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SSC JE - Basics of Neurology 1000+ MCQ [Solved] PDF Download

Thursday 9th of March 2023

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1. Topic: Horner's Syndrome
Subject: Medicine
A 54-year-old white male presents with drooping of his right eyelid for 3 weeks. On examination, he has ptosis of the right upper lid, miosis of the right pupil, and decreased sweating on the right side of his face. Extraocular muscle movements are intact. In addition to a complete history and physical examination, which one of the following would be most appropriate at this point?

A. A chest radiograph
B. MRI of the brain and orbits
C. 131 Iodine thyroid scanning
D. A fasting blood glucose level
Answer : A
2. Topic: Benign Positional Vertigo
Subject: Medicine
Which one of the following is characteristic of benign positional vertigo?

A. A duration of 10-15 minutes
B. Associated hearing loss and tinnitus
C. Associated diplopia and facial numbness
D. Being triggered by turning the head
Answer : D
3. Topic: Cholinergic Toxidrome
Subject: Medicine
A 37 year old male arrives at the Emergency Department unconscious. He is warm and sweaty. His heart rate is 52 bpm, his BP is 90/60. His pupils are constricted, his eyes are teary, and he is drooling. You assume he is suffering from a toxidrome.
What antidote will you give him?

A. Flumazenil
B. Naloxone
C. Glucagon
D. Atropine
Answer : D
4. Topic: Horner's Syndrome
Subject: Medicine
A 70-year-old man presented with ptosis, myosis and anhydrosis on the left side. Which one of the following is the most likely cause of this condition?

A. Tumour induced exophthalmos
B. Fourth cranial nerve palsy
C. Apical pulmonary carcinoma
D. Enlarged thyroid gland
Answer : C
5. Topic: Diagnostic Investigations
Subject: Medicine
A 52 year old male with a history of psychosis presents with muscle stiffness and resting tremors, associated with difficulty in balance and initiating movements. What is the best diagnostic method for detection of the above condition?

A. Serum dopamine levels
B. Computed tomography scan
C. Positron emission tomography scan
D. Magnetic resonance imaging
Answer : C
6. Topic: Alzheimer's Disease
Subject: Medicine
Which one of the following has NOT been identified as a risk factor for Alzheimer-type dementia (AD)?

A. Trisomy 18
B. Head trauma
C. Advanced age
D. Obesity and hypertension
Answer : A
7. Topic: Diagnostic Investigations
Subject: Medicine
A 50-year-old male is brought to the emergency department because of a syncopal episode. Prior to the episode, he felt bad for 30 minutes, then developed nausea followed by vomiting. During a second bout of vomiting he blacked out and fell to the floor. His wife did not observe any seizure activity, and he was unconscious only for a few seconds. His history is otherwise negative, his past medical history is unremarkable, and he currently takes no medications. A physical examination is normal.
Which one of the following would be the most helpful next step?

A. CT of the head
B. Carotid ultrasonography
C. A CBC and complete metabolic profile
D. An EKG
Answer : D
8. Topic: Alzheimer's Disease
Subject: Medicine
A 62 year old woman has demonstrated increasing loss of recent memory over a 5 year period, now associated with reduced affect and nominal dysphasia. She dresses neatly and social amenities are preserved. There are no localizing motor or sensory findings.
Which one of the following is the most likely diagnosis?

A. Cerebral vascular disease
B. Hydrocephalus
C. Huntington's disease
D. Alzheimer's disease
Answer : D
9. Topic: MMSE
Subject: Medicine
The Mini-Mental State Examination (MMSE) tests for:

A. Mood
B. Behavior
C. Intelligence quotient
D. Cognitive function
Answer : D
10. Topic: Mini Mental Status Exam (or MMSE)
Subject: Medicine
A 63-year-old retired teacher shared with his primary care physician (PCP) during a routine office visit that he has noticed increasing difficulty with his memory. Otherwise he is in good health and requiring no medication.
Which one of the following psychological tests is a valuable screening device to be used by primary care physicians in this type of situation?

