreifuss muscular dystrophy
D. Landouzy-Dejerine (fascioscapulohumeral) dystrophy
E. myotonic dystrophy
136. Contractures of the elbow flexors and neck extensors occur early.
C. Emery-Dreifuss muscular dystrophy
137
For questions 132 to 141, match the muscular dystrophy with the description. Each response may be used once, more than once, or not at all.
A. Becker's muscular dystrophy
B. Duchenne's muscular dystrophy
C. Emery-Dreifuss muscular dystrophy
D. Landouzy-Dejerine (fascioscapulohumeral) dystrophy
E. myotonic dystrophy
137. Abnormal gene is on chromosome 4.
D. Landouzy-Dejerine (fascioscapulohumeral) dystrophy
138
For questions 132 to 141, match the muscular dystrophy with the description. Each response may be used once, more than once, or not at all.
A. Becker's muscular dystrophy
B. Duchenne's muscular dystrophy
C. Emery-Dreifuss muscular dystrophy
D. Landouzy-Dejerine (fascioscapulohumeral) dystrophy
E. myotonic dystrophy
138. Lens opacities are found in 90% of patients.
E. myotonic dystrophy
139
For questions 132 to 141, match the muscular dystrophy with the description. Each response may be used once, more than once, or not at all.
A. Becker's muscular dystrophy
B. Duchenne's muscular dystrophy
C. Emery-Dreifuss muscular dystrophy
D. Landouzy-Dejerine (fascioscapulohumeral) dystrophy
E. myotonic dystrophy
139. occasionally associated with congenital absence of an involved muscle
D. Landouzy-Dejerine (fascioscapulohumeral) dystrophy
140
For questions 132 to 141, match the muscular dystrophy with the description. Each response may be used once, more than once, or not at all.
A. Becker's muscular dystrophy
B. Duchenne's muscular dystrophy
C. Emery-Dreifuss muscular dystrophy
D. Landouzy-Dejerine (fascioscapulohumeral) dystrophy
E. myotonic dystrophy
140. Masseter atrophy, ptosis, and frontal baldness are characteristic.
E. myotonic dystrophy
141
For questions 132 to 141, match the muscular dystrophy with the description. Each response may be used once, more than once, or not at all.
A. Becker's muscular dystrophy
B. Duchenne's muscular dystrophy
C. Emery-Dreifuss muscular dystrophy
D. Landouzy-Dejerine (fascioscapulohumeral) dystrophy
E. myotonic dystrophy
141. Abnormal gene is on chromosome 19.
E. myotonic dystrophy
142
```
142. Monoplegia without muscular atrophy is most often secondary to a lesion in the
A. brainstem
B. cortex
C. internal capsule
D. peripheral nerve
E. spinal cord
```
B. cortex
143
```
143. The transmissable agent of Creutzfeldt -Jakob disease is inactivated by
I. formalin
II. autoclaving at B2°C under pressure for 1 hour
III. alcohol
IV. immersion for 1 hour in bleach
A. I, II, III •
B. I, III
C. II, IV
D. IV
E. all of the above
```
C. II, IV
144
```
144. The most common finding on audiography in patients with acoustic neuromas is
A. flat loss
B. high-frequency loss
C. low tone loss
D. normal audiogram
E. trough-shaped loss
```
B. high-frequency loss
145
```
For questions 145 to 149, match the brachial plexus lesion with the description. Each response may be used once, more than once, or not at all.
A. lateral cord lesion
B. lower trunk lesion
C. medial cord lesion
D. middle trunk lesion
E. upper trunk lesion
```
145. Median sensory responses from the index and middle finger are low in amplitude, but motor conduction velocities of the hand muscles are normal.
D. middle trunk lesion
146
```
For questions 145 to 149, match the brachial plexus lesion with the description. Each response may be used once, more than once, or not at all.
A. lateral cord lesion
B. lower trunk lesion
C. medial cord lesion
D. middle trunk lesion
E. upper trunk lesion
```
146. Ulnar sensory response from the little finger is abnormal; electromyographic exam of the extensor indicis proprius and abductor pollicis longus is abnormal.
