A 27 yo patient is seen for intermittent muscle twitching. Examination demonstrates full strength with normal muscle bulk. An EMG demonstrates spontaneous discharges which are relatively constant and represent firing of the motor unit. These findings are typical of:
A. Cramps
B. spasms
C. myokym...
A 27 yo patient is seen for intermittent muscle twitching. Examination demonstrates full strength
with normal muscle bulk. An EMG demonstrates spontaneous discharges which are relatively
constant and represent firing of the motor unit. These findings are typical of:
A. Cramps
B. spasms
C. myokymia
D. fibrillations
E. Fasciculations - ANSWERE. Fasciculations
A 72 yo patient presents with subacute onset of progressive ataxia of gait and limbs. Laboratory
testing reveals the presence of an anti-Yo antibody in the serum. Which of the following tests should
be ordered next?
A. Single photon emission computed tomography scan of the brain
B. Computed tomography scan of the chest, abdomen and pelvis
C. MRI brain
D. Serial titers of Anti-yo antibody
E. MRI spine - ANSWERB. CT chest, abdomen, pelvis
Which of the following is associated with increased risk of depression in patients with MS?
A. older age
B. Female sex
C. Type of deficit
D. Lesion volume
E. Family history of depression - ANSWERD. Lesion volume
When testing for the babinski reflex, what alternative stimuli can be used by the examiner to
overcome the withdrawal response by a patient?
A. Flicking the big toe
B. Dorsiflexing the foot
C. Downward scraping of shin
D. Tapping dorsum of foot
,E. Squeezing of the foot by the examiner - ANSWERC. Downward scraping of shin
When observed in a young adult, bilateral paresis fo the medial rectus muscle of the eye on
attempted lateral gaze, with a coarse nystagmus in the abducting eye, is characteristic of which of the
following conditions?
A. Multiple sclerosis
B. Small pontine infarct
C. Phencyclidine intoxication
D. Wernicke encephalopathy
E. Bilateral third nerve damage - ANSWERA. Multiple sclerosis
A stroke in which of the following arterial territories would result in an inability to read, but with
preserved ability to write?
A. Carotid
B. Basilar
C. Vertebral
D. Middle cerebral
E. Posterior cerebral - ANSWERE. Posterior cerebral
Patients with which of the following neurological disorders have been reported to have the highest
prevalence of pathological laughing and crying?
A. MS
B. Parkinsons
C. TBI
D. MSA
E. ALS - ANSWERE. ALS
A 32 yo presents with new onset headache characterized by unilateral, stabbing eye pain. During
these episodes the patient develops runny nose and conjunctival injection on the same side as the
headache. These episodes occur every evening after falling asleep and last up to two hours. Bsaed on
this history the patient most likely has:
A. Sleep apnea
B. Seizure disorder
C. Cluster headache
D. Migraine headache
E. Transient ischemic attacks - ANSWERC. Cluster headache
Black on CT Head represents what? - ANSWERRemote stroke
,During a neurological examination an 80 yo patient is unable to demonstrate how to blow out a
match. Motor and sensory function are normal, and the rest of the neurological examination is
unremarkable. The patient's inability to perform this action is termed:
A. Atonia
B. Apraxia
C. Aphasia
D. Areflexia
E. Agraphesthesia - ANSWERB. Apraxia
Which of the following medications is an effective first-line treatment for patients with restless leg
syndrome?
A. Carbamazepine
B. Pramipexole
C. Clonazepam
D. IMipramine
E. Gabapentin - ANSWERB. Pramipexole
Which of the following is most likely to reduce psychotic symptoms in patients with parkinson
disease without worsening motor symptoms?
A. quetiapine
B. Mirtazapine
C. Aripiprazole
D. Rivastigmine
E. Pimavanserin - ANSWERE. Pimavanserin
A 72 yo patient developed sudden onset of memory loss, and was unaware of how the patient and
spouse arrived at the supermarket. The spouse noted that the patient was able to drive without
problem, but appeared anxious during much of the trip. The patient was able to appropriately
answer questions, but then didn't remember the conversation. The entire episode lasted 3 hours,
after which time the patient returned to baseline. The most likely diagnosis is:
A. Presyncope
B. Complicated migraine
C. Complex partial seizure
D. Transient global amnesia
E. Posterior circulation stroke - ANSWERD. Transient Global Amnesia (TGA)
A patient undergoes a multiple sleep latency test (MSLT) and is diagnosed with narcolepsy. What
finding on MSLT would confirm the diagnosis?
, A. Increased sleep latency
B. Decreased REM latency
C. Decreased total REM sleep
D. Increased total REM sleep
E. Decreased sleep efficiency - ANSWERB. Decreased REM latency
A 65 yo patient has fallen several times over the past 6 months. The patient's mental status exam is
normal. Smooth pursuit and saccadic movements are impaired, more prominently for vertical gaze,
but full range of motion is easily elicited by doll's head maneuvers. The patient has mild symmetric
rigidity and bradykinesia. There is no tremor. A brain MRI scan is unremarkable, as are the results of
CSF and routine laboratories including toxic drugs screen. Which of the following is the most likely
patient diagnosis?
A. Corticobasal degeneration
B. Olivopontocerebellar degeneration
C. Idiopathic Parkinson Disease
D. Primary progressive aphasia
E. Progressive supranuclear palsy - ANSWERE. Progressive supranuclear palsy
High voltage delta activity associated with slow eye-rolling movements on polysomnogram is
characteristic of what stage of sleep?
A. N1
B. N2
C. N3
D. REM - ANSWERC. N3
Event-related potentials on electroencephalograph are currently most useful for confirming which of
the following diagnoses?
A. Schizophrenia
B. Panic Disorder
C. Conversion disorder
D. Bipolar affective disorder
E. Female orgasmic disorder - ANSWERC. Conversion disorder
A 71 yo patient who was diagnosed with Parkinson disease three years ago is brought to the clinic for
changes in mood and thinking. The patient's motor symptoms are well controlled on
carbidopa/levodopa. The patient's spouse states that the patient has trouble getting up and
motivated to do anything, and the patient does not express interest in attending social events. There
has also been a recent "slowness" in the patient's thinking, with the symptoms remaining stable
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