Test your basic knowledge |

USMLE Step3 Neurology

Subjects : health-sciences, usmle-step-3

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. differentiate picks and huntington
RBC count >6000
Tick born paralysis fastest manifestation. presents within a day of exposure; no FEVER - csf exam normal
Both slowly progressive; huntington with abrupt jerk of limb - trunk - grimacing - other abnormal movement - picks are irritable - quiet - sucks lip frequently and have symmetric atrophy of frontal/temporal lobes
Spastic paraparesis

2. How to differentiate medial and lateral medullary syndrome
Younger patients <60yrs due to concerns about long term efficacy and s/e levodopa
Femoral n lesion
Cluster; l for lacrimation - you for unilateral; episodes occur in cluster/grops; each last 30 min to 3h; c for conjunctival injection; r for retroorbital pain/rhinorhoea
MP: paralysis always medial due to involvement of f gracilis and f cunetus - so loss of touch and position sense and injury to hypglossal n in same side; lateral involve spinothalamic which has L; so pain and temp sensation altered;

3. Most effective to reduce aspiration in stroke or patient with swallowing dysfunction
Upright supine position
Lateral involve trigeminal which has L and has limb ataxia ; medial - ipsilateral limb ataxia and contralateral eye deviation and paralysis of face - arm and leg
Spontaneous remission; admit if suspected and monitor pulse ox for resp failure
Beta interferon and glatiramer acetate; they are teratogenic; contraception should be advised

4. lesion in dominant tempora lobe
Nystagmus on far lateral gaze
RBC count >6000
Difficulty in understanding spoken or written language; difficulty in expressing thoughts in a meaningful manner
Frontotemporal: weird behviors - NPH: incontinence - enlarged ventricls - gait prob; vascular: gradually progressive - mild dementia; Lewy body: l for hallucination +parkinsonism l

5. How to prevent prevent frequency of MS exacerbation
Entacapone - COMT inhibitor
Bilateral but worse unilateral - morning headache - n/v - headache worsened by bending - night awakening
Lateral involve trigeminal which has L and has limb ataxia ; medial - ipsilateral limb ataxia and contralateral eye deviation and paralysis of face - arm and leg
Beta interferon and glatiramer acetate; they are teratogenic; contraception should be advised

6. earliest sign of phenytoin toxicity
Nystagmus on far lateral gaze
Aphasia - neglect - agnosia - acalculia etc
Beta interferon and glatiramer acetate; they are teratogenic; contraception should be advised
Follows viral illness; vertigo - tinnitus - nausea. self limiting

7. Tx of bells palsy
Corticosteroid and acyclovir
MS: CSF increased IgG -IgM and IgA also increased. not specific to MS
Entacapone - COMT inhibitor
Despite the term neuroma they arise from schwann cells - schwanoma

8. construction worker works in squatting position; now develop decreased sensation over anterolateral thigh
Reduced efficacy of OCP
MS
MS: CSF increased IgG -IgM and IgA also increased. not specific to MS
Injury to lateral femoral cutaneous nerve; small sensory nerve direct branch of lumbar plexus; meralgia paresthetica

9. How to confirm braindeath?
First nerulogical exam must demonstrate absent cerebral and brainstem reflexes; absent motor response to pain - absent pupillary reflex - corneal reflex - cough reflex - and tracheal suctioning; then apnea test.
Taper gradually to prevent seizure relapse
Aphasia - neglect - agnosia - acalculia etc
Pure motor lacunar stroke; aspirin failure; give more aggressive antiplatelet therapy with clopidogrel

10. women with unilateral eye pain; neurlogic symptoms here there at different times
Cluster; l for lacrimation - you for unilateral; episodes occur in cluster/grops; each last 30 min to 3h; c for conjunctival injection; r for retroorbital pain/rhinorhoea
In BET - no resting tremor (tremor worsens at rest and improves with acitivity) - bradykinesia or slowing in voluntary movement; gait difficulty; have positive family hx
Construction apraxia; lesion in non dominant parietal lobe (right)
MS: CSF increased IgG -IgM and IgA also increased. not specific to MS

