Quiz Neuroscience Part 4 of 4
Quiz Neuroscience Part 4 of 4
Quiz Neuroscience Part 4 of 4
3.1) Which of the following GABA-A subunits is involved in the benzodiazepine binding
site?
a) ! subunit
b) " subunit
c) # subunit
d) $ subunit
e) % subunit
3.2) The chloride channels is triggered by binding of GABA to which of the following
subunits?
a) ! & "
b) " & #
c) # & $
d) $ & %
e) % & !
4.1) Which of the following describes the action of benzodiazepines?
a) Increase frequency of GABA-mediated Cl- channel opening
b) Increase duration of GABA-mediated Cl- channel opening
c) Increase frequency of GABA-mediated Cl- channel opening and block
glutamic acid
d) Increase duration of GABA-mediated Cl- channel opening and block glutamic
acid
4.2) Which of the following describes the action of barbiturates?
a) Increase frequency of GABA-mediated Cl- channel opening
b) Increase duration of GABA-mediated Cl- channel opening
c) Increase frequency of GABA-mediated Cl- channel opening and block
glutamic acid
d) Increase duration of GABA-mediated Cl- channel opening and block glutamic
acid
5) Low dose benzodiazepines and barbiturates exert a calming affect with anxiety relief
(sedation). Higher doses will induce sleep (hypnosis). During hypnosis induced by
sedative-hypnotics, which of the following is increased?
a) Time to fall asleep
b) Duration of stage 2 NREM sleep
c) Duration of REM sleep
d) Duration of stage 4 NREM slow-wave sleep
e) Psychomotor and cognitive functions
6.1) Which of the following is NOT characteristic of physiological dependence to a drug
when the user stops taking the drug?
a) Anxiety
b) Tremors
c) Compulsion
d) Seizures
e) Hyper-reflexia
6.2) Sedative-hypnotics are NOT commonly associated with development of tolerance.
a) True
b) False
7.1) Which of the following drugs should be given if the goal is to decreases the latency
of sleep onset (fall asleep quickly) without affecting REM sleep?
a) Zolpidem
b) Zaleplon
c) Eszopiclone, low dose
d) Eszopiclone, high dose
7.2) Which of the following drugs should be given if the goal is to increase total sleep
time without decreasing REM sleep?
a) Zolpidem
b) Zaleplon
c) Eszopiclone, low dose
d) Eszopiclone, high dose
8) Flumazenil (Romazicon, Anexate) acts as a competitive antagonist to reverse the CNS
depressant effects of which of the following?
a) Cocaine
b) Ethanol
c) Opioids
d) Barbiturates
e) Benzodiazepines
9.1) Which of the following acts as a partial agonist at brain 5-HT1A receptors, exerting
an anxiolytic effect?
a) Zolpidem (Ambien)
b) Zaleplon (Sonata)
c) Eszopiclone (Lunesta)
d) Buspirone (BuSpar)
9.2) Which of the following is a non-benzodiazepine used for short-term treatment of
insomnia?
a) Zolpidem (Ambien)
b) Zaleplon (Sonata)
c) Eszopiclone (Lunesta)
d) Buspirone (BuSpar)
10) Which of the following is NOT true regarding the use of benzodiazepines for
treatment of anxiety?
a) Relatively high therapeutic index
b) Availability of drug(s) to treat overdose
c) Low risk of drug interactions based on liver enzyme induction
d) Minimal effects on cardiovascular or autonomic functions
e) Fast elimination rates
11) Which of the following drugs would have the highest risk of adverse effects (anxiety,
orthostatic hypotension, hyper-reflexia, seizures) if it were discontinued abruptly?
a) Eszopiclone, 6 hour half-life
b) Zolpidem, 1.5-3.5 hour half-life
c) Zaleplon, 1-2 hour half-life
d) Triazolam, 2-3 hour half-life
e) Flurazepam, 40-100 hour half-life
12) Which of the following dosages should be used when giving benzodiazepines to
elderly patients?
a) 3 times younger-adult dose
b) 2 times younger-adult dose
c) Normal dosage
d) 1/2 younger-adult dose
e) 1/3 younger-adult dose
13.1) Which of the following drugs has the highest risk of causing impaired cognitive
function, impaired psychomotor skills, and excessive daytime sedation in an elderly
patient, which could lead to falls and fractures?
a) Eszopiclone, 6 hour half-life
b) Zolpidem, 1.5-3.5 hour half-life
c) Zaleplon, 1-2 hour half-life
d) Triazolam, 2-3 hour half-life
e) Flurazepam, 40-100 hour half-life
13.2) A college student presents to the Emergency Room with anterograde amnesia
stating she believes she was recently given a date-rape drug. Which of the following
would most likely show up in blood work if benzodiazepines were suspected?
a) Triazolam, low dose
b) Triazolam, high dose
c) Flunitrazepam, low dose
d) Flunitrazepam, high dose
e) Eszopiclone
13.3) Extensive clinical use of this of the following can lead to serious CNS effects
including behavioral disinhibition, delirium, aggression, and violence?
a) Alprazolam
b) Diazepam
c) Flurazepam
d) Midazolam
e) Triazolam
6.2) An infant presents to the emergency room with metabolic acidosis and severely
compromised vital signs. A frantic mother believes the child drank antifreeze (ethylene
glycol) in the garage. Which of the following should be given to the patient if the goal is
to inhibit alcohol dehydrogenase and thus prevent metabolism of ethylene glycol?
a) IV Fomepizole
b) IV Disulfiram
c) IV Naloxone
d) IV Flumazanil
e) IV Ethanol
e) Atonic seizures
f) None of the above
2.2) What type of seizure always involves the limbic system, involves memory loss of the
event, and usually involves automatisms (e.g. lip smacking, fumbling, walking about)?
a) Complex partial seizures
b) Generalized tonic-clonic (grand mal) seizures
c) Absence (petit mal) seizures
d) Myoclonic jerking seizures
e) Atonic seizures
f) None of the above
2.3) In the Emergency Room, a mother rushes to the reception desk distressed that her
child is “shaking all over the bed.” Entering the child’s room, the patient is convulsing
and has urinary incontinence. Which of the following drugs would NOT be an option for
this patient?
a) Valproate
b) Phenytoin
c) Barbiturates
d) Carbamazepine
e) Ethosuximide
2.4) A mentally retarded infant presents with brief, recurrent myoclonic jerks of the body
with sudden flexion and extension of the limbs. Which of the following drugs should be
administered via the IM route?
a) Clonazepam
b) Phenytoin
c) Barbiturates
d) Carbamazepine
e) Corticotrophin
2.5) Which of the following is a drug of choice for atonic seizures?
a) Clonazepam
b) Phenytoin
c) Valproate
d) Carbamazepine
e) Lamotrigine
2.6) Which of the following would NOT be given for absence status seizures?