B. lower trunk lesion
147
```
For questions 145 to 149, match the brachial plexus lesion with the description. Each response may be used once, more than once, or not at all.
A. lateral cord lesion
B. lower trunk lesion
C. medial cord lesion
D. middle trunk lesion
E. upper trunk lesion
```
147. Ulnar sensory response from the little finger is abnormal; normal responses are seen from the extensor indicis proprius.
C. medial cord lesion
148
```
For questions 145 to 149, match the brachial plexus lesion with the description. Each response may be used once, more than once, or not at all.
A. lateral cord lesion
B. lower trunk lesion
C. medial cord lesion
D. middle trunk lesion
E. upper trunk lesion
```
148. Action potentials from the deltoid and biceps are of low amplitude.
E. upper trunk lesion
149
```
For questions 145 to 149, match the brachial plexus lesion with the description. Each response may be used once, more than once, or not at all.
A. lateral cord lesion
B. lower trunk lesion
C. medial cord lesion
D. middle trunk lesion
E. upper trunk lesion
```
149. Abnormal median sensory responses and denervation are seen in the biceps and flexor carpi radialis; normal response is seen from the abductor pollicis brevis.
A. lateral cord lesion
150
```
150. Persons migrating from a zone with high risk of mUltiple sclerosis (MS) to one of low risk after age 15 show a risk of developing MS that is
A. equal to that of the high-risk zone
B. equal to that of the low-risk zone
C. intermediate between the two zones
D. lower than that of the low-risk zone
E. unpredictable
```
A. equal to that of the high-risk zone
151
```
151. Eye findings in botulinism include
I. ptosis
II. strabismus
III. diplopia
IV. unreactive pupils
A. I, II, III
B. I, III
C. II, IV
D. IV
E. all ofthe above
```
E. all ofthe above
152
```
152. Repetition is least likely to be affected by a
A. Broca's aphasia
B. conduction aphasia
C. global aphasia
D. transcortical sensory aphasia
E. Wernicke's aphasia
```
D. transcortical sensory aphasia
153
```
153. Which stage of sleep is prominent on EEG at the onset of narcoleptic sleep attacks?
A. stage 1
B. stage 2
C. stage 3
D. stage4
E. REM
```
E. REM
154
```
154. The most common cause of viral meningitis is
A. enterovirus
B. human immunodeficiency virus (HIV)
C. leptospirosis
D. lymphocytic choriomeningitis
E. mumps
```
A. enterovirus
155
```
155. Successive involvement of all cranial nerves on one side has been reported in
A. meningitis
B. sarcoidosis
C. tumors of the brainstem
D. tumors of the cavernous sinus
E. tumors of the clivus
```
E. tumors of the clivus
156
156. Each of the following is true of Meniere's disease except
A. Distention of the endolymphatic duct occurs.
B. Hearing loss is usually unilateral.
C. High tone loss occurs early in the disease.
D. Horizontal nystagmus occurs during an acute attack.
E. Low-pitched tinnitus is typical.
C. High tone loss occurs early in the disease.
157
157. Each of the following is true of Eaton-Lambert syndrome except
A. Autono,ptic disturbances are seen.
B. Fasciculations are not seen.
C. It has been associated with carcinoma of the stomach and colon.
D. Temporary increase in muscle power may occur during the first few contractions.
E. Women are more frequently affected than men.
E. Women are more frequently affected than men.
158
158. Type I (red) muscle fibers differ from type II (white) fibers in all of the following ways except that they
A. are more fatiguable
B. fire more tonically
C. have a slower contraction and relaxation rates
D. have more mitochondria
E. have more oxidative enzymes
A. are more fatiguable
159
```
159. Historically, one of the treatment modalities of Parkinson's disease was surgical ligation of the
A. anterior cerebral artery
B. anterior choroidal artery
C. middle cerebral artery
D. posterior communicating artery
E. recurrent artery of Huebner I
```
B. anterior choroidal artery
160
160. Which of the following is not characteristic of diabetic mononeuritis multiplex?
A. Lower extremities are more commonly affected than upper extremities.
B. painful neuropathy
C. Proximal extremities are more commonly affected than distal extremities.
D. Recovery is usual.
E. symmetric neuropathy
E. symmetric neuropathy
161
```
For questions 161 to 165, provide the best match of each antiepileptic drug with the seizure type. Each response may be used once, more than once, or not at all.