11. drags leg forward in every steps - no knee flexion; hip flexion and straight legs
Difficulty in understanding spoken or written language; difficulty in expressing thoughts in a meaningful manner
Myasthenia; due to autoantibodies against acetylecholine receptor;
Frontotemporal: weird behviors - NPH: incontinence - enlarged ventricls - gait prob; vascular: gradually progressive - mild dementia; Lewy body: l for hallucination +parkinsonism l
Spastic paraparesis

12. MMSE score of less than 24
Propranolol or primidone
Gilberts disease
Both slowly progressive; huntington with abrupt jerk of limb - trunk - grimacing - other abnormal movement - picks are irritable - quiet - sucks lip frequently and have symmetric atrophy of frontal/temporal lobes
82% specific for dementia

13. What is can be used cluster headache prevention
Femoral n lesion
Verapamil
Acute attack; tx with 100% O2; other options are sumatriptan sq/intranasal; ergot - NSAID
Progressive paralysis in GBS; absent DTR - flaccid paralysis; then resp failure

14. How to differentiate medial and lateral pontine syndrome
First 3 to 4.5 hours following symptom onset; CT scan should be done first to r/o intracranial hemorrahge
Lateral involve trigeminal which has L and has limb ataxia ; medial - ipsilateral limb ataxia and contralateral eye deviation and paralysis of face - arm and leg
Injury to lateral femoral cutaneous nerve; small sensory nerve direct branch of lumbar plexus; meralgia paresthetica
Lesion in nondominant temporal lobe

15. When headache is presenting complaint of brain tumor
Severe flaccid paralysis - patient on mech ventilation; bubar palsy; resp failure
Lateral involve trigeminal which has L and has limb ataxia ; medial - ipsilateral limb ataxia and contralateral eye deviation and paralysis of face - arm and leg
Bilateral but worse unilateral - morning headache - n/v - headache worsened by bending - night awakening
Younger patients <60yrs due to concerns about long term efficacy and s/e levodopa

16. How to stop antiepileptic drugs
MS
90% of right handed and 60% of left handed persons; speech and language function
Taper gradually to prevent seizure relapse
Preoxygenate and then disconnect ventilator - absence of respiratory drive for 8-10 min with PCO2 >60 pH <7.28 suggest positive apnea test

17. indication of plasmapheresis in GBS
L for l ; lewy has lots of hallucination; parkinsonism like features - falls are common; presence lewy body in cytosplasm of brain cells; vascular demential develop very suddenly; hx dm -htn - athero
Taper gradually to prevent seizure relapse
HTN upto 220/120 permitted in patient who did n't receive thrombolytic therapy
Severe flaccid paralysis - patient on mech ventilation; bubar palsy; resp failure

18. severe headache and high BP
Do CT scan at first to r/o SAH - if ct neg lumbar puncture
Both in alcoholic; wernicke develop at first with horizontal nystagmus - and ataxia; if not treated they develop memory loss and psychosis which is named korsakoff
Difficulty in writing - calculating - distinguishing left and write
First 3 to 4.5 hours following symptom onset; CT scan should be done first to r/o intracranial hemorrahge

19. oligoclonal band in CSF
MS
Spontaneous remission; admit if suspected and monitor pulse ox for resp failure
First nerulogical exam must demonstrate absent cerebral and brainstem reflexes; absent motor response to pain - absent pupillary reflex - corneal reflex - cough reflex - and tracheal suctioning; then apnea test.
HTN upto 220/120 permitted in patient who did n't receive thrombolytic therapy

20. double vision at the end of day and ptosis
Diabetes insipidus
First nerulogical exam must demonstrate absent cerebral and brainstem reflexes; absent motor response to pain - absent pupillary reflex - corneal reflex - cough reflex - and tracheal suctioning; then apnea test.
Myasthenia; due to autoantibodies against acetylecholine receptor;
Do CT scan at first to r/o SAH - if ct neg lumbar puncture

