MRCP Part 1 Neurology and Psychiatry

Question 1

A 30-year-old woman presents with optic neuritis. MRI brain shows periventricular white matter lesions. CSF shows oligoclonal bands not matched in serum. What is the most likely diagnosis?

Accepted Answer

Multiple sclerosis

Answer

Neuromyelitis optica

Answer

Acute disseminated encephalomyelitis

Answer

CNS lymphoma

Question 2

A 72-year-old man presents with a resting tremor, bradykinesia, and rigidity. Which neurotransmitter deficiency is primarily responsible?

Accepted Answer

Dopamine

Answer

Serotonin

Answer

Acetylcholine

Answer

GABA

Question 3

A patient presents with sudden onset worst headache of their life, neck stiffness, and photophobia. CT head is normal. What is the next most appropriate investigation?

Accepted Answer

Lumbar puncture (after 12 hours from onset)

Answer

MRI brain

Answer

CT angiography immediately

Answer

Repeat CT head in 24 hours

Question 4

A 65-year-old right-handed man suddenly develops expressive dysphasia with comprehension preserved. He can understand commands but struggles to produce fluent speech. Which area of the brain is most likely affected?

Accepted Answer

Broca's area (left inferior frontal gyrus)

Answer

Wernicke's area (left superior temporal gyrus)

Answer

Right inferior frontal gyrus

Answer

Bilateral occipital lobes

Question 5

A 25-year-old woman presents with episodic severe unilateral headache with visual aura lasting 20 minutes followed by nausea and photophobia. She has 4 attacks per month. What is the most appropriate prophylactic medication?

Accepted Answer

Propranolol

Answer

Sumatriptan

Answer

Paracetamol

Answer

Codeine phosphate

Question 6

A patient with depression has been started on an SSRI. When counselling about side effects, how long should you advise before full therapeutic effect is expected?

Accepted Answer

4-6 weeks

Answer

24-48 hours

Answer

7 days

Answer

3 months