A. adrenocorticotropic hormone (ACfH)
B. ethosuximide
C. lorazepam
D. Tegretol
E. valproic acid
```
161. status epilepticus
C. lorazepam
162
```
For questions 161 to 165, provide the best match of each antiepileptic drug with the seizure type. Each response may be used once, more than once, or not at all.
A. adrenocorticotropic hormone (ACfH)
B. ethosuximide
C. lorazepam
D. Tegretol
E. valproic acid
```
162. absence seizures
B. ethosuximide
163
```
For questions 161 to 165, provide the best match of each antiepileptic drug with the seizure type. Each response may be used once, more than once, or not at all.
A. adrenocorticotropic hormone (ACfH)
B. ethosuximide
C. lorazepam
D. Tegretol
E. valproic acid
```
163. complex partial seizures
D. Tegretol or
| E. valproic acid
164
```
For questions 161 to 165, provide the best match of each antiepileptic drug with the seizure type. Each response may be used once, more than once, or not at all.
A. adrenocorticotropic hormone (ACfH)
B. ethosuximide
C. lorazepam
D. Tegretol
E. valproic acid
```
164. infantile seizures
A. adrenocorticotropic hormone (ACfH)
165
```
For questions 161 to 165, provide the best match of each antiepileptic drug with the seizure type. Each response may be used once, more than once, or not at all.