21. dominant parietal lobe on the left side
90% of right handed and 60% of left handed persons; speech and language function
Beta interferon and glatiramer acetate; they are teratogenic; contraception should be advised
Femoral n lesion
Pure motor lacunar stroke; aspirin failure; give more aggressive antiplatelet therapy with clopidogrel

22. patient with hx of cluster headache p/w retroorbital pain lacrimation - vomiting suddenly
Younger patients <60yrs due to concerns about long term efficacy and s/e levodopa
Acute attack; tx with 100% O2; other options are sumatriptan sq/intranasal; ergot - NSAID
Spastic paraparesis
Normal pressure hydrocephalus

23. acoustic neuroma
Acetylecholinersterase inhibitors
Spontaneous remission; admit if suspected and monitor pulse ox for resp failure
Despite the term neuroma they arise from schwann cells - schwanoma
Clonidine will take care both high bp and withdrawal

24. Should we tx htn in acute ischemic stroke

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

25. How to tx lewy body dementia
Acetylecholinersterase inhibitors
Cholinesterase inhibitor; and antiparkinsonism drugs
Tick born paralysis fastest manifestation. presents within a day of exposure; no FEVER - csf exam normal
Verapamil

26. cortical lesion
Alzheimers have decreased level acetylecholine due to degeneration of choline acetyltransferase which synthesize acetylecholine; donepezil inhibits breakdown of aceytylecholine thus increases its level
Aphasia - neglect - agnosia - acalculia etc
Antitoxin
Progressive paralysis in GBS; absent DTR - flaccid paralysis; then resp failure

27. get up and go test
Acute attack; tx with 100% O2; other options are sumatriptan sq/intranasal; ergot - NSAID
CT scan - if no bleeding tPA - then freq neurocheck - strict BP control with IV beta blocker; bp should be below 180/105;
Get up from chair walk a short distance turn around and sit; screening test for fall
Botulism has descending paralysis in contrast othere have ascending paralysis

28. impaired perception of complex sounds
Lesion in nondominant temporal lobe
<20; if patient scores >25 benign forgetfulness
HTN upto 220/120 permitted in patient who did n't receive thrombolytic therapy
High dose IV methyleprednisone;

29. Tx of GBS
Xanthochrmia and discoloration of centrifuged CSF due to Hb breakdown; present in 90% of SAH
Both slowly progressive; huntington with abrupt jerk of limb - trunk - grimacing - other abnormal movement - picks are irritable - quiet - sucks lip frequently and have symmetric atrophy of frontal/temporal lobes
Spontaneous remission; admit if suspected and monitor pulse ox for resp failure
High dose IV methyleprednisone;

30. Patient with carbamazepine; What should be advice?
If develop fever - mouth ulcer - easy brusing - petechie - see a doc ; the drug cause neutropenia - and bone marrow suppression; elderly are at risk of SIADH
Younger patients <60yrs due to concerns about long term efficacy and s/e levodopa
L for l ; lewy has lots of hallucination; parkinsonism like features - falls are common; presence lewy body in cytosplasm of brain cells; vascular demential develop very suddenly; hx dm -htn - athero
82% specific for dementia

31. differentiate wenicke and korsakoff
Both in alcoholic; wernicke develop at first with horizontal nystagmus - and ataxia; if not treated they develop memory loss and psychosis which is named korsakoff
Cholinesterase inhibitor; and antiparkinsonism drugs
Status epilepticus-clue is twhiching; seizure lasting longer than 5-10 min; tx benzo after ABC - if fails - phenobarbital or phenytoin
Reduced efficacy of OCP

32. prodrome of vasovagal syncope
Acute attack; tx with 100% O2; other options are sumatriptan sq/intranasal; ergot - NSAID
Cholinesterase inhibitor; and antiparkinsonism drugs
Coronary artery disease
Tunnel vision - diaphoresis - nausea - pallor

33. what drug is used to extend effects of levodopa
CT scan - if no bleeding tPA - then freq neurocheck - strict BP control with IV beta blocker; bp should be below 180/105;
Entacapone - COMT inhibitor
Xanthochrmia and discoloration of centrifuged CSF due to Hb breakdown; present in 90% of SAH
Pt is asked to hold both arms fully extended at shoulder level in front of him with palms upwards; unable to maintain such position means positive test; closing eye will accentuate the effect

