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. anerior and anteriomedial thigh paresthesia - decreased DTR
Femoral n lesion
Lesion in nondominant temporal lobe
Spastic paraparesis
Tunnel vision - diaphoresis - nausea - pallor

2. How to stop antiepileptic drugs
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
Taper gradually to prevent seizure relapse
<20; if patient scores >25 benign forgetfulness
Cholinesterase inhibitor; and antiparkinsonism drugs

3. How to confirm braindeath?
Aphasia - neglect - agnosia - acalculia etc
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.
Younger patients <60yrs due to concerns about long term efficacy and s/e levodopa

4. best diagnosis for parkinsonim
MS: CSF increased IgG -IgM and IgA also increased. not specific to MS
Tunnel vision - diaphoresis - nausea - pallor
Autospy gold standard
Develop hypocalcemia (muscle spasms - diaphoresis - bilateral hand contracture); cannot metabolize citrate to lactate

5. prodrome of vasovagal syncope
MCA stroke; if comes in < 3-4.5 h - do CT and if neg give tPA
Get up from chair walk a short distance turn around and sit; screening test for fall
Tunnel vision - diaphoresis - nausea - pallor
High dose IV methyleprednisone;

6. contraindication of sumatripta
Coronary artery disease
Nystagmus on far lateral gaze
Not within 24 hours; give afte 24-48 hours if patient stable
Xanthochrmia and discoloration of centrifuged CSF due to Hb breakdown; present in 90% of SAH

7. severe headache and high BP
Do CT scan at first to r/o SAH - if ct neg lumbar puncture
Femoral n lesion
Antitoxin
Spontaneous remission; admit if suspected and monitor pulse ox for resp failure

8. How to tx acute exacerbation of MS
Wernicke's encephalopathy; due to thiamine definition; medical emergency
Distal lower motor neuron disease
Clonidine will take care both high bp and withdrawal
High dose IV methyleprednisone;

9. get up and go test
Acute attack; tx with 100% O2; other options are sumatriptan sq/intranasal; ergot - NSAID
Uptake K by newly formed mature RBC can lead to severe hypokalemia; serum k should be monitor Q48
Get up from chair walk a short distance turn around and sit; screening test for fall
Younger patients <60yrs due to concerns about long term efficacy and s/e levodopa

10. benign essential tremor
It patient has electrolyte imbalance and hypothermia
Femoral n lesion
82% specific for dementia
Propranolol or primidone

11. at first tingling in toes and feet then weakness in extremities
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
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
Progressive paralysis in GBS; absent DTR - flaccid paralysis; then resp failure
Construction apraxia; lesion in non dominant parietal lobe (right)

12. phenytoin and OCP
Reduced efficacy of OCP
Diabetes insipidus
Pineal tumor; parinaud syndrome; some releases hcg which cause precocious puberty
Progressive paralysis in GBS; absent DTR - flaccid paralysis; then resp failure

13. How to diffrentiate tick borne paralysis from GBS and spinal cord tumor
First 3 to 4.5 hours following symptom onset; CT scan should be done first to r/o intracranial hemorrahge
Aphasia - neglect - agnosia - acalculia etc
Diabetes insipidus
Tick born paralysis fastest manifestation. presents within a day of exposure; no FEVER - csf exam normal

14. excessive elevation of legs during walking (toe touch floor earlier than heels)
Despite the term neuroma they arise from schwann cells - schwanoma
Acetylecholinersterase inhibitors
Normal pressure hydrocephalus
Distal lower motor neuron disease

15. 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

16. What is can be used cluster headache prevention
Verapamil
Entacapone - COMT inhibitor
Lesion in nondominant temporal lobe
Difficulty in writing - calculating - distinguishing left and write

17. What bp med to be given in a patient with high bp and signs of opioid withdrawal
Clonidine will take care both high bp and withdrawal
Difficulty in writing - calculating - distinguishing left and write
Pure motor lacunar stroke; aspirin failure; give more aggressive antiplatelet therapy with clopidogrel
<20; if patient scores >25 benign forgetfulness

18. When to use dopamine agonist pramipexol in parkinson
Uptake K by newly formed mature RBC can lead to severe hypokalemia; serum k should be monitor Q48
Younger patients <60yrs due to concerns about long term efficacy and s/e levodopa
Not within 24 hours; give afte 24-48 hours if patient stable
Pure motor lacunar stroke; aspirin failure; give more aggressive antiplatelet therapy with clopidogrel