a) Diazepam
b) Lorazepam
c) Phenytoin
d) Clonazepam
e) Midazolam
3) Which of the following teratogenic drugs has been implicated in spina bifida and is not
associated with fetal hydantoin syndrome (embryopathy)?
a) Phenytoin
b) Valproate
c) Carbamazepine
d) Phenobarbital
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d) Propofol
e) Etomidate
8) If rapid recovery is associated with fewer post-operative adverse effects, which of the
following inhaled anesthetics would be a poor choice in balance anesthesia (inhaled + IV
anesthetic)?
a) Nitrous oxide
b) Halothane
c) Sevoflurane
d) Desflurane
e) Methoxyflurane
9.1) Which of the following drugs is preferred in patients with cerebral swelling as it does
not increase intracranial pressure?
a) Etomidate
b) Propofol
c) Midazolam
d) Thiopental
e) Fentanyl
9.2) Which of the following is associated with a high incidence of anterograde amnesia
(clinically useful effect)?
a) Etomidate
b) Propofol
c) Midazolam
d) Thiopental
e) Fentanyl
9.3) What drug in combination with N2O and droperidol gives neuroleptanesthesia,
which is amnesia and analgesia?
a) Etomidate
b) Propofol
c) Midazolam
d) Thiopental
e) Fentanyl
9.4) Which of the following is NOT true regarding propofol (Diprivan)?
a) Has antiemetic actions
b) Is popular as an induction agent
c) Is used for anesthesia maintenance
d) Causes a decrease in blood pressure
e) Is relatively cheap
9.5) Naloxone is a receptor antagonist that can reverse the effects of which of the
following?
a) Etomidate
b) Propofol
c) Midazolam
d) Thiopental
e) Fentanyl
9.6) Which of the following drugs is used to induce patients with limited cardiovascular
reserve and can cause adrenocortical suppression?
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a) Etomidate
b) Propofol
c) Midazolam
d) Thiopental
e) Fentanyl
10) Which of the following is NOT true regarding conscious sedation?
a) Alleviates anxiety
b) Alleviates pain
c) Causes motor paralysis
d) Allows for maintenance of patent airway
e) Allows for the ability to respond to verbal commands
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2) Which of the following is used to treat Parkinson disorders as it can cross the blood-
brain barrier and is converted to a useful form?
a) Dopamine
b) Carbidopa
c) L-DOPA
d) Glutamate
e) Glycine
3) What is the role of carbidopa in the drug Sinemet?
a) Increase metabolism of levodopa in the periphery
b) Increase metabolism of levodopa in the brain
c) Decrease metabolism of levodopa in the periphery
d) Decrease metabolism of levodopa in the brain
4) Which of the following is NOT a side effect seen in patients receiving L-DOPA
treatment?
a) Nausea and vomiting
b) Bradycardia
c) Atrial fibrillation
d) Dyskinesias
e) Choreoathetosis of the face
5) Fluctuations in clinical state unrelated to timing of L-DOPA doses is known as the
“on-off phenomenon.” The recommended clinical method to alleviate this is to have the
patient discontinue the drug for 3-21 days (“drug holiday”).
a) True
b) False, this will not alleviate symptoms
c) False, the risks likely outweigh the benefit
6) Which of the following patients should NOT receive L-DOPA?
a) Diabetic patients
b) Hypertensive patients
c) Patients with decreased cardiac output
d) Patients with angle-closure glaucoma
e) Patients with resting tremors
7) Which of the following is true regarding dopamine agonists in the treatment of
Parkinson disease?
a) They require enzymatic conversion to an active metabolite
b) They have at least two toxic metabolites
c) They compete with substances for active transport into the blood
d) The have a lower incidence of “on-off phenomenon” fluctuations
e) They should be used as a replacement to L-DOPA
8.1) Which of the following is NOT a contraindication of dopamine agonist drugs?
a) Psychotic illness
b) Dyskinesias
c) Recent MI
d) Active peptic ulcerations
e) Peripheral vascular disease
8.2) Which of the following dopamine agonist drugs is a D3 receptor agonist, used to
treat mild and advanced disease Parkinsonism?
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a) Bromocriptine
b) Pergolide
c) Pramipexole
d) Ropinirole
8.3) Which of the following is a monoamine oxidase inhibitor (MAOI) B, which retards
the breakdown of dopamine and enhances the effect of L-DOPA?
a) Benztropine
b) Amantadine
c) Selegiline
d) Bromocriptine
e) Entacopone
8.4) A patient with Parkinson disease is being put on a drug (tolcapone) to help decrease
the peripheral metabolism of L-DOPA. They are told they will need to complete a
consent form, have liver function tests every two-weeks for a year, and that their urine
might turn orange. What type of drug is this?
a) Dopamine receptor agonist
b) Monoamine oxidase (MAO) inhibitor
c) Catechol-O-methyl transferase (COMT) inhibitor
d) Anti-viral agent
e) Acetylcholine blocker
8.5) A patient with Parkinson disease is given the anti-viral agent amantadine after
ensuring the patient does not have a history of seizures or heart failure. What is the
mechanism of action for this drug?
a) Dopamine receptor agonist
b) Selective MAO inhibitor
c) Acetylcholine blocker
d) Acetylcholine esterase agonist
e) Unknown
8.6) Benztropine should be avoided in patients with prostatic hyperplasia, obstructive GI
disease, or angle-closure glaucoma. What is the mechanism of action for this drug?
a) Dopamine receptor agonist
b) Monoamine oxidase (MAO) inhibitor
c) Catechol-O-methyl transferase (COMT) inhibitor
d) Anti-viral agent
e) Acetylcholine blocker
9) In patients with severe Parkinsonism and long-term complications of L-DOPA
therapy, such as the on-off phenomenon, a trial of what type of drug may be worthwhile?
a) Dopamine receptor agonist
b) Monoamine oxidase (MAO) inhibitor
c) Catechol-O-methyl transferase (COMT) inhibitor
d) Anti-viral agent
e) Acetylcholine blocker
10) A patient presents with progressive chorea and dementia. History reveals an
autosomal dominant disorder of chromosome 4. Which of the following drugs should be
given if the goal is the deplete cerebral dopamine in the nigostriatal pathway by
preventing intraneuronal storage?
