ABPN Neurological Examination and Conditions 3 — Questions and Answers
Question 1: A patient presents with sudden weakness of the entire right face, arm, and leg, plus aphasia. Which vascular territory is most likely involved?
- Right posterior cerebral artery
- Left middle cerebral artery (Correct answer)
- Right anterior cerebral artery
- Basilar artery tip
Correct answer: Left middle cerebral artery
The left MCA supplies motor/sensory cortex for the right body and dominant-hemisphere language areas, explaining right-sided weakness with aphasia.
Question 2: Which bedside test best assesses cerebellar function of the upper limbs?
- Finger-to-nose testing (Correct answer)
- Deep tendon reflexes
- Two-point discrimination
- Grip strength
Correct answer: Finger-to-nose testing
Finger-to-nose testing reveals dysmetria and intention tremor characteristic of cerebellar dysfunction.
Question 3: A patient has ptosis, miosis, and anhidrosis on one side of the face. This triad is called:
- Horner syndrome (Correct answer)
- Bell's palsy
- Cushing's triad
- Weber syndrome
Correct answer: Horner syndrome
Horner syndrome results from disruption of the sympathetic pathway, producing drooping lid, small pupil, and reduced sweating.
Question 4: Nuchal rigidity, fever, and photophobia in an acutely ill patient most strongly suggest:
- Migraine
- Meningitis (Correct answer)
- Tension headache
- Bell's palsy
Correct answer: Meningitis
Meningeal irritation from meningitis classically causes neck stiffness, fever, and photophobia.
Question 5: Which grade on the Medical Research Council (MRC) scale indicates movement with gravity eliminated but not against gravity?
- Grade 1
- Grade 2 (Correct answer)
- Grade 3
- Grade 4
Correct answer: Grade 2
MRC grade 2 is active movement possible only when gravity is removed.
Question 6: A tuning fork placed on the mastoid then near the ear canal (Rinne test) normally shows:
- Bone conduction louder than air
- Air conduction louder than bone (Correct answer)
- No sound in either position
- Equal loudness in both
Correct answer: Air conduction louder than bone
In normal hearing, air conduction is louder and heard longer than bone conduction (positive Rinne).
Question 7: A patient's tongue deviates to the left when protruded. This suggests a lesion of which cranial nerve on which side?
- Right hypoglossal (CN XII)
- Left hypoglossal (CN XII) (Correct answer)
- Left facial (CN VII)
- Right vagus (CN X)
Correct answer: Left hypoglossal (CN XII)
The tongue deviates toward the side of a hypoglossal lesion, so leftward deviation indicates a left CN XII lesion.
ABPN Neurological Examination and Conditions 3
A patient presents with sudden weakness of the entire right face, arm, and leg, plus aphasia.
Which vascular territory is most likely involved?