Neurology Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Neurology. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Neurology Indian Medical PG Question 1: A 45-year-old man presents with weakness in his right arm and slurred speech that started suddenly 2 hours ago. Which diagnostic test is most appropriate to confirm the diagnosis?
- A. Nerve conduction study
- B. Electroencephalogram (EEG)
- C. CT scan of the head (Correct Answer)
- D. MRI of the spine
Neurology Explanation: ***CT scan of the head***
- A **CT scan of the head** is the most appropriate initial diagnostic test for sudden onset neurological deficits like **weakness** and **slurred speech** to rule out an acute intracranial hemorrhage or ischemic stroke [1].
- It is rapid, widely available, and crucial for guiding immediate management decisions [1].
*Nerve conduction study*
- **Nerve conduction studies** are used to evaluate the function of peripheral nerves and muscles, typically for conditions like **neuropathy** or myasthenia gravis, which are not suggested by the acute, focal central nervous system symptoms.
- These studies would not provide time-sensitive information about an acute stroke or hemisphere.
*Electroencephalogram (EEG)*
- An **EEG** measures electrical activity in the brain and is primarily used to diagnose **seizure disorders**, sleep disorders, or assess altered mental status.
- It is not indicated for the initial evaluation of sudden focal neurological deficits such as stroke.
*MRI of the spine*
- An **MRI of the spine** is used to visualize the spinal cord and surrounding structures to diagnose conditions like **spinal cord compression**, disc herniation, or myelitis.
- The patient's symptoms of right arm weakness and slurred speech clearly localize to the brain, not the spine.
Neurology Indian Medical PG Question 2: Superior temporal gyrus lesion leads to?
- A. Anomic aphasia
- B. Broca's aphasia
- C. Wernicke's aphasia (Correct Answer)
- D. Non-fluent aphasia
Neurology Explanation: ***Wernicke's aphasia***
- A lesion in the **superior temporal gyrus** (Wernicke's area) leads to Wernicke's aphasia, characterized by impaired **comprehension of language** [1].
- Patients with Wernicke's aphasia exhibit **fluent but meaningless speech** (word salad) and are often unaware of their deficits [1].
*Anomic aphasia*
- Characterized by difficulty finding words, particularly nouns and verbs, and is often associated with lesions in the **angular gyrus** or **temporal lobe** [1].
- Speech remains fluent and grammatically correct, but it is marked by frequent pauses and circumlocutions as the individual struggles to retrieve specific words.
*Broca's aphasia*
- Results from damage to **Broca's area** in the posterior inferior frontal gyrus, causing **non-fluent speech** and difficulty with speech production [1].
- While comprehension is relatively preserved, patients struggle to form complete sentences and may exhibit agrammatism.
*Non-fluent aphasia*
- A broad category of aphasias, including Broca's aphasia, where speech production is notably impaired, and the output is effortful and characterized by **agrammatism** and **short, telegraphic sentences**.
- **Wernicke's aphasia** is typically considered a **fluent aphasia**, as speech production itself is not interrupted, though its content is often incomprehensible [1].
Neurology Indian Medical PG Question 3: Frontal gyrus lesion leads to?
- A. Nominal aphasia
- B. Akinetic mutism
- C. Wernicke's aphasia
- D. Broca's aphasia (Correct Answer)
Neurology Explanation: ***Broca's aphasia***
- A lesion in the **frontal gyrus**, specifically **Broca's area** (Brodmann areas 44 and 45), leads to Broca's aphasia [1].
- This condition is characterized by **non-fluent speech**, difficulty with articulation, and telegraphic sentences, while comprehension remains relatively intact [1].
*Nominal aphasia*
- This is also known as **anomic aphasia**, characterized primarily by difficulty with **word finding** (naming objects).
- It results from lesions in various cortical areas, but typically not isolated to Broca's area in the frontal gyrus.
*Akinetic mutism*
- This condition involves a state of **unresponsiveness** where the patient is awake but does not move or speak.