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a) Reserpine
b) Haloperidol
c) Perphenazine
d) Olanzapine
e) Phenothiazine or butyrophenones
11) What is the drug of choice for patients with chronic, multiple tics (Tourette
syndrome)?
a) Clonidine
b) Haloperidol
c) Perphenazine
d) Penicillamine
e) Roprinole
12.1) A 16-year-old patient presents with recurrent hepatic disease. Testing reveals
increased urinary copper and a low serum ceruloplasmin (<20mg/dL). Ophthalmologic
exam reveals an abnormality, shown here. Along with potassium disulfide, what drug
should be given as a chelating agent?
a) Clonidine
b) Haloperidol
c) Reserpine
d) Penicillamine
e) Roprinole
12.2) A patient presents with an unpleasant creeping discomfort arising deep within the
legs that is preventing adequate sleep. Blood test reveals low iron. Which of the
following drugs should be used as primary treatment?
a) Clonidine
b) Haloperidol
c) Reserpine
d) Penicillamine
e) Roprinole
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1.6) Which of the following opioid receptor subtypes has psychomotor effects?
a) Mu
b) Delta
c) Kappa
1.7) Which of the following opioid receptor subtypes is involved in sedation and
inhibition of respiration?
a) Mu
b) Delta
c) Kappa
1.8) Which of the following is a strong opioid receptor antagonist?
a) Morphine
b) Codeine
c) Fentanyl (Sublimaze)
d) Naloxone (Narcan)
e) Nalbuphine (Nubain)
1.9) Although all of the following opiod receptor subtypes are pre-synaptic, which one is
also post-synaptic and works by hyperpolarizing second-order pain transmission neurons
by increasing K+ conductance and thus inhibiting the post-synaptic action potential?
a) Mu
b) Delta
c) Kappa
2) Pain signals generally follow an fferent nociceptor fiber to the dorsal cord of the spinal
cord, decussate and travel to the parabrachial nuclei of the medulla/pons, travel to the
ventral caudal thalamus, and finally to the cortex. Which of the following is NOT a site
of action for opioids?
a) Afferent nociceptor fiber
b) Dorsal horn of the spinal cord
c) Parabrachial nuclei of the medulla/pons
d) Ventral caudal thalamus
3) Which of the following sites of opioid analgesia action on the descending inhibitory
pathway is indirectly controlled by the locus caeruleus (site of norepinephrine synthesis)?
a) Periaqueductal gray of the midbrain
b) Rostral ventral medulla of the medulla/pons
c) Dorsal horn of the spinal cord
4) '9-tetrahydrocannavinol (THC) is the main psychoactive ingredient found in
marijuana and acts primarily on CB1 cannabinoid receptors. Under certain circumstances,
it can interact with the TRPV1 capsaicin receptor, which is normally activated by hot
peppers, producing what affect?
a) Severe pain
b) Unconsciousness
c) Analgesia
d) Hallucinations
e) Intense hunger
5) Which opioid receptor type is most closely associated with opioid-mediated analgesia?
a) Mu
b) Delta
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c) Kappa
6) A non-tolerant adult goes into respiratory arrest normally at about 60mg of morphine.
Opiod tolerant patients may receive dosages of 100mg or 200mg. What dose is required
for a maximally tolerant adult to go into respiratory arrest?
a) 250mg
b) 500mg
c) 1g
d) 2g
e) 3g
7) Which of the following is NOT a sign and symptom of opioid withdrawal?
a) Rhinorrhea
b) Diarrhea
c) Lacrimation
d) Yawning
e) Chills
f) Gooseflesh
8) A patient is given codeine for cough suppression. Which of the following affects has a
high degree of tolerance (tolerance can develop)?
a) Bradycardia
b) Miosis
c) Constipation
d) Convulsions
e) Cough supression
9.1) Opiod antagonists such as naloxone, naltreone, and nalmefene have a high affinity
for which of the following receptor sites?
a) Mu
b) Delta
c) Kappa
9.2) A 19-year-old Asian male presents to the Emergency Room responsive only to
painful stimuli. General examination reveals pinpoint pupils, injection marks in the
antecubital region, and respiratory compromise. Examination of the back reveals several
linear red marks and a strong smell of menthol. The patient’s mother says she used Tiger
Balm and “coining” to help her son. The clinician gives an opioid antagonist
intravenously. The patient awakens quickly and is combative. The clinician has the
patient monitored over the next 1-2 hours, as the drug will be metabolized and the patient
may again experience respiratory compromise. What drug was administered?
a) Flumazenil (Romazicon)
b) Fentanyl (Sublimaze)
c) Nalmefene (Revix)
d) Naltrexone (Revia, Depade)
e) Naloxone (Narcan)
9.3) Which of the following is a potent receptor agonist that also blocks NMDA receptors
and monoaminergic reuptake, and is used to treat neuropathic pain and opioid abuse?
a) Morphine (a phenanthrene)
b) Methadone (a phenylheptylamine)
c) Meperidine (a phenylpiperidine)
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d) Levorphanol (a morphinan)
e) Codeine (a phenanthrene)
f) Propoxyphene (a phenylheptylamine)
g) Diphenoxylate (a phenylpipere)
9.4) Which of the following is a partial opioid receptor agonist that is usually combined
in formulation containing aspirin or acetaminophen?
a) Morphine (a phenanthrene)
b) Methadone (a phenylheptylamine)
c) Meperidine (a phenylpiperidine)
d) Levorphanol (a morphinan)
e) Codeine (a phenanthrene)
f) Propoxyphene (a phenylheptylamine)
g) Diphenoxylate (a phenylpipere)
9.5) Which of the following is used with atropine to threat diarrhea?
a) Morphine (a phenanthrene)
b) Methadone (a phenylheptylamine)
c) Meperidine (a phenylpiperidine)
d) Levorphanol (a morphinan)
e) Codeine (a phenanthrene)
f) Propoxyphene (a phenylheptylamine)
g) Diphenoxylate (a phenylpipere)
9.6) Which of the following mixed opioid receptor drugs works partially on the mu
receptor, has a long duration, and is as effective as methadone?
a) Nalbupine (a phenanthrene)
b) Buprenorphine (a phenanthrene)
c) Butrophanol (a morphinan)
d) Pentazocine (a benzomorphan)
e) Dezocine (a benzomorphan)
9.7) Nalbupine is a strong agonist of what opioid receptor subtype?
a) Mu
b) Delta
c) Kappa
10.1) Anti-tussives (cough suppressants) should NOT be taken with which of the
following, as it could result in hyperpyrexic (high fever) coma?
a) Dopamine receptor agonists
b) Monoamine oxidase (MAO) inhibitors
c) Catechol-O-methyl transferase (COMT) inhibitors
d) Anti-viral agents
e) Acetylcholine blockers
f) Selective serotonin reuptake (SSR) inhibitors
g) Anti-fungal agents
10.2) Which of the following anti-tussives works at lower doses than those required for
analgesia?
a) Codeine
b) Dextromethorphan
c) Levopropoxyphene
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b) Nicotine
c) LSD
d) Cocaine
e) Ecstasy
4.1) Dronabinol, an appetite stimulant, and nabilone, an anti-emetic, are analogs of which
of the following types of drugs?
a) Cannabinoids
b) Nicotine
c) LSD
d) Cocaine
e) Ecstasy
4.2) Which of the following involves buproprion (Wellbutrin) as a treatment option and is
associated with Alzheimer dementia with loss of acetylcholine-releasing neurons from
the nucleus basalis of Meynert?
