Neurology - CM

Bessisy Tamir G1248

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9.

Branches of the basilar artery are the:

A. [X] superior cerebellar artery
B. [X] anterior inferior cerebellar artery
C. [X] pontine branches
D. [ ] labyrinthine artery
E. [ ] posterior inferior cerebellar artery
Which of the following nuclei are affected in Wallenberg syndrome:
A. [X] nucleus vestibularis inferior
B. [ ] nucleus dorsalis vagi
C. [ ] nucleus tractus solitarii
D. [X] nucelus ambiguus
E. [X] spinal trigeminal nucleus
Which of the following tracts/structures are involved in Wallenberg syndrome:
A. [ ] tractus spinocerebellaris anterior
B. [X] tractus tegmentalis centralis
C. [X] tractus spinothalamicus
D. [X] pedunculus cerebellaris inferior
E. [ ] tractus rubrospinalis
Signs of Wallenberg syndrome include:
A. [ ] absence of pain on the contralateral side of the face
B. [ ] ipsilateral nystagmus
C. [X] ipsilateral ataxia
D. [X] contralateral sensory disturbance
E. [X] Horner triad
Midbrain is supplied by the:
A. [X] superior cerebellar artery
B. [ ] middle cerebral artery
C. [ ] rami interpedunculares
D. [ ] posterior choroidal artery
E. [X] posterior cerebral artery
The signs and symptoms of vertebrobasilar stroke may include:
A. [X] Dizziness
B. [ ] numbness around the mouth
C. [ ] aphasia
D. [X] drop attacks
E. [X] unsteadiness
Which of the following statements are true concerning " ischemic penumbra" :
A. [X] it occurs in the area surrounding the ischemic core
B. [ ] in the area of penumbra, the nerve cells undergo necrosis
C. [X] it is a term which refers to the reversible loss of neuronal cell function related to cerebral hypoperfusion
D. [ ] after restoration of circulations, the cells do not regain their functionality
E. [X] positron emission tomography (PET) is the imaging technique for penumbral detection
Which of the following statements is/are true concerning the so-called luxury perfusion:
A. [X] it is generally caused by lactic acidosis
B. [ ] vasomotor deregulation
C. [X] in the affected site, the metabolism is damaged
D. [ ] in the affected site, the neurons regain rapidly their function
E. [X] in the affected site, the nerve cells undergo necrosis
Which of the following statements is/are true regarding the fat embolism syndrome:
A. [X] it generally follows long bone fractures
B. [X] an asymptomatic period of about 12-48 hours precedes clinical manifestations
C. [X] petechial rashes appear on the upper anterior portion of the body
D. [X] altered level of consciousness is not uncommon
E. [ ] it is characterized by demyelination affecting the dorsal columns

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Bessisy Tamir G1248
10. The most common complications of SAH are:
A. [X] Vasospasm
B. [X] Rebleeding
C. [ ] peripheral paresis
D. [X] hydrocephalus
E. [ ] meningitis
11. The most common signs of encephalitis include:
A. [X] altered consciousness
B. [X] taste disturbance
C. [X] epileptic seizures
D. [ ] peripheral paresis
E. [X] headache
12. Plasmapheresis is accepted for the treatment of:
A. [X] myasthenia gravis
B. [ ] polymyositis
C. [X] Guillain-Barr syndrome
D. [ ] Foster-Kennedy syndrome
E. [X] Lambert-Eaton Syndrome
13. Spastic paraparesis may be associated with:
A. [X] multiple sclerosis
B. [X] transverse myelitis
C. [X] anterior spinal artery thrombosis
D. [ ] cervical myelopathy
E. [ ] middle cerebral artery thrombosis
14. Epileptic seizure often associates with:
A. [X] intracranial tumors
B. [X] chronic alcoholism
C. [X] head injury
D. [ ] multiple sclerosis
E. [ ] myasthenia gravis
15. Which of the following structures are affected in poliomyelitis:
A. [ ] posterior horns of the spinal cord
B. [ ] motoneurons of the ventral horns in the spinal cord
C. [ ] pontine tegmentum
D. [X] nuclei of the caudal cranial nerves
E. [X] spinotalamic tract
16. Which of the following drugs are used for treatment of tuberculosis:
A. [X] Isoniazid
B. [X] Rifampicin
C. [X] Pyrazinamide
D. [X] Ethambutol
E. [ ] Pramipexole
17. Which of the following drugs are used for treatment of multiple sclerosis:
A. [X] Interferon Beta-1b (Betaseron)
B. [ ] Pramipexole (Mirapex)
C. [X] Glatiramer Acetate (Copaxone)
D. [ ] Ticlopidine hydrochloride (Ticlid)
E. [X] Betaserc
18. Ptosis or proptosis is a common sign of:
A. [X] Horner syndrome
B. [X] sinus cavernous thrombosi
C. [X] myasthenia gravis
D. [ ] tegmental lesion of the midbrain
E. [ ] multiple sclerosis

Neurology - CM
Bessisy Tamir G1248
19. Nonsteroidal anti-inflammatory drugs (NSAIDs) include:
A. [ ] baclofen
B. [ ] haloperidol
C. [X] indomethacin
D. [ ] valium
E. [X] diclofenac
20. Which of the following are characteristic of myasthenic crisis:
A. [X] miosis
B. [ ] Mydriasis
C. [ ] bradycardia
D. [X] tachycardia
E. [ ] salivation
21. The most widely used agent(s) for reduction of spasticity is/are:
A. [ ] Diclofenac
B. [X] Tizanidine
C. [X] Diazepam
D. [ ] Madopar
E. [X] Baclofen
22. Indications for beta blocker administration are:
A. [X] migraine prophylaxis
B. [ ] epilepsy
C. [X] essential tremor
D. [ ] Guillain-Barr syndrome
E. [ ] blepharospasm
23. Local injections of botulinum toxin are effective in the treatment of:
A. [ ] athetosis
B. [X] blepharospasm
C. [ ] chorea
D. [X] spasmodic torticollis
E. [ ] essential tremor
24. Treatment of Wilson disease includes:
A. [ ] use of tiamin
B. [X] low-copper diet
C. [X] use of zinc acetate
D. [ ] copper-rich diet
E. [X] use of D-Penicillinamin
25. Cerebral edema may be associated with:
A. [X] brain abscess
B. [X] leukodystrophy
C. [ ] multiple sclerosis
D. [ ] Huntington disease
E. [X] glioblastoma multiforme
26. Which of the following statements are true regarding subacute combined degeneration of the spinal cord:
A. [X] it is a disorder caused by vitamin B12 deficiency
B. [X] it is characterized by demyelination affecting the dorsal columns
C. [X] it often associated with pernicious anemia
D. [ ] the first symptom is generally urinary incontinence
E. [ ] it is characterized by radicular syndrome
27. Which of the following diseases are muscular in origin:
A. [X] progressive muscular dystrophy
B. [ ] Werdnig-Hoffmann disease
C. [ ] myotonia congenita
D. [X] amyotrophic lateral sclerosis
E. [ ] primary lateral sclerosis

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Bessisy Tamir G1248
28. The limbic system consist of the:
A. [X] gyrus cinguli
B. [ ] amygdala
C. [X] fornix
D. [ ] corpus mamillare
E. [X] hippocampus
29. Cerebellum is important for:
A. [ ] Visual function
B. [X] regulating muscle tone
C. [X] performing rapid, precise, coordinated movement patterns
D. [ ] regulating sphincter functions
E. [X] maintaining balance
30. Muscular rigidity is a common sign of:
A. [ ] Myastenia gravis
B. [X] Parkinson disease
C. [X] stiff-man syndrome
D. [ ] Guillain-Barr syndrome
E. [X] Hereditary Spastic Paraplegia (Strumpel Disease).
31. Which of the following results from a damage of the parietal lobe:
A. [X] contralateral sensory impairment
B. [ ] finger agnosia
C. [X] astereognosis
D. [ ] optic agnosia
E. [X] right-left confusion
32. Gerstmann's syndrome includes:
A. [ ] astereognosis
B. [X] acalculia
C. [X] right-left confusion
D. [X] finger agnosia
E. [X] agraphia
33. Damage to the temporal lobe would result in:
A. [X] psychomotor seizures
B. [X] contralateral upper quadrant anopia
C. [X] uncinate fits
D. [ ] Broca's aphasia
E. [X] Wernicke aphasia
34. Which of the following diseases are manifestations of treponema pallidum infection:
A. [X] chancre
B. [X] syphilis
C. [X] meningovascular lues
D. [ ] borreliosis
E. [X] tabes dorsalis
35. Which of the following drugs are used for the treatment of Parkinson disease:
A. [X] levodopa
B. [X] pramipexole
C. [ ] ethosuximide
D. [X] ropinirole
E. [X] bromocriptine
36. Which of the following are used for the treatment of migraine:
A. [X] ergotamine tartrate
B. [X] dihydroergotamine
C. [X] sumatriptan
D. [ ] simvastatin
E. [X] zolmatriptan

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Bessisy Tamir G1248
37. Which of the following cause cerebral atrophy:
A. [ ] perinatal damage
B. [ ] chronic alkoholism
C. [ ] arterioslerosis
D. [ ] syringobulbia
E. [X] chronic hypoxia
38. Elevated CSF protein content can be found in:
A. [X] cerebral tumors
B. [X] tumors of the spinal cord
C. [ ] radiculopathies
D. [X] meningitis
E. [X] demyelinating polyneuropathy
39. Contraindications for lumbar puncture include:
A. [X] papilledema
B. [ ] papillitis
C. [X] skin infection near the puncture site
D. [X] severe bleeding disorders
E. [X] suspicion of increased intracranial pressure
40. Damage to the frontal cortex results in the following:
A. [X] loss of initiative
B. [X] decreased spontaneity
C. [ ] sensory inattention
D. [X] perseveration
E. [X] apathy
41. Cerebellar nuclei include:
A. [X] nucleus emboliformis
B. [ ] nucleus caudatus
C. [X] nucleus dentatus
D. [X] nucleus fastigii
E. [X] nucleus globosus
42. Combined unilateral lesion of the III., IV., and VI. cranial nerves is associated with:
A. [X] Foville syndrome
B. [X] superior orbital fissure syndrome
C. [ ] Millard-Gubler syndrome
D. [X] Tolosa-Hunt syndrome
E. [X] Avellis syndrome
43. In which of the following syndromes is the facial nerve affected:
A. [X] Melkersson Rosenthal
B. [ ] Avellis
C. [X] Millard-Gubler
D. [ ] Parinaud
E. [ ] Weber
44. Neurological complications of AIDS include:
A. [ ] Dermatomyositis
B. [ ] Dementia
C. [X] malignant intracranial tumors
D. [X] progressive multifocal leukoencephalopathy
E. [X] opportunistic infections
45. Characteristic signs of Binswanger's disease are:
A. [X] gait disturbances
B. [X] progressive dementia
C. [X] urinary incontinence
D. [ ] double vision
E. [X] aphasia

