1 >>A 28-year-old man presents with right eye pain and blurry vision developing over 3 days. After examination and further history, a diagnosis of papillitis is made. How can papillitis be distinguished from the papilledema of increased intracranial pressure (ICP)? ?
(A) A 28-year-old man presents with right eye pain and blurry vision developing over 3 days. After examination and further history, a diagnosis of papillitis is made. How can papillitis be distinguished from the papilledema of increased intracranial pressure (ICP)?
(B) Associated homonymous hemianopsia
(C) Characteristic visual loss
(D) Associated limitation of eye movement
2 >>A 19-year-old woman with headaches and visual blurring has prominent bulging of both optic nerve heads with obscuration of all margins of both optic discs. Her physician is reluctant to pursue neurological studies because the patient is 8 months pregnant and had similar symptoms during the last month of another pregnancy. Her physical and neurological examinations are otherwise unrevealing. If neuroimaging studies were to be performed on this woman, they probably would reveal which of the following? ?
(A) A subfrontal meningioma
(B) Slitlike ventricles
(C) Transtentorial herniation
(D) Metastatic breast carcinoma
3 >>A 36-year-old woman has tunnel vision in which she reports the same size area of perception regardless of how far from the testing screen the examination is performed. This history often indicates which of the following? ?
(A) Retinitis pigmentosa
(D) Conversion disorder
4 >>A young man with multiple sclerosis (MS) exhibits paradoxical dilation of the right pupil when a flashlight is redirected from the left eye into the right eye. Swinging the flashlight back to the left eye produces constriction of the right pupil. Which of the following is the most likely diagnosis? ?
(A) Early cataract formation in the right eye
(B) Optic atrophy
5 >>A 23-year-old woman has 2 days of visual loss associated with discomfort in the right eye. She appears otherwise healthy, but her family reports recurrent problems with bladder control over the prior 2 years, which the patient is reluctant to discuss. On neurological examination, this young woman exhibits dysmetria in her right arm, a plantar extensor response of the left foot, and slurred speech. Which of the following would be the most informative ancillary test? ?
(A) Visual evoked response (VER) testing
(B) Electroencephalography (EEG)
(C) Computed tomography (CT)
(D) Magnetic resonance imaging (MRI)
6 >>Injuries to the macula or fovea centralis typically affect vision by producing which of the following? ?
(A) Bitemporal hemianopsia
(B) Nyctalopia (night blindness)
(C) Severe loss of visual acuity
(D) Mild loss of visual acuity
Neurology Objective Questions | Neurology Quiz
7 >>A 64-year-old man who has had hypertension for more than 30 years is being examined. The most obvious changes seen during retinal examination would include which of the following? ?
(A) Retinal tears
(B) Optic atrophy
(C) Segmental narrowing of arterioles
8 >>Routine funduscopic examination of a 52-year-old man reveals small, discrete red dots located in largest numbers in the paracentral region. Such retinal microaneurysms most often occur with which of the following? ?
(B) Chronic hypertension
(C) Diabetes mellitus
9 >>A 72-year-old woman presents with the acute onset of double vision. The second image disappears if she covers either eye. Which of the following nerves is most likely to be impaired in this patient? ?
10 >>A 7-year-old girl acutely develops horizontal diplopia that worsens over the course of a few days. Examination reveals that the double vision is exacerbated by leftward gaze. Red glass testing reveals that the “” image is from the left eye. She is most likely to have which of the following? ?
(A) Pontine glioma
(B) Medullary glioma
(C) Mesencephalic infarction
(D) Pontine infarction
11 >>A 6-year-old girl has left facial pain and blurry vision. Careful examination reveals a deficit of the abducens nerve. Which of the following is the most likely etiology? ?
12 >>A 19-year-old man is hit in the face with a lead pipe. The ocular motor muscle most likely to be injured in this case is that innervated by which of the following? ?
(A) Superior division of the third cranial nerve
(B) Inferior division of the third cranial nerve
(C) Fourth (trochlear) cranial nerve
(D) Long ciliary nerve
13 >>A 17-year-old girl develops a painful vesicular rash around her left eye. This is followed by blurry vision that occurs only when both eyes are open. She is diagnosed with varicella zoster ophthalmicus. Which ocular motor nerve is most likely to be affected? ?
(A) Superior division of the third
(B) Inferior division of the third
(C) Fourth (trochlear)
(D) Long ciliary
14 >>A 32-year-old woman has an MRI done because of a first seizure. No etiology for the seizure is found, but there is the incidental finding of an aneurysm. The aneurysm is 5 mm and affects the posterior communicating artery. It is very close to the third cranial nerve. The initial sign of pressure on the third nerve is usually which of the following? ?
(A) Impaired adduction
(B) Impaired pupillary constriction
(C) Impaired depression
(D) Impaired elevation
15 >>A 58-year-old man with type 2 diabetes presents with the acute onset of double vision. Examination reveals a deficit of the third cranial nerve. A third-nerve palsy associated with diabetes mellitus is usually characterized by which of the following? ?
(A) Poor pupillodilation
(B) Poor pupilloconstriction
(C) Sparing of pupillary function
(D) Inversion of the affected eye
16 >>A 65-year-old man is having a neurological examination because of tingling in his feet. During the course of the examination, it is noticed that pupillary constriction occurs with attempted adduction of the globe. This suggests which of the following? ?
(A) Mesencephalic infarction
(B) Aberrant third-nerve regeneration
(D) Pontine glioma
17 >>A 35-year-old man with MS presents with blurry vision. Examination reveals that the medial rectus muscle fails to move synchronously with the contralateral lateral rectus muscle on attempted gaze to either side. When each eye is tested individually, medial rectus function is relatively preserved. In addition, prominent nystagmus is present in the abducting eye. These findings indicate evidence of which of the following? ?
(A) A mesencephalic or pontine injury
(B) Thalamic hemorrhage
(C) Cerebellar dysfunction
(D) Cortical injury in the frontal eye fields
18 >>A 34-year-old woman recently emigrated from Poland. She has a history of some type of progressive, episodic neurological disease that began 5 years ago. Examination shows evidence of bilateral injury to the medial longitudinal fasciculus (MLF). Which of the following is the most likely diagnosis? ?
19 >>A 42-year-old man has horizontal nystagmus in primary gaze and while looking to both the left and the right. The only other examination finding is a slight gait ataxia. Which of the following is the most likely cause of this patient’s induced nystagmus? ?
(B) Drug intoxication
20 >>A child with rapid downward deviation of both eyes followed by slow upward conjugate eye movements probably has which of the following? ?