Neuroscience

Question 1

A 40-year-old man was admitted to the neurology service for evaluation of persistent numbness over his left jaw and lower face. MRI reveals a schwannoma, which is compressing a cranial nerve as the nerve exits the skull.
The cranial nerve involved in this case exits the skull through which of the following foramina?
(A) Foramen ovale
(B) Foramen rotundum
(C) Foramen spinosum
(D) Jugular foramen
(E) Superior orbital fissure

Answer 1

(A) Foramen ovale

Question 2

A 63-year-old homeless woman is brought to the ER by the police, who noted her to be disoriented and confused. On questioning, the patient appears to be having a problem with her short-term memory, frequently forgetting what question she had been asked.
She provides plausible details of the events prior to her coming to the hospital, but the police report it to be untrue. On physical examination she is emaciated and has nystagmus and an unsteady gait. Examination of emergency department records reveals that she has presented multiple times in the past for alcohol withdrawal.
The lesion accounting for the patient’s symptoms is located in which part of the brain?
(A) Basal ganglia
(B) Broca’s area
(C) Cerebellar vermis
(D) Mamillary bodies
(E) Wernicke’s area

Answer 2

(D) Mamillary bodies

Question 3

A 32-year-old man comes to the physician because of headaches that occur at night and without warning. They begin in his left eye and then generalize to the left side of his face. Alcohol can precipitate attacks, which last for less than 1 hour. The patient rates the pain as a 10/10, and multiple over-the-counter analgesics have resulted in minimal benefit. He is given a prescription for sumatriptan to treat his symptoms and is prescribed verapamil for prophylaxis.
Which of the following is the most likely diagnosis?
(A) Cluster headache
(B) Medication-overuse headache
(C) Migraine headache
(D) Temporomandibular joint dysfunction syndrome
(E) Tension headache

Answer 3

(A) Cluster headache

Question 4

A 25-year-old man with a history of intractable seizures has recently been switched to a new antiseizure medication by his neurologist. He subsequently develops a rash on his body, which consists of maculopapular blistering lesions with central erythema surrounded by a halo of erythema. His neurologist also notes that he has developed lesions on his gums and anus. The neurologist discontinues the medication immediately and admits the patient to the hospital. Laboratory test results shows significant low WBC count. Which of the following medication is most likely to have resulted in the patient’s symptoms?
(A) Carbamazepine
(B) Gabapentin
(C) Phenytoin
(D) Valproic acid
(E) Ethosuximide

Answer 4

(A) Carbamazepine