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46. Paraneoplastic syndromes include:
A. [ ] subarachnoid hemorrhage
B. [ ] progressive multifocal leukoencephalopathy
C. [X] polyneuropathy
D. [X] cerebellar atrophy
E. [ ] dermatomyositis
47. Nuchal rigidity (meningismus) can be found in:
A. [X] Bacterial meningitis
B. [X] Raised intracranial pressure
C. [ ] Tabes dorsalis
D. [X] Subarachnoid hemorrhage
E. [X] Viral meningitis
48. Spinal cord vascularization is provided by:
A. [X] aorta
B. [ ] brachiocephalic artery
C. [ ] common carotid artery
D. [X] vertebral arteries
E. [X] subclavian arteries
49. Which of the processes listed below can lead to spinal ischemic stroke?
A. [X] atheromatous plaques in the aorta in the emerging areas of segmental arteries.
B. [X] dissecting aneurysm
C. [X] stenosis
D. [X] thrombosis
E. [ ] ultrasonography aorta
50. Choose the correct statements related to clinical manifestations of acute transverse medullary stroke:
A. [ ] flaccid paraplegia
B. [ ] absens of tendon reflexes
C. [X] paraplegic anesthesia
D. [X] sphincter disturbances
E. [ ] evolution is relatively easy, with complete recovery, especially motor and autonomic functions.
51. Tick the early signs of diabetic polyneuropathy:
A. [ ] bilateral distal motor disturbances.
B. [X] agitation, hallucinations, visual disturbances.
C. [X] paresthesia in the distal lower limbs.
D. [ ] trophic disorders.
E. [ ] absence of achiliene reflexes.
52. Tick the multiple sclerosis types, characterized by the disease's progression:
A. [X] relapsing remitting type
B. [X] secondary progressive type
C. [X] primary progressive type
D. [ ] primary regressive type
E. [ ] monophasic (acute disseminated encephalomyelitis) type.
53. Long-term side effects of corticosteroids used in multiple sclerosis are:
A. [X] Cushing syndrome
B. [ ] cataracts
C. [ ] hypotension
D. [X] bone fracture
E. [X] osteoporosis
54. The diagnostic methods of choice in epidural hematoma are:
A. [X] CT.
B. [X] Magnetic resonance imaging.
C. [ ] Electroencephalography.
D. [ ] Angiography.
E. [ ] Transcranial Doppler Ultrasonography

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Bessisy Tamir G1248
55. Thomsen`s congenital myotonia is characterized by:
A. [ ] increased muscle strength
B. [X] muscular hypertrophy
C. [X] delayed relaxation of muscles after voluntary contraction
D. [ ] dicreased tendon reflexes
E. [ ] the prolonged muscle contractions are often enhanced by warm
56. Which therapeutic measures are used to treat myasthenia gravis:
A. [X] anticholinesterases (pyridostigmine).
B. [X] thymectomy
C. [ ] vitamins
D. [X] immunosuppressive therapy (corticosteroids, azathioprine).
E. [X] plasma exchange
57. Which products can cause vasoconstriction and, respectively, access of migraine:
A. [X] red wine
B. [X] cheese
C. [X] nuts
D. [ ] honey
E. [X] chocolate
58. Intracranial hypertension is often caused by:
A. [X] brain tumor
B. [ ] hysteria
C. [X] meningitis
D. [X] encephalitis
E. [X] brain abscess
59. Which of the states listed below may cause reversible coma?
A. [X] hypoglycemia
B. [ ] infiltrative tumor of the brainstem
C. [X] meningoencephalitis
D. [ ] epidural hematoma
E. [ ] subdural hematoma
60. Which cranial nerves come out of the cerebellopontine angle:
A. [ ] oculomotor nerve
B. [X] facial nerve.
C. [X] vestibulocochlear nerve.
D. [ ] intermediary nerve
E. [ ] glosofaringian nerve.
61. Which of the following are functions of the nervous system?
A. [X] senses changes.
B. [X] analyzes changes.
C. [ ] stores calcium.
D. [X] responses to changes.
E. [ ] turning food into the energy
62. Ptosis or proptosis is a common sign of:
A. [X] Horner syndrome
B. [ ] sinus cavernous thrombosis
C. [X] myasthenia gravis
D. [X] tegmental lesion of the midbrain
E. [ ] internal capsular lesion
63. Which nuclei are located in the medulla oblongata:
A. [X] nucleus hypoglossus
B. [ ] abducens nucleus
C. [X] inferior and superior salivatory nuclei
D. [ ] Westphal-Edinger nucleus
E. [ ] nucleus of Perlia

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Bessisy Tamir G1248
64. Vestibular nuclei include:
A. [X] nucleus superior Bechterew
B. [ ] nucleus of Perlia
C. [X] nucleus lateralis Deiters
D. [X] nucleus medialis Schwalbe
E. [ ] nucleus descendes spinalis Roller

AUTONOMIC NERVOUS SYSTEM:

65. ALL In the autonomic nervous system, all the following is correct:
A. [ ] In sympathetic ganglia, the ratio of preganglionic fibres to postganglionic fibres is 1:32.
B. [ ] In parasympathetic ganglia, the ratio of preganglionic fibres to postganglionic fibers is 1:32.
C. [X] The splanchnic nerves contain sympathetic preganglionic fibres.
D. [X] Stimulation of oculomotor nerve produces accommodation.
E. [ ] The vagus nerve contains parasympathetic preganglionic fibres.
66. ALL The sympathetic supply is responsible for:
A. [ ] Constriction of the pupil.
B. [X] Erection of hair.
C. [X] Secretion of eccrine sweat glands.
D. [ ] Dilatation of skeletal muscle blood vessels.
E. [ ] Spleen contraction.
67. ALL A lesion in the cervical sympathetic chain (Horner's syndrome) causes the following, except:
A. [X] Increased sweating .
B. [ ] Drooping of the upper eyelid.
C. [X] Vasoconstriction of the skin blood vessels (leading to pallor).
D. [X] Mydriasis.
E. [ ] Inhibition of salivary glands secretion.
68. ALL Regarding the pelvic nerve, the following is true :
A. [X] It is the nerve of erection (= nerves erigents).
B. [X] It is motor to the urinary bladder & distal half of the large intestine.
C. [X] It is inhibitory to both the internal anal & urethral sphincters.
D. [ ] It has both preganglionic & postganglionic nerve fibres.
E. [ ] Its functions are normally under continuous inhibition.
69. ALL The sympathetic nervous system has all of the following characters:
A. [X] It is mostly noradrenergic.
B. [ ] It is involved more frequently in generalized actions.
C. [ ] It is of little importance in visual accommodation.
D. [X] It antagonizes mostly parasympathetic functions.
E. [ ] It is anabolic.
70. ALL Which of the following structures is an example where double innervation applies?
A. [X] The heart.
B. [X] The bladder.
C. [X] The stomach.
D. [X] The intestines.
E. [ ] Splenic capsule.
71. ALL A drug which blocks the beta adrenergic receptors causes the following, except:
A. [X] Dilatation of the bronchial muscle.
B. [X] Relaxation of the sphincters in the alimentary canal.
C. [ ] Inhibition of cardiac properties.
D. [X] Dilatation of the visceral blood vessels.
E. [X] Reduction of the blood glucose due to stimulation of insulin release.
72. ALL All the following statements are correct:
A. [X] Stimulation of the greater splanchnic nerve causes adrenomedullary secretion.
B. [ ] Acetylcholine is normally present at low concentrations in the blood.

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Bessisy Tamir G1248

73.

74.

75.

76.

77.

78.

79.

80.

81.

C. [ ] Intravenous injection of acetylcholine does not cause exactly the same effects as parasympathetic stimulation.
D. [X] The dilator pupillae muscle contains alpha receptors while the cardiac muscle contains beta receptors.
E. [ ] Stimulation of the postganglionic nerve fibers arising from the collateral ganglia cause secretion from the adrenal
(suprarenal ) medulla.
ALL About acetylcholine, all the following is true:
A. [ ] It makes reading difficult because of relaxation of the ciliary muscle.
B. [X] It is the chemical transmitter released by all preganglionic nerve fibers.
C. [X] It is broken down enzymatically by the choline esterase enzyme.
D. [X] It is liberated by all parasympathetic nerve fibres.
E. [ ] It is synthesized & released by some sympathetic postganglionic nerve fibres.
ALL Concerning the adrenal medulla, all the following is true :
A. [X] Its secretion is increased in emergency conditions.
B. [X] It secrets epinephrine 80% & norepinephrine 20%.
C. [X] It augments and prolongs the effects of sympathetic stimulation.
D. [ ] It receives preganglionic nerve supply from the anterior horn cells of the lower 6 thoracic segments of spinal cord.
E. [X] It is a modified sympathetic ganglion.
ALL The alpha adrenergic receptors mediate all the following effects:
A. [X] Vasoconstriction.
B. [X] Pupil dilatation.
C. [ ] Increased cardiac activity
D. [X] Spleen contraction.
E. [ ] Relaxation of the intestinal wall.
ALL The synthesis of norepinephrine is prevented by the following, EXCEPT:
A. [X] Alpha methyldopa.
B. [ ] Ephedrine.
C. [ ] Pilocarpine.
D. [X] Reserprine.
E. [X] Hexamethonium.
ALL Acetylcholine is secreted at all the following sites:
A. [ ] Postganglionic sympathetic nerve terminals at skeletal muscles.
B. [X] Postganglionic parasympathetic nerve terminal.
C. [X] Preganglionic sympathetic. & parasympathetic nerve terminals.
D. [X] Myoneural junctions.
E. [ ] Postganglionic sympathetic noradrenergic nerve terminals.
ALL Integration of the autonomic functions involves the following higher centers:
A. [X] Cerebral cortex.
B. [ ] Cerebellum.
C. [X] Hypothalamus.
D. [X] Limbic system.
E. [ ] Brain stem.
ALL About the chemical transmission in the sympathetic nervous system all the following are true, EXCEPT:
A. [X] Noradrenaline is released by both the pregang. & postgang. Symp. nerve fibres.
B. [ ] Noradrenaline acts mainly on the beta adrenergic receptors.
C. [ ] Noradrenaline contributes to 80% of the secretion of the suprarenal medullae
D. [ ] The alpha adrenergic stimulators cause contraction of the plain muscles in the seminal vesicles & vas deferens.
E. [X] The adrenal medulla secretes mainly at rest and during sleep.
ALL Parasympathetic tone is mostly responsible for the following, EXCEPT:
A. [ ] Maintaining resting heart rate within normal.
B. [X] Decreasing the blood flow to the gut (GIT or alimentary canal).
C. [ ] Maintenance of the systemic arterial blood pressure constant.
D. [X] Keeping the fasting blood glucose level constant.
E. [X] Causing bronchodilatation.
ALL The posterior limbic zone consists of the following:
A. [ ] Olfactory bulb.
B. [ ] Olfactory tract.