a) Amphetamines
b) Benzodiazepines
c) Cannabinoids
d) Cocaine
e) Nicotine
4.3) Which of the following inhibits voltage gated Na+ channels in the PNS, blocks
uptake of dopamine in the CNS, and can lead to hyperthermic coma with overdose?
a) Opioids
b) Benzodiazepines
c) Cannabinoids
d) Cocaine
e) Nicotine
4.4) A 17-year-old female presents to the Emergency Room after passing out at a “rave”
party. She is hot to the touch and very diaphoretic. Examination finds two bottles of
water, glow sticks, and an infant pacifier (to prevent teeth grinding). Which of the
following is the most likely?
a) Cannabinoids
b) Amphetamine
c) LSD
d) Cocaine
e) Ecstasy
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6) Which of the following involves patient resistance to passive extension of the knee
with the hip flexed?
a) Nuchal rigidity (meningismus)
b) Brudzinski sign
c) Kernig sign
d) Thomas test
e) Straight leg raise test
f) Rovsing sign
7) Kayser-Fleisher rings around the iris are associated with which of the following?
a) Brain tumor
b) Neuro syphilis
c) Hepatic degeneration
d) Creutzfeldt-Jakob disease (CJD)
e) Wilson disease
8.1) A positive Myerson sign is often an early sign of Parkinson disease. Which of the
following describes the primitive (frontal release sign) reflex for this?
a) Palmar: elicited by stroking the skin of the patients palm, if the reflex is
present, the patients finger will close around the examiners and often times with
the inability to let go
b) Plantar: flexion and adduction of the toes in response to stimulation of the foot
sole
c) Palmomental: scratching along the length of the palm of the hand results in
contraction of the ipsilateral chin (mentalis) and perioral (orbicularis) muscles
d) Suck: sucking movements upon gentle tapping of the lips
e) Snout: tapping on the lips results in their protrusion
f) Glabellar: elicited by repeated tapping of the forehead causing persistent
blinking
8.2) Which of the following is a disorder of articulation that spares oral and written
language comprehension and written expression?
a) Aphasia
b) Dysarthria
c) Agraphesthesia
d) Astereognosia
e) Apraxia
f) Pseudobulbar palsy
9.1) Which step of the Mini Mental Status Examination (MMSE) involves re-drawing the
image shown here?
a) Orientation
b) Registration
c) Attention & Calculation
d) Recall
e) Language
9.2) Which step of the Mini Mental Status Examination (MMSE) involves using serial
7’s or spelling the word “world” backwards?
a) Orientation
b) Registration
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c) Protein >45mg/dL
d) Glutamine <25mcg/dL
e) Appearance clear
16.1) A lumbar puncture reveals slightly cloudy CSF, normal pressure, an increase in
mononuclear cells, a decrease in glucose, an increase in protein, and a positive India Ink
stain on smear. Which of the following is the most likely?
a) Bacterial meningitis
b) Tuberculosis (TB) meningitis
c) Fungal meningitis
d) Viral meningitis
e) Leptomeningeal carcinomatosis
f) Subarachnoid hemorrhage
16.2) A lumbar puncture reveals mononuclear cell infiltration with a drastic decrease in
glucose. Culture is negative but cytology is positive for an abnormality. History reveals
painful ejaculations over the past few months. Results of a PSA test are pending. Which
of the following is the most likely?
a) Bacterial meningitis
b) Tuberculosis (TB) meningitis
c) Fungal meningitis
d) Viral meningitis
e) Leptomeningeal carcinomatosis
f) Subarachnoid hemorrhage
16.3) A patient presents with the “worst headache of my life.” A spinal tap reveals pink
CSF with increased pressure and moderately increased protein. Smear and culture are
negative. Which of the following is the most likely?
a) Bacterial meningitis
b) Tuberculosis (TB) meningitis
c) Fungal meningitis
d) Viral meningitis
e) Leptomeningeal carcinomatosis
f) Subarachnoid hemorrhage
17) A teenager presents with confusion, nausea, hypotension, and papillary constriction.
A Foley catheter is put in place to relieve urinary retention. Examination finds “track
marks” on the anterior left arm. To rule-out a pontine hemorrhage, which of the following
should be given to the patient?
a) Furosemide (Lasix)
b) Mannitol
c) Dobutamine
d) Flumazenil
e) Naloxone
18) A runner presents to the medical tent at the finish line of a marathon (26.2 miles).
The patient is delirious, confused, and combative. The patient says he drank water at ever
rest station along the way but did not have any electrolyte rehydration drinks. An IV is
started and the patient is given hypertonic saline. The infusion should not be done rapidly
to prevent which of the following?
a) Retinal detachment
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b) Subarachnoid hemorrhage
c) Central pontine myelinolysis
d) Absence seizures
e) Atrial fibrillation
19) A patient presents with several neurologic symptoms including delirium and
hallucinations. ECG reveals a prolonged QT interval (ventricular repolarization).
Percussion of the facial nerve anterior to the ear produces hyper-excitability
(Chvostek/Weiss sign). While obtaining a blood pressure, hyper-reflexia of the wrist
occurs (Trousseau sign). Which of the following is the most likely?
a) Hypokalemia
b) Hyperkalemia
c) Hypocalcemia
d) Hypercalcemia
e) Hyponatremia
20.1) A patient presents with an electric-shock sensation down their spine with neck
flexion (Lhermitte sign). Lab tests show thrombocytopenia with giant neutrophils and
pernicious anemia with a positive Shilling test. IM injections of cyanocobalamin are
started. Which of the following does this patient have?
a) Reye syndrome
b) Hepatic encephalopathy
c) Wenicke encephalopathy
d) B12 deficiency
e) Korsakoff amnestic syndrome
20.2) A heavy-drinker presents with cognitive disturbances and asterixis. Examination
reveals brisk ocular reflexes. Blood testing reveals increased ammonia; lactulose is given
to decrease pH. Which of the following is the most likely?
a) Reye syndrome
b) Hepatic encephalopathy
c) Wenicke encephalopathy
d) B12 deficiency
e) Korsakoff amnestic syndrome
20.3) Which of the following is associated with a triad of ophthalmoplegia, ataxia, and
confusional state?
a) Reye syndrome
b) Hepatic encephalopathy
c) Wenicke encephalopathy
d) B12 deficiency
e) Korsakoff amnestic syndrome
20.4) Which of the following is associated with varicella, influenza B, and the use of
aspirin to treat febrile illness in children?
a) Reye syndrome
b) Hepatic encephalopathy
c) Wenicke encephalopathy
d) B12 deficiency
e) Korsakoff amnestic syndrome
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20.5) A heavy-drinker presents with memory loss, confusion, and confabulation. Which
of the following is the most likely?
a) Reye syndrome
b) Hepatic encephalopathy
c) Wenicke encephalopathy
d) B12 deficiency
e) Korsakoff amnestic syndrome
21.1) Which of the following forms of bacterial meningitis is associated with a petechial
rash?
