Neuro multiple choice questions

Question 1

which of the following is associated with an increased incidence of multiple sclerosis?A. latitude of patients home countryB. high dietary cassavaC. hypercalcaemiaD. fungal toe nail infectionE. exposure to vinyl chloride

Answer 1

A. latitude of patient’s home countrycassava is associated with a multi-nodular goitre as they contain thiocyanate

Question 2

gabby sustains a hockey stick injury. she is initially dazed but rapidly recovers and continues with the match. 30 minutes later she collapses and the paramedics report her GCS as E2V3M3. what injury has she most likely sustained?a. acute subdural haemorrhageb. chronic subdural haemorragec. acute extradural haemorraged. cerebral contusione. ruptured cerebral aneurysm

Answer 2

C. acute extradural haemorrhage there is a lucid interval

Question 3

‘The other Andy’ (ex-alcoholic) is living in a nursing home and it is noticed he has a steady deterioration in memory over 3 days. CT head shows an isodense convex mass between the right frontotemporal cortex and the skull. what is this lesion?a. meningiomab. chronic subdural haematomac. Alzheimer’s amyloid plaqued. Frontotemporal dementia e. Choroid plexus cyst

Answer 3

B. chronic subdural haematoma

Question 4

Ibby is performing poorly in school. the teachers complain of recurring episodes of daydreaming lasting for several seconds, from which he cannot be aroused. the boy denies these. what is the most likely cause?a. leukaemiab. attention deficit hyperactivity disorder (ADHD)c. narcolepsyd. cataplexye. absence seizures

Answer 4

E. absence seizures

Question 5

Niall has a witnessed episode of becoming unresponsive, picking at his clothes and lip smacking. his face started twitching followed by his left arm and leg and then entire body. the whole episode lasts 5 minutes. he can remember picking at his clothes, but feeling dreamlike cannot remember the lip smacking. what is this called?a. simple partial seizureb. complex partial seizurec. complex partial seizure with secondary generalizationd. generalised tonic-clonic seizuree. dissociative (functional) seizure(pesudoseizure)

Answer 5

complex partial seizure with secondary generalization

Question 6

Liam suffers an anterior circulation ischaemic stroke. the biggest modifiable risk factor for ischaemic stroke is:a. hypertensionb. hypercholesterolaemiac. smokingd. obesitye. diabetic control

Answer 6

hypertension

Question 7

Matt presents to his GP with a 1 month history of breast swelling, tenderness and recently, occasional lactation. Pregnancy test is negative, but thyroid function tests show a low TSH and low free T3/T4. which blood test should his GP next undertake?a. serum LH/FSHb. serum vasopressinc. lumbar punctured. digital rectal exam for bantse. urinary catecholaminesf. serum prolactin

Answer 7

serum prolactin - may be caused by a prolactinoma

Question 8

taste sensation for the posterior third of the tongue is transmitted to the brain by which nerve?a. CN Vb. CN VIIc. CN IXd. CN Xe. CN XII

Answer 8

CN IX - the glossopharyngeal nerve. make sure you know the number of the nerves

Question 9

Eaton-Lambert Myasthenia Syndrome (LEMS) is characterised by what?a. anti-acetylcholine receptor antibodiesb. Anti-voltage-gated-calcium-channel receptor antibodies (anti VGC)c. anti-acetylcholinesterase antibodiesd. positive tensilon teste. sensory disturbance

Answer 9

b. anti-voltage-gated-calcium-channel receptor antibodies

Question 10

which of the following is not a sign of an upper motor neurone deficit?a. weaknessb. tremorc. spasticityd. hyper-reflexiae. clasp-knife rigidity

Answer 10

tremor- this is an extra-pyramidal sign such as in parkinsons which affects the substantia nigra (part of the basal ganglia that is aka the extra-pyramidal system of the body)

Question 11

which of the following drugs can be used to terminate tonic-clonic seizures?a. dihydrocodeineb. duloxetinec. percacetsd. dantrolenee. diclofenacf. diazepam

Answer 11

f. diazepam

Question 12

which of the following is a sign of cerebellar lesion?a. shuffling gaitb. high-stepping gaitc. stamping gaitd. wide-based gaite. antalgic gait

