Top 80+ Solved Neurological MCQ Questions Answer

a. Idiopathic seizures usually start age 5-20 yrs.

b. Post head trauma seizures usually begin within 2 years of trauma.

c. Acute strokes are the most common cause in > 65 yr olds.

d. Space occupying lesions account for 1% of new seizures age 35-65.

e. Phenylketonuria may cause seizures.

a. Diazepam has the most rapid onset of the BDZ’s.

b. The LD of phenytoin needs to be decreased in renal impairment.

c. Phenobarbital has duration of action of 3 days.

d. Paraldehyde can be used rectally at a dose of 0.3mls/kg.

e. Phenytoin is usually ineffective in seizures secondary to alcohol withdrawal or intoxication.

a. There is decreased risk of seizures in pregnancy.

b. Eclamptic seizures are typically brief, self-terminating preceded by headache and visual disturbances.

c. Pseudo seizures are often recognized by pelvic thrusting which occurs in 45%.

d. Classic ethanol withdrawal seizures occur 6-48 hrs post withdrawal but can occur up to one week after withdrawal.

e. Seizures in HIV patients are usually secondary to intracranial pathology and all require urgent CT scan.

a. Mortality at 60 mins of status is around 30%.

b. Leucocytosis up to 20,000 is very common.

c. SE occurs most commonly in patients without prior hx of seizures and in extremes of age.

d. In phase 1 there is increased cerebral metabolism, hyperglycaemia, hyperpyrexia and hypertension.

e. Muscle relaxants should be used in intubated patients to avoid self- inflicted injury.

a. Radiculopathy

b. Neuropathy

c. Neuromuscular junction disease

d. Myopathy

e. All of the above result in more marked proximal weakness.

a. Onset in females usually 2nd and 3rd decades, males 7th and 8th decades.

b. The thymus is abnormal in 75% and removal will improve symptoms in the majority.

c. Acute crises in these patients can be due to myasthenia crisis or cholinergic crisis secondary to the medication.

d. Muscle weakness is more marked peripherally.

e. Diagnosis with Ach receptor antibody testing is possible but false negatives occur in 15%.

a. 80% of patients will have antecedent infection with Campylobacter jejuni.

b. CSF will show low protein, high glucose and often a pleocytosis up to 100.

c. High dose immune globulin and plasmapheresis have been shown to be equally efficacious in reducing length of illness.

d. Severe cases will not only involve demyelination but also axonal degeneration.

e. 85% will recover to their previous normal functioning in one year.

a. Carpal tunnel syndrome usually produces more pain at night.

b. Bell’s palsy cause sudden facial weakness with peak paralysis seen at 48 hrs.

c. Use of steroids and acyclovir has been advocated for treatment of Bell’s palsy as one study showed reduced length of paralysis.

d. Entrapment of deep peroneal nerve will result in foot drop and paraesthesia between big toe and second toe.

e. Ulnar nerve entrapment usually occurs at the wrist resulting in numbness of 5th digit and half of 4th digit.

a. It is 2-3 times more common in females

b. The most common reported symptom initially is sensory loss.

c. Optic neuritis is usually unilateral can afferent pupillary response may be present.

d. The majority of patients will show plaques on MRI T2 weighted scans.

e. CSF often shows elevated protein, gamma-globulin and slightly elevated WCC.

a. Interferon and glatiramer have bee shown to reduce number of relapses in relapsingremitting MS.

b. IV immunoglobulin monthly for 2 years has shown to reduce annual exacerbations in relapsing-remitting MS.

c. No treatment currently exists for primary progressive MS to modify the disease.

d. Exacerbations of MS are treated with methlypred IV as studies have shown this to be superior to other glucocorticoids.

e. Symptomatic treatment of muscle spasticity is usually best achieved with baclofen.

a. 90% of cases occur in the first 5 years, with peak at 6 months of age.

b. Damage is due to the inflammatory response not bacterial toxins.

c. Brudzinski’s sign is involuntary hip flexion with passive neck flexion.

d. CT may be normal even in the presence of elevated ICP in up to 45%.

e. LP is always abnormal with bacterial meningitis.

a. Acute bacterial.

b. Viral meningitis.

c. Normal result.

d. TB meningitis

e. TB meningitis or partly treated bacterial meningitis.

a. Empiric treatment in adults consists of ceftriaxone 2g IV.

b. There is no evidence to support dexamethasone in infants with meningitis especially with Hib meningitis.

c. Strep pneumoniae is becoming increasingly resistant to ceftriaxone in Australia as well as penicillin.

d. Neisseria meningitis has high rates of resistance to benzylpen, so ceftriaxone is the first treatment of choice now.

e. There is no parental treatment available for cryptocccocal meningitis.

a. MRI shows characteristic temporal and frontal lobe changes in HSV.

b. CSF usually shows aseptic meningitis.

c. PCR for HSV is insensitive but very specifi

d. Acyclovir has only been shown to be effective in HSV, but is also used in herpes zoster encephalitis.

e. Mortality from HSV is higher than herpes zoster or CMV.

a. Classical triad of headache, fever and focal neurological deficit occurs in over 80% of patients.

b. CT without contrast may miss the diagnosis.

c. Lumbar puncture is contraindicated.

d. Spread is haematogenous, contiguous or from neursurg or penetrating trauma.

e. Anaerobes predominate as infecting organisms.