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Bessisy Tamir G1248
C. [ ] Olfactory tubercle.
D. [X] Cingulate cortex.
E. [X] Hippocampus.
82. ALL Increased release of epinephrine from adrenal medulla during muscular exercise causes the following:
A. [X] Stimulates glycogenolysis in the liver
B. [ ] Stimulates glycogenesis in the liver
C. [ ] Increases coronary flow rate
D. [ ] Constricts the ciliary muscle in the eye
E. [X] Raises blood pressure and cardiac output
83. ALL Voluntary hyperventilation lasting for 3 minutes can cause the following:
A. [ ] Loss of consciousness for a few seconds.
B. [ ] Bilateral ptosis.
C. [X] Cardiac palpitations.
D. [X] Dyspnea.
E. [ ] Anxiety.
84. ALL The superior salivatory nucleus of cranial nerve VII innervates the following, EXCEPT:
A. [ ] The pterygopalatine and submandibular ganglia.
B. [X] Pharyngeal and thoracoabdominal ganglia to numerous glands and organs.
C. [X] The cilliary ganglion.
D. [X] The otic ganglion.
E. [X] Abdomino-pelvic ganglia.

Cerebellum + Ataxias
85. ALL The anatomical divisions of the cerebellum are the following:
A. [ ] Paravermian lobe
B. [X] Anterior lobe
C. [X] Posterior lobe
D. [ ] Vermian lobe
E. [X] Flocculonodular lobe
86. ALL Features of most Spinocerebellar ataxias:
A. [ ] Upper motor neuron signs
B. [ ] Parkinsonism
C. [ ] Axonal polyneuropathy
D. [ ] Photosensitivity and skin malignancies
E. [ ] Sensorineural deafness
87. ALL Clinical tests for dystaxia of stance and gait:
A. [ ] Tandem-walking
B. [X] Free walking
C. [X] Finger-to nose test
D. [X] Heel-to-shin test
E. [ ] Heel and toe walking
88. ALL Afferent fibers enter the inferior cerebellar peduncle from the following sources:
A. [ ] Fastigiobulbar tract
B. [X] Vestibulocerebellar tract
C. [ ] Olivocerebellar tract
D. [X] Dorsal spinocerebellar tract
E. [ ] Reticulocerebellar tract
89. ALL What are the clinical abnormalities of cerebellar dysfunction:
A. [X] Asynergy
B. [X] Tremor
C. [ ] Involuntary movements
D. [X] Nystagmus
E. [X] Dysarthria

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90. ALL Clinical tests that help diagnose a cerebellar dysfunction:
A. [ ] Arm suspension
B. [ ] Straight leg raising
C. [ ] Tandem walking
D. [ ] Finger-tapping
E. [ ] Spiral drawing
91. ALL A horizontal section of the cerebellum reveals:
A. [ ] Dentate nucleus
B. [ ] Red nucleus
C. [ ] Globose nucleus
D. [ ] Emboliform nucleus
E. [ ] Deep tegmental gray
92. ALL Lesions of the Vestibulocerebellum are leading to:
A. [ ] The patient has difficulty standing upright (astasia)
B. [ ] The inability to stop a direct movement on time (dysmetria)
C. [ ] The patient has difficulty walking (abasia)
D. [ ] Gaze-evoked nystagmus
E. [ ] Impairment of rapid alternating movements (dysdiadochokinesia)
93. ALL What clinical manifestations can help us suspect a Cerebrocerebellum lesion:
A. [ ] The patient has difficulty walking (abasia)
B. [ ] The inability to stop a direct movement on time (dysmetria)
C. [ ] Intention or action tremor
D. [ ] Loss of the precise cooperation of multiple muscle groups (dyssynergia)
E. [ ] Ataxia of stance
94. ALL What do we call a Rebound phenomenon (Stewart-Holmes):
A. [ ] When the patient presses against the examiners hand with maximum strength and the examiner suddenly pulls his
own hand away
B. [ ] When examiner releases the arm, the arm of the patient will hit his body.
C. [ ] A sign of cerebellar disease
D. [ ] A sign of parkinsonism
E. [ ] The re-emergence of symptoms that where controlled while taking a medication after discontinuation of it
95. ALL The Spinocerebellar ataxia:
A. [ ] Over 20 different types
B. [ ] Results in the cerebellum and brainstem herniation through the foramen magnum into spinal cord
C. [ ] Characterized by alteration of CSF hydrodynamics
D. [ ] An autosomal dominant disorder
E. [ ] Typical onset after age 18
96. ALL What is the functional importance of the cerebellum:
A. [X] Aids organizing the range, velocity, direction, and force of muscular contractions
B. [ ] Controls motor and sensory activities, respiration, cardiovascular functions
C. [ ] Regulates mechanisms related to sleep and consciousness
D. [X] Coordinates movement and maintains equilibrium and muscle tone
E. [ ] Coordination of the planning of limb movements
97. ALL Which of the following statements about a cerebellar disorder are true:
A. [ ] Lessions of the midline impair coordination involving stance and gait
B. [ ] Lateral lessions impair the limbs ipsilateral to the cerebellar lesion
C. [ ] Lessions of the hemisphere ultimately impair movement on the contralateral side of the body
D. [ ] Lessions of the hemisphere ultimately impair movement on the ipsilateral side of the body
E. [ ] Lessions of the superior cerebellar peduncle and deep nuclei produce an insignificant disturbance
98. ALL What are the clinical features of the cerebellopontine angle syndrome:
A. [ ] Depression or absence of the ipsilateral corneal reflex
B. [ ] A lower motor neuron paralysis of the ipsilateral face
C. [ ] Involuntary movements
D. [ ] Hearing loss, tinnitus, vertigo
E. [ ] Dystonia

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99. ALL Which of the cranial nerves are involved in the cerebellopontine angle syndrome:
A. [X] VIIth nerve
B. [X] VIth nerve
C. [ ] Vth nerve
D. [X] VIIIth nerve
E. [ ] IXth nerve

CORTEX:
100. ALL Which of the following is associated with an increased risk of developing dementia following a stroke:
A. [X] A previous history of stroke;
B. [ ] A higher level of education;
C. [ ] Diabetes;
D. [X] Older age;
E. [ ] Normal level of cholesterol.
101. ALL Which of the following are the functions of the prefrontal lobe:
A. [X] Planning;
B. [X] Initiative;
C. [ ] Organising;
D. [X] Memory;
E. [ ] Vision.
102. ALL The higher cortical (cognitive) dysfunction is the following:
A. [ ] dysphasia
B. [ ] dysphonia
C. [X] dyslexia
D. [X] dysmnesia
E. [ ] dysdiadochokinesis.
103. ALL Dysphasia may develop with damage in:
A. [ ] frontal lobe cortex;
B. [X] cerebellar cortex;
C. [ ] temporal lobe cortex
D. [X] pons varolii
E. [ ] hypoglossal nerve.
104. ALL What are the patterns of Lewy Body disease:
A. [ ] Nigrostriatal involvement;
B. [X] Cortical involvement;
C. [X] Basal Ganglia involvement;
D. [ ] Sympathetic nervous system involvement;
E. [ ] All of the above.
105. ALL Which of the following components make up the memory process?
A. [ ] Encoding;
B. [X] Storage;
C. [ ] Transfer;
D. [X] Retrieval;
E. [ ] All of the above.
106. ALL Besides chronic alcohol abuse, causes of Korsakoffs Syndrome include:
A. [X] Dietary deficiency;
B. [ ] Chemotherapy;
C. [ ] Mercury poisoning;
D. [X] Eating disorders;
E. [ ] Diabetes mellitus
107. ALL The microscopic changes for Alzheimers disease?
A. [X] Neurofibrillary changes or tangles;
B. [ ] Nigrostriatal degeneration;

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C. [X] Neuritic plaques;
D. [ ] Granulovacuolar degeneration;
E. [ ] Lewy bodies
108. ALL Clinical features for Lewy Body dementia are:
A. [X] Parkinsonian syndrome (usually symmetric);
B. [X] Fluctuation in behavior and cognition;
C. [ ] Non REM sleep behavior disorder;
D. [X] Recurrent hallutinations;
E. [ ] Cerebellar syndrome
109. ALL Types of apraxia:
A. [X] Ideational;
B. [X] Ideomotor;
C. [ ] Acustico-visual apraxia;
D. [X] Construction apraxia;
E. [ ] Anapraxia
110. ALL Gerstmann syndrome consist in:
A. [X] Dyscalculia or acalculia;
B. [X] Dysgraphia or agraphia;
C. [X] Finger agnosia;
D. [ ] Inability to distinguish right from left;
E. [ ] Dyslexia.
111. ALL Which of the following conditions can affect a patients cognitive function and produce dementias symptoms?
A. [ ] Infections;
B. [X] Stroke;
C. [ ] Normal level glucose;
D. [X] Metabolic disorders;
E. [ ] Normal-pressure hydrocephalus
112. ALL Which of the following is a risk factor for vascular dementia:
A. [ ] Gender;
B. [ ] Exposure to polluants;
C. [X] Diabetes;
D. [ ] Ethnic background;
E. [ ] Normal blood pressure.
113. ALL Potentially treatable forms of dementia are:
A. [X] Chronic intoxication;
B. [X] Caused by normal-pressure hydrocephalus;
C. [ ] Alzheimers disease;
D. [ ] Dementia of AIDS;
E. [X] Pseudodementia of depression.

DEMYELINATING DISEASES OF THE NERVOUS SYSTEM

AMYOTROPHIC LATERAL SCLEROSIS
114. ALL One or more lesions should be found in at least two of these areas in MRI for diagnosis of multiple sclerosis:
A. [ ] Optic nerves
B. [ ] Juxtacortical
C. [ ] Infratentorial
D. [X] Periventricular
E. [X] Spinal cord.
115. ALL Which of the following are true about multiple sclerosis?
A. [X] It is more common in women than men
B. [ ] It commonly occurs after 50 yrs of age
C. [X] It is known to be associated with vitamin D deficiency
D. [ ] It is associated with DRB1 locus

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E. [ ] It destroys the vessel wall.
116. ALL The common symptoms in multiple sclerosis include:
A. [X] Muscle weakness
B. [X] Bilateral optic neuritis
C. [ ] Paresthesia
D. [X] Sensory loss
E. [ ] Epilepsy.
117. ALL How does multiple sclerosis progress?
A. [X] In a series of attacks and remissions
B. [X] In a gradual decline of function with no remission
C. [ ] In a gradual decline after a period with attacks and remission
D. [ ] The disease does not progress
E. [ ] The disease doesnt have specific pattern of evolution.
118. ALL Which of the following is true about the epidemiology of multiple sclerosis?
A. [X] There is a gradient of increasing prevalence with increasing latitude
B. [ ] There is a gradient of increasing prevalence with decreasing latitude
C. [X] Women are more affected than man
D. [ ] Children are more affected than adults
E. [X] There is a gradient of increasing prevalence with increasing longitude
119. ALL Select the useful investigations in the diagnosis of multiple sclerosis:
A. [X] MRI
B. [ ] Chest Xray
C. [X] CSF oligoclonal bands
D. [X] Evoked potentials
E. [ ] Needle EMG.
120. ALL Identify the hallmarks of the Neuromyelitis optica:
A. [X] Separate attacks of acute optic neuritis and myelitis
B. [ ] Involvement of brainstem and spinal cord like primary manifestation of the disease
C. [X] Uncommon association with systemic autoimmune diseases
D. [ ] Usually normal cerebral MRI
E. [X] Association with specific autoantibody against aquaporin 4.
121. ALL Which of the following characterize Devic disease:
A. [ ] Worsening of symptoms with the heat
B. [X] Separate attacks of acute optic neuritis and myelitis
C. [X] Brain stem, cerebellar and cognitive involvement
D. [ ] Frequent association with systemic autoimmune diseases
E. [ ] Normal MRI of the spinal cord
122. ALL Regarding acute disseminated encephalomyelitis (ADEM), select the false answers:
A. [ ] Also known as postvaccinal encephalomyelitis when it follows vaccination
B. [ ] Always a monophasic illness
C. [ ] Lesions on MRI are present in the optic nerves and spinal cord
D. [X] More common in children than adults
E. [X] Association with specific autoantibody against aquaporin 4.
123. ALL Select the treatment and prevention options for acute disseminated encephalomyelitis:
A. [X] Corticotherapy
B. [X] Plasma exchange
C. [ ] Intravenous immune globulin
D. [ ] Introduction of new tissue culture vaccines
E. [ ] Intensive antiviral therapy.
124. ALL Select the possible clinical patterns of acute disseminated encephalomyelitis:.
A. [ ] acute polyneuropathy
B. [X] myelitis
C. [X] encephalitis
D. [ ] bilateral internuclear ophtalmoplegia
E. [X] encephalomyelitis