19. How to differentiate medial and lateral pontine syndrome
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
Diabetes insipidus
Bilateral but worse unilateral - morning headache - n/v - headache worsened by bending - night awakening
Coronary artery disease

20. How to tx lewy body dementia
Cholinesterase inhibitor; and antiparkinsonism drugs
CT scan - if no bleeding tPA - then freq neurocheck - strict BP control with IV beta blocker; bp should be below 180/105;
Aspirin - control HTN and swallow eval before giving any oral meds
Distal lower motor neuron disease

21. cortical lesion
IVIG and plasmapheresis
Cerebral palsy; dx mri
Aphasia - neglect - agnosia - acalculia etc
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

22. how donepezil - acetylecholinsterase inhibitor works in Alzheimers
Antitoxin
Alzheimers have decreased level acetylecholine due to degeneration of choline acetyltransferase which synthesize acetylecholine; donepezil inhibits breakdown of aceytylecholine thus increases its level
20%
Status epilepticus-clue is twhiching; seizure lasting longer than 5-10 min; tx benzo after ABC - if fails - phenobarbital or phenytoin

23. drags leg forward in every steps - no knee flexion; hip flexion and straight legs
Spastic paraparesis
Nystagmus on far lateral gaze
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
Wernicke's encephalopathy; due to thiamine definition; medical emergency

24. differentiate wenicke and korsakoff
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
First 3 to 4.5 hours following symptom onset; CT scan should be done first to r/o intracranial hemorrahge
RBC count >6000
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

25. differentiate picks and huntington
Alzheimers have decreased level acetylecholine due to degeneration of choline acetyltransferase which synthesize acetylecholine; donepezil inhibits breakdown of aceytylecholine thus increases its level
Frontotemporal: weird behviors - NPH: incontinence - enlarged ventricls - gait prob; vascular: gradually progressive - mild dementia; Lewy body: l for hallucination +parkinsonism l
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
Follows viral illness; vertigo - tinnitus - nausea. self limiting

26. When to start fibrinolytic therapy in stroke patient?
Wernicke's encephalopathy; due to thiamine definition; medical emergency
First 3 to 4.5 hours following symptom onset; CT scan should be done first to r/o intracranial hemorrahge
Develop hypocalcemia (muscle spasms - diaphoresis - bilateral hand contracture); cannot metabolize citrate to lactate
Lesion in nondominant temporal lobe

27. How to differentiate botulism from tick born paralysis - GBS and MG
Botulism has descending paralysis in contrast othere have ascending paralysis
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
Aphasia - neglect - agnosia - acalculia etc
Autospy gold standard

28. walking like drunken sailor; jerky hesitant and walks in zigzag pattern
90% of right handed and 60% of left handed persons; speech and language 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
Cerebellar lesion
Normal pressure hydrocephalus

29. How to differentiate parkinson and benign essential tremor
Cholinesterase inhibitor; and antiparkinsonism drugs
First 3 to 4.5 hours following symptom onset; CT scan should be done first to r/o intracranial hemorrahge
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
CT scan - if no bleeding tPA - then freq neurocheck - strict BP control with IV beta blocker; bp should be below 180/105;

30. Most effective to reduce aspiration in stroke or patient with swallowing dysfunction
Upright supine position
MS
EPV - campylobacter - HSV
Femoral n lesion

31. impaired hepatic conjugation of billirubin
Gilberts disease
It patient has electrolyte imbalance and hypothermia
Spontaneous remission; admit if suspected and monitor pulse ox for resp failure
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

32. GBS
IVIG and plasmapheresis
Despite the term neuroma they arise from schwann cells - schwanoma
82% specific for dementia
CT scan - if no bleeding tPA - then freq neurocheck - strict BP control with IV beta blocker; bp should be below 180/105;

33. medial thigh sensory loss and weakness in addcution
Obturator n lesion
Myasthenia; due to autoantibodies against acetylecholine receptor;
Aspirin - control HTN and swallow eval before giving any oral meds
Pineal tumor; parinaud syndrome; some releases hcg which cause precocious puberty

34. craniopharyngioma
Wernicke's encephalopathy; due to thiamine definition; medical emergency
Diabetes insipidus
Upright supine position
Construction apraxia; lesion in non dominant parietal lobe (right)