A. adrenocorticotropic hormone (ACfH)
B. ethosuximide
C. lorazepam
D. Tegretol
E. valproic acid
```
165. atypical petit mal syndrome of Lennox-Gastaut
E. valproic acid
166
166. Each of the following is true of polymyositis associated with carcinoma except
A. Carcinoma affects 9% of patients with polymyositis.
B. It is most commonly associated with lung and prostate cancer in men.
C. It is usually painful.
D. Muscle biopsies show no evidence of tumor cells.
E. Proximal muscles are initially affected more than distal ones.
C. It is usually painful.
167
167. Which of the following is least suggestive of cluster headaches?
A. associated with lacrimation and rhinorrhea
B. bilateral location
C. daily occurrence for 2 months
D. male predominance
E. orbital location
B. bilateral location
168
```
168. Organophosphate poisoning is characterized by all of the following except
A. bronchial spasms
B. drymouth
C. miosis
D. sweating
E. vomiting
```
B. drymouth
169
```
169. One of the cerebral biochemical defects in Huntington's disease is
A. decreased dopamine
B. decreased GABA
C. decreased norepinephrine
D. decreased somatostatin
E. increased acetylcholine
```
B. decreased GABA
170
170. Prosopagnosia is associated with lesions of the
A. anterior corpus callosum
B. bilateral anterorinferior temporal lobes
C. bilateral medial temporo-occipitallobes
D. occipital poles
E. posterior corpus callosum
C. bilateral medial temporo-occipitallobes
171
```
171. A lesion of the supplementary motor cortex produces
A. echolalia
B. palilalia
C. poverty of spontaneous speech
D. receptive aphasia
E. no speech abnormalities
```
C. poverty of spontaneous speech
172
172. Lesions offlle peroneal nerve produce weakness of the
A. abductor hallucis and gastrocnemius
B. extensor digitorum longus and brevis and abductor hallucis
C. gastrocnemius and flexor hallucis longus
D. tibialis anterior and extensor digitorum longus and brevis
E. tibialis anterior and flexor digitorum brevis
D. tibialis anterior and extensor digitorum longus and brevis
173
```
173. Which of the following is not characteristic ofTay-Sachs disease?
A. abnormal startle response
B. autosomal recessive inheritance
C. cherry-red spots in the retina
D. deficiency of sphingomyelinase
E. macrocephaly
```
D. deficiency of sphingomyelinase
174
```
174. Which of the following deficits is least characteristic of Alzheimer's disease?
A. corticospinal tract dysfunction
B. dysnomia
C. Korsakoffs amnesic state
D. personality change
E. spatial disorientation
```
A. corticospinal tract dysfunction
175
175. Each of the following is true of Guillain-Barre syndrome except
A. Disturbances of autonomic function are common.
B. High-dose steroids form the mainstay of therapy.
C. Hypo- or areflexia is characteristic.
D. The mortality rate is 3%.
E. The peak severity is 10 to 14 days after onset in 80% of cases.
B. High-dose steroids form the mainstay of therapy.
176
176. The second-order neuron in the sympathetic pathway to the pupil arises from the:
A. ciliary ganglion to the iris
B. Edinger-Westphal nucleus to the ciliary ganglion
C. hypothalamus to the lateral hom cells at (8 to T3
D. lateral hom cells at (8 to T3 to the superior cervical ganglion
E. superior cervical ganglion to the iris
D. lateral hom cells at (8 to T3 to the superior cervical ganglion
177
```
177. The treatment of choice for toxoplasmosis is
A. penicillin
B. praziquantel
C. pyrimethamine and sulfadiazine
D. rifampin and nafcillin
E. thiabendazole
```
C. pyrimethamine and sulfadiazine
178
178. Which of the following is true of subacute sclerosing panencephalitis (SSPE)?
A. Intracytoplasmic but not intranuclear inclusions are found.
B. It is more common in patients
D. The EEG shows characteristic periodic 2 to 3 per second waves.
179
179. The treatment of choice for optic neuritis is
A. intrathecal prednisolone
B. intravenous methylprednisolone followed by oral prednisone
C. oral prednisone only
D. oral prednisone followed by intravenous methylprednisolone
E. plasmapheresis
B. intravenous methylprednisolone followed by oral prednisone
180
```
180. Schilder's disease most closely resembles
A. Duchenne muscular dytrophy
B. Krabbe's disease
C. multiple sclerosis
D. trisomy 13
E. tuberous sclerosis
```
C. multiple sclerosis
181
181. The cricothyroid muscle is innervated by the
A. external branch of the superior laryngeal nerve
B. internal laryngeal branch of the superior laryngeal nerve
C. ninth cranial nerve
D. recurrent laryngeal nerve
E. seventh cranial nerve
A. external branch of the superior laryngeal nerve
182
182. Korsakoffs syndrome is best characterized by (a)
A. defect in learning and loss of past memories
B. global confusional state
C. manic-depressive state
D. paranoid ideation
E. stupor or coma
A. defect in learning and loss of past memories
183
```
183. Werdnig-Hoffmann disease is notable for all of the following except
A. areflexia
B. autosomal recessive inheritance
C. hypotonia
D. involvement of chromosome 5q
E. mental retardation
```
E. mental retardation
184
```
184. Tricyclic antidepressants
I. block norepinephrine uptake
II. block oxidative deamination of monoamines
III. block serotonin uptake
IV. bBind to GABA receptors
A. I, II, III
B. I, III
C. II, IV
D. IV
E. all ofthe above
```
B. I, III
185
```
For questions 185 to 189, match the description with the disease.
A. amyotrophic lateral sclerosis (ALS)
B. cervical spondylosis
C. both
D. neither
```
185. lower extremity spasticity
C. both
186
```
For questions 185 to 189, match the description with the disease.
A. amyotrophic lateral sclerosis (ALS)
B. cervical spondylosis
C. both
D. neither
```
186. hyporeflexia
D. neither
187
```
For questions 185 to 189, match the description with the disease.
A. amyotrophic lateral sclerosis (ALS)
B. cervical spondylosis
C. both
D. neither
```
187. hyperreflexia
C. both
188
```
For questions 185 to 189, match the description with the disease.
A. amyotrophic lateral sclerosis (ALS)
B. cervical spondylosis
C. both
D. neither
```
188. absence or paucity of sensory symptoms
A. amyotrophic lateral sclerosis (ALS)
189
```
For questions 185 to 189, match the description with the disease.
A. amyotrophic lateral sclerosis (ALS)
B. cervical spondylosis
C. both
D. neither
```
189. atrophy of the hand muscles
C. both
190
```
For questions 190 to 195, match the vasculitis with the description. Each response may be used once, more than once, or not at all.
