AMC MCQ Neurology and Mental Health 4

Question 1

A 50-year-old develops sudden severe vertigo, ipsilateral facial numbness, Horner's syndrome and contralateral limb sensory loss. Which artery is most likely involved?

Accepted Answer

Posterior inferior cerebellar artery

Answer

These lateral medullary (Wallenberg) signs result from posterior inferior cerebellar artery territory infarction.

Question 2

A 32-year-old woman with depression on a high-dose SSRI is started on tramadol and develops agitation, clonus, hyperreflexia, tremor and fever. What is the most likely diagnosis?

Accepted Answer

Serotonin syndrome

Answer

Clonus, hyperreflexia and agitation after adding a serotonergic drug indicate serotonin syndrome.

Question 3

A 65-year-old reports brief recurrent stabbing pains in the cheek triggered by chewing and touching the face. What is the most likely diagnosis?

Accepted Answer

Trigeminal neuralgia

Answer

Brief, severe, electric-shock facial pain triggered by light touch or chewing is characteristic of trigeminal neuralgia.

Question 4

A 45-year-old man with bipolar disorder on lithium presents with coarse tremor, ataxia, confusion and vomiting. What is the most appropriate first step?

Accepted Answer

Withhold lithium and check serum lithium level

Answer

These signs suggest lithium toxicity, so lithium should be stopped and the level urgently measured.

Question 5

A 6-year-old has brief episodes of staring and eyelid fluttering, several times a day, each lasting a few seconds with immediate recovery. What is the most likely diagnosis?

Accepted Answer

Absence (petit mal) seizures

Answer

Brief frequent staring spells with abrupt onset and recovery in a child are typical absence seizures.

AMC MCQ Practice Test

AMC MCQ Practice Test

AMC MCQ Neurology and Mental Health 4