a) S. pneumonia
b) Haemophilis
c) N. meningitidis
d) Listeria
e) M. tuberculosis
f) T. pallidum
21.2) Isoniazid is a first-line drug used for which of the following?
a) Bacterial meningitis
b) Neuro syphilis
c) Lyme disease
d) Tuberculosis
e) AIDS
21.3) Which of the following is used to treat Lyme disease (B. burgdorferi)?
a) Acyclovir
b) Doxycycline
c) Penicillin
d) Isoniazid
e) Amphotericin B
21.4) Which of the following forms of meningitis seen in AIDS patients affects the basal
ganglia and is declining in frequency with the use of trimethoprim-sulfamethoxole for P.
carinii?
a) Cryptococcus
b) HSV/VZV
c) CMV
d) Toxoplasmosis
e) Primary CNS lymphoma
22) Which of the following is often associated with a lateral skull fracture (e.g. fracture at
the pterion) without loss of consciousness?
a) Concussion
b) Epidural hematoma
c) Subdural hematoma
d) Intracerebral hematoma
23) Which of the following reflexes is most commonly lost with increasing age?
a) Biceps
b) Brachioradialis
c) Triceps
d) Patella
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e) Achilles
24) Which of the following is an irreversible cause of dementia?
a) Normal pressure hydrocephalus
b) Intracranial mass lesion
c) Vitamin B12 deficiency
d) Hypothyroidism
e) Creutzfeldt-Jakob disease
Match the disease with the description:
25.1) Severe depression with cognitive changes a) Alzheimer disease
25.2) 50-70 years old after minor head trauma b) Creutzfeldt-Jakob disease (CJD)
25.3) Pseudobulbar palsy, dysarthria, dysphagia c) Normal pressure hydrocephalus
25.4) Dementia, gait ataxia, incontinence d) Vascular dementia
25.5) From corneal transplant or growth hormones e) Chronic subdural hematoma
25.6) German heritage, neurofibtrillary tangles, beta amyloid f) Pseudodementia
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a) Carbamazepine
b) Oxcarbazepine
c) Phenytoin
d) Lamotrigine
e) Baclofen
29.2) A 55-year-old patient presents with pain over the left forehead. Examination reveals
a decreased blink reflex on the left. History reveals a recent infection. Which of the
following is suspected if the clinician begins treatment with acyclovir?
a) Pseudotumor cerebri
b) Trigeminal neuralgia
c) Postherpetic neuralgia
d) Giant cell arteritis
e) Intracranial mass
29.3) High dose prednisone will show very fast relief of symptoms, such as headaches
and jaw claudication, when given for which of the following?
a) Pseudotumor cerebri
b) Trigeminal neuralgia
c) Postherpetic neuralgia
d) Giant cell arteritis
e) Intracranial mass
29.4) In pseudotumor cerebri, the intracranial pressure is usually self-limiting over
several months, especially with treatment including acetazolamine and furosemide.
Which of the following is characteristic of the epidemiology of this disease?
a) 16-year-old pregnant drinker
b) 24-year-old extremely athletic male
c) 26-year-old obese female
d) 35-year-old diabetic male
e) 75-year-old swimmer
29.5) A patient wakes up with a headache that reaches maximal intensity within a few
seconds and is accompanied by nausea and vomiting. Which of the following is the most
likely?
a) Pseudotumor cerebri
b) Trigeminal neuralgia
c) Postherpetic neuralgia
d) Giant cell arteritis
e) Intracranial mass
30) Which of the following is distinguished from a stroke by gradual onset and
spontaneous resolution?
a) Tension headache
b) Migraine
c) Cluster headache
31.1) A patient presents with bilateral throbbing pain, cervical muscle contraction, and
scalp tenderness. History reveals similar headaches after eating chocolate or take-out
Chinese food. Which of the following is the most likely?
a) Cluster headache
b) Tension headache
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c) 11
d) 17
f) 21
34.3) A patient presents with complains of nausea and lightheadedness when sleeping on
one side. The clinician performs a series of maneuvers while holding the patient’s head in
an attempt to help move debris from the endolymph. Which of the following is causing
the patient’s symptoms?
a) Benign positional vertigo
b) Ménière disease
c) Vestibular neuronitis
d) Cerebellopontine angle tumor
34.4) A patient presents with spontaneous attacks of vertigo accompanied by nausea and
vomiting. In the primary care clinic, the patient has another episode and lays on her right
side, refusing to move. Caloric testing is defective in the right ear. Nystagmus is present
toward the left side. The patient is prescribed a trial of prednisone for which of the
following?
a) Benign positional vertigo
b) Ménière disease
c) Vestibular neuronitis
d) Cerebellopontine angle tumor
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c) Bitemporal hemianopia
d) Contralateral hemianopia
e) Contralateral homonymous superior quadrantanopia
f) Contralateral homonymous inferior quadrantanopia
g) Contralateral homonymous hemianopia
37.2) Posterior cerebral artery occlusion damaging the optic radiation causes:
a) Central scotoma
b) Ipsilateral blindness
c) Bitemporal hemianopia
d) Contralateral hemianopia
e) Contralateral homonymous superior quadrantanopia
f) Contralateral homonymous inferior quadrantanopia
g) Contralateral homonymous hemianopia
37.3) A pituitary tumor would cause:
a) Central scotoma
b) Ipsilateral blindness
c) Bitemporal hemianopia
d) Contralateral hemianopia
e) Contralateral homonymous superior quadrantanopia
f) Contralateral homonymous inferior quadrantanopia
g) Contralateral homonymous hemianopia
38) Which of the following would be seen bilaterally during an ophthalmologic exam
with increased intracranial pressure and/or with brain tumors?
a) Arteriovenous nicking
b) Flame hemorrhages
c) Hard exudates
d) Papilledema
e) Cotton wool spots
39) The pupillary light reflex involves accommodation and reaction to light and is
associated with what cranial nerve(s)?
a) II
b) III
c) II, III
d) III, IV, VI
e) II, III, IV, VI
40.1) During a swinging-flashlight test, the pupils constricts less when the light is swung
from the left eye to the right eye. There is no anisocoria. The right eye still senses light
but the reaction is diminished. Which of the following describes this patient?
a) Non-reactive pupils
b) Light-near dissociation
c) Argyll-Robertson pupils
d) Tonic pupils
e) Horner syndrome
f) Afferent pupillary defect (Marcus Gunn pupil)
40.2) Examination of a patient with suspected Holmes-Adie syndrome reveals that the
left pupil is larger than the right and the left pupil reacts sluggishly to changes in
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41.2) A patient presents with transient monocular blindness (amaurosis fugax) due to
emboli in the carotid artery bifurcation. Which of the following should be used to treat
this patient?
a) Prednisone
b) Methylprednisolone
c) Amitriptyline
d) Phenytoin
e) Aspirin
41.3) A demyelinating disease leads to optic neuritis. Which of the following should be
given to the patient initially?