A. MMPI
B. WAIS
C. Thematic Apperception Test
D. Mini-Mental State Exam
Answer : D
11. Topic: Amnesia
Subject: Medicine
Which of the following medications may cause amnesia as a side effect?

A. Hydroxyzine
B. Fluoxetine
C. Triazolam
D. Clonidine
Answer : C
12. Topic: Horner's Syndrome
Subject: Medicine
A 66-year-old diabetic man presents with constriction of the pupil, drooping of the upper lid, and anhidrosis on the left. Which one of the following nerves is most likely involved?

A. Oculomotor
B. Sympathetic
C. Trochlear
D. Trigeminal
Answer : B
13. Topic: Brown-Sequard Syndrome
Subject: Medicine
Which of the following would not be expected in a right-sided Brown-S�quard syndrome?

A. Right-sided hemi-paresis
B. Right-sided loss of proprioception
C. Left-sided decreased sensitivity to pinprick
D. Left-sided decreased vibration sense
Answer : D
14. Topic: Intracranial Hemorrhage
Subject: Medicine
The most significant risk factor for spontaneous intracerebral hemorrhage is:

A. Atrial fibrillation
B. Cigarette smoking
C. Excessive alcohol use
D. Hypertension
Answer : D
15. Topic: Glasgow Coma Scale
Subject: Medicine
A 27 year old man is brought into the ER after a bicycling accident. A car door suddenly opened in front of him, of which he smashed into and was thrown 15 feet. On examination, he is drowsy and confused. He opens his eyes when his name is called. When he speaks, you understand his words but the sentences do not make sense. He moves all four limbs but does not respond to any commands. He is able to pull both hands away when pinched and squirms when his sternum is rubbed, making no effort to stop you.
What is his Glasgow Coma Scale score?

A. 11
B. 10
C. 9
D. 8
Answer : B
16. Topic: Adverse Drug Effect
Subject: Medicine
Which one of the following is most associated with falls in older adults?

A. Diphenhydramine (Benadryl)
B. Atorvastatin (Lipitor)
C. Metformin (Glucophage)
D. Memantine (Namenda)
Answer : A
17. Topic: Temporal Arteritis
Subject: Medicine
A female patient complains of a severe headache and jaw pain when she chews. She also complains of shoulder pain and bilateral wrist weakness. Initial lab tests show an ESR of 75 (normal is less than 30).
What is the most appropriate diagnosis?

A. Rheumatoid Arthritis
B. Temporal Arteritis
C. Polymyositis
D. Sarcoidosis
Answer : B
18. Topic: Dementia
Subject: Medicine
An 85 year old white male is brought to you for the first time by his son. The father has recently seen a neurologist who performed a workup for dementia and diagnosed moderate Alzheimers disease. Which one of the following is true regarding the use of a cholinesterase inhibitor in this patient?

A. It is too late to initiate cholinesterase therapy
B. Agitation is often intensified by these agents
C. Memory is likely to improve significantly
D. Nursing-home placement may be delayed a year or longer
Answer : D
19. Topic: Dementia
Subject: Medicine
A 60-year-old white female presents for her annual physical examination. She tells you that since her last visit she has begun taking ginkgo biloba to improve her memory. She takes no other medications. The evidence supporting a benefit from ginkgo biloba is best for which one of the following?

A. Tinnitus
B. Benign prostatic hyperplasia
C. Dementia
D. Intermittent claudication
Answer : C
20. Topic: Status Epilepticus
Subject: Medicine
A 58-year-old male with a history of seizure attacks suffered from a 30 min loss of consciousness with repetitive seizures with no recovery of consciousness between attacks. What is the disorder this patient is suffering from?

A. Tonic-clonic seizure
B. Absence seizure
C. Atonic seizure
D. Status epilepticus
Answer : D
21. Topic: Organophosphate poisoning
Subject: Medicine
What is the mechanism of action in organophosphate poisoning?