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125. ALL Choose the laboratory and imaging findings characteristic for acute disseminated encephalomyelitis:
A. [X] CSF shows a slight increase in lymphocytes and protein content, but these are highly variable
B. [X] CSF oligoclonal bands
C. [ ] Bilateral confluent white matter lesions in both cerebral hemispheres on the MRI
D. [ ] Dawson fingers sign on MRI
E. [ ] B and D
126. ALL Amyotrophic lateral sclerosis associated dysphagia is caused by:
A. [X] Involvement of the bulbar motor neurons
B. [ ] Lesion of the corticonuclear tracts
C. [X] Tongue atrophy
D. [ ] Impairment of gustative receptors
E. [ ] Facial diplegia
127. ALL Select the electrophysiological modifications in Amyotrophic lateral sclerosis patients:
A. [X] Spontaneous electric activity on needle EMG (fibrillation and fasciculation potentials)
B. [ ] Polyphasic motor units with high amplitude and long duration
C. [X] Biphasic motor units with low amplitude
D. [ ] Normal motor nerve conduction studies
E. [ ] Abnormal sensory conduction studies
128. ALL Regarding the treatment of ALS, which of the following statements are false?:
A. [X] Glucocorticoids can delay the evolution of the disease
B. [X] Plasma exchange and IV Ig present disease modifying potential for ALS patients
C. [X] Interferon beta and monoclonal antibodies are widely used for the control of symptoms in ALS patients
D. [ ] Riluzole is the single confirmed drug with positive effect (versus placebo) on the evolution of ALS
E. [X] ALS is a curable disease in case of early diagnosis.
129. ALL Choose the correct affirmations regarding Amyotrophic Lateral Sclerosis:
A. [X] Affects the central and peripheral motor neurons
B. [ ] The classic clinical triad includes atrophic weakness of the hands and forearms, spasticity of the legs and hyperreflexia
C. [ ] Sensory and autonomic manifestations are frequently associated
D. [X] The disease is irremediably progressive with death resulting from aspiration pneumonia or inanition
E. [X] Fasciculations are a common EMG finding.
130. ALL Which pathomorphologic features are not seen in ALS?:
A. [X] Death of the sensory neurons of the dorsal horns of the spinal cord
B. [ ] Death of lower motor neurons and upper, or corticospinal, motor neurons
C. [X] Selective death of lower motor neuron
D. [X] Selective death of the upper motor neuron
E. [ ] None of the above
131. ALL Select the motor neuron diseases affecting upper motor neuron:
A. [X] Familial spastic paraplegia
B. [ ] Primary lateral scelrosis
C. [X] Pseudobulbar palsy
D. [ ] Bulbar palsy
E. [ ] Charcot-Marie-Tooth ataxia
132. ALL Select the motor neuron disease affecting lower motor neuron:
A. [ ] Familial spastic paraplegia
B. [X] Primary lateral sclerosis
C. [ ] Pseudobulbar palsy
D. [X] Bulbar palsy
E. [X] Progressive muscular atrophy
133. ALL The respiratory disturbances in Amyotrophic lateral sclerosis are:
A. [X] Developing in the evolution of the disease
B. [X] The main cause of death in ASL patients
C. [ ] Well responding to corticosteroids
D. [ ] Well responding to bronchodilators drugs
E. [ ] Mandatory to confirm the diagnosis of ALS

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EXTRAPYRAMIDAL
134. The classic features of Parkinson's disease are:
A. [X] Tremor at rest
B. [X] Rigidity
C. [ ] Akinesia
D. [ ] Hypotonia
E. [X] Spasticity
135. Parkinsonism is a movement disorder that typically involves:
A. [X] Gait disturbance
B. [X] Bradykinesia
C. [X] Tremor
D. [ ] Gait apraxia
E. [X] Rigidity
136. ALL Parkinsonism may be caused by:
A. [X] Neuroleptics
B. [X] Metoclopramide
C. [ ] Carbon monoxide poisoning
D. [X] Encephalitis
E. [ ] Lead poisoning
137. ALL Basal ganglia include all the following, except:
A. [ ] caudate nucleus
B. [X] dentate nucleus
C. [ ] subthalamic nucleus
D. [ ] substantia nigra reticulate
E. [X] Edinger Westphal nucleus
138. ALL The extrapyramidal motor system:
A. [X] Plays a role in the initiation and execution of somatic motor activity
B. [X] is involved in automatic stereotyped motor activity of a postural and reflex nature
C. [X] Plays a role in maintenance of balance and posture
D. [X] allows to maintain gaze on an object when the head is rotated
E. [ ] The function in motor control is not known.
139. ALL The characteristic tremor of Parkinsons disease is described as:
A. [X] Alternating
B. [X] Pill-rolling
C. [X] Resting
D. [ ] Action
E. [ ] Vermiform
140. ALL The following categories of drugs are used in the symptomatic treatment of Parkinsons disease:
A. [X] Dopamine agonist
B. [X] MAO Inhibitor
C. [ ] Na+ channel blockers
D. [X] Anticholinergic
E. [X] COMT inhibitors
141. ALL The following symptoms may present as common features of non-motor fluctuation in Parkinsons disease:
A. [X] Pain
B. [ ] Hemianopia
C. [X] Hyposmia
D. [ ] Paresthesiae
E. [ ] Restless leg syndrome
142. ALL In Parkinsons disease, restlessness during nocturnal sleep is likely to be due to:
A. [X] Nocturnal dyskinesias
B. [ ] Restless leg syndrome (RLS)
C. [X] REM sleep behavior disorder
D. [ ] Night terrors

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E. [ ] Shift in the circadian cycle
143. ALL Common non-motor features that precede the motor findings in Parkinsons disease include all of the following?
A. [ ] Diplopia
B. [ ] Constipation
C. [X] Excessive daytime sleepiness
D. [X] Hyposmia
E. [X] Dementia
144. ALL Choreic movements can be found in:
A. [ ] Fahrs disease
B. [ ] Wilson disease
C. [X] Sydenhams chorea
D. [ ] Chronic hepatitis
E. [X] Huntington disease
145. ALL The neurotransmitters involved in the internal circuitry of the basal ganglia include:
A. [X] GABA
B. [X] Glutamate
C. [X] Dopamine
D. [ ] Serotonin
E. [ ] Substance P
146. ALL Huntingtons disease is characterized by:
A. [ ] It is a sporadic disease
B. [X] dyskinesia and dopaminergic hyperactivity
C. [X] rapid, jerky, involuntary movements of the face, arms, and legs
D. [X] It is a dominantly inherited disease
E. [ ] usually appears in the 60s
147. ALL A lesion of the basal ganglia can manifest by:
A. [X] Involuntary movements
B. [ ] Action tremors
C. [X] Abnormal posture
D. [X] Rigidity
E. [X] Mask-like face
148. ALL Wilsons disease is most accurately diagnosed with the following:
A. [X] Biopsy of the liver
B. [ ] Computed tomography
C. [ ] MRI
D. [X] Serum ceruloplasmin
E. [X] Urinary copper excretion
149. ALL Focal dystonia:
A. [X] uncontrollable and sometimes painful muscle spasms
B. [X] a recently introduced treatment is botulinum toxin
C. [ ] pathological postures caused by muscle hypotonia
D. [ ] a recently introduced treatment is intravenous immunoglobulins
E. [ ] limited to specific parts of the body
150. ALL Dopamine agonists used in Parkinsons disease include:
A. [X] Pramipexole
B. [X] Ropinirole
C. [X] Bromocriptine
D. [ ] Entacapone
E. [ ] Selegeline
151. ALL Treatment of Wilson disease includes:
A. [X] Low copper diet
B. [ ] Copper rich diet
C. [X] Use of zinc acetate
D. [X] Use of D-Penicillamin
E. [ ] Use of thiamin

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152. ALL Effective in managing essential tremor:
A. [X] Propranolol
B. [ ] Metoprolol
C. [X] Primidone
D. [X] Diazepam
E. [ ] chlordiazepoxide
153. ALL Choose the false statements about Progressive Supranuclear Palsy (Steel- Richardson-Olszewski syndrome):
A. [ ] PSP involves neurofibrillary tangles, but no degeneration.
B. [ ] A common characteristic of PSP gait disturbance involves falling forward.
C. [ ] Supranuclear gaze palsy causes patients with PSP to have difficulty making vertical saccades.
D. [ ] The tau protein tangles are especially prominent in the primary motor cortex.
E. [ ] Pseudobulbar palsy creates the inability to use one's hands for fine motor movements

HEADACHE
154. ALL These headaches have no identified organic cause. Just a reflection of intrinsec disturbance of the brain:
A. [ ] Post-traumatic headache
B. [ ] Cluster headache
C. [X] Idiopathic trigeminal neuralgia
D. [ ] Normal pressure hydrocephalus
E. [X] Paroxysmal hemicrania
155. ALL Which of the following are not primary headaches?
A. [ ] Migraine
B. [ ] Tension headache
C. [X] Space occupying lesion
D. [ ] Cluster Headache
E. [X] Meningitis
156. ALL Tension headache:
A. [ ] The worst pain in life
B. [ ] Sharp pain
C. [X] Lasts 4-6 hours
D. [ ] Lasts 3-5 minutes
E. [X] Mild to moderate pain, mainly bilateral
157. ALL Headache symptoms that suggest a serious underlying disorder:
A. [ ] First severe headache
B. [X] Abnormal neurological examination
C. [ ] Onset after after age 30
D. [ ] Fever
E. [X] Worst headache ever
158. ALL What are the abortive therapies for the treatment of migraines?
A. [ ] Antiemetics
B. [X] Ergotamine
C. [X] Triptans
D. [X] NSAIDs
E. [ ] SSRIs
159. ALL Preventive treatment for cluster headache:
A. [ ] NSAIDs
B. [X] Verapamil
C. [ ] Antiemetics
D. [X] Lithium
E. [X] Steroids
160. ALL Stages of uncomplicated migraine are:
A. [X] Prodrome
B. [X] Aura

