USMLE: Neurology

Question 1

MRI:

• Flattening of posterior globe
• CSF above 300mm

Answer 1

Pseudotumour cerebri

Question 2

Causes compression of the anterior cerebral artery (ACA)

Answer 2

Cerebral herniation

Question 3

Failure of fusion of the lateral folds of the neural plate

Answer 3

Neural tube defect

Question 4

Inadequate maternal folic acid levels before pregnancy

Answer 4

Neural tube defect

Question 5

Tear in bridging veins between brain and dural sinuses

Answer 5

Subdural haematoma

Question 6

Best imaging for subdural haematoma

Answer 6

CT scan

Question 7

Commonly risk factor for meningitis in children

Answer 7

Haematogenous spread of otitis media

Question 8

Protein coding gene most commonly associated with multiple sclerosis

Answer 8

HLA-DR2

Question 9

Conditions resulting in decreased CSF glucose

Answer 9

• Bacteria infection

- Fungal infection

Question 10

Benign tumour derived from ependymal cells

Answer 10

Ependymoma

Question 11

Symptoms:

• Neurofibromatosis NF2
• Tinnitus
• Sensorineural deafness
• Sensory changes in CN V distribution

Answer 11

Schwannoma

Question 12

Associated with cholesterol deposits in corneal storm

Answer 12

Arcus senilis

Question 13

Increased endolymph in inner ear and loss of cochlear hairs

Answer 13

Meniere’s disease

Question 14

Damage to the superior frontal gyrus and anterior cingulate gyrus results in what symptom?

Answer 14

Urinary incontinence

Question 15

What precipitates most atherosclerotic strokes?

Answer 15

Transient ischaemic attack

Question 16

Damage to frontal eye fields in frontal lobe results in what symptoms?

Answer 16

Transient loss of voluntary saccadic eye movement to contralateral side

Question 17

Causes of global hypoxic injury (3)

Answer 17

• Cardiac arrest
• Hypovalemic shock
• CO poisoning

Question 18

Most common sites of stroke lesions for atherosclerotic stroke (3)

Answer 18

• Middle cerebral artery (MCA)
• Internal carotid artery
• Basilar artery

Question 19

Most common origin for embolic stroke

Answer 19

Left side of the heart

Question 20

Most common location for saccular aneurysm

Answer 20

Junction of communicating branches and main cerebral artery

Question 21

Most common cause of intracerebral haemorrhage

Answer 21

Hypertension

Question 22

What is likely to result from fractures of the tempo parietal bone?

Answer 22

Acute epidural haematoma

Question 23

Autosomal dominant disease associated with mental retardation and seizures beginning in infancy

Answer 23

Tuberous sclerosis

Question 24

Cystic dilation of the fourth ventricle, treated by shunt to treat hydrocephalus

Answer 24

Dandy walker malformation

Question 25

Open communication between ventricles (enlarged) and subarachnoid space results in what?

Answer 25

Hydrocephalus

Question 26

What is the treatment for normal pressure hydrocephalus

Answer 26

Ventriculoperitoneal or ventriculoarterial shunting

Question 27

MRI findings in Alzheimer’s disease

Answer 27

• Cerebral atrophy

- Dilation of ventricles

Question 28

X-linked disorder associated with enzyme deficiency resulting in fatty acid build up and damage to myelin sheath of nerves

Answer 28

Adrenoleukodystrophy

Question 29

Striatal systems involved in Parkinsonism (6)

Answer 29

• Substantia nigra
• Caudate
• Putamen
• Globus pallidus
• Subthalamus
• Thalamus

Question 30

What DNA segment is involved in Huntington’s disease

Answer 30

CAG repeat

Question 31

Autosomal dominant disease associated with CAG disorder on chromosome 4

Answer 31

Huntington’s disease

Question 32

Diagnosis of Huntington’s disease

Answer 32

• Genetic testing (HTT gene)

- Imaging: CT, MRI