A. Cogan's syndrome
B. polyarteritis nodosa
C. systemic lupus erythematosus
D. Takayasu's syndrome
E. temporal arteritis
F. Wegener's granulomatosis
```
190. antineutrophil cytoplasmic antibodies
F. Wegener's granulomatosis
191
```
For questions 190 to 195, match the vasculitis with the description. Each response may be used once, more than once, or not at all.
A. Cogan's syndrome
B. polyarteritis nodosa
C. systemic lupus erythematosus
D. Takayasu's syndrome
E. temporal arteritis
F. Wegener's granulomatosis
```
191. antinuclear antibodies and malar rash
C. systemic lupus erythematosus
192
```
For questions 190 to 195, match the vasculitis with the description. Each response may be used once, more than once, or not at all.
A. Cogan's syndrome
B. polyarteritis nodosa
C. systemic lupus erythematosus
D. Takayasu's syndrome
E. temporal arteritis
F. Wegener's granulomatosis
```
192. visual loss and claudication with chewing
E. temporal arteritis
193
```
For questions 190 to 195, match the vasculitis with the description. Each response may be used once, more than once, or not at all.
A. Cogan's syndrome
B. polyarteritis nodosa
C. systemic lupus erythematosus
D. Takayasu's syndrome
E. temporal arteritis
F. Wegener's granulomatosis
```
193. visual loss and loss of peripheral pulses
D. Takayasu's syndrome
194
```
For questions 190 to 195, match the vasculitis with the description. Each response may be used once, more than once, or not at all.
A. Cogan's syndrome
B. polyarteritis nodosa
C. systemic lupus erythematosus
D. Takayasu's syndrome
E. temporal arteritis
F. Wegener's granulomatosis
```
194. mononeuritis multiplex, kidney involvement, and skin purpura
B. polyarteritis nodosa
195
```
For questions 190 to 195, match the vasculitis with the description. Each response may be used once, more than once, or not at all.
A. Cogan's syndrome
B. polyarteritis nodosa
C. systemic lupus erythematosus
D. Takayasu's syndrome
E. temporal arteritis
F. Wegener's granulomatosis
```
195. deafness and keratitis
A. Cogan's syndrome
196
196. Wernicke's encephalopathy consists of all of the following except
A. defect in retentive memory out of proportion to other cognitive functions
B. gait ataxia
C. gaze palsy
D. mental confusion
E. nystagmus
A. defect in retentive memory out of proportion to other cognitive functions
197
```
197. Which of the following is least suggestive of a parietal lobe lesion?
A. astereognosis
B. loss of position sense
C. loss of temperature sensation
D. loss of two-point discrimination
E. atopognosia
```
C. loss of temperature sensation
198
198. The purest form of achromatopsia is caused by a lesion involving the
A. left calcarine cortex
B. left superior occipitotemporal region
C. right inferior occipitotemporal region
D. right occipital cortex and angular gyrus
E. right superior calcarine cortex
C. right inferior occipitotemporal region
199
199. Failure of a miotic pupil to dilate after instilling 2 to 10% cocaine followed by 1% hydroxyamphetamine indicates a
A. first-order Horner's syndrome
B. second-order Horner's syndrome
C. third-order Horner's syndrome
D. first- or second-order Horner's syndrome
E. second- or third-order Horner's syndrome ,
C. third-order Horner's syndrome
200
```
200. Somnambulism occurs in which stage of sleep?
A. stage 1
B. stage 2
C. stage 4
D. REM
E. all of the above
```
C. stage 4
201
```
201. The most effective treatment of enuresis is
A. clonopin
B. clonidine
C. haloperidol (Haldol)
D. imipramine (Tofranil)
E. methylphenidate (Ritalin)
```
D. imipramine (Tofranil)
202
```
202. In most ca!es, section of the corpus callosum causes
A. apraxia of both hands to command
B. apraxia ofthe left hand to command
C. apraxia ofthe right hand to command
D. object agnosia
E. no deficit
```
B. apraxia ofthe left hand to command
203
For questions 203 to 208, match the aphasia with the description. Each response may be used once, more than once, or not at all.