A. Cholinesterase inhibition
B. Cholinesterase activation
C. Catecholamine inhibition
D. Catecholamine activation
Answer : A
22. Topic: Seizure
Subject: Medicine
A 52-year-old man with a history of seizure attacks suffered from loss of consciousness and tonic and clonic muscular contractions. His tongue fell back into his throat and he choked. What is the best diagnostic test for assessment of the presenting condition of this patient?

A. X-rays
B. CT-Scan
C. Electroencephalogram
D. Discography
Answer : C
23. Topic: Neurologic pain
Subject: Medicine
A 21-year-old man presented to the emergency hospital with severe abdominal pain. The pain started four hour ago. His medical history reveals Acute Intermittent Porphyria (AIP) and he used to have frequent attacks of abdominal pain and believes that this attack is no different. On examination, the patient is in acute pain and slightly feverish but not pale, jaundiced or cyanosed. However, his blood pressure is found to be high and he has tachycardia.
You should consider a diagnosis other than an AIP attack if the pain is associated with:

A. Constipation
B. Tenderness
C. Abdominal distension
D. Decreased bowel sounds
Answer : B
24. Topic: Brain Death
Subject: Medicine
A 30 year old man has been on life support systems for the past 48 hours following blunt head trauma. Brain death cannot be established in this patient if there is the presence of which of the following?

A. Carotid blood flow
B. Cremasteric reflexes
C. Elevated serum aminoglycoside concentrations
D. Hypothermia
Answer : D
25. Topic: Seizure
Subject: Medicine
A 36-year-old male with a history of a seizure disorder is brought to the emergency department with generalized tonic-clonic activity. Emergency medical personnel report this has been ongoing for 20 minutes.
After initial resuscitative measures, the preferred medication in this situation is:

A. Phenytoin (Dilantin)
B. Fosphenytoin (Cerebyx)
C. Naloxone
D. Lorazepam (Ativan)
Answer : D
26. Topic: Subarachnoid Hemorrhage
Subject: Medicine
A 36-year-old female presents with the sudden onset of severe headache, nausea, and photophobia. Her level of consciousness is progressively diminishing. Which one of the following would be the most appropriate next step?

A. Head CT without contrast
B. Head CT with contrast
C. Head MRI
D. Lumbar puncture
Answer : A
27. Topic: Fragile X Syndrome
Subject: Medicine
You are asked to see a mentally challenged 45-yearold male from a nearby group home who has groin pain. On examination you notice that he has large ears, a prominent jaw, and large symmetric testicles.
These findings are consistent with:

A. A variant form of Down syndrome
B. Aspergers syndrome
C. Klinefelters syndrome
D. Fragile X syndrome
Answer : D
28. Topic: Cauda Equina Syndrome
Subject: Medicine
A 65-year-old male presents with a 1-month history of problems passing urine. He says that his bladder will feel full when he needs to urinate, but the urine stream is weak and his bladder does not feel as if it has emptied completely. The symptoms have become increasingly severe over the past week. Other symptoms include upper respiratory congestion for 3 days which he has treated with an over-thecounter decongestant with some relief, constipation wih no passage of stool in the past 9 days, and increasing low back pain incompletely relieved with ibuprofen, with associated weakness in both legs. Examination shows a healthy-appearing male who is moderately overweight. He is afebrile and vital signs are normal. There is no abdominal tenderness and no masses are detected. A rectal examination reveals a large amount of hard stool in the rectum; a markedly enlarged (4+), boggy, tender prostate gland; laxity of the anal sphincter; and numbness in the perianal area. Urinalysis shows trace protein and 10-20 WBCs/hpf. Ultrasonography shows a post-void residual volume of 250 mL (normal for age <100).
Which one of the following must be done urgently in this patient?

A. Foley catheterization
B. Hospitalization for intravenous antibiotics
C. Digital disimpaction of the rectum, and Fleet enemas until clear
D. MRI of the lumbosacral spine
Answer : D
29. Topic: Seizure
Subject: Medicine
A 52-year-old male with a history of seizure attacks suffered from loss of consciousness and tonic-clonic muscular contractions. His tongue fell back into his throat and he choked.
What is the medication of choice for the treatment of this patient's condition?