Answer 12

D. wide based gaita shuffling gait is characteristic of parkinson’sa high stepping gait is the result of a foot drop (peroneal nerve in mononeuritis diabetes)stamping gait is due to a peripheral proprioceptive defectan antalgic gait is due to pain

Question 13

horner’s syndrome results from injury to which of the following structures:a. axillary nerveb. brachial plexusc. parotid glandd. cervical sympathetic ganglione. occulo-motor nerve

Answer 13

D. cervical sympathetic ganglion

Question 14

which of the following conditions is associated with oligoclonal immunoglobulin bands on cerebrospinal fluid electrophoresis?a. multiple sclerosisb. meningitisc. stroked. intracranial abscesse. arachnoiditis

Answer 14

a. multiple sclerosis

Question 15

paul is admitted following a seizure. he opens his eyes to voice but is confused asking nursing staff why they are in his house and pushes you away when you attempt to take blood. he is unable to follow simple instructions.what is his Glasgow coma score?a. E2V3M6b. E3V3M5c. E3V4M5d E3V5M5e. E4V5M4

Answer 15

E3V4M5

Question 16

andy docherty crashes his car at 80mph. he is thrown through the windscreen, not wearing a seatbelt and collides with the road central reservation. at the roadside his airway is obstructed and he does not move, speak or even open his eyes in response to pain. what is his GCS?a. E0 V0 M0b. E1 V1 M1c. E2 V2 M2d. E2 V1 M1e. E1 V1 M2

Answer 16

B - E1V1M1

Question 17

Which of the following signs is consistent with a right-sided parietal lobe lesion?a. Disinhibitionb. Loss of episodic memoryc. Cortical blindnessd. Cognitive regressione. Hemisensory neglect

Answer 17

E - hemisensory neglect

Question 18

Patients with thiamine deficiency are at risk of which condition?a. Frontal dementiab. Idiopathic juvenile seizuresc. Central pontine myelinolysisd. Vanishing white matter diseasee. Wernicke’s encephalopathy

Answer 18

E - Wernicke’s encephalopathy

Question 19

What percentage of strokes are ischaemic in nature?a. 25%b. 45%c. 65%d. 85%e. 95%

Answer 19

d - 85%

Question 20

Which of the following is not a form of cerebral herniation?a. Sprigelian herniationb. Cingulate herniationc. Subfalcine herniationd. Uncal herniatione. Tentorial herniation

Answer 20

a. Sprigelian herniation

Question 21

Neurodegeneration in which of the following structures characterises Parkinson’s disease?a.Putamenb. Substantia nigrac. Globus pallidus internusd. Claustrume. Caudate nucleus

Answer 21

B - substantia nigra

Question 22

Which of the following conditions shows genetic anticipation?a. Amyotrophic lateral sclerosisb. Huntington’s diseasec. Charcot-Marie-Tooth Diseased. Alzheimer’s diseasee. Lewy Body Dementia

Answer 22

b. Huntington’s disease

Question 23

The foramen lacerum transmits which structure?a. Optic nerveb. Trigeminal nervec. Middle meningeal arteryd. Internal Carotid arterye. Jugular vein

Answer 23

internal carotid artery

Question 24

Which of the following increases cerebral blood flow?a. Alkalosisb. Hyperventilationc. Hypothermiad. Hyperglycaemiae. Hypercapnia

Answer 24

Hypercapnia

Question 25

Where is cerebrospinal fluid produceda. Venous sinusesb. Arachnoid granulationsc. Choroid plexusd. Spinal nerve rootse. Cavernous sinusesf. digital rectal exam just for bants

Answer 25

choroid plexus

Question 26

Which of the following is associated with Migraine aura?a. Blurring of visionb. Hemiplegiac. Incontinenced. Diarrhoeae. Neck stiffness

Answer 26

blurring of vision

Question 27

Action potential propagation along an axon is dependent on which ion channels?a. Voltage gated calcium channelsb. Voltage gated sodium channelsc. Voltage gated potassium channelsd. Voltage gated magnesium channelse. Voltage gated chloride channels

Answer 27

B - voltage gated sodium channels