35. hx of epilepsy - now unresponsive - slight twhiching of mouth and arms
Status epilepticus-clue is twhiching; seizure lasting longer than 5-10 min; tx benzo after ABC - if fails - phenobarbital or phenytoin
Frontotemporal: weird behviors - NPH: incontinence - enlarged ventricls - gait prob; vascular: gradually progressive - mild dementia; Lewy body: l for hallucination +parkinsonism l
Tick born paralysis fastest manifestation. presents within a day of exposure; no FEVER - csf exam normal
Lesion in nondominant temporal lobe

36. 2 yr old child with developmental delay; crawing at 11m; scissoring gait
Construction apraxia; lesion in non dominant parietal lobe (right)
MS
If glucose is given instead of thiamin in korsakoff psychosis; patient confabulate to fill gaps in memory; mamilary bodies affected; DX mri-increased enhancement
Cerebral palsy; dx mri

37. What mmse score suggest dementia
<20; if patient scores >25 benign forgetfulness
Deficit in cranial nerve function
Injury to lateral femoral cutaneous nerve; small sensory nerve direct branch of lumbar plexus; meralgia paresthetica
Distal lower motor neuron disease

38. How to differentiate traumatic LP and SAH
Xanthochrmia and discoloration of centrifuged CSF due to Hb breakdown; present in 90% of SAH
Autospy gold standard
MS
HTN upto 220/120 permitted in patient who did n't receive thrombolytic therapy

39. headache - non reactive pupil - fall on both sides during walking - impaired upward gaze
Develop hypocalcemia (muscle spasms - diaphoresis - bilateral hand contracture); cannot metabolize citrate to lactate
Taper gradually to prevent seizure relapse
MS: CSF increased IgG -IgM and IgA also increased. not specific to MS
Pineal tumor; parinaud syndrome; some releases hcg which cause precocious puberty

40. infections in GBS
EPV - campylobacter - HSV
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
Nystagmus on far lateral gaze
Construction apraxia; lesion in non dominant parietal lobe (right)

41. brain stem lesion
Alzheimers have decreased level acetylecholine due to degeneration of choline acetyltransferase which synthesize acetylecholine; donepezil inhibits breakdown of aceytylecholine thus increases its level
Obturator n lesion
Pure motor lacunar stroke; aspirin failure; give more aggressive antiplatelet therapy with clopidogrel
Deficit in cranial nerve function

42. How to prevent prevent frequency of MS exacerbation
Beta interferon and glatiramer acetate; they are teratogenic; contraception should be advised
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.
Cerebral palsy; dx mri
Construction apraxia; lesion in non dominant parietal lobe (right)

43. How to perform apnea test
Preoxygenate and then disconnect ventilator - absence of respiratory drive for 8-10 min with PCO2 >60 pH <7.28 suggest positive apnea test
CT scan - if no bleeding tPA - then freq neurocheck - strict BP control with IV beta blocker; bp should be below 180/105;
Cerebral palsy; dx mri
Obturator n lesion

44. women with unilateral eye pain; neurlogic symptoms here there at different times
Cerebellar lesion
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.
MS: CSF increased IgG -IgM and IgA also increased. not specific to MS
Reduced efficacy of OCP

45. indication of plasmapheresis in GBS
Severe flaccid paralysis - patient on mech ventilation; bubar palsy; resp failure
Do CT scan at first to r/o SAH - if ct neg lumbar puncture
Get up from chair walk a short distance turn around and sit; screening test for fall
Lesion in nondominant temporal lobe

46. oligoclonal band in CSF
High dose IV methyleprednisone;
RBC count >6000
MS
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

47. How to tx stroke patient came after 6h
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.
Aspirin - control HTN and swallow eval before giving any oral meds
Uptake K by newly formed mature RBC can lead to severe hypokalemia; serum k should be monitor Q48
Not within 24 hours; give afte 24-48 hours if patient stable

48. differentiate lewy body dementia and vascular dementia
Construction apraxia; lesion in non dominant parietal lobe (right)
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
Upright supine position
Botulism has descending paralysis in contrast othere have ascending paralysis

49. Unable to copy of matchstick - unable to dress up
Botulism has descending paralysis in contrast othere have ascending paralysis
Construction apraxia; lesion in non dominant parietal lobe (right)
High dose IV methyleprednisone;
Progressive paralysis in GBS; absent DTR - flaccid paralysis; then resp failure

50. alcoholic p/w confusion - ataxia - tremor - nystamgus

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

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