A. Phenytoin
B. Valproic acid
C. Tiagabine
D. Phenobarbital
Answer : B
30. Topic: Mini Mental Status Exam (or MMSE)
Subject: Medicine
While performing the Mini-Mental State Exam the PCP asks her patient to copy the following design. What cognitive function is being assessed by this request?

A. Language
B. Orientation
C. Registration
D. Visual-motor integrity
Answer : D
31. Topic: Normal Pressure Hydrocephalus
Subject: Medicine
A previously alert, otherwise healthy 74-year-old black male has a history of slowly developing progressive memory loss and dementia associated with urinary incontinence and gait disturbance resembling ataxia.
This presentation is most consistent with:

A. Normal pressure hydrocephalus
B. Alzheimers disease
C. Subacute sclerosing panencephalitis
D. Multiple sclerosis
Answer : A
32. Topic: Seizure
Subject: Medicine
A 52-year-old male with a history of seizure attacks suffered from loss of consciousness and tonic and clonic muscular contractions. His tongue fell back into the throat and he choked. What is the most likely diagnosis of this presentation?

A. Petit mal seizure
B. Grand mal seizure
C. Myoclonic seizure
D. Atonic seizure
Answer : B
33. Topic: Osmotic Demyelination
Subject: Medicine
Osmotic demyelination can result when which one of the following is corrected too rapidly?

A. Hypocalcemia
B. Hypoglycemia
C. Hypomagnesemia
D. Hyponatremia
Answer : D
34. Topic: Alzheimer's Disease
Subject: Medicine
Which one of the following tests is most useful for the initial workup of suspected Alzheimers disease?

A. Carotid Doppler ultrasonography
B. An erythrocyte sedimentation rate
C. A cardiac stress test
D. A TSH level
Answer : D
35. Topic: Dementia
Subject: Medicine
Clinical features of multi-infarct dementia may include all of the following, except:

A. Parkinsonism
B. Deteriorating course
C. Evidence of cerebrovascular disease
D. Focal neurologic signs
Answer : A
36. Topic: Brain Death
Subject: Medicine
A 57-year-old white male with coronary artery disease suffered a cardiac arrest while jogging 10 days ago. He was resuscitated after 45 minutes but has remained unresponsive and on a ventilator since then.
Which one of the following is required to diagnose brain death in this patient?

A. Hypothermia
B. Continuous mechanical ventilation
C. The absence of spontaneous body movements
D. Electroencephalographic confirmation
Answer : D
37. Topic: Foot Drop
Subject: Medicine
During the physical exam of a patients foot, you notice an inability to dorsiflex. What nerve root(s) is most likely affected?

A. T12
B. L1
C. L2
D. L4 - L5
Answer : E
38. Topic: Korsakoff's Psychosis
Subject: Medicine
In a patient with recent onset of alcohol amnestic disorder, the mental status test most likely to be done poorly is memory of:

A. Political figures of 10 years ago
B. Digits (forward)
C. His own name
D. Three items for 5 minutes
Answer : D
39. Topic: Mini Mental Status Exam (or MMSE)
Subject: Medicine
In healthy adults, performance on the Folstein Mini-Mental State Examination is affected by which one of the following?

A. Educational attainment
B. Socioeconomic status
C. Gender
D. Race
Answer : A
40. Topic: Analgesics
Subject: Medicine
A 74-year-old black female has moderately severe pain due to osteoarthritis. However, she is also on medication for a seizure disorder. When choosing medications to manage her chronic pain, which one of the following should be used with caution because of her history of seizures?

A. Salsalate (Disalcid)
B. Celecoxib (Celebrex)
C. Hydrocodone (Lortab)
D. Tramadol (Ultram)
Answer : D
41. Topic: Alzheimer's Disease
Subject: Medicine
Which one of the following is most predictive of the progression from mild cognitive impairment to frank Alzheimers dementia?