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C. [ ] Headache
D. [ ] Myalgia
E. [X] Postdrome
161. ALL Migraine prophylaxis:
A. [X] SSRIs
B. [X] Anticonvulsants
C. [X] Tricyclic antidepressants
D. [X] Beta-blockers
E. [ ] 5HT anatgonists (Methylsergide)
162. ALL Classification of migraines:
A. [X] Common migraine
B. [X] Classic migraine
C. [ ] Primary migraine
D. [ ] Secondary migraine
E. [X] Complicated migraine
163. ALL Cluster headache:
A. [X] Usually bilateral
B. [ ] Usually unilateral
C. [X] Pain lasting 15-180 minutes (untreated)
D. [ ] Pain lasting 4-5 hours (untreated)
E. [X] Usually associated with conjunctival injection, nasal congestion
164. ALL LP and CT must be performed if the headache is associated with:
A. [X] Fever
B. [ ] Conjunctival injection
C. [X] Altered level of conciousness
D. [X] Focal neurological symptoms
E. [ ] Meningismus
165. ALL What are the clinical features of Tic Doloreux?
A. [X] Sharp pain in projection of V1/V2/V3
B. [X] Pain lasts seconds to minutes
C. [ ] May be brought on by triggers
D. [ ] Steroids are the first choice treatment
E. [X] Anticonvulsants arte the first choice treatment
166. ALL What causes of headache are serious and must be ruled out?
A. [X] [X] SAH
B. [X] Meningitis
C. [ ] Tension-type
D. [X] Temporal arteritis
E. [ ] Paroxysmal hemicrania
167. ALL What are the features of temporal arteritis?
A. [X] Develops in patients> 50 years
B. [ ] Treatment with glucocorticoids is not effective
C. [X] Tenderness of the temporal arteries is common
D. [ ] Develops usually in women between 15-30 years
E. [ ] Artery biopsy is not important for diagnosis
168. ALL Symptoms accompanying severe migraine attacks:
A. [X] Nausea
B. [X] Photophobia
C. [ ] Stiff neck
D. [X] Lightheadedness
E. [ ] Altered consciousness
169. ALL Acute attack treatment for cluster headache:
A. [ ] Antiemetics
B. [ ] Anticonvulsants
C. [X] Oxygen

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D. [X] Triptans
E. [ ] Beta-blockers
170. ALL The essential features of proxysmal hemicrania are:
A. [X] Unilateral, very severe pain
B. [ ] Long-lasting attacks (>3h)
C. [X] Marked autonomic features ipsilateral to the pain
D. [X] Excellent response to indomethacin
E. [ ] Excellent response to prednisone
171. ALL Which of these foods can trigger migraine headaches?
A. [X] Red wine
B. [ ] Milk
C. [X] Chocolate
D. [ ] White bread
E. [X] Cheese
172. ALL If clinical findings suggest idiopathic intracranial hypertension, which of the following test should be done:
A. [ ] Fundoscopy
B. [ ] PET
C. [X] SPECT
D. [X] MRI
E. [X] LP
173. ALL Treatment of idiopathic intracranial hypertension:
A. [ ] Ibuprofen
B. [X] Acetazolamide
C. [X] Weight loss
D. [ ] Topiramate
E. [ ] Indomethacine

HEREDITARY DISEASES
174. ALL Which ones of the following are not the autoimmune diseases affecting the neuromuscular junction?
A. [ ] Myasthenia Gravis
B. [X] Parkinsons Disease
C. [ ] Multiple Sclerosis
D. [ ] Amyotrophic Lateral Sclerosis
E. [X] Alzheimers Disease
175. ALL Common causes of death in patients with Duchenne muscular dystrophy include:
A. [X] Respiratory infections/ insufficiency
B. [ ] Food aspiration
C. [ ] Learning Difficulties
D. [ ] Acute gastric dilation
E. [X] Cardiac failure
176. ALL Duchenne muscular dystrophy is characterised by the following:
A. [ ] Most common hereditary neuromuscular disease
B. [ ] Both boys and girls are equally affected
C. [ ] Pseudohypertrophy of calves and high muscles
D. [ ] High serum creatinine phosphokinase levels
E. [ ] Weakness is severe in the evening
177. ALL Which ones of the peripheral neuropathy described below is not due to genetic cause:
A. [ ] cryoglobulinemia
B. [X] Guillian-Barre syndrome
C. [X] multifocal motor neuropathy
D. [X] toxic polyneuropathy
E. [ ] Charcot-Marie-Tooth disease

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178. ALL Tensilon test is not diagnostic in the following diseases:
A. [X] Alzheimers Disease
B. [ ] Myasthenia Gravis
C. [X] Parkinsons Disease
D. [X] Multiple Sclerosis
E. [X] Amyotrophic Lateral Sclerosis
179. ALL Which symptoms are characteristic for Myasthenia Gravis:
A. [X] diplopia
B. [ ] nystagmus
C. [X] dysphagia
D. [ ] ataxia
E. [X] ptosis
180. ALL Drooping eyelids and double vision found in patients with Myasthenia Gravis are known as:
A. [ ] dysarthria
B. [ ] dysphagia
C. [X] diplopia
D. [X] ptosis
E. [ ] nystagmus
181. ALL Difficulty speaking and swallowing found in patients with Myasthenia Gravis are known as:
A. [ ] ptosis
B. [X] dysphagia
C. [ ] diplopia
D. [X] dysarthria
E. [ ] nystagmus
182. ALL Which of the followings are true with regard to the clinical presentation of Myasthenia Gravis?
A. [X] weakness worsens as the day progresses
B. [X] weakness is severe in the evening
C. [ ] limb weakness is more severe distally than proximally
D. [ ] weakness is not affected by the level of activity
E. [ ] weakness progresses in severity very rapidly
183. The peak incidence of Myasthenia Gravis is
A. [X] third decade in females
B. [X] sixth or seventh decade in males
C. [ ] third decade in males
D. [X] sixth or seventh decade in females
E. [ ] second decade in males and sixth or seventh decade in females
184. ALL What are the management measures of Myasthenia Gravis
A. [X] anticholinesterase (AchE) inhibitors
B. [ ] antiagregants
C. [X] intravenous immune globulin (IVIg)
D. [X] plasmapheresis
E. [X] thymectomy
185. ALL Which structures of the nervous system are affected in Friedreich's ataxia:
A. [ ] Temporal lobe
B. [X] Spinocerebellar tracts
C. [ ] Posterior columns
D. [ ] Facial nerve
E. [X] Lateral corticospinal tracts

INFECTIONS OF THE NERVOUS SYSTEM

186. ALL Specify the possible clinical manifestations in a patient with bacterial meningitis:
A. [X] Decreased consciousness
B. [X] Seizures

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C. [X] Raised intracranial pressure
D. [ ] Stroke
E. [ ] Muscular fasciculations
187. ALL Which of the following structures are affected in meningoencephalitis:
A. [X] The meninges
B. [ ] Peripheral nerves
C. [ ] The subarachnoid space
D. [X] The brain parenchyma
E. [ ] Neuromuscular junction
188. ALL Specify in which categories of individuals Listeria monocytogenes may be a causative agent of bacterial meningitis:
A. [ ] Immunocompetent individuals
B. [X] Neonates (<1 month)
C. [ ] Pregnant women
D. [ ] Individuals > 60 years
E. [X] Immunocompromised individuals
189. ALL Predisposing conditions to develop a pneumococcal meningitis are:
A. vChronic pancreatitis
B. [X] Pneumococcal pneumonia
C. [X] Chronic sinusitis
D. [ ] Head trauma with basilar skull fracture
E. [ ] Weight loss
190. ALL Which of the following causes raise the intracranial pressure in bacterial meningitis:
A. [X] Interstitial edema
B. [X] Vasogenic edema
C. [ ] Pulmonary edema
D. [X] Cytotoxic edema
E. [ ] Quinckes edema
191. ALL Clinical signs of intracranial hypertension in bacterial meningitis include:
A. [ ] Urinary incontinence
B. [X] Reduced level of consciousness
C. [ ] Papilledema
D. [X] Dilated poorly reactive pupils
E. [ ] Decerebrate posturing
192. ALL Cerebral herniation in bacterial meningitis may be the result of:
A. [X] Cerebral edema
B. [X] Hydrocephalus
C. [ ] Dural sinus thrombosis
D. [ ] Lesion of the spinal nerves
E. [ ] Cortical vein thrombosis
193. ALL Which of the following antibiotics are used as empirical treatment of bacterial meningitis:
A. [X] Ampicillin
B. [ ] Aciclovir
C. [X] Ceftriaxone
D. [X] Vancomycin
E. [ ] Rifampicin
194. ALL Specify the classical CSF abnormalities in bacterial meningitis:
A. [X] Polymorphonuclear leucocytosis
B. [X] Decreased glucose concentration
C. [X] Increased protein concentration
D. [X] Increased opening pressure
E. [ ] Presence of eosinophils
195. ALL A decreased level of CSF /serum glucose ratio (< 0.4) is suggestive for:
A. [ ] Vascular myelopathy
B. [X] Bacterial meningitis
C. [X] Fungal meningitis

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D. [X] Tuberculous meningitis
E. [X] Carcinomatous meningitis
196. ALL Which of the following clinical conditions can mimic a bacterial meningitis:
A. [ ] Subarachnoid hemorrhage
B. [X] Lateral amyotrophic sclerosis
C. [X] Carcinomatous meningitis
D. [X] Sarcoidosis
E. [ ] Guillain-Barre syndrome
197. ALL Specify the germs that can cause a chronic meningitis:
A. [ ] Haemophilus influenzae
B. [X] Mycobacterium tuberculosis
C. [X] Treponema pallidum
D. [ ] Neisseria meningitidis
E. [ ] Streptococcus pneumoniae
198. ALL Which of the following antibiotics are used in treatment of meningococcal meningitis:
A. [ ] Aciclovir
B. [ ] Peniciline G
C. [X] Ampicillin
D. [X] Ceftriaxone
E. [X] Cefotaxime
199. ALL Which of the following medication should be given prophylactically to persons in contact with patients with
meningococcal meningitis:
A. [X] Rifampin
B. [X] Ceftriaxone
C. [ ] Amfotericine B
D. [ ] Aciclovir
E. [ ] Natalizumab
200. ALL Specify the causes of aseptic meningitis:
A. [X] Enteroviruses
B. [ ] H.influenzae
C. [X] Herpes simplex virus 2
D. [ ] Lymphocitic choriomeningitis virus
E. [ ] N.meningitidis
201. ALL Specify the typical CSF abnormalities in viral meningitis:
A. [X] Lymphocytic pleocitosis
B. [X] Increased protein concentration
C. [ ] Decreased glucose concentration
D. [ ] Polymorphonuclear leucocytosis
E. [ ] Presence of erytrocites
202. ALL Mumps meningitis may be accompanied by the following extraneurological manifestations:
A. [ ] Arthritis
B. [X] Parotitis
C. [X] Orchitis
D. [X] Pancreatitis
E. [ ] Osteoporosis
203. ALL The most common focal findings in encephalitis are:
A. [X] Aphasia
B. [X] Fever
C. [ ] Ataxia
D. [X] Paresis
E. [ ] Cranial nerves deficits
204. ALL Which of the following diagnostic procedures are used to diagnose encephalitis:
A. [ ] Doppler ultrasound of cerebral vessels
B. [X] Cerebral MRI
C. [X] Cerebral CT

