9 USMLE Neurology Quick Review Questions with Answers (Set 2)

These 9 quick USMLE review questions test high-yield facts that show up again and again on the exam: Lewy body dementia, meningitis management, stroke thrombolysis, Guillain-Barre syndrome, myasthenia gravis, epidural hematoma, serotonin, giant cell arteritis and diabetic neuropathy. 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. A 75-year-old man presents with visual hallucinations over the past 3 months. Last year he developed tremors, gait disturbance, confusion and forgetfulness. Which of the following is the most likely diagnosis?

A- Alzheimer disease
B- Lewy body dementia
C- Parkinson’s disease
D- Vascular dementia

B- Lewy body dementia- It is more progressive than any other types of dementia and associated with features of Parkinson’s disease. Alzheimer’s has a progressive and gradual course while vascular dementia has a stepwise progression.
The correct answer is B

 

Question 2. A patient presents with fever, neck stiffness, severe headache and photophobia. On examination, there is weakness of the left extremities. Which of the following is the first step of action?

A- Administer ceftriaxone
B- Head CT scan
C- Lumbar puncture
D- Neurology consultation

A- Administer ceftriaxone- Suspected bacterial meningitis is an emergency: draw blood cultures and start empiric antibiotics (ceftriaxone plus vancomycin, with dexamethasone) right away. Because this patient has a focal neurologic deficit, a head CT is needed before lumbar puncture to rule out a mass or abscess, but antibiotics must NOT be delayed while waiting for the CT.
The correct answer is A

 

Question 3. tPA can be used up to 4.5 hours after onset of the stroke for which one of the following patients?

A- The patient has NIH stroke scale of 22
B- The patient is 56 years old
C- The patient is 82 years old
D- The patient is diabetic and had a previous stroke

B- The patient is 56 years old- tPA is used up to 4.5 hours after the onset of stroke if the patient is younger than 80 years old, HIN stroke scale less than 25 and if not a diabetic with a previous stroke.
The correct answer is B

 

Question 4. A 27-year-old man with a history of diarrhea for a month presents with the inability to walk for the past 3 days. Examination reveals 0/5 power and areflexia in both lower extremities. Which of the following is the most likely diagnosis?

A- Guillain-Barre syndrome
B- Lyme disease
C- Multiple sclerosis
D- Poliomyelitis

A- Guillain-Barre syndrome- It is an autoimmune disease usually following a viral illness. It is characterized by bilateral ascending muscle weakness.
The correct answer is A

 

Question 5. Which of the following factors does NOT trigger or exacerbate myasthenia gravis?

A- Cold weather
B- Emotional distress
C- Menstruation
D- Pregnancy

A- Cold weather- Warm weather, not cold, may trigger or exacerbate myasthenia gravis. Other factors, beside the listed ones, are surgery, immunization and viral infection.
The correct answer is A

 

Question 6. In a case of complicated head trauma, rupture of which one of the following vessels leads to epidural hematoma?

A- Bridging veins
B- Middle meningeal artery
C- Posterior communicating artery
D- Saphenous vein

The correct answer is B- Rupture of middle meningeal artery leads to epidural hematoma. Subdural hematoma is caused by rupture of bridging veins. Other options are distractions.

 

Question 7. Which one of the following transmitters is primarily associated with mood regulation, sleep, and appetite?

A- Acetylcholine
B- Dopamine
C- GABA (Gamma-Aminobutyric Acid)
D- Serotonin

D- Serotonin- It plays a key role in mood regulation, sleep, and appetite. Imbalance in serotonin levels may lead to depression, anxiety and eating disorders.
The correct answer is D

 

Question 8. Which one of the following laboratory tests is the most accurate test for diagnosis of polymyalgia rheumatica?

A- Biopsy of the temporal artery
B- C-reactive protein
C- Erythrocyte sedimentation rate
D- Rheumatic factor

A- Biopsy of the temporal artery- All the test on the list can be elevated in a case of polymyalgia rheumatica but the biopsy of the affected artery is the most accurate test.
The correct answer is A

 

Question 9. Accumulation of which one of the following substances inside the cell is responsible for most diabetic complications such as peripheral neuropathy?

A- Creatinine
B- Glucagon
C- Ketones
D- Sorbitol

D- Sorbitol- Due to relative deficiency of sorbitol dehydrogenase, sorbitol accumulates inside the cells causing osmotic damage. This is responsible for diabetic complications such as peripheral neuropathy, retinopathy and cataracts.
The correct answer is D

 

High-yield points from this set

  • Visual hallucinations and parkinsonism early in dementia = Lewy body dementia.
  • Never delay antibiotics in suspected meningitis; CT first only if indicated.
  • Ascending weakness after diarrhea = Guillain-Barre syndrome.
  • Middle meningeal artery rupture causes epidural hematoma.

Keep practicing

Leave a Comment