Neurology Practice Questions

Q: All of the following are used for the graduation of coma using the Glasgow Coma Scale, except?

Heart rate. The **Glasgow Coma Scale (GCS)** is a standardized clinical tool used to assess the level of consciousness and the severity of brain injury [1], [2]. It is based on three objective clinical parameters: **Eye opening (E)**, **Verbal response (V)**, and **Motor response (M)**. ### Explanation of Options: * **Heart Rate (Correct Answer):** Heart rate is a vital sign, not a component of the GCS [2]. While changes in heart rate (e.g., bradycardia in Cushing’s triad) can indicate increased intracranial pressure, it is not used to calculate the GCS score. * **Eye Opening (A):** Scored from 1 to 4. It assesses the brainstem's reticular activating system. * **Verbal Response (C):** Scored from 1 to 5. It assesses central nervous system integration and orientation. * **Motor Response (B):** Scored from 1 to 6. It is the most significant predictor of clinical outcome. ### High-Yield Clinical Pearls for NEET-PG: * **Score Range:** The total GCS score ranges from a **minimum of 3** (deep coma or death) to a **maximum of 15** (fully awake). There is no score of 0. * **Severity Grading:** * **Mild:** 13–15 [1] * **Moderate:** 9–12 [1] * **Severe (Coma):** ≤ 8 [1] * **Mnemonic:** *"GCS of 8, Intubate"* — Patients with a score of 8 or less usually require airway protection. * **Modified GCS:** For intubated patients, the verbal score is replaced with 'T' (e.g., E4VTM6). * **GCS-P:** A newer variant that includes **Pupillary reactivity** to better predict prognosis in neurocritical care.

Q: Wernicke-Korsakoff syndrome is characterized by all of the following except?

Loss of remote memory. **Explanation:** Wernicke-Korsakoff Syndrome (WKS) is a spectrum of neurological disorders caused by **Thiamine (Vitamin B1) deficiency**, most commonly seen in chronic alcoholics [2]. It consists of two phases: Wernicke Encephalopathy (acute) and Korsakoff Syndrome (chronic) [1]. **Why "Loss of remote memory" is the correct answer:** In Korsakoff Syndrome, the hallmark memory deficit is **anterograde amnesia** (inability to form new memories) and **retrograde amnesia** (loss of recent past memories) [1]. Crucially, **remote memory** (long-term memories from childhood or many years ago) is typically **preserved**. Patients often use **confabulation** (filling memory gaps with fabricated stories) to compensate for these deficits. **Analysis of incorrect options:** * **A. Ataxia:** This is a classic component of the Wernicke triad [1]. It manifests as a wide-based gait due to cerebellar vermis degeneration. * **B. Paralysis of ocular muscles:** Ophthalmoplegia (specifically weakness of the lateral rectus/6th nerve palsy) and nystagmus are key diagnostic signs of acute Wernicke Encephalopathy [1]. * **D. Global confusion:** An altered mental state, ranging from mild disorientation to profound encephalopathy, is the third component of the classic triad [1]. **NEET-PG High-Yield Pearls:** 1. **The Classic Triad:** Confusion, Ataxia, and Ophthalmoplegia (Goes by the mnemonic **CAN**: **C**onfusion, **A**taxia, **N**ystagmus). 2. **Pathology:** Characterized by symmetrical lesions/petechial hemorrhages in the **mammillary bodies** and periaqueductal gray matter [3]. 3. **Treatment Rule:** Always administer **Thiamine before Glucose**. Giving IV Glucose first in a thiamine-deficient patient can precipitate or worsen Wernicke Encephalopathy by exhausting remaining thiamine stores during glycolysis. 4. **MRI Finding:** Increased T2/FLAIR signal intensity in the mammillary bodies and dorsomedial thalamus.

Q: Gustatory hallucination is most commonly associated with which condition?

