MCCQE Neurological Disorders 3

Question 1

A 55-year-old diabetic man presents with foot drop and inability to evert his foot. There is sensory loss over the dorsum of the foot. Which nerve is most likely injured?

Accepted Answer

Common peroneal nerve

Answer

Femoral nerve

Answer

Sciatic nerve

Answer

Tibial nerve

Question 2

A 19-year-old man has brief staring spells lasting 5-10 seconds with eyelid fluttering, occurring multiple times daily. His mother says he had similar episodes as a child. EEG shows 3 Hz spike-and-wave during hyperventilation. What is the most likely diagnosis?

Accepted Answer

Absence epilepsy

Answer

Complex partial seizures

Answer

Juvenile myoclonic epilepsy

Answer

Lennox-Gastaut syndrome

Question 3

A 75-year-old man presents with fluctuating cognition, visual hallucinations of animals and people, and parkinsonian features. He is very sensitive to haloperidol. What is the most likely diagnosis?

Accepted Answer

Lewy body dementia

Answer

Alzheimer's disease

Answer

Parkinson's disease dementia

Answer

Vascular dementia

Question 4

A 48-year-old man presents with sharp stabbing facial pain in the distribution of V2 and V3, triggered by chewing and touching his face. The pain lasts seconds. Neurological examination is normal. What is the most appropriate first-line treatment?

Accepted Answer

Carbamazepine

Answer

Amitriptyline

Answer

Gabapentin

Answer

Sumatriptan

Question 5

A 32-year-old woman presents with sudden-onset weakness and areflexia in all four limbs after recovering from a respiratory illness. She requires mechanical ventilation. Which monitoring parameter is most important in this condition?

Accepted Answer

Forced vital capacity (FVC)

Answer

Serial MRI brain imaging

Answer

Serum CK levels

Answer

Continuous EEG monitoring

Question 6

A 40-year-old man presents with a 3-month history of progressively worsening headaches, worse in the morning and with Valsalva maneuver. He has papilledema and no focal deficits. MRI shows a ring-enhancing lesion with surrounding edema. What is the most likely diagnosis?

Accepted Answer

Glioblastoma multiforme

Answer

Primary CNS lymphoma

Answer

Brain abscess

Answer

Metastatic carcinoma

Question 7

A 62-year-old woman presents with sudden painless loss of vision in her left eye lasting 10 minutes that resolved completely. Fundoscopy during the episode showed segmental pallor of the retina. What is the most important next investigation?

Accepted Answer

Carotid Doppler ultrasound

Answer

MRI brain with contrast

Answer

Lumbar puncture

Answer

Electroencephalogram