a) Prednisone
b) Methylprednisolone
c) Amitriptyline
d) Phenytoin
e) Aspirin
42) Which of the following is characteristic of diabetic third nerve palsy, and not
aneurismal third nerve palsy?
a) Involvement of the posterior communicating artery
b) Offending location is in the subarachnoid space
c) Pupillary sparing
d) Lack of CN VI involvement
e) Lack of CN IV involvement
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a) Hypertonia
b) Hypotonia
c) Areflexia
d) Hyporeflexia
e) Hyperreflexia
46.2) Which of the following is associated with the Hoffmann sign, where eliciting finger
flexion causes thumb flexion?
a) Hypertonia
b) Hypotonia
c) Areflexia
d) Hyporeflexia
e) Hyperreflexia
46.3) If the abdominal reflex (T8-12) is elicited by stroking the left upper quadrant of the
abdomen, which direction will the umbilicus tend to move with abdominal muscle
contraction?
a) Toward the right upper quadrant (RUQ)
b) Toward the left upper quadrant (LUQ)
c) Toward the right lower quadrant (RLQ)
d) Toward the left lower quadrant (LLQ)
46.4) The cremaster reflex is associated with what root levels?
a) T8-10
b) L1-2
c) L2-4
d) S1-S2
e) L4-S1
47) Which of the following signs is indicative of a lower motor neuron lesion?
a) Positive Babinski sign
b) Spasticity and hyperreflexia
c) Weakness or paralysis
d) Loss of superficial abdominal reflexes
e) Wasting and fasciculations
48) A patient presents with an extensive, but unilateral cord lesion (hemisection). In
Brown-Séquard syndrome, motor deficit is accompanied by ____ impairment of vibration
and position sense as well as ____ loss of pain and temperature appreciation.
a) Ipsilateral; Ipsilateral
b) Ipsilateral; Contralateral
c) Contralateral; Contralateral
d) Contralateral; Ipsilateral
49) Which of the following is NOT true of myopathic disorders?
a) Weakness is usually most marked distally
b) No muscle wasting is present
c) Deep tendon reflexes are intact
d) No sensory loss
e) No sphincter disturbances
50.1) When checking serum enzymes for muscle disease, which of the following will
show the greatest increase and is the most useful in following the course of the disease?
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a) Creatine kinase
b) Aldolase
c) Lactic acid dehydrogenase
d) Transaminases
50.2) A muscle biopsy specimen shows atrophied fibers in groups, with adjacent groups
of larger, uninvolved fibers. Which of the following describes the underlying weakness?
a) Neurogenic
b) Myopathic
c) A & B
d) None of the above
51.1) Which of the following is associated with the development of focal scattered areas
of demyelination followed by a reactive gliosis?
a) Huntington disease
b) Parkinson disease
c) Multiple sclerosis
d) Down syndrome
e) Amyotrophic lateral sclerosis
51.2) A 24-year-old female from Wisconsin presents with relapsing and recurring muscle
weakness. Studies have revealed two lesions involving different regions of the central
white matter at different times. Which of the following types of drugs can help reduce the
relapse rate for this patient?
a) Corticosteroids
b) Mitozantrone
c) Cyclophosphamide
d) Interferon "
e) Amantadine
52.1) A patient presents with fever, backache, and tenderness along a spinal nerve root
distribution. MRI with gadolinium enhancement shows an epidural abscess. Which of the
following is the most likely cause?
a) Staphylococcus aureus
b) Niesseria gonorrhoeae
c) Bacillus anthracis
d) Borrelia burgdorferi
e) Moraxella catarrhalis
52.2) A patient presents with spastic paraparesis with brisk tendon reflexes. History
reveals they recently had flaccidity. Examination reveals pain and temperature
appreciation are lost. Abdominal examination reveals a pulsating mass and ultrasound
reveals a dissecting aortic aneurysm. Which of the following arteries is involved in this
patient’s neurologic symptoms?
a) Posterior inferior cerebellar artery
b) Anterior inferior cerebellar artery
c) Posterior spinal artery
d) Anterior spinal artery
e) Basilar artery
52.3) A patient presents with pain that radiates down the neck when they cough. CSF is
yellow (xanthochromic) with increased protein, increased WBC count, and decreased
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f) Mononeuropathy
g) Polyneuropathy
56.2) Which of the following denotes an unpleasant sensation produced by a stimulus that
is usually painless?
a) Parathesia
b) Dysesthesia
c) Anesthesia
d) Hypesthesia
e) Hyperesthesia
f) Mononeuropathy
g) Polyneuropathy
57) When a patient says a part of their body is numb, they most likely mean that part of
their body is experiencing:
a) Heaviness
b) Weakness
c) Deadness
d) Any of the above
58.1) Which of the following tracts corresponds to “1” in the spinal cord section here?
a) Lateral spinothalamic
b) Anterior spinothalamic
c) Corticospinal
d) Rubrospinal
e) Fasciculus gracilis
58.2) What tract corresponds to “5”?
a) Lateral spinothalamic
b) Anterior spinothalamic
c) Corticospinal
d) Rubrospinal
e) Fasciculus gracilis
59.1) Which of the following dermatomes is incorrect?
a) Male nipple: T4
b) Umbilicus: T10
c) Inguinal region: L1
d) Lateral calf: L4
e) Lateral foot: S1
59.2) What root level most corresponds to the dermatome of the middle finger?
a) C5
b) C6
c) C7
d) C8
e) T1
59.3) What nerve sensory distribution accounts for the lateral (thumb) side of the back
(dorsum) of the hand?
a) Ulnar nerve
b) Median nerve
c) Radial nerve
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a) Ulnar
b) Median
c) Radial
d) Peroneal
e) Femoral
65.2) Which of the following nerves is most likely to be damaged with compression in
the axilla?
a) Ulnar
b) Median
c) Radial
d) Peroneal
e) Femoral
65.3) Thoracic outlet syndrome caused by a cervical rib usually affects the C5-C6
distribution.
a) True
b) False, it affects the C8-T1 distribution
65.4) A patient presents with a dragging left foot (foot drop). History reveals traumatic
injury near the lateral knee. Which of the following nerves was damaged?
a) Lateral femoral cutaneous
b) Femoral
c) Peroneal
d) Radial
e) Median
66) A college student presents with new onset of distal parasthesia and weakness in the
extremities. Examination reveals increased reflexes and Barber Chair Phenomenon
(Lhermitte sign). History reveals a recent change to a vegetarian diet. If subacute
combined degeneration is suspected, what vitamin will be deficient?
a) Vitamin A
b) Vitamin B3
c) Vitamin B6
d) Vitamin B12
e) Vitamin E
67) Which of the following would result in causalgia, not reflex sympathetic dystrophy?
a) Soft tissue trauma
b) Bone fracture
c) Nerve trauma
d) Myocardial infarction
e) Stroke
68) Which of the following maneuvers would most close the intervertebral foramen of
the cervical spine on one side in an attempt to recreate radiculopathy (Spurling test)?
a) Rotation and flexion
b) Rotation and side-bending
c) Rotation and extension
d) Side-bending and flexion
69) Which of the following is/are the best modalities of treatment for low back and neck
pain as it relates to trauma (musculoskeletal pain)?