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D. [X] EEG
E. [ ] Osteodensitometry
205. ALL Specify epidemiological factors that need to be evaluated in patients with encephalitis:
A. [X] Season of the year
B. [X] Geographic location
C. [ ] Travel history
D. [ ] Possible exposure to animal or ticks bite
E. [X] History of cardiovascular disease
206. ALL Specify antiviral treatment that can be used in viral encephalitis:
A. [ ] Ceftriaxone
B. [X] Aciclovir
C. [X] Ganciclovir
D. [ ] Rifampicin
E. [X] Foscarnet
207. ALL Which of the following factors predispose development of a cerebral bacterial abcess:
A. [ ] Arterial hypertension
B. [X] Otitis media
C. [X] Paranasal sinusitis
D. [ ] Dental infections
E. [ ] Osteoporosis
208. ALL Specify the possible pathways of spreading of a cerebral bacterial abcess:
A. [X] Direct spread from a contiguous cranial site of infection
B. [ ] Following head trauma
C. [X] Following a neurosurgical procedure
D. [ ] Airborne
E. [X] Hematogenous spread
209. ALL The basic clinical manifestations of a cerebral bacterial abcess are:
A. [X] Headache
B. [ ] Flaccid paraparesis
C. [X] Fever
D. [X] Focal neurologic deficit
E. [ ] Cauda equina syndrome
210. ALL The differential diagnosis of a cerebral abcess is made with:
A. [ ] Miasthenia Gravis
B. [ ] Lateral amiotrophic sclerosis
C. [X] Subdural empiema
D. [X] Bacterial meningitis
E. [ ] Superior sagittal sinus thrombosis
211. ALL Which of the following methods are used in treatment for cerebral bacterial abcess:
A. [ ] Plasmaferesis
B. [ ] I/v immunoglobulins
C. [ ] Endarterectomy
D. [X] High-dose parenteral antibiotics
E. [X] Neurosurgical drainage
212. ALL Which of the following medications are used in treatment for neurocysticercosis:
A. [ ] Aciclovir
B. [ ] Vancomycin
C. [X] Albendazole
D. [ ] Ceftriaxone
E. [X] Praziquantel
213. ALL The signs of the septic cavernous sinus thrombosis are:
A. [X] Fever
B. [ ] Retroorbital pain
C. [X] Proptosis and chemosis
D. [ ] Extraocular dysmotility

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E. [ ] Chorea
214. ALL Which of the following cranial nerves are injured in septic cavernous sinus thrombosis:
A. [ ] VII
B. [X] III
C. [X] IV
D. [ ] XI
E. [X] VI
215. ALL Specify the germs that can cause a chronic meningitis:
A. [ ] Borrelia burgdorferi
B. [ ] N.meningitidis
C. [X] Treponema pallidum
D. [X] Mycobacterium tuberculosis
E. [ ] Str. Pneumoniae
216. ALL Specify common opportunistic infections in HIV-infected patients with the impairment of nervous system:
A. [X] Toxoplasmosis
B. [X] Cryptococcosis
C. [ ] Primary CNS lymphoma
D. [ ] Tuberculosis
E. [ ] Vacuolar myelopathy
217. ALL Specify common peripheral nervous system diseases in HIV-infected patients:
A. [X] Toxoplasmosis
B. [ ] Cryptococcosis
C. [ ] Guillain-Barre syndrome
D. [ ] Primary CNS lymphoma
E. [X] Distal symmetric polyneuropathy
218. ALL Specify common neoplasms in HIV-infected patients:
A. [X] Kaposis sarcoma
B. [ ] Cryptococcosis
C. [X] Primary CNS lymphoma
D. [ ] Tuberculosis
E. [ ] Vacuolar myelopathy
219. ALL Polyradiculopathy due to citomegalovirus infection in patient with HIV presents with:
A. [X] Headache
B. [X] Lower extremity and sacral paresthesias
C. [X] Difficulty in walking
D. [ ] Areflexia
E. [ ] Urinary retention
220. ALL Primary CNS lymphoma in patient with HIV presents with:
A. [ ] Lower extremity and sacral paresthesias
B. [X] Cranial nerves abnormalities
C. [X] Headache
D. [X] Seizures
E. [ ] Areflexia
221. ALL Which of the following manifestations are specific for cerebral toxoplasmosis:
A. [ ] Radicular pain
B. [X] Fever
C. [ ] Headache
D. [ ] Focal neurologic deficit
E. [X] Muscle cramps
222. ALL Which of the following medications are used in treatment for cerebral toxoplasmosis:
A. [ ] Albendazole
B. [ ] Ceftriaxone
C. [ ] Amphotericin B
D. [X] Sulfadiazine
E. [X] Pyrimethamine

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223. ALL The causes of seizures in patient with HIV infection are:
A. [X] Cerebral toxoplasmosis
B. [X] Primary CNS lymphoma
C. [X] Cryptococcal meningitis
D. [ ] Distal symmetric polyneuropathy
E. [ ] Guillain-Barre syndrome
224. ALL Which of the following manifestations are specific for spinal cord damage in myelitis:
A. [X] Sensitive disorders below the site of the lesion
B. [X] Motor disorders below the site of the lesion
C. [ ] Cranial nerve disorders
D. [X] Autonomic nervous system disorders
E. [ ] Cognitive impairment
225. ALL Specify manifestations in spinal epidural abscess:
A. [ ] Optic nerve atrophy
B. [ ] Dementia
C. [X] Dorsal pain
D. [X] Fever
E. [X] Progressive limb weakness
226. ALL CSF abnormalities in subdural abscess consist of:
A. [X] Pleocytosis with a preponderance of polymorphonuclear cells
B. [X] Elevated protein level
C. [X] Reduced glucose level
D. [ ] Presence of eosinophils
E. [ ] Presence of oligloclonal IgG bands
227. ALL Which of the following viruses are responsible for infectious myelitis:
A. [X] Herpes zoster
B. [ ] Treponema pallidum
C. [ ] Mycoplasma pneumoniae
D. [ ] Epstein Bar
E. [X] Herpes simplex
228. ALL Specify diseases that can affect the spinal cord:
A. [ ] Epilepsy
B. [ ] Trigeminal neuralgia
C. [X] Multiple sclerosis
D. [X] Vertebral-medullary trauma
E. [X] Syringomyelia
229. ALL Specify the causes of a compressive myelopathy:
A. [X] Epidural, intradural, or intramedullary neoplasm
B. [X] Epidural abscess
C. [X] Herniated disk
D. [X] Posttraumatic compression by fractured or displaced vertebra
E. [ ] Vitamin B 12 deficiency

MOTILITY
230. ALL The lower motor neurons are located in:
A. [ ] The posterior column of the spinal cord
B. [ ] The lateral horn of the spinal cord
C. [X] The anterior horn of the spinal cord
D. [X] The brainstem motor nuclei
E. [ ] The posterior horn of the spinal cord
231. ALL Axons of the upper motor neurons descend through:
A. [X] The subcortical white matter (corona radiata)
B. [X] The posterior limb of the internal capsule

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C. [ ] The anterior limb of the internal capsule
D. [ ] The posterior column of the spinal cord
E. [X] The lateral column of the spinal cord
232. ALL Axons of the lower motor neurons descend through:
A. [X] Anterior nerve root
B. [X] Spinal nerve trunk
C. [X] Brachial plexuses
D. [ ] The subcortical white matter (corona radiata)
E. [ ] The posterior limb of the internal capsule
233. ALL Lower motor neuron weakness produce:
A. [ ] extensor plantar (Babinski) response
B. [X] flaccidity
C. [X] muscle atrophy
D. [X] absent tendon reflexes
E. [X] fasciculations
234. ALL Upper motor neuron weakness produce:
A. [ ] fasciculations
B. [X] spastic muscle tone
C. [ ] muscle pain
D. [X] hyperactive tendon reflexes
E. [X] extensor plantar (Babinski) response
235. ALL Typically assessed muscle stretch reflexes are:
A. [X] Biceps reflexes
B. [ ] Grasp reflex
C. [X] Triceps reflexes
D. [X] Patellar reflexes
E. [ ] Palmomental reflex
236. ALL Typically assessed cutaneous reflexes are:
A. [X] Plantar reflex
B. [ ] Patellar reflexes
C. [X] Abdominal reflexes
D. [ ] Triceps reflexes
E. [ ] Achilles reflex
237. ALL Motor examination will be done by assessing:
A. [X] muscle tone
B. [ ] joint position testing
C. [X] muscle strength
D. [X] muscle stretch reflexes
E. [X] gait examination
238. ALL Acute or episodic hemiparesis usually results from:
A. [X] Ischemic stroke
B. [ ] Cerebral neoplasm
C. [X] Cerebral trauma
D. [ ] Degenerative disease
E. [X] Hemorrhagic stroke
239. ALL Paraparesis may result from:
A. [X] A cauda equina syndrome
B. [ ] Unilateral frontal lobe lesion
C. [X] A midline disk herniation
D. [X] Intraspinal tumor
E. [X] Polyneuropathy
240. ALL Causes of episodic generalized weakness are:
A. [X] Electrolyte disturbances
B. [X] Muscle disorders
C. [X] Myasthenia gravis

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D. [X] Lambert-Eaton syndrome
E. [ ] brachial plexopathy
241. ALL Which of the following features are characteristic for amyotrophic lateral sclerosis:
A. [X] It is a progressive motor neuron disease
B. [X] It is a neurodegenerative disease
C. [ ] It is an infectious disease
D. [X] No treatment arrests the underlying pathologic process
E. [ ] The drug of choice is Aciclovir
242. ALL Differential diagnosis of amyotrophic lateral sclerosis should be done with:
A. [X] Compression of the cervical spinal cord
B. [X] Multifocal motor neuropathy
C. [X] Chronic lead poisoning
D. [ ] Hemorrhagic stroke
E. [ ] Bacterial meningitis
243. ALL Amyotrophic lateral sclerosis management may consist of:
A. [X] Riluzole (100mg/d)
B. [ ] Antibiotics (penicillin group)
C. [X] Respiratory support
D. [ ] Steroid pulse therapy
E. [X] Rehabilitative aids
244. ALL Clinical manifestations of amyotrophic lateral sclerosis are
A. [X] Progressive flaccid paresis
B. [X] Atrophy of muscles
C. [ ] Sensory loss
D. [ ] Urinary incontinence
E. [X] Fasciculations
245. ALL Chronic hemiparesis usually results from:
A. [X] Degenerative disease
B. [ ] Ischemic stroke
C. [X] Cerebral neoplasm
D. [X] Cerebral vascular malformation
E. [ ] Hemorrhagic stroke
246. ALL Clinical features of motility system disorders may be:
A. [X] Paralysis
B. [ ] Paresthesia
C. [ ] Neck stiffness
D. [X] Spasticity
E. [X] Abnormal gait
247. ALL Anterior horns from the spinal cord comprise :
A. [ ] Pseudounipolar cells
B. [X] Alfa-cells
C. [ ] Beta-cells
D. [X] Gamma-cells
E. [ ] Delta-cells
248. ALL Reflexes are graded according to the following scale:
A. [ ] Optimal
B. [X] Normoactive
C. [X] Diminished
D. [X] Absent
E. [X] Exaggerated
249. ALL Select primitive reflexes:
A. [ ] Gag reflex
B. [X] Suck response
C. [X] Grasp reflex
D. [X] Palmomental response