A. Self-reported memory deficits
B. Memory deficits reported by a family member
C. A normal MRI scan of the brain
D. The absence of the apolipoprotein E4 allele
Answer : B
42. Topic: Guillain-Barr� syndrome
Subject: Medicine
A 43-year-old man presents 2 weeks after you see him for infectious diarrhea caused by C. jejuni. He has now developed bilateral proximal lower limb weakness and bilateral distal parasthesia and decreased ankle tendon reflex.
What is the most likely diagnosis?

A. Guillain-Barr� syndrome
B. Multiple Sclerosis
C. Myasthenia Gravis
D. Systemic Lupus Erythematosus
Answer : A
43. Topic: Delirium Tremens
Subject: Medicine
A patient with delirium tremens manifests all of the following, except:

A. Clouded consciousness
B. Hypothermia
C. Coarse tremor
D. Tachypnea
Answer : B
44. Topic: Subarachnoid Hemorrhage
Subject: Medicine
A 25-year-old male presents 5 hours after the onset of the worst headache of my life. His temperature is 37.0°C (98.6°F), blood pressure 140/90 mm Hg, respiratory rate 20/min, and pulse rate 90 beats/min. The patient is lethargic but oriented; there are no focal neurologic findings, but neck stiffness is present. Unenhanced CT of the head is negative. You elect to perform a lumbar puncture. At this time, which one of the following findings in bloody spinal fluid would indicate a diagnosis of subarachnoid hemorrhage?

A. Yellow-orange cerebrospinal fluid supernatant
B. A WBC:RBC ratio of 1/1000
C. A protein (g/L) to RBC (count/L) of 1/1000
D. A glucose level below 2.2 mmol/L
Answer : A
45. Topic: Temporal Lobe Lesion
Subject: Medicine
A 40 year old man presents with sporadically occurring behaviour automatisms and olfactory hallucinations. Which one of the following is the most likely diagnosis?

A. Schizophrenia
B. Schizophreniform psychosis
C. Hysterical personality disorder
D. Temporal lobe lesion
Answer : D
46. Topic: DM neuropathy
Subject: Medicine
In which of the following diseases would you see a gloves and stocking neuropathy?

A. Diabetes mellitus
B. Lupus
C. Multiple sclerosis
D. ALS
Answer : A
47. Topic: Seizure
Subject: Medicine
Of the following, which is the most frequent cause of seizures in the elderly?

A. Alcohol withdrawal
B. Stroke
C. Head trauma
D. Hypoglycemia
Answer : B
48. Topic: Essential Tremor
Subject: Medicine
A 66 year old white female consults you because she has developed a tremor of her right hand that interferes with her ability to do needlework. She has noticed that the tremor improves when she rests her hands in her lap and gets worse when she holds them up against gravity. She has developed a slight quiver to her voice as well. Her symptoms started gradually over 6 months ago and have progressed slowly. She remembers her mother having similar problems in her later years. She takes no medications, and her physical examination corroborates her history. No other abnormalities are noted. A multiple chemistry screen and TSH level are normal.
Which one of the following is most likely to alleviate her tremor?

A. Propranolol (Inderal)
B. Paroxetine (Paxil)
C. Carbidopa/levodopa (Sinemet)
D. Bromocriptine (Parlodel)
Answer : A
49. Topic: Alzheimer's Disease
Subject: Medicine
Which one of the following is associated with an increased risk of developing Alzheimers disease?

A. A positive homozygous genotype for apolipoprotein E4
B. Elevated serum aluminum
C. Elevated serum alpha-tocopherol
D. Decreased serum Beta-carotene
Answer : A
50. Topic: Adverse Drug Effect
Subject: Medicine
A 68-year-old man with a history of urolithiasis, suffered from a seizure attack which involved loss of consciousness with tonic and clonic muscular contractions. His tongue fell back into his throat and he choked. He is treated with valproic acid.
What are the most common side effects caused by this medication?

A. Weight gain
B. Rash
C. Nausea and headache
D. Tardive dyskinesia
Answer : C

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