Multiple Choice Questions (MCQ)

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Category: Q&A Medicine--->Neurology
Page: 4

Question 16#Print Question

A 46-year-old man presents with numbness in his distal fingertips. The patient rarely seeks medical attention and has an insignificant past medical and family history. The patient reports drinking 6 to 7 beers per week and smoking a half pack of cigarettes per day. During neurologic examination, the patient is asked to extend his arms with his eyes shut and maintain his palms facing up. During this maneuver, the patient’s arms both pronate.

Based on the above finding, which of the following is impaired in this patient?

a. Proprioception
b. Upper motor neuron pathway
c. Tactile sensation
d. Cerebellar function

Question 17#Print Question

A 26-year-old man presents with a stabbing, severe pain in the left side of his face for the past 2 weeks. The pain is described as a “stabbing knife” sensation and occurs about every 12 to 15 minutes. It lasts for about 4 to 5 seconds. The pain is so unbearable that the patient cannot sleep or function in his employment as an accountant. The patient has tried aspirin and acetaminophen to no avail. Physical examination is unremarkable, but the patient has one of the attacks during the visit and visibly shows excruciating pain.

Which of the following is the treatment of choice for this patient’s condition?

a. Sumatriptan
b. Acyclovir
c. Morphine
d. Carbamazepine

Question 18#Print Question

A 36-year-old woman presents with a 2-day history of fever, stiff neck, and headaches. She also was reported to have had one seizure just prior to her admission. The patient has a temperature of 39°C, blood pressure of 120/80 mmHg, and heart rate of 106 beats per minute. A lumbar puncture is performed and her CSF studies reveal the following:

  • Opening pressure   218 mm H2O
  • Protein   210 mg/dL
  • Glucose   58 mg/dL
  • Leukocytes   160/mm3
  • Lymphocytes   92%
  • Neutrophils   8%
  • RBC   220/mm3

Which of the following is the most likely diagnosis in this patient?

a. Meningococcal meningitis
b. Herpes simplex encephalitis
c. Tuberculous meningitis
d. Pneumococcal meningitis

Question 19#Print Question

A 56-year-old man presents for evaluation of a tremor. The patient reports that over the last 6 months he has been having tremors in both hands that appear to improve with alcohol intake. The patient denies any tremors at rest. The tremor is worsened when he reaches for his coffee cup in the cupboard each morning. The patient reports that his father appeared to be “shaky” but does not recall his exact diagnosis since he passed when the patient was very young. Physical examination demonstrates a tremor that increases in amplitude at the end of goaldirected activities (reaching for a piece of paper).

Which of the following is the medication of choice for this patient’s condition?

a. Propranolol
b. Trihexyphenidyl
c. Haloperidol
d. Primidone

Question 20#Print Question

A 44-year-old woman presents with a 5-month history of headaches and weight loss. The headache is diffusely painful and is markedly worse when the patient coughs or bends over. The patient has vomited several times over the last few months. Neurologic examination reveals papilledema on fundoscopy. An MRI of the head is ordered and shows below.

Which of the following is the most likely diagnosis?

a. Low-grade astrocytoma
b. Meningioma
c. Glioblastoma multiforme
d. Metastatic brain tumor

Category: Q&A Medicine--->Neurology
Page: 4 of 4