34. When to use brain spect scintigraphy to confirm brain death
Uptake K by newly formed mature RBC can lead to severe hypokalemia; serum k should be monitor Q48
Cerebral palsy; dx mri
It patient has electrolyte imbalance and hypothermia
Pineal tumor; parinaud syndrome; some releases hcg which cause precocious puberty

35. best diagnosis for parkinsonim
Construction apraxia; lesion in non dominant parietal lobe (right)
Taper gradually to prevent seizure relapse
Autospy gold standard
Normal pressure hydrocephalus

36. How to tx acute exacerbation of MS
Follows viral illness; vertigo - tinnitus - nausea. self limiting
Develop hypocalcemia (muscle spasms - diaphoresis - bilateral hand contracture); cannot metabolize citrate to lactate
High dose IV methyleprednisone;
Antitoxin

37. botulism
Antitoxin
Corticosteroid and acyclovir
Beta interferon and glatiramer acetate; they are teratogenic; contraception should be advised
Uptake K by newly formed mature RBC can lead to severe hypokalemia; serum k should be monitor Q48

38. How to diffrentiate tick borne paralysis from GBS and spinal cord tumor
Tick born paralysis fastest manifestation. presents within a day of exposure; no FEVER - csf exam normal
Vitamin B12 deficiency
Both slowly progressive; huntington with abrupt jerk of limb - trunk - grimacing - other abnormal movement - picks are irritable - quiet - sucks lip frequently and have symmetric atrophy of frontal/temporal lobes
Both in alcoholic; wernicke develop at first with horizontal nystagmus - and ataxia; if not treated they develop memory loss and psychosis which is named korsakoff

39. brain stem lesion
Beta interferon and glatiramer acetate; they are teratogenic; contraception should be advised
Deficit in cranial nerve function
Wernicke's encephalopathy; due to thiamine definition; medical emergency
Younger patients <60yrs due to concerns about long term efficacy and s/e levodopa

40. at first tingling in toes and feet then weakness in extremities
Progressive paralysis in GBS; absent DTR - flaccid paralysis; then resp failure
Acute attack; tx with 100% O2; other options are sumatriptan sq/intranasal; ergot - NSAID
Difficulty in writing - calculating - distinguishing left and write
Deficit in cranial nerve function

41. contraindication of sumatripta
Gilberts disease
Progressive paralysis in GBS; absent DTR - flaccid paralysis; then resp failure
Tick born paralysis fastest manifestation. presents within a day of exposure; no FEVER - csf exam normal
Coronary artery disease

42. How to perform apnea test
Tick born paralysis fastest manifestation. presents within a day of exposure; no FEVER - csf exam normal
Preoxygenate and then disconnect ventilator - absence of respiratory drive for 8-10 min with PCO2 >60 pH <7.28 suggest positive apnea test
Diabetes insipidus
Cluster; l for lacrimation - you for unilateral; episodes occur in cluster/grops; each last 30 min to 3h; c for conjunctival injection; r for retroorbital pain/rhinorhoea

43. hx of epilepsy - now unresponsive - slight twhiching of mouth and arms
Pt is asked to hold both arms fully extended at shoulder level in front of him with palms upwards; unable to maintain such position means positive test; closing eye will accentuate the effect
Femoral n lesion
Vitamin B12 deficiency
Status epilepticus-clue is twhiching; seizure lasting longer than 5-10 min; tx benzo after ABC - if fails - phenobarbital or phenytoin

44. Unable to copy of matchstick - unable to dress up
Aphasia - neglect - agnosia - acalculia etc
Both slowly progressive; huntington with abrupt jerk of limb - trunk - grimacing - other abnormal movement - picks are irritable - quiet - sucks lip frequently and have symmetric atrophy of frontal/temporal lobes
Construction apraxia; lesion in non dominant parietal lobe (right)
Reduced efficacy of OCP