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E. [ ] Jaw-jerk reflex
250. ALL Muscle strength is graded according to the following scale:
A. [ ] 0 full power
B. [X] 5 full power
C. [X] 0 no movement
D. [ ] 5 no movement
E. [ ] 1 flicker movement
251. ALL Decreased tone is:
A. [X] Due to lower motor neuron
B. [X] Due to peripheral nerve disorders
C. [ ] Due to upper motor neuron
D. [ ] Due to cortical disorders
E. [X] Due to cerebellum disorders
252. ALL Increased tone may be evident as:
A. [X] Spasticity
B. [X] Rigidity
C. [X] Paratonia
D. [ ] Flaccidity
E. [ ] Fasciculations
253. ALL Select diseases in which upper motor neuron weakness occur:
A. [X] Cerebral tumors
B. [X] Brainstem tumors
C. [X] Ischemic stroke
D. [X] Encephalitis
E. [ ] Neuritis
254. ALL Select diseases in which lower motor neuron weakness occur:
A. [X] Spinal cord tumors
B. [X] Neuritis
C. [ ] Ischemic stroke
D. [ ] Brainstem tumors
E. [X] Polyneuropathies
255. ALL Examples of abnormal gait are:
A. [X] Gait apraxia
B. [X] Shuffling
C. [X] Paretic gait
D. [ ] Reflex gait
E. [X] Hemiparetic
256. ALL Abnormal gait occur when the lesion is in:
A. [X] Frontal lobe
B. [ ] Temporal lobe
C. [X] Cerebellum
D. [X] Basal ganglia
E. [X] Peripheral nerves
257. ALL Abnormal gait occur in the following diseases:
A. [X] Parkinson disease
B. [X] Ischemic stroke
C. [X] Acute polyneuropathy
D. [ ] Migraine with aura
E. [ ] Bells palsy
258. ALL Gait examination will comprise:
A. [X] Normal walking
B. [X] Toe walking
C. [X] Heel walking
D. [X] Walking with closed eyes
E. [ ] Walking with closed ears

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259. ALL Paraparesis results from:
A. [X] Bilateral lumbar-sacral plexus lesion
B. [ ] An upper motor neuron lesion above the midcervical spinal cord
C. [X] A lesion below the upper thoracic spinal cord level
D. [ ] Brachial plexus lesion
E. [X] Medullar ischemia

PERIFERIC NERVOUS SYSTEM

260. ALL The parasympathetic nervous system:
A. [X] decreases cardiac frequence
B. [ ] increases cardiac frequence
C. [ ] stimulates bronchial dilation
D. [ ] controls locomotion
E. [X] stimulates bronchial constriction
261. ALL The peripheral nervous system includes:
A. [X] cranial nerves
B. [ ] brain
C. [ ] spinal cord
D. [X] spinal nerves
E. [ ] temporal lobe
262. ALL The peripheral nervous system is divided into:
A. [X] somatic
B. [X] vegetative
C. [ ] motor
D. [ ] sensitive
E. [ ] primary
263. ALL The symptoms of peripheral neuropathy:
A. [X] sensitive
B. [X] motor
C. [ ] independent
D. [ ] autonomic
E. [ ] aphasia
264. ALL The spinal nerves are formed by the fusion of:
A. [X] anterior root
B. [ ] proximal root
C. [X] posterior root
D. [ ] distal root
E. [ ] ganglia
265. ALL The vegetative nervous system controls:
A. [X] inervation of the internal organs
B. [X] smooth muscles
C. [X] cardiac muscles
D. [ ] tendons
E. [ ] joints
266. ALL The vegetative nervous system are divided in:
A. [X] central portion
B. [ ] primary
C. [ ] secundary
D. [X] peripheric portion
E. [ ] distal portion
267. ALL The peripheric part of autonomic nervous system contains:
A. [X] ganglia
B. [X] nerve fibers

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C. [ ] motor nerves
D. [ ] sensitive nerves
E. [X] mixed nerves
268. ALL Choose the correct answers:
A. [X] 3 sympathetic cervical ganglia
B. [X] 10-12 sympathetic thoracal ganglia
C. [ ] 2 sympathetic cervical ganglia
D. [X] 5 sympathetic lombar ganglia
E. [ ] 6 sympathetic lombar ganglia
269. ALL Which of the following structures is not a part of the peripheral nervous system:
A. [X] brain
B. [X] spinal cord
C. [ ] ganglia
D. [X] cerebellum
E. [X] cerebral basal nuclei
270. ALL The sympathetic nervous system:
A. [X] relaxes bronchial muscle
B. [X] increases frequency of heart rate
C. [ ] decreases frequency of heart rate
D. [X] relaxes bladder
E. [X] salivary glands viscous secretions
271. ALL The parasympathetic nervous system:
A. [ ] relaxes bronchial muscle
B. [ ] increases frequency of heart rate
C. [X] decreases frequency of heart rate
D. [ ] relaxes bladder
E. [X] salivary glands watery secretions
272. ALL Etiology of radial nerve palsy:
A. [X] the compression of nerve during the sleep
B. [X] inflammatory or neoplasic processes
C. [ ] intoxications
D. [X] bone fractures
E. [ ] indirect trauma
273. ALL Signs of lesion of n. medianus
A. [X] hand flexion weakness
B. [X] low cubito-pronator reflex
C. [ ] high cubito-pronator reflex
D. [ ] hyperestesia in the median nerve skin zones
E. [ ] high bicipital tap reflex
274. ALL Which of the following represent lesions of the nerves of the upper limb
A. [X] N. radialis palsy
B. [X] N. medianus palsy
C. [ ] N. cruralis palsy
D. [ ] N. femoralis palsy
E. [X] N. ulnaris palsy
275. ALL Which of the following are the signs of the tibial nerve lesion
A. [X] Sensory loss to the plantar aspect of the foot
B. [X] Low Achilles tendon reflex
C. [ ] High Achilles tendon reflex
D. [ ] Pozitive Babinski sign
E. [X] Loss of ankle and toe plantar flexion
276. ALL Which of the following represent types of the upper limb plexus lesions:
A. [X] The upper type
B. [X] The lower type
C. [X] Total type

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D. [ ] Primary type
E. [ ] Secondary type
277. ALL Which of the following are the signs of the upper brachial plexus lesion:
A. [X] Low tendon reflexes
B. [X] High tendon reflexes
C. [X] Sensory deficit
D. [ ] Increased muscle tone
E. [ ] Positive Babinski sign
278. ALL Which of the following are the signs of the lower brachial plexus lesion:
A. [ ] Dejerine-Klumpke type
B. [ ] C8/T1 dermatome distribution numbness
C. [X] Atrophy of the muscles of the arm
D. [X] Weakness in the proximal muscle group
E. [X] Weakens in the distal muscle group

STROKE
279. ALL Upper Motor Neuron Lesions signs
A. [ ] Fasciculations
B. [X] Superficial reflexes preserved
C. [X] Deep Tendon Reflexes exaggerated
D. [ ] Poliomyelitis is an example
E. [X] Cogwheel rigidity is typical
280. ALL Lower Motor Neuron Lesions signs
A. [ ] Pseudo Hypertrophy of the muscles affected
B. [ ] Spasticity
C. [ ] Tremor
D. [X] Atrophy
E. [X] Absent reflexes
281. ALL Cerebellar Lesions can result in
A. [X] Dysarthria
B. [X] Aphasia
C. [X] Hypotonia
D. [ ] Hyperreflexia
E. [ ] Pendular Knee jerk
282. ALL Risk factors for Ischemic stroke
A. [X] Increasing age
B. [X] Diabetes
C. [X] Hypertension
D. [X] Previous stroke protects against future strokes
E. [ ] Anticoagulation is indicated for all patients as secondary prevention
283. ALL Ataxia
A. [X] Seen in cerebellar lesions
B. [X] Associated with muscle weakness
C. [X] Associated With absent reflexes
D. [ ] May be associated with sensory loss
E. [ ] Hereditary forms are not seen
284. ALL Subarachnoid haemorrhage
A. [ ] Recurrence is rare
B. [X] Berry aneurysm is commonest cause
C. [X] Presents with worse head ache ever
D. [X] Meningitis is a complication
E. [ ] Hypernatremia is usual

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285. ALL Acute ischemic stroke
A. [X] Can change into haemorrhagic form
B. [ ] Alteplase is the treatment given for all patients
C. [X] Prognosis is better as compared to haemorrhagic stroke
D. [ ] Has lesser incidence than haemorrhagic stroke
E. [ ] Controlling hypertension reduces incidence
286. ALL Haemorrhagic stroke
A. [ ] Diabetes is the commonest cause
B. [X] Surgery is treatment of choice
C. [ ] Intravenous Heparin is the treatment of choice
D. [ ] Thrombolysis is an option if the cause is cerebral venous thrombosis
E. [X] Morbidity is more when compared to ischemic strokes
287. ALL 55 Year old man developed acute right sided weakness with aphasia His blood pressure is 220/110. He presents to
the Emergency room within 2 hours of onset.
A. [X] Assess if he is suitable for thrombolysis
B. [ ] He is not a suitable candidate for thrombolysis
C. [X] Treat his Blood Pressure with Labetol If eligible for thrombolysis
D. [X] Treat his Blood Pressure with Lasix
E. [X] Start anticoagulation
288. ALL Lacunar strokes
A. [X] Seen in white matter
B. [ ] Usually associated with large infarcts
C. [X] involve penetrating arteries
D. [ ] Anterior cerebral artery most commonly involved
E. [ ] Pure sensory form can be seen.
289. ALL Thrombolysis in Stroke -Absolute contraindications
A. [X] Haemorrhagic stroke
B. [ ] Window period 120 minutes
C. [X] Blood pressure 200 over 110 in a patient with ischemic stroke
D. [X] Massive stroke with poor prognostic indicators
E. [ ] Patient diabetes type I
290. ALL Carotid endarterectomy
A. [ ] Better results in asymptomatic than symptomatic patients
B. [X] Performed when more than 70 percent of stenosis
C. [X] Performed within a week of diagnosis for better result
D. [ ] Not performed if the patient is older than 75 years of age.
E. [ ] Outcome of operation same in all centres
291. ALL Benedict syndrome
A. [X] Posterior circulation stroke
B. [ ] Frontal lobe involved
C. [X] includes third cranial nerve palsy on the side of the lesion,
D. [X] Contralateral hand tremor
E. [X] Ataxia.
292. ALL Weber syndrome
A. [X] Midbrain lesion
B. [ ] Ipsilateral hemiplegia
C. [X] Contralateral hemiplegia
D. [ ] Severe burning pain on the contralateral side
E. [X] Ipsilateral third nerve palsy
293. ALL IN PROSOPOGNOSIA
A. [ ] Decision making is intact.
B. [ ] Inability to write
C. [X] Failure to recognize familiar faces
D. [X] Can recognize own face
E. [ ] Can be treated with haloperidol

