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Neurology Quiz | Practice MCQ #mcq.ImBooz

February 13, 2020 by imBooz Leave a Comment

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1 >>A 30-year-old woman has progressive hearing loss. A magnetic resonance imaging (MRI) reveals bilateral acoustic schwannomas (neuromas). Which of the following is the most likely diagnosis? ?

  • (A) Type 1 neurofibromatosis (von Recklinghausen disease)
  • (B) Type 2 neurofibromatosis
  • (C) Meningeal carcinomatosis
  • (D) Multifocal meningiomas

2 >>People with traumatic head injury are highly susceptible to subsequent impaired sense of smell. The olfactory cortex in humans is located in which of the following locations? ?

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  • (A) Anterior perforated substance
  • (B) Lateral olfactory gyrus (prepiriform area)
  • (C) Posterior third of the first temporal gyrus
  • (D) Angular gyrus

3 >>The hypogonadism and anosmia of Kallmann syndrome usually attract medical attention during which stage of life? ?

  • (A) The newborn period
  • (B) Infancy
  • (C) Childhood
  • (D) Adolescence

4 >>A 22-year-old woman is involved in a head-on motor vehicle accident. She was not wearing a seat belt, and she received a skull fracture when her head hit the windshield. By what mechanism would this patient develop anosmia? ?

  • (A) Subarachnoid blood causes pial adhesions on the olfactory nerve.
  • (B) Injury to the temporal tip injures the olfactory cortex.
  • (C) Torsion on the brainstem injures trigeminal tracts.
  • (D) Shearing forces sever filaments of the receptor cells as they cross the cribriform plate.

5 >>A 45-year-old man has noticed over the past 6 months that his sense of smell is not as sensitive as it used to be. On examination he has unilateral anosmia, ipsilateral optic atrophy, and contralateral papilledema. Which of the following is the most likely diagnosis? ?

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  • (A) Pseudotumor cerebri
  • (B) Multiple sclerosis (MS)
  • (C) Olfactory groove meningioma
  • (D) Craniopharyngioma

6 >>A 60-year-old woman has intermittent dizzy spells during the day. Her symptoms are worse when she turns her head to the left, to the point that she tends to keep her head stiff, looking forward. She becomes particularly dizzy when she lies down in bed at night or turns onto her left side. She occasionally wakes up in the middle of the night feeling dizzy. She had a similar experience 2 years ago, which lasted for 2 weeks and then spontaneously resolved. She has otherwise felt well, and her hearing is normal. On examination, putting her head back and the left ear down elicits a feeling of dizziness and nausea associated with rotatory nystagmus, which lasts for 15 seconds and then resolves. ?

  • (A) Benign positional vertigo (BPV)
  • (B) Multiple sclerosis (MS)
  • (C) Olfactory groove meningioma
  • (D) Craniopharyngioma

7 >>A 34-year-old investment banker has intermittent episodes of vertigo associated with a feeling of fullness in his right ear. These last for several hours. He has had progressive hearing loss in the right ear. There are no other symptoms. He takes no medications and has no history of head trauma. ?

  • (A) Meniere disease
  • (B) Promethazine
  • (C) Penicillin
  • (D) Dimenhydrinate

8 >>A 47-year-old woman with a history of orthotopic heart transplantation 6 months ago has had a complicated postoperative course and was readmitted 3 months ago with pneumonia. She was treated with gentamicin, vancomycin, and clindamycin, as well as her usual regimen of immunosuppressant medications, lipid-lowering drugs, and aspirin. Since then, she has had severe but stable disequilibrium, with inability to walk without a cane. There has been no hearing loss or weakness. ?

  • (A) Aminoglycoside toxicity
  • (B) Frontal lobe
  • (C) Parietal lobe
  • (D) Temporal lobe

9 >>A 72-year-old man awakens with severe vertigo associated with nausea and vomiting. He is ataxic. Over the next several days, he develops numbness of the left side of his body, dysphagia, and hiccups. On examination, he has a left homonymous hemianopsia, left-sided sensory loss, dysmetria with the right hand, and no weakness. He has had intermittent episodes of dizziness for the past month. ?

  • (A) Vertebral artery occlusion
  • (B) Frontal lobe
  • (C) Parietal lobe
  • (D) Temporal lobe

10 >>A 57-year-old woman began having weakness and trouble walking 1 year ago. Current examination findings include weak, wasted muscles with spasticity, fasciculations, extensor plantar responses, and hyperreflexia. Which of the following is the most likely diagnosis? ?