Temporal lobe epilepsy. **Explanation:** **Temporal lobe epilepsy (TLE)** is the correct answer because gustatory hallucinations (perceiving tastes that aren't there, often metallic or unpleasant) are a classic manifestation of **uncinate fits**. These occur when an epileptic focus involves the **uncus** or the **primary gustatory cortex** (located in the insula and the opercular part of the frontal/parietal lobes). Since the temporal lobe houses the limbic system and olfactory/gustatory processing areas, irritation here frequently results in sensory "auras" [1]. **Analysis of Incorrect Options:** * **Schizophrenia:** While auditory hallucinations are hallmark features, gustatory and olfactory hallucinations are rare and should always prompt an investigation for organic brain pathology. * **Delirium Tremens:** This severe form of alcohol withdrawal is most characteristically associated with **visual hallucinations** (e.g., seeing small animals or insects) and tactile hallucinations (formication), rather than taste. * **Cotard’s Syndrome:** This is a rare neuropsychiatric condition (nihilistic delusion) where the patient believes they are dead, rotting, or do not exist. It is not primarily associated with sensory hallucinations of taste. **High-Yield Clinical Pearls for NEET-PG:** * **Uncinate Fits:** Characterized by a triad of olfactory/gustatory hallucinations, a "dreamy state," and involuntary movements like lip-smacking (automatisms). * **Primary Gustatory Cortex:** Located in the **Insula** and **Frontal Operculum** (Brodmann area 43). * **Most common aura in TLE:** Epigastric rising sensation, followed by olfactory/gustatory disturbances [1]. * **Foster Kennedy Syndrome:** Anosmia (olfactory loss) due to a frontal lobe tumor, often confused with sensory disturbances in exams.

Question 1

A 23-year-old woman presents with arm weakness, decreasing vision in her right eye, and difficulty with her balance. An MRI of the brain reveals multiple demyelinating lesions. For the above patient with neurologic symptoms, select the most likely structural pathology.

Accepted Answer

Infectious process

Answer

Aqueductal stenosis

Answer

Enlarged foramina of Luschka

Answer

Agenesis of the corpus callosum

Question 2

A 70-year-old man presents with progressive memory loss, urinary incontinence, and gait instability. MRI of the brain reveals dilatation of the ventricular cavities with normal cerebral sulci. No infarcts are observed. Cerebrospinal fluid (CSF) analysis shows occasional increases in CSF pressure. A biopsy of the frontal cortex demonstrates the absence of neurofibrillary tangles and senile plaques. What is the most appropriate treatment for this patient?

Accepted Answer

Ventricular shunt

Answer

Acetylcholinesterase inhibitors

Answer

Aspirin

Answer

L-DOPA

Question 3

A 25-year-old male presents with generalized restriction of eye movement in all directions, intermittent ptosis, and proximal muscle weakness with fatigability. What is the most useful diagnostic test?

Accepted Answer

Edrophonium test

Answer

Creatine phosphokinase (CPK)

Answer

Electromyography (EMG)

Answer

Muscle biopsy

Question 4

Metabolic encephalopathy typically presents with which of the following neurological deficits?

Accepted Answer

Anomic aphasia

Answer

Broca's aphasia

Answer

Transcortical sensory aphasia

Answer

Transcortical motor aphasia

Question 5

All of the following are used for the graduation of coma using the Glasgow Coma Scale, except?

Accepted Answer

Heart rate

Answer

Eye opening

Answer

Motor response

Answer

Verbal response

Question 6

Wernicke-Korsakoff syndrome is characterized by all of the following except?

Accepted Answer

Loss of remote memory

Answer

Ataxia

Answer

Paralysis of ocular muscles

Answer

Global confusion

Question 7

Gustatory hallucination is most commonly associated with which condition?

Accepted Answer

Temporal lobe epilepsy

Answer

Schizophrenia

Answer

Delirium tremens

Answer

Cotard's syndrome

Question 8

Which of the following conditions is characterized by the absence of cardiomyopathy?

Accepted Answer

Becker Dystrophy

Answer

Duchenne Muscular Dystrophy

Answer

Myotonic Dystrophy

Answer

Myasthenia Gravis

Question 9

Which of the following statements about Alzheimer's disease is false?

Accepted Answer

Down's syndrome is associated with an increased risk of Alzheimer's disease.

Answer

Neurofibrillary tangles and senile plaques containing Ab amyloid are characteristic pathological findings.

Answer

The hippocampus is severely affected, leading to memory impairment.

Answer

Capgras syndrome is a rare delusion that may occur in patients with Alzheimer's disease.

Question 10

Triple H therapy for subarachnoid hemorrhage consists of all the following except?

Accepted Answer

Hypothermia

Answer

Hypertension

Answer

Hypervolemia

Answer

Hemodilution

Neurology — MCQs

Neurology — MCQs

On this page

Practice by Chapter

Want unlimited practice?