A man with a peculiar gate

Neurology MCQ

Question:
Two teenage girls spend their afternoon at the shopping mall 'people watching'. They notice a man with a peculiar gate. He has short shuffling steps and his arms don't swing when he walks. As he walks, his pace increases. What is this type of gait associated with?

a) Huntington's disease
b) posterior column disease
c) Parkinson's disease
d) tabes dorsalis
e) cerebellar disease

A 5 month old infant with recurrent flexor rapid sudden flexion and extension of the extremities

Neurology MCQ

Question:
A 5 month old infant with recurrent flexor rapid sudden flexion and extension of the extremities. The spasms were bilateral and symmetric, and appeared in clusters, also involving the head and trunk. On examination he was noted to have arrested psychomotor development. His EEG pattern revealed high-voltage slow waves, irregularly interspersed with spikes and sharp waves occurring randomly in all cortical areas. These features are characteristic of a

a) Atonic seizure
b) Jacksonian seizure
c) simple partial seizure
d) West's syndrome
e) Petit mal seizure

A 57 year old woman is driving home from work one evening and makes a left hand turn

Neurology MCQ

Question:
A 57 year old woman is driving home from work one evening and makes a left hand turn. She is completely unaware of a car approaching from behind on the left and she causes a minor traffic accident. She is brought to an emergency room. Her history is unremarkable, other than a complaint of chronic headaches. On physical exam, she is found to have a defect in her peripheral field of vision, but her central field of vision is fine. What would explain a loss of the field of vision on the periphery, but not a loss of the central vision?

a) pituitary adenoma
b) embolus from the internal carotid artery
c) multiple sclerosis
d) hysteria
e) chronic alcoholism

A middle aged man is unable to perform rapid alternating movements

Neurology MCQ

Question:
A middle aged man is unable to perform rapid alternating movements.
This clinical sign is best described as

a) Dyssynergia
b) Dysmetria
c) Dysdiadochokinesia
d) Hypometria
e) intention tremor

A 55 year old woman complains to her general practitioner of a progressive difficulty of holding objects with her left hand

Neurology MCQ

Question:
A 55 year old woman complains to her general practitioner of a progressive difficulty of holding objects with her left hand. She also admitted to swallowing difficulties over the past 6 months. On examination the physician noted signs of lower motor neurone involvement. An initial diagnostic test in the work up of this patient should include

a) barium swallow
b) Electromyography
c) CT scan of the spine
d) MRI of the spine
e) MRI of the brain

A 22 year old male is brought to the emergency department in the afternoon after he collapsed at home

Neurology MCQ

Question:
A 22 year old male is brought to the emergency department in the afternoon after he collapsed at home. His girlfriend reported that he had complained of an 'incredibly severe headache,just like someone gave him a hard blow from behind',since that morning. She also claimed that over the last 24 hours he was becoming more and more confused. On examination he was conscious; his temperature was 37.4 F, and he is disoriented to place and person. Further examination revealed bilateral papilloedema. As part of the work up in establishing a diagnosis, which of the following is the most appropriate next step?

a) ECG
b) visual acuity test
c) CT scan
d) MRI scan
e) Chest XRay

A 5 year old boy has recurring seizures since he was 2

Neurological MCQ

Question:
A 5 year old boy has recurring seizures since he was 2. His seizures have a very distinct pattern, the seizures last 15 minutes each, with about 2 minutes in between. His seizures typically begin on the right side of his face, causing numbness and tingling, and progressively march down the right side of his body only. He is awake and alert throughout the seizures. These features are characteristic of a 

a) Atonic seizure   
b) Jacksonian seizure   
c) simple partial seizure   
d) West's syndrome
e) Petit mal seizure

A 70 year old known hypertensive man presents to the general practitioner complaining of sudden onset of a drooping right eyelid and slurred speech.

Neurological MCQ

Question:
A 70 year old known hypertensive man presents to the general practitioner complaining of sudden onset of a drooping right eyelid and slurred speech. Examination revealed the tongue deviated to the right.A Horner's syndrome on the right was diagnosed. Further examination showed a loss of pain sensation of the left side.The physician also noted a poor visual acuity from both eyes. Which area of the brain is involved in ischaemia? 

a) spinal cord at the level of C2
b) dorsolateral medulla 
c) anterior pons 
d) right side of midbrain 
e) left side of midbrain

A 55 year old headmaster complains of recurrent attacks of a perception of spinning lasting hours to days and associated with hearing loss.

Neurological MCQ

Question:
A 55 year old headmaster complains of recurrent attacks of a perception of spinning lasting hours to days and associated with hearing loss. The onset is frequently sudden, reaching peak intensity within minutes and lasting for an hour or more before subsiding. He also complains of a feeling of ear fullness that resolves after episodes of vertigo. These attacks are accompanied by nausea, vomiting, and ataxia. A likely diagnosis is

a) occlusion of the right posterior inferior cerebellar artery 
b) occlusion of the left superior cerebellar artery 
c) Meniere's disease 
d) acute labyrinthitis 
e) senile calcific aortic stenosis