  • (A) Dorsal spinal root disease
  • (B) Ventral spinal root disease
  • (C) Arcuate fasciculus damage
  • (D) Motor neuron disease

11 >>A 35-year-old woman falls 12 feet from a ladder and fractures her c-spine, causing damage at the C4 level. She is initially a flaccid quadriplegic with areflexia. This areflexia and flaccidity usually evolve into hyper-reflexia and spasticity within which of the following time periods? ?

  • (A) 2-to-4 months
  • (B) 1-to-2 months
  • (C) 3 days-to-3 weeks
  • (D) 5-to-25 minutes

12 >>After biopsy resection of a lymph node in her neck, a 23-year-old woman notices instability of her shoulder. Neurological examination reveals winging of the scapula on the side of the surgery. During surgery, she probably suffered damage to which of the following? ?

  • (A) Deltoid muscle
  • (B) Long thoracic nerve
  • (C) Serratus anterior muscle
  • (D) Suprascapular nerve

13 >>A 25-year-old woman is involved in a motor vehicle accident. Among her injuries is a lumbar vertebral body fracture. Which of the following most likely contributed to this injury? ?

  • (A) Flexion
  • (B) Extension
  • (C) Torsion
  • (D) Spondylolisthesis

14 >>A 35-year-old man injured his thoracic spine in a motor vehicle accident 2 years ago. Initially he had a bilateral spastic paraparesis and urinary urgency, but this has improved. He still has pain and thermal sensation loss on part of his left body and proprioception loss in his right foot. There is still a paralysis of the right lower extremity as well. This patient most likely has which of the following spinal cord conditions? ?

  • (A) Brown-Sequard (hemisection) syndrome
  • (B) Complete transection
  • (C) Posterior column syndrome
  • (D) Syringomyelic syndrome

15 >>A 19-year-old man injured his cervical spine in a swimming pool diving accident. After an initial severe quadriparesis, there was a rapid recovery of much motor function over several weeks. Which of the following would you expect to find in this patient 12 months from now? ?

  • (A) Fasciculations
  • (B) Fibrillations
  • (C) Flaccid paralysis
  • (D) Spastic paralysis

16 >>A 92-year-old woman with known cervical stenosis has poor balance. The examination finding of impaired joint proprioception is due to dysfunction of neurons which decussate at what level? ?

  • (A) At the medulla
  • (B) At the midbrain
  • (C) At the pons
  • (D) At the thalamus

17 >>An 82-year-old woman with bilateral leg weakness has a greatly dilated abdominal aorta with a normal thoracic aorta. Which of the following is the most likely cause of this damage? ?

  • (A) Syphilis
  • (B) Atherosclerosis
  • (C) Diabetes mellitus
  • (D) Chronic hypertension

18 >>A 61-year-old man, who smokes five packs of cigarettes per day and has hypertension, had an abdominal aortic aneurysm repair 8 hours ago. The surgery went very well, and there were no reported perioperative complications. Now the patient is unable to move his legs and states that they are “numb.” On examination, he has a flaccid paresis of both lower extremities and has impaired pinprick sensation to a T9 level bilaterally. Joint proprioception is normal. Which of the following is the most likely diagnosis in this case? ?

  • (A) Conversion disorder
  • (B) Multiple sclerosis (MS)
  • (C) Spinal cord compression
  • (D) Spinal cord infarct

19 >>A 62-year-old man has been diagnosed with an abdominal aortic aneurysm. He is told that he is at high risk for aneurysm rupture, which would almost certainly kill him. Although a surgical procedure could dramatically reduce this risk, the operation itself has risks, including postoperative paraplegia. The arteria radicularis magna (artery of Adamkiewicz) enters at approximately what level? ?

  • (A) C2 to C5
  • (B) C5 to C8
  • (C) T2 to T8
  • (D) T10 to L1

20 >>In a 56-year-old patient with a thoracic spinal cord hemisection, where would you expect the pain and temperature abnormalities to begin? ?

  • (A) Exactly at the level of the lesion
  • (B) Four or five segments above the lesion
  • (C) Four or five segments below the lesion
  • (D) One or two segments below the lesion

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