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294. ALL Frontal lobe lesions may result in
A. [X] Aphasia
B. [ ] Disinhibition
C. [ ] Blindness
D. [X] Apraxia
E. [ ] Anton Syndrome
295. ALL General features of a Posterior Circulation Stroke
A. [ ] Vertigo
B. [ ] Ataxia
C. [ ] Sensory loss over V1 V2 is not seen
D. [ ] Crossed Hemiplegia is a feature
E. [ ] is commoner than Anterior Circulation Stroke
296. ALL Unilateral Thalamic Leisons can present with
A. [ ] Ipsilateral Sensory Loss
B. [ ] spontaneous Pain Ipsilaterally
C. [ ] Contralateral Choreoathetosis
D. [ ] contralateral Ataxia
E. [ ] Contralateral hemiperisis
297. ALL Anterior Cerebral Artery infarct results in
A. [X] Ipsilateral paralysis of leg and foot with paresis of arm
B. [ ] Urinary incontinence is not a feature
C. [X] Gait apraxia
D. [X] Mutism
E. [ ] Spasticity
298. ALL Wallenberg Syndrome
A. [ ] Lesion In Fronto Temporal lobes (basal part)
B. [ ] Vagus Nerve Palsy is Ipsilateral
C. [X] Cerebellar signs are Ipsilateral
D. [ ] Pain temperature touch sensations of face are impaired on contralateral side
E. [X] Pain and temperature sensations of the body are impaired on contralateral side

TRAUMA
299. ALL Which of the following is true in spasticity following traumatic brain injury (TBI)?
A. [ ] spasticity of cerebral origin characteristically presents with lesser extensor tone in the lower extremities and more
tendency to spasms compared with spinal cord spasticity
B. [ ] Diazepam and oral baclofen are recommended for spasticity
C. [ ] liver enzymes need to be monitored when using Dantrolene sodium
D. [ ] splinting techniques can be used both to decrease tone and to stretch soft tissues
E. [ ] Botulinum toxin A is recommended for focal spasticity
300. ALL Which of the following statements is correct regarding the prognosis of traumatic brain injury
A. [ ] duration of post-traumatic amnesia is a good indicator
B. [ ] school age children and young adults achieve better outcomes than infants or older adults (> 45 years)
C. [ ] one or both non-reactive pupillary light reflexes is associated with a poorer outcome
D. [ ] combined severe musculo-skeletal injuries predict worse outcomes
E. [ ] findings on CT scan of the brain are more sensitive compared to MRI as good predictor of outcome following
severe traumatic brain injury
301. ALL Which is an accepted treatment of patients with severe head injury and ICP >40 mmHg.
A. [ ] Correct hypovolemia with isotonic saline.
B. [ ] Mannitol 1 g/kg of 20% mannitol.
C. [ ] Elevation of head to 30 degrees.
D. [ ] Loading with phenytoin 15-18 mg/kg.
E. [ ] Hydrocortisone 100 mg/ 6 hrly.

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302. ALL Which is true of basal skull fractures?
A. [X] CSF rhinorrhea tests positive for glucose.
B. [X] There is no increased risk of meningitis despite CSF leak.
C. [ ] Usually they involve petrous part of temporal bone, and external auditory canal and tympanic membrane.
D. [X] They may present with vertigo and 7th nerve palsy.
E. [X] Mastoid ecchymoses is a positive Battles sign.
303. ALL Which is correct regarding intracranial haematomas?
A. [X] Epidural haematomas are associated with fracture of the temporal bone in 80-90% of cases.
B. [X] Extradurals are uncommon in elderly and children less than 2 years of age.
C. [ ] Patients with brain atrophy are more at risk for Subdural haematomas.
D. [X] Traumatic SAHs are the most common abnormality seen on CT of moderate and severe head injuries.
E. [ ] Diffuse axonal injury causes potentially reversible injury to axonal fibres on impact.
304. ALL Which is correct of cervical spine injuries?
A. [X] The majority of spinal injuries occur in the cervical spine.
B. [X] In the adult the spinal cord ends at L1.
C. [ ] The spinothalamic tract transmits pain and temperature from the opposite side of the body.
D. [X] The diaphragm is paralysed in spinal injury if the lesion is above C3.
E. [X] The neurologic level of injury is the most caudal segment of the spinal cord with abnormal sensory and motor function.
305. ALL Which dermatome is CORRECT?
A. [X] C7 middle finger
B. [X] T4 - nipple
C. [ ] T8 umbilicus
D. [X] S4-S5 perianal region.
E. [X] L4 medial aspect of leg.
306. ALL All of the following are true about spinal injuries, except ?
A. [ ] About 80% of spinal injuries result in neurological deficit
B. [ ] Thoracolumbar spine injury may result in paraplegia
C. [ ] Cervical spine injury may result in Quadriplegia
D. [X] Any lesion to the spinal cord above T5 causes hypotension
E. [X] Myelogram has proved to be a very helpful investigation in acute spinal injuries
307. ALL With regards to spinal cord injuries, which of the following is incorrect?
A. [ ] Brown-Sequard syndrome manifests as loss of motor function and position sense on the same side, and loss of
pain and temperature on the opposite side.
B. [ ] Transverse spinal cord syndrome has sparing of the dorsal columns.
C. [ ] Cervical spine injuries occur most commonly at C4/5.
D. [X] In patients with a cervical spine fracture, it is unnecessary to look for further fractures elsewhere
E. [X] Thoracolumbar spine injury may result in tetraplegia.
308. ALL Complications of spinal cord injury include:
A. [X] Autonomic Instability
B. [X] Neurogenic shock
C. [X] Pulmonary Oedema
D. [ ] Associated splenic injury
E. [ ] None of the above
309. ALL Prognosis in head injury is best given by, except:
A. [ ] Glasgow coma scale
B. [X] Age of patient
C. [X] Mode of injury
D. [ ] CT head
E. [ ] MRI head
310. ALL Which is correct of spinal cord syndromes?
A. [ ] Central cord syndrome has greater power loss of lower extremities than upper.
B. [X] Central cord syndrome occurs with hyperextension injuries often with patients with pre-existing cervical canal stenosis.
C. [X] Anterior cord syndrome is characterized by paraplegia and loss of pain and temperature sensation, with intact
position sense, vibration.
D. [X] Brown-Sequard syndrome results from hemisection of the cord.

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E. [X] Central cord syndrome and anterior cord syndrome are thought to result from compromised anterior spinal artery
blood supply.

Tumors
311. ALL Which of the following statements are true about meningiomas?
A. [ ] They are benign tumors that are believed to arise from the dura.
B. [ ] The cerebellopontine angle is the most common location.
C. [X] They are associated with neurofibromatosis type 2.
D. [X] They can be cured by complete resection
E. [X] They are associated with hyperostosis of the underlying bone, homogenous enhancement with contrast and an
enhancing "dural tail" on imaging studies.
312. ALL The less common primary malignant tumor of the brain are
A. [X] oligodendroglioma
B. [X] ependymoma
C. [ ] astrocytoma
D. [X] ganglioglioma
E. [X] meningioma
313. ALL Which of the following is used to distinguish a benign from a malignant neoplasm?
A. [X] degree of cellular differentiation
B. [X] rate of growth
C. [ ] type and amount of necrosis
D. [X] evidence of metastasis
E. [X] mode of spread
314. ALL Which of the following brain tumors spread via CSF
A. [X] Germ cell tumors
B. [X] Medulloblastoma
C. [X] CNS lymphoma
D. [ ] Craniopharyngoma
E. [X] Ependimoma
315. ALL Klatzo and Fishman specified the categories of brain edema:
A. [X] vasogenic
B. [X] cytotoxic
C. [X] interstitial
D. [ ] localized
E. [ ] generalized
316. ALL Vasogenic edema:
A. [X] is the type seen in the vicinity of tumor growths and other localized processes
B. [X] it is practically limited to the white matter
C. [ ] to refer to any increase in the extravascular intercellular compartment of the brain
D. [ ] occurs with obstructive hydrocephalus
E. [ ] all the cellular elements (neurons, glia, and endothelial cells) swell with fluid
317. ALL The clinical behavior of intracranial tumors and mass lesions of any type evolve with the effects of:
A. [X] elevated intracranial pressure,
B. [X] localized vasogenic edema
C. [X] displacements of tissue
D. [X] herniations
E. [ ] bradicardia
318. ALL The clinical manifestations of brain tumor:
A. [X] Seizure
B. [X] Vomiting and dizziness
C. [X] Headache
D. [X] Changes in mental function
E. [ ] Diplopia

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319. ALL Oligodendroglioma:
A. [X] It is derived from oligodendrocytes or their precursor cells
B. [X] It may occur at any age, most often in the third and fourth decades
C. [X] The incidence in men is twice that in women.
D. [ ] It is less benign than the malignant astrocytoma.
E. [ ] The surgical treatment is not used
320. ALL The most common sites of oligodendroglioma are:
A. [X] The frontal lobe
B. [X] The temporal lobe
C. [ ] The parietal lobe
D. [ ] The occipital lobe
E. [ ] The cerebellum
321. ALL The conventional treatment for oligodendroglioma:
A. [X] Surgical excision
B. [X] Radiation therapy
C. [ ] Symptomatic treatment
D. [ ] Corticosteroids
E. [ ] Immunomodulatory treatment
322. ALL Meningiomas:
A. [X] approximately 15 percent of all primary intracranial tumors
B. [X] are more common in women than in men (2: 1)
C. [X] persons who have undergone radiation therapy to the scalp or cranium are vulnerable to the development of meningiomas
D. [ ] the tumor appear at an older age in persons who have undergone radiation therapy to the scalp or cranium
E. [X] originating from the dura mater or arachnoid.
323. ALL The common clinical manifestations of metastatic carcinoma of the brain:
A. [X] Seizures, headache
B. [X] Focal weakness
C. [X] Mental and behavioral abnormalities,
D. [X] Ataxia, aphasia,
E. [ ] The clinical manifestations evolve years
324. ALL Brainstem metastases originating in the lungs:
A. [X] are rare
B. [X] giving rise to diplopia
C. [X] giving rise to imbalance
D. [X] giving rise to facial palsy
E. [ ] are often
325. ALL The modifications of the CSF in carcinomatous meningitis:
A. [X] Increased pressure in the subarachnoid space
B. [X] Elevation of CSF protein
C. [X] Low glucose levels
D. [X] Lymphocytic pleocytosis (up to 100 cells but typically much fewer)
E. [ ] Leukocytosis

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