Neurologic System Practice Test Questions

1) A 30-year-old woman with a history of epilepsy adequately treated with phenytoin presents to her PCP with her husband because she has been having trouble walking and speaking. Her gums are swollen, and she states that they bleed very easily when she brushes her teeth. There is no history of alcohol or illicit drug use. Physical examination reveals gingival hyperplasia, dysarthria, and ataxia. What is the most likely cause of this condition?

2) A 35-year-old female patient with a strong family history of headaches presents to the emergency room with a chief complaint of headache. She describes the pain as unilateral, 8/10 intensity, with associated photo- and phonophobia. She has been having these headaches since she was 13. Her mother had similar headaches that resolved somewhat after menopause. These symptoms keep the patient from performing her daily activities. Which of the following is the most likely diagnosis?

3) Which of the following medications is a seizure medication commonly prescribed for the treatment of petit mal seizures?

4) A 45-year-old male presents to the emergency room by ambulance with his wife. He complains of racing heart beat and weakness that started in the legs and seems to be “creeping up my body.” Shortly before presenting to the emergency room, he had a syncopal episode and shortness of breath. Past medical history is significant only for a recent “stomach bug” that started after a vacation overseas. Physical exam reveals 0/5 ankle jerk reflex and hypotension. Which of the following is the most common group of tests ordered to diagnose his disease?

5) A 15-month-old boy presents to the pediatrician with his mother. The boy’s history is significant only for a delivery via C-section at 36 weeks after signs of fetal distress during labor. The mother is concerned that her child is not developing normally. He has not met developmental milestones of sitting, rolling, or crawling. Which of the following is the most accurate diagnosis?

6) A 24-year-old female presents with a severe headache, very high fever, and nuchal rigidity. She is exhibiting Brudzinski’s and Babinski’s signs. Which one of the following procedures would you have to perform before doing a spinal tap on this patient?

7) Albuterol is commonly prescribed to treat which of the following?

8) Spina bifida is also known as a myelomeningocele. This defect occurs when the caudal end of the neural tube fails to close. … How can this defect most effectively be avoided?

9) A 60-year-old female presents to her PCP complaining of severe pain on the left side of the face, mostly located around the cheek. The patient states that even a very light touch can provoke excruciating pain. On exam, she weighs 135 pounds, which is 10 pounds lower than her baseline. On palpation of the left side of the face, no lesions are noted, but pain is present out of proportion with physical exam. Which of the following is the most likely diagnosis?

10) A 51-year-old female presents with chorea, dystonia, and impaired gait. In addition, she has been exhibiting anxiety and a slowed thought process. Which of the following is the most appropriate diagnosis?

11) A 65-year-old male presents to his PCP with his daughter. She states that the patient has had a tremor that is mostly noticed at rest. The tremor started in one hand but seems to be worsening and becoming more pervasive. The daughter also states that the patient has been confused and “moody” and has been having difficulty eating and speaking. Examination reveals cogwheel rigidity of the limbs and bradykinesia. What is the most appropriate treatment for this patient’s condition?

12) A newborn boy is being evaluated for small head circumference and low birth weight of 4 lbs. The mother reports that she did not have prenatal care. Physical examination reveals a smooth philtrum, thin vermillion, and small palpebral fissures. Upon further questioning, the mother reports that she did drink heavily during the pregnancy. According to the patient’s history and physical examination, which of the following would be the most appropriate diagnosis?

13) A 21-year-old male presents to his PCP with his mother because of recent odd behavior. She has noticed that he often neglects to bathe or brush his hair. He has recently lost his job because he was frequently hours late. When he did report to his job, he would often spend long periods of time appearing to be doing nothing. He has lost a great number of friends because of his odd behavior. His mother frequently misses phone calls because he has taken the phones off the hook due to worry that he is being “spied on.” What is the most likely diagnosis?

14) A 70-year-old man is brought into the office by his wife. She believes his health is deteriorating and she wants to know what is wrong with him. The patient states that he has had a hard time writing checks lately because his writing is barely legible. He has also become “clumsy,” falling twice in the last month. Examination reveals a “pill rolling” tremor of the right hand while at rest, as well as difficulty initiating movement when standing up from the chair. Which of the following is the most appropriate diagnosis?

15) A 45-year-old musician presents to the emergency room with a complaint of tremors. He has had a mild tremor in both hands for three years, but the problem is worsening. It is starting to affect his performance on the piano, and he has even noticed a slight “vibrato” in his singing voice. He feels better if he has a couple of beers before he gets on stage. He is worried that he may share the same fate as his mother, who was a famous musician whose career was cut short by similar symptoms. Physical exam is essentially normal. What is the most appropriate line of treatment for this patient?

16) A 12-year-old boy is brought into the emergency room by his mother. She states that he has been convulsing for the last 45 minutes. The boy has a history of epilepsy, and his treatment was modified two weeks ago. The patient is in a generalized tonic clonic seizure upon presentation to the ER. Which of the following medications is the most appropriate for this situation?

17) A 25-year-old Asian female in her first trimester of pregnancy presents with intermittent muscle weakness and fatigue. These episodes are brought on by exercise and resolve with rest, but with pregnancy they have been more persistent. She also states that she has periods of double vision and difficulty speaking and chewing. Which of the following medications is the most appropriate treatment?

18) Each of the following medications could be prescribed to effectively treat generalized anxiety disorder, EXCEPT

19) A 45-year-old woman presents to the emergency room with her husband. She complains of a severe headache of sudden onset, which she describes as “the worst headache of my life.” The patient has no history of trauma. Physical exam reveals somnolence, nuchal rigidity, and a BP of 170/105. What is the most likely etiology of this patient’s condition?

20) A 23-year-old man is brought to the emergency room by paramedics after a bar fight. During the fight, he was hit in the head with a baseball bat. He presents with anisocoria and is rated at a 7 on the Glasgow coma scale. The CT scan shows a hyper-dense convex image between the brain and the skull. Which of the following interventions is the most appropriate for this patient’s condition?

21) A 33-year-old white female, with a previous history of hypothyroidism, presents with diplopia, paresthesia, dizziness, and fatigue. She complains of a “shock sensation” when she moves her head a certain way. A spinal tap reveals elevated immunoglobulin concentration with the presence of oligoclonal bands in the CSF. Which of the following is the most appropriate diagnosis?

22) A 40-year-old woman presents to her PCP with a chief complaint of moderate bilateral headache for five months. She started pursuing a new degree five months ago and has been spending a lot more time on the computer. She states that typing for long periods of time triggers her headaches. She states that ibuprofen usually helps to alleviate the headaches. The patient also reports that she saw her dentist seven months ago for nighttime teeth grinding. Physical exam reveals muscle spasm around the head and neck. Neurologic exam is normal. Which of the following interventions is required to diagnose this condition?

23) A 19-year-old male presents after a motor vehicle accident with dizziness, headache, and vomiting after loss of consciousness. CT scan of the brain is normal. Which of the following is the most accurate diagnosis?

24) An 8-year-old boy presents with his mother to his pediatrician. She is worried about his performance at school. The boy’s teacher reports that the boy often stares into space for a few seconds and then asks questions about the subjects that were just covered. The patient sometimes blinks excessively during these episodes and does not respond to the teacher. What would be the most appropriate medication for this diagnosis?