- It usually results from lesions in the **cingulate gyrus**, basal ganglia, or medial frontal lobes, often bilateral, not typically a solitary frontal gyrus lesion.
*Wernicke's aphasia*
- Wernicke's aphasia results from damage to **Wernicke's area**, located in the **posterior superior temporal gyrus** [1].
- It is characterized by **fluent but nonsensical speech** with impaired comprehension [1].
Neurology Indian Medical PG Question 4: Which of the following antiepileptic drugs is preferred for treating generalized tonic-clonic seizures?
- A. Ethosuximide
- B. Gabapentin
- C. Valproic acid (Correct Answer)
- D. Carbamazepine
Neurology Explanation: ***Valproic acid***
- **Valproic acid** is a broad-spectrum antiepileptic drug effective against various seizure types, including **generalized tonic-clonic seizures**.
- It is considered the **gold standard** for generalized seizures because it is effective against all types (absence, myoclonic, and tonic-clonic).
- It works by increasing GABA levels, blocking voltage-gated sodium channels, and inhibiting T-type calcium channels.
*Ethosuximide*
- **Ethosuximide** is specifically used for **absence seizures** (petit mal) and is not effective for generalized tonic-clonic seizures.
- It primarily acts by blocking **T-type calcium channels** in the thalamus.
*Gabapentin*
- **Gabapentin** is primarily used for **focal (partial) seizures** and neuropathic pain, not generalized tonic-clonic seizures.
- Its mechanism involves modulating the release of neurotransmitters, possibly by binding to the **α2δ subunit of calcium channels**.
*Carbamazepine*
- **Carbamazepine** is a first-line treatment for **focal (partial) seizures** and is also effective for **generalized tonic-clonic seizures**, though valproic acid is generally preferred for purely generalized seizures.
- It works by blocking voltage-gated sodium channels.
- It should be **avoided in absence and myoclonic seizures** as it can worsen these seizure types.
- Also used for **trigeminal neuralgia**.
Neurology Indian Medical PG Question 5: Glasgow coma scale of a patient with head injury who is confused, localizes to pain on the right side but shows abnormal flexion on the left side, and opens eyes only to painful stimuli on sternum:
- A. 11 (Correct Answer)
- B. 12
- C. 6
- D. 7
Neurology Explanation: ***11***
- The Glasgow Coma Scale (GCS) score is calculated by summing the scores for **Eye Response**, **Verbal Response**, and **Motor Response**.
- In this case: **Eye Response = 2** (opens eyes to painful stimuli), **Verbal Response = 4** (confused), and **Motor Response = 5** (localizes to pain on the right side).
- **Key principle**: When there is **asymmetric motor response**, the **best motor response** is used for GCS calculation, not the worse response or an average.
- Right side localizes to pain (M5) and left side shows abnormal flexion (M3), so we use M5.
- **Total GCS = E2 + V4 + M5 = 11**
*12*
- This score would require a better response in at least one GCS component than what is described.
- For a GCS of 12, the patient would need either: eyes opening to voice (E3), or obeys commands for motor (M6), or no confusion (V5).
- The given patient has E2 + V4 + M5, which totals to 11, not 12.
*6*
- A score of 6 indicates **severe neurological impairment**, much worse than the described patient.
- A GCS of 6 might include: no eye opening (E1) + incomprehensible sounds (V2) + abnormal flexion (M3) = 6.
- This is significantly worse than the patient's current state with localizing response and confused speech.
*7*
- A GCS of 7 also represents **severe neurological deficit**, though not as profound as a score of 6.
- This score would typically involve lower responses such as: E1 + V2 + M4 (withdrawal to pain) = 7, or E2 + V1 + M4 = 7.
- The described patient has better responses (E2 + V4 + M5 = 11) than this would indicate.
More Neurology Indian Medical PG questions available in the OnCourse app. Practice MCQs, flashcards, and get detailed explanations.