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c) Chorea
d) Tics
e) Dystonia
Match the disease with the description:
73.1) Streptococcus infection, arteritis a) Familial and essential tremor
73.2) More troublesome at night, use dopaminergic drugs b) Huntington disease
73.3) CAG repeats, dementia, chorea c) Sydenham chorea
73.4) Striato-thalamo-cortico pathways, clonidine for tics d) Spasmodic torticollis
73.5) Affects hands and voice, but not usually legs e) Gilles de la Tourette syndrome
73.6) Tendency for neck to twist to one side f) Restless leg syndrome
74) A patient presents with hypokinesia. Lab tests reveal the presence of Lewy bodies.
Which of the following is the most likely?
a) Huntington disease
b) Parkinson disease
c) Multiple sclerosis
d) Down syndrome
e) Amyotrophic lateral sclerosis
75.1) A patient presents with Parkinsonism symptoms. Which of the following would
NOT be seen if the syndrome were drug-induced?
a) Bradykinesia
b) Resting tremor
c) Rigidity
d) Postural instability
75.2) Neuroleptic Malignant Syndrome, which mimics malignant hyperthermia, is a rare
complication of which of the following drugs?
a) Reserpine
b) Haloperidol
c) Perphenazine
d) Olanzapine
e) Metoclopramide
75.3) Tardive Dyskinesia is seen often in institutionalized individuals with long-term use
of which of the following drugs?
a) Reserpine
b) Haloperidol
c) Perphenazine
d) Olanzapine
e) Metoclopramide
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a) Syncope
b) Absence seizure
c) Atonic seizure
d) Tonic-clonic seizure
e) Epilepsy
78) Which of the following would NOT likely cause seizures?
a) Head trauma
b) Meningitis
c) Drug overdose
d) Hypoglycemia
e) Hyperkalemia
79) A 2-year-old child is brought into the Emergency Room because it was “shaking and
turned blue.” Physical exam reveals a high fever. What drug should be given for
prolonged convulsions and to possibly reduce recurrence?
a) Phenytoin
b) Zaleplon
c) Phenobarbital
d) Diazepam
e) Flumazenil
80.1) Which of the following involves loss of consciousness without loss of postural tone
and may have subtle motor manifestations like eye blinking or lip smacking?
a) Tonic-clonic seizure (grand mal)
b) Absence seizure (petit mal)
c) Myoclonic seizure
d) Simple partial seizure
e) Complex partial seizure
80.2) Which of the following involves the temporal lobe and may have affective (fear)
sensations, cognitive (déjà vu) sensations, sensory (olfactory) hallucinations, and
involuntary motor activities (automatisms)?
a) Tonic-clonic seizure (grand mal)
b) Absence seizure (petit mal)
c) Myoclonic seizure
d) Simple partial seizure
e) Complex partial seizure
80.3) Myoclonic, or shock-like contracting, seizures may be associated with all of the
following EXCEPT:
a) Todd paralysis
b) Unverricht-Lundborg disease
c) Lafora body disease
d) Neuronal ceroid lipofuscinosis
e) Mitochondrial encephalomyopathy
f) Sialidosis
80.4) Which of the following is associated with autonomic symptoms (pallor, flushing,
sweating, vomiting, borborygmi, incontinence) with preserved consciousness?
a) Tonic-clonic seizure (grand mal)
b) Absence seizure (petit mal)
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c) Myoclonic seizure
d) Simple partial seizure
e) Complex partial seizure
80.5) Which of the following mimics opisthotonos and may involves a crying or moaning
sound and tongue trauma?
a) Tonic-clonic seizure (grand mal)
b) Absence seizure (petit mal)
c) Myoclonic seizure
d) Simple partial seizure
e) Complex partial seizure
81) Status epilepticus is defined as a seizure lasting longer than ____ minutes or that
recur so frequently that consciousness is not regained. They are considered a medical
emergency as permanent brain damage can result from hyperpyrexia, circulatory
collapse, or excitoxic neuronal damage.
a) 3
b) 5
c) 10
d) 15
e) 30
f) 60
82) Primary generalized seizures affect ____ cerebral hemisphere(s) and secondary
generalized seizures affect ____ cerebral hemisphere(s).
a) One; One
b) One; Both
c) Both; One
d) Both; Both
83) Which of the following is true of absence seizures, when compared with complex
partial seizures?
a) Preceded by aura
b) Lasts seconds
c) Has automatisms
84) Which of the following should be done if a patient has new onset seizures after the
age of 25 or if neurological exam is abnormal?
a) EEG (abnormal spikes, polyspikes, spike-wave complexes)
b) Serium calcium
c) Fasting glucose
d) Serum FTA-ABS
e) Brain MRI
85) Which of the following is NOT true regarding therapeutic management of epilepsy?
a) Epilepsy drugs may cause seizures in normal (non-epileptic) patients
b) Establish a diagnosis of epilepsy before starting therapy
c) Choose the right drug for the seizure type
d) Treat seizures rather than the serum drug level
e) Evaluate two drugs at a time to help prevent symptoms
Match the type of seizure with the drugs that can be used for treatment:
86.1) Generalized seizures a) Valproic acid, Ethosuximide
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106) Which of the following is NOT given immediately to a coma patient if the coma is
of unknown origin?
a) Dextrose
b) Thiamine
c) Naloxone
d) Flumazenil
Match the clinical signs with the possible cause of the coma:
107.1) Coma preceeded by confusional state a) Subarachnoid hemorrhage
107.2) Symptoms days or weeks prior to coma b) Tumor, abscess
107.3) Rapid progression from hemispheric signs to coma c) Intracerebral hemorrhage
107.4) Sudden onset coma d) Metabolic derangement
108) A 24-year-old racecar driver presents to the Emergency Room with head trauma
after a car crash. A basilar skull fracture is suspected. Which of the following would
NOT likely be seen?
a) Periorbital ecchymoses (Raccoon eyes)
b) Perimastoid ecchymoses (Battle sign)
c) Hemotympanum (blood in ears)
d) CSF otorrhea or rhinorrhea
e) Decorticate or decerebrate positioning
Match the clinical presentation with the level of CNS involvement:
109.1) Fixed midsized pupils, no motor response a) Early diencephalon
109.2) Decerebrate, fixed midsized pupils b) Late diencephalon
109.3) Decorticate with painful stimuli, small pupils c) Midbrain
109.4) Semi-purposeful response to painful stimuli, small pupils d) Pons/Medulla
110) Which of the following would be seen with a lesion of the thalamus (decorticate),
not with a lesion of the midbrain (decerebrate)?
