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 Answer - E. 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 Answer - B. 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 Answer - D. 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 Answer - C. 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 Answer - A. 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 Answer - E. Posterior cerebral
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 Answer - E. 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 Answer - D. 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
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