10 USMLE Neurology, Physiology and Endocrine Quick Review Questions with Answers (Set 1)

These 10 quick USMLE review questions test high-yield facts that show up again and again on the exam: Wernicke encephalopathy, GnRH, myasthenia gravis, Golgi tendon organs, ADH, creatinine clearance, hydrocephalus after meningitis, diffuse axonal injury, hypopituitarism and thyroid hormone. Each question includes the correct answer.

Written by Dr. Ray Makar, MD, author of the Repeated USMLE Questions eBook series.

Prefer video? Watch daily USMLE case questions on MedFocus by Dr. Ray on YouTube.

How to use this page: read the question, pick your answer, then tap Show Answer and Explanation.

Questions

Question 1. Foci of hemorrhage and necrosis in which of the following parts of the brain is characteristic of Wernicke’s encephalopathy?

A- Anterior pituitary
B- Basal ganglia
C- Mamillary bodies
D- Posterior pituitary

C- Mamillary bodies- This disease is common in alcoholics and characterized by foci of hemorrhage in mamillary bodies and around ventricular regions of thalamus and hypothalamus.
The correct answer is C

 

Question 2. Gonadotropin-releasing hormone is produced by which of the following nuclei of hypothalamus?

A- Anterior nucleus
B- Arcuate nucleus
C- Dorsomedial nucleus
D- Ventromedial nucleus

B- Arcuate nucleus- It produces dopamine, corticotropin-releasing hormone, GH releasing hormone, thyrotropin-releasing hormone and somatostatin.
The correct answer is B

 

Question 3. An old woman is having difficulty in holding or keeping her head up. She also mentions that she experiences fatigue in her hands shortly after washing dishes. Physical examination reveals neck flexion weakness as well as proximal weakness in the arms. Which of the following is the initial diagnosis for her condition?

A- Meningitis
B- Myasthenia gravis
C- Peripheral neuropathy
D- Spinal cord compression

B- Myasthenia gravis- It is one of the most common autoimmune diseases that affects the neuromuscular junction. It is typically characterized by painless, fatigable muscle weakness. It has a bimodal age of onset, meaning it will either affect at a young age or elderly.
The correct answer is B

 

Question 4. A 30-year-old man tells you that when he carries a heavy lift, his muscle gives up all of a sudden. Which of the following actions is responsible for abrupt cessation of skeletal muscle contraction?

A- Activation of Golgi tendon organs
B- Activation of lower motor neuron
C- Activation of muscle spindles
D- Lower blood supply to the muscle

A- Activation of Golgi tendon organs- Prolonged stretch of a skeletal muscle results in activation of Golgi organs which leads to reflex relaxation of the muscle. Ischemia leads to gradual relaxation, not abrupt
The correct answer is A

 

Question 5. Which of the following factors directly stimulates the release of antidiuretic hormone (ADH)?

A- Decreased extracellular fluid osmolality
B- Decreased temperature
C- Increased blood volume
D- Increased extracellular fluid osmolality

D- Increased extracellular fluid osmolality- ADH secretion is triggered by increased extracellular fluid osmolality mainly due to dehydration leading to restoring water from losing it in urine.
The correct answer is D

 

Question 6. Laboratory tests for a patient are as follows: Plasma creatinine concentration is 0.8 mg/dL Urine creatinine concentration is 80 mg/dL Urine volume is 1 ml/min Which of the following is the creatinine clearance?

A- 50 ml/min
B- 100 ml/min
C- 200 ml/min
D- 300 ml/min

B- 100 ml/min- Creatinine clearance = urine volume X urine creatinine conc./ plasma creatinine conc.
The correct answer is B

 

Question 7. A patient with a recent history of meningitis develops headache, blurred vision and cognitive decline. CT scan shows enlarged ventricles. Which of the following is most likely responsible for this condition?

A- Destruction of the gray matter
B- Excessive CSF production
C- Impaired CSF resorption
D- Obstruction of cerebral aqueduct

C- Impaired CSF resorption- Meningitis can cause scarring of the arachnoid granulations, which are responsible for returning fluid from the CSF into circulation, leads to failure to resorb adequate CSF.
The correct answer is C

 

Question 8. A patient is brought to the emergency room in a deep coma following a motor car accident. Vital signs, general examination and local chest and abdominal examinations are normal. Head CT scan is normal. Which of the following is the most likely initial diagnosis?

A- Cerebral contusion
B- Diffuse axonal injury
C- Epidural hematoma
D- Subdural hematoma

B- Diffuse axonal injury- This is the only lesion on the list that is not evident on CT scan of the head. MRI would show diffuse white matter disruption.
The correct answer is B

 

Question 9. A 15-year-old girl presents with potential growth delay. She had a traumatic brain injury two years ago due to a car accident. Her secondary sex characteristics are absent. Endocrine profile shows low FSH, LH, estradiol, DTEAS and prolactin. What is the most likely diagnosis?

A- Hashimoto’s disease
B- Post-traumatic hypopituitarism
C- Primary adrenal insufficiency
D- Tanner syndrome

B- Post-traumatic hypopituitarism- This is most likely a case called empty Sella syndrome due to traumatic injury to the brain. It is confirmed by MRI to the brain.
The correct answer is B

 

Question 10. Thyroid hormone can cause which one of the following effects?

A- Hypoglycemia
B- Lowers blood cholesterol
C- Lowers body temperature
D- Lowers oxygen consumption

B- Lowers blood cholesterol- Thyroid hormone act on the nucleus and altering the rate of gene expression. It causes increase in oxygen consumption, decreased blood cholesterol levels, hyperglycemia and thermogenesis.
The correct answer is B

 

High-yield points from this set

  • Wernicke encephalopathy damages the mammillary bodies; give thiamine.
  • Rising plasma osmolality is the main trigger for ADH release.
  • Hydrocephalus after meningitis is communicating (impaired CSF resorption).
  • Coma after high-speed trauma with a normal CT = diffuse axonal injury.

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