45. How to differentiate dementias
Gilberts disease
Frontotemporal: weird behviors - NPH: incontinence - enlarged ventricls - gait prob; vascular: gradually progressive - mild dementia; Lewy body: l for hallucination +parkinsonism l
CT scan - if no bleeding tPA - then freq neurocheck - strict BP control with IV beta blocker; bp should be below 180/105;
Obturator n lesion

46. walking like drunken sailor; jerky hesitant and walks in zigzag pattern
MS: CSF increased IgG -IgM and IgA also increased. not specific to MS
Cerebral palsy; dx mri
Antitoxin
Cerebellar lesion

47. craniopharyngioma
Xanthochrmia and discoloration of centrifuged CSF due to Hb breakdown; present in 90% of SAH
Tick born paralysis fastest manifestation. presents within a day of exposure; no FEVER - csf exam normal
Severe flaccid paralysis - patient on mech ventilation; bubar palsy; resp failure
Diabetes insipidus

48. When to start fibrinolytic therapy in stroke patient?
First 3 to 4.5 hours following symptom onset; CT scan should be done first to r/o intracranial hemorrahge
Deficit in cranial nerve function
Lateral involve trigeminal which has L and has limb ataxia ; medial - ipsilateral limb ataxia and contralateral eye deviation and paralysis of face - arm and leg
If develop fever - mouth ulcer - easy brusing - petechie - see a doc ; the drug cause neutropenia - and bone marrow suppression; elderly are at risk of SIADH

49. medial thigh sensory loss and weakness in addcution
Distal lower motor neuron disease
Lateral involve trigeminal which has L and has limb ataxia ; medial - ipsilateral limb ataxia and contralateral eye deviation and paralysis of face - arm and leg
Obturator n lesion
Alzheimers have decreased level acetylecholine due to degeneration of choline acetyltransferase which synthesize acetylecholine; donepezil inhibits breakdown of aceytylecholine thus increases its level

50. excessive elevation of legs during walking (toe touch floor earlier than heels)
Aphasia - neglect - agnosia - acalculia etc
Distal lower motor neuron disease
Despite the term neuroma they arise from schwann cells - schwanoma
Entacapone - COMT inhibitor

Sorry!:) No result found.

Can you answer 50 questions in 15 minutes?

Major Subjects
Tests & Exams AP CLEP DSST GRE SAT GMAT	Certifications CISSP go to https://www.isc2.org/ PMP ITIL RHCE MCTS More...	IT Skills Android Programming Data Modeling Objective C Programming Basic Python Programming Adobe Illustrator More...	Business Skills Advertising Techniques Business Accounting Basics Business Strategy Human Resource Management Marketing Basics More...
Soft Skills Body Language People Skills Public Speaking Persuasion Job Hunting And Resumes More...	Vocabulary GRE Vocab SAT Vocab TOEFL Essential Vocab Basic English Words For All Global Words You Should Know Business English More...	Languages AP German Vocab AP Latin Vocab SAT Subject Test: French Italian Survival Norwegian Survival More...	Engineering Audio Engineering Computer Science Engineering Aerospace Engineering Chemical Engineering Structural Engineering More...
Health Sciences Basic Nursing Skills Health Science Language Fundamentals Veterinary Technology Medical Language Cardiology Clinical Surgery More...	English Grammar Fundamentals Literary And Rhetorical Vocab Elements Of Style Vocab Introduction To English Major Complete Advanced Sentences Literature Homonyms More...	Math Algebra Formulas Basic Arithmetic: Measurements Metric Conversions Geometric Properties Important Math Facts Number Sense Vocab Business Math More...	Other Major Subjects Science Economics History Law Performing-arts Cooking Logic & Reasoning Trivia

Test your basic knowledge |

USMLE Step3 Neurology

Sorry!:) No result found.

Can you answer 50 questions in 15 minutes?

Let me suggest you:

Browse all subjects

Browse all tests

Most popular tests

Major Subjects

Tests & Exams

Certifications

IT Skills

Business Skills

Soft Skills

Vocabulary

Languages

Engineering

Health Sciences

English

Math

Other Major Subjects

Browse all subjects

Browse all tests

Most popular tests