A. good comprehension, fluent speech, poor repetition
B. good comprehension, nonfluent speech, good repetition
C. good comprehension, nonfluent speech, poor repetition
D. poor comprehension, fluent speech, good repetition
E. poor comprehension, fluent speech, poor repetition
F. poor comprehension, nonfluent speech, poor repetition
203. Broca's aphasia
C. good comprehension, nonfluent speech, poor repetition
204
For questions 203 to 208, match the aphasia with the description. Each response may be used once, more than once, or not at all.
A. good comprehension, fluent speech, poor repetition
B. good comprehension, nonfluent speech, good repetition
C. good comprehension, nonfluent speech, poor repetition
D. poor comprehension, fluent speech, good repetition
E. poor comprehension, fluent speech, poor repetition
F. poor comprehension, nonfluent speech, poor repetition
204. conduction aphasia
A. good comprehension, fluent speech, poor repetition
205
For questions 203 to 208, match the aphasia with the description. Each response may be used once, more than once, or not at all.
A. good comprehension, fluent speech, poor repetition
B. good comprehension, nonfluent speech, good repetition
C. good comprehension, nonfluent speech, poor repetition
D. poor comprehension, fluent speech, good repetition
E. poor comprehension, fluent speech, poor repetition
F. poor comprehension, nonfluent speech, poor repetition
205. global aphasia
F. poor comprehension, nonfluent speech, poor repetition
206
For questions 203 to 208, match the aphasia with the description. Each response may be used once, more than once, or not at all.
A. good comprehension, fluent speech, poor repetition
B. good comprehension, nonfluent speech, good repetition
C. good comprehension, nonfluent speech, poor repetition
D. poor comprehension, fluent speech, good repetition
E. poor comprehension, fluent speech, poor repetition
F. poor comprehension, nonfluent speech, poor repetition
206. transcortical motor aphasia
B. good comprehension, nonfluent speech, good repetition
207
For questions 203 to 208, match the aphasia with the description. Each response may be used once, more than once, or not at all.
A. good comprehension, fluent speech, poor repetition
B. good comprehension, nonfluent speech, good repetition
C. good comprehension, nonfluent speech, poor repetition
D. poor comprehension, fluent speech, good repetition
E. poor comprehension, fluent speech, poor repetition
F. poor comprehension, nonfluent speech, poor repetition
207. transcortical sensory aphasia
D. poor comprehension, fluent speech, good repetition
208
For questions 203 to 208, match the aphasia with the description. Each response may be used once, more than once, or not at all.
A. good comprehension, fluent speech, poor repetition
B. good comprehension, nonfluent speech, good repetition
C. good comprehension, nonfluent speech, poor repetition
D. poor comprehension, fluent speech, good repetition
E. poor comprehension, fluent speech, poor repetition
F. poor comprehension, nonfluent speech, poor repetition
208. Wernicke's aphasia
E. poor comprehension, fluent speech, poor repetition
209
```
For questions 209 to 215, match the description with the disease.
A. dermatomyositis
B. polymyositis
C. both
D. neither
```
209. may be associated with carcinoma
C. both
210
```
For questions 209 to 215, match the description with the disease.
A. dermatomyositis
B. polymyositis
C. both
D. neither
```
210. Men are more frequently affected than women.
D. neither
211
```
For questions 209 to 215, match the description with the disease.
A. dermatomyositis
B. polymyositis
C. both
D. neither
```
211. Necrosis and phagocytosis of individual muscle fibers are the principal changes.
B. polymyositis
212
```
For questions 209 to 215, match the description with the disease.
A. dermatomyositis
B. polymyositis
C. both
D. neither
```
212. Perifascicular muscle degeneration and atrophy are found.
A. dermatomyositis
213
```
For questions 209 to 215, match the description with the disease.
A. dermatomyositis
B. polymyositis
C. both
D. neither
```
213. Large numbers of T cells are found in the intramuscular inflammatory exudates.
B. polymyositis
214
```
For questions 209 to 215, match the description with the disease.
A. dermatomyositis
B. polymyositis
C. both
D. neither
```
214. Immune complexes are deposited in the walls of arterioles and venules.
A. dermatomyositis
215
```
For questions 209 to 215, match the description with the disease.
A. dermatomyositis
B. polymyositis
C. both
D. neither
```
215. Corticosteroids have no effect on symptoms.
D. neither
