Neurology

Topics in this chapter

• Neurologic Localization and Cranial Nerves
• Cerebrovascular Disease and Aphasia
• Headache and Migraine Disorders
• Neurodegenerative and Motor Neuron Disorders
• Demyelinating and Neuromuscular Junction Disorders
• Central Nervous System Infections
• Cerebrospinal Fluid and Hydrocephalus Disorders
• Nutritional and Metabolic Encephalopathies

Practice questions

1. Question 1Q-47D8E3

   A 62-year-old man presents with progressive weakness and muscle wasting in his right hand for the past 4 months, followed by similar involvement of the left hand and both legs. On examination, he has fasciculations and muscle atrophy in the upper limbs, along with hyperreflexia, upgoing plantars, and a spastic gait. Cranial nerve examination is completely normal, and there are no sensory deficits. What is the most likely diagnosis?

   1. A.Amyotrophic lateral sclerosis
   2. B.Primary lateral sclerosis
   3. C.Progressive muscular atrophy
   4. D.Cervical spondylotic myelopathy
   See the answer and solution
2. Question 2Q-4B68C9

   A 28-year-old woman presents with episodes of severe, throbbing right-sided headaches lasting 12 hours, associated with nausea, vomiting, photophobia, and phonophobia. She reports seeing jagged lines of light in her left visual field for about 20 minutes before the headache begins. Which of the following is the most appropriate acute treatment for this patient's headache?

   1. A.Sumatriptan
   2. B.Carbamazepine
   3. C.Indomethacin
   4. D.Propranolol
   See the answer and solution
3. Question 3Q-DC32F2

   A 55-year-old chronic alcoholic man is brought to the emergency department in a confused state. Examination reveals ophthalmoparesis, horizontal nystagmus, severe ataxia of gait, and global confusional state with apathy. Which anatomical structure is most classically involved in the pathogenesis of this condition?

   1. A.Medial temporal lobes
   2. B.Mammillary bodies and periaqueductal gray matter
   3. C.Substantia nigra pars compacta
   4. D.Nucleus basalis of Meynert
   See the answer and solution
4. Question 4Q-51C296

   A 70-year-old man presents with progressive memory loss, gait disturbances, and urinary incontinence over the past 6 months. Magnetic resonance imaging of the brain shows marked ventriculomegaly that is disproportionate to the degree of cerebral cortical atrophy, along with stretching of the corpus callosum. Lumbar puncture opening pressure is normal. What is the most likely diagnosis?

   1. A.Alzheimer disease
   2. B.Normal pressure hydrocephalus
   3. C.Huntington disease
   4. D.Creutzfeldt-Jakob disease
   See the answer and solution
5. Question 5Q-2ED23F

   A 45-year-old woman presents with double vision and drooping of her left eyelid, which worsens toward the end of the day and improves after rest. On examination, there is left-sided ptosis and weakness of upward gaze, which fatigues on sustained upward looking. Ice pack application to the left eye significantly improves the ptosis. Which of the following autoantibodies is most specific for this condition?

   1. A.Anti-acetylcholine receptor antibodies
   2. B.Anti-muscle-specific kinase (MuSK) antibodies
   3. C.Anti-voltage-gated calcium channel antibodies
   4. D.Anti-glutamic acid decarboxylase antibodies
   See the answer and solution