a) Patient unconscious
b) Shoulders internally rotated
c) Leg extension
d) Elbows flexed
111) A patient presents with ipsilateral pupillary dilation, impaired adduction of the eye,
and eventual loss of consciousness. Which of the following herniations is most likely?
a) Central herniation
b) Uncal herniation
c) Cerebellar herniation
d) Tosillar herniation
e) Cingulate herniation
112) Which of the following breathing patterns are indicative of a pontomedullary lesion?
a) Cheyne-Stokes
b) Central hyperventilation
c) Ataxic
d) Gasping
e) A & B
f) C & D
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113) A patient presents with cerebral edema. The clinician starts an IV line running
hypertonic saline (3%). Which of the following is an osmotic diuretic agent that can help
relieve intracranial pressure?
a) Dexamethasone
b) Dextrose
c) Mannitol
d) Dobutamine
e) Milrinone
114.1) A patient is being treated for a cardiac arrest in the Emergency Room. Shortly
after treatment, the patient experiences opisthotonic posturing with seizures and fecal
incontinence. Examination reveals rapidly dilating pupils. Which of the following is the
mostly likely?
a) Subdural hematoma
b) Epidural hematoma
c) Intracerebral hemorrhage
d) Brain abscess
e) Pontine hemorrhage
f) Global cerebral ischemia
114.2) Which of the following should be given for an insulin overdose?
a) Dexamethasone
b) Dextrose
c) Mannitol
d) Dobutamine
e) Milrinone
114.3) A patient presents with apopletic onset coma and hyperthermia. Examination
revealed ocular bobbing prior to unconsciousness. Which of the following is the most
likely?
a) Subdural hematoma
b) Epidural hematoma
c) Intracerebral hemorrhage
d) Brain abscess
e) Pontine hemorrhage
f) Global cerebral ischemia
114.4) Patients with which of the following are the most likely to have intracerebral
hemorrhages?
a) Diabetes
b) Epilepsy
c) Hypertension
d) Bradycardia
e) Pneumonia
114.5) Which of the following is seen in patients with cyanotic congenital heart disease
or recent head trauma?
a) Global cerebral ischemia
b) Epidural hematoma
c) Intracerebral hemorrhage
d) Brain abscess
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e) Pontine hemorrhage
115) A 16-year-old patient presents with a coma. Oculocephalic testing reveals an
absence of extraocular movements with preservation of pupillary light reflex. Pupils are
normal in size. The patient’s mother thinks the patient took the pills she uses for acute
management of her status eilepticus. Which of the following would be most beneficial for
this patient?
a) Alcohol detoxification
b) IV naloxone
c) IV flumazenil
d) IV dextrose
e) Oral activated charcoal
116) Which of the following would NOT be seen in a patient with hepatic
encephalopathy?
a) Hyporeflexia
b) Asterixis
c) Somnolence or delerium
d) Respiratory alkalosis
e) Hyperventilation
A patient presents in a coma of known origin. Brainstem reflexes are absent and the
patient is unresponsive. For diagnosis of brain death, match the description with the
length of time for confirmation:
117.1) Anoxic brain injury without confirmatory EEG a) 6-hours
117.2) Brain injury with confirmatory isoelectric EEG b) 12-hours
117.3) Brain injury without confirmatory EEG c) 24-hours
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120) Electromyography (EMG) and a nerve conduction study (NCS) are often used in
conjunction to help understand and diagnose various neurologic problems.
a) True
b) False, EMG is no longer used
c) False, NCS is no longer used
d) False, neither of these tests are used
121) Diagnosis of which of the following requires an MRI, not just a CT scan?
a) Dementia
b) Tumor
c) Stroke
d) Subarachnoid hemorrhage
e) Multiple sclerosis
122) Cerebral angiography is NOT useful in which of the following cases?
a) Arteriovenous malformations
b) Aneurysms > 3mm in diameter
c) Visualizing the circle of Willis
d) Detecting subdural hematomas
e) Screening for aortic stenosis
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d) Krabbe disease
e) Metachromatic leukodystrophy
5) Which of the following is an autosomal recessive lysosomal storage disease that
results in demylination and progressive dementia, caused by an accumulation of sulfatide
in the brain, kidneys, liver, and peripheral nerves?
a) Alzheimer disease
b) Huntington disease
c) Parkinson disease
d) Krabbe disease
e) Metachromatic leukodystrophy
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Neuroscience – Part 4 14Mar2009
James Lamberg
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Neuroscience – Part 4 14Mar2009
AnswerKey 4.1) A 9) C
Neuro #1 Neuro #3 4.2) C 10) A
1) B 1.1) C 4.3) C 11) B
2) C 1.2) E 4.4) C 12.1) D
3.1) D 1.3) D 4.5) A 12.2) E
3.2) C 2.1) C 5) E
3.3) A 2.2) E 6.1) B Neuro #8
3.4) E 3) D 6.2) C 1.1) B
3.5) B 4) E 6.3) A 1.2) C
3.6) A 5.1) B 7) C 1.3) A
3.7) C 5.2) A 8) A 1.4) B
4) D 5.3) C 9.1) D 1.5) B
5) E 6.1) E 9.2) C 1.6) C
6) C 6.2) A 9.3) E 1.7) A
7.1) C 9.4) E 1.8) D
7.2) B Neuro #4 9.5) E 1.9) A
8.1) D 1.1) B 9.6) A 2) C
8.2) B 1.2) D 10) C 3) C
8.3) A 1.3) A 4) C
8.4) A 1.4) B Neuro #6 5) A
8.5) D 1.5) C 1) E 6) D
8.6) F 1.6) C 2.1) D 7) B
8.7) E 1.7) B 2.2) C 8) E
8.8) C 1.8) A 3) D 9.1) A
1.9) A 4) D 9.2) E
Neuro #2 1.10) B 5) A 9.3) B
1) A 1.11) C 6.1) C 9.4) E
2) D 1.12) D 6.2) A 9.5) G
3.1) C 1.13) D 6.3) C 9.6) B
3.2) A 2.1) E 7.1) D 9.7) C
4.1) A 2.2) A 7.2) B 10.1) B
4.2) D 2.3) E 10.2) A
5) B 2.4) E Neuro #7
6.1) C 2.5) C 1) C Neuro #9
6.2) B 2.6) C 2) C 1) D
7.1) B 3) B 3) C 2.1) D
7.2) C 4) B 2.2) D
8) E Neuro #5 5) C 2.3) E
9.1) D 1.1) A 6) C 3.1) A
9.2) C 1.2) E 7) D 3.2) G
10) E 1.3) C 8.1) B 3.3) F
11) D 1.4) D 8.2) C 3.4) B
12) D 1.5) A 8.3) C 3.5) C
13.1) E 1.6) B 8.4) C 3.6) D
13.2) D 2) C 8.5) E 3.7) E
13.3) E 3) A 8.6) E 3.8) D
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Neuroscience – Part 4 14Mar2009
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Neuroscience – Part 4 14Mar2009
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