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Rafi Neurology: Questions With Verified Solutions
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Rafi Neurology: Questions With Verified Solutions
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Rafi Neurology: Questions With Verified SolutionsA 31-year-old female presents to the GP complaining of double vision when
she looks to the left. You examine her and note that when she looks to the left,
her right eye adducts minimally. Her left eye abducts but you notice
nystagmus of this eye. She has no changes to her speech or hearing and is able
to understand what you say to her. You think a lesion in the brain may be
causing this.
Where is the lesion most likely to be located?
Superior temporal gyrus
Medial longitudinal fasciculus
Occipital lobe
Inferior frontal gyrus
Arcuate fasciculus" Right Ans - Medial longitudinal fasciculus
"
A young man presents following a bullet wound, with left-sided spastic
weakness, ipsilateral loss of proprioception and vibration, and contralateral
loss of pain and temperature sensation. The sensory deficits start from the
umbilicus. What is the nature and location of this man's lesion?
Left-sided Brown-Sequard syndrome at L1
Right-sided Brown-Sequard syndrome at T10
Left-sided Brown-Sequard syndrome at T10
Transverse myelitis at T11
Transverse myelitis at T10" Right Ans - Left-sided brown-sequard
synderome at T10
"
A 49-year-old man is involved in a road traffic accident and is subsequently
placed on a neuro-rehabilitation ward to help with his recovery.
His cranial nerve (CN) examination is as follows:
CN I: demonstrates anosmia with the scents used for this test (orange and
coffee).
,CN II: pupils are equal and reactive to light. Snellen chart examination is 6/6
bilaterally. No visual field deficits found on direct confrontation. No colour
blindness is detected.
CN III, IV and VI: no diplopia, nystagmus or gaze palsy detected.
CN V: facial sensation is intact. Muscles of mastication are functioning and a
jaw jerk reflex is present.
CN VII: facial movement is intact.
CN VIII: no conductive or sensorineural hearing loss detected.
CN IX and X: no deviation of uvula detected.
CN XI: neck rotation and shrugging movements are intact.
CN XII: no tongue muscle wasting or reduced power detected.
When asking questions during Right Ans - "Frontal Lobe
**brocas is lesion to inferior frontal gyrus, and has anosmia"
"
A 68-year-old man attends his general practitioner with his wife. His wife
reports that over the past three weeks he has been speaking normally
however his sentences do not make any sense. He is unaware that there is any
issue.
It is noted during the consultation that his fluency is preserved however he is
unable to understand many of the questions you ask him verbally and is
unable to interpret written language. His speech is inappropriate and consists
of sentences that make no sense.
A CT head is performed to determine the aetiology of his symptoms.
Where would you expect to find a lesion given this man's symptoms?
Left angular gyrus
Left inferior frontal gyrus
Left fusiform gyrus
Left superior temporal lobe
Left sylvian fissure" Right Ans - Left inferior frontal gyrus
"
,A patient complaining of loss of taste in the anterior 2/3 of the tongue has
most likely suffered damage to which nerve?
Glossopharyngeal nerve
Facial nerve
Vagus nerve
Trigeminal nerve
Hypoglossal nerve" Right Ans - Facial nerve
"
A 40-year-old female presents to the GP due to noticing changes in her face.
She noticed that morning that the left side of her face was drooping and she
was unable to fully close her left eye and her smile was asymmetrical. She is
otherwise well and on no other medication. On examination of her facial
nerve, you note that there is a complete lower motor neurone paralysis of the
left facial nerve. What is the most likely cause of this?
Multiple sclerosis
Stroke
Bell's palsy
Ramsey hunt syndrome
Motor neurone disease" Right Ans - Bell's palsy
"
A 43- year- old patient presents to his General practitioner complaining of
fatigue and weight loss. He mentions he experiences pain around his right
shoulder region and tingling sensations of his fourth and fifth fingers on his
right hand. He is later diagnosed with an apical lung tumour, which presses on
the C8-T1 nerve roots of the brachial plexus. Which nerve of the upper limb is
primarily compromised?
Axillary nerve
Musculoskeletal nerve
Radial nerve
Ulnar nerve
Median nerve" Right Ans - Ulnar nerve
"
, A 38-year-old woman presents with her worried partner as she has been
acting bizarrely over the last few days. The partner describes an increase in
confusion over this time, hypersexuality, putting objects in her mouth, has
been eating constantly whilst awake and has recently stopped being able to
recognise her mother and father.
Full neurological examination only reveals mild neck stiffness. Routine
observations are all normal, apart from a high temperature of 38ºC.
A CT scan is done which is reported as normal and a lumbar puncture reveals
a high lymphocyte count and mildly raised protein. T2 weighted MRI
demonstrated hyperintensities within the temporal lobe of the brain.
Which region of the temporal lobe is likely to be affected?
Amygdala
Caudate nucleus
Hippocampus
Internal capsule
Thalamus" Right Ans - "Amydala
**Kluver-bucy syndrome"
"
During a ward round on the stroke ward, you notice a patient responds to
questions with unrelated words and phrases. His speech is technically good
and fluent but the sentences make no sense. He does not appear to be aware
of this and struggles to understand questions when written down.
Where is the location of the lesion producing this sign?
Arcuate fasciculus
Corpus callosum
Inferior frontal gyrus
Primary motor cortex
Superior temporal gyrus" Right Ans - Superior temporal gyrus
"
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