NBME Neuroscience 2

Question 1

A patient presents with a dilated, non-reactive pupil and ptosis of the right eye with the eye deviated down and out. Which cranial nerve is most likely compressed?

Accepted Answer

Cranial nerve III (oculomotor)

Answer

Cranial nerve IV (trochlear)

Answer

Cranial nerve VI (abducens)

Answer

Cranial nerve II (optic)

Question 2

A patient with a cerebellar lesion on the right side is most likely to show deficits on which side of the body?

Accepted Answer

Right side only

Answer

Left side only

Answer

Bilateral equally

Answer

Neither side — cerebellar lesions cause no limb deficits

Question 3

Stimulation of the direct pathway of the basal ganglia results in which of the following?

Accepted Answer

Facilitation of movement via disinhibition of the thalamus

Answer

Inhibition of the thalamus via increased GPi activity

Answer

Increased release of acetylcholine in the striatum

Answer

Suppression of dopamine from the substantia nigra

Question 4

A patient is quadriplegic and anarthric but can move his eyes vertically and blink voluntarily. He is fully conscious. Which structure is most likely damaged?

Accepted Answer

Ventral pons

Answer

Bilateral cerebral cortex

Answer

Dorsal pons and midbrain

Answer

Medullary reticular formation

Question 5

A patient presents with inability to close the right eye, drooping of the right corner of the mouth, and loss of taste from the anterior two-thirds of the right tongue. Where is the lesion?

Accepted Answer

Right facial nerve nucleus or nerve (LMN lesion)

Answer

Right cerebral cortex (UMN lesion)

Answer

Left cerebral cortex (UMN lesion)

Answer

Right glossopharyngeal nerve

Question 6

A patient with multiple sclerosis develops left eye adduction failure on attempted right lateral gaze, with nystagmus of the abducting right eye. Which structure is demyelinated?

Accepted Answer

Left medial longitudinal fasciculus (MLF)

Answer

Right abducens nucleus

Answer

Right oculomotor nucleus

Answer

Left abducens nucleus

Question 7

Damage to Wernicke's area results in which type of aphasia?

Accepted Answer

Fluent aphasia with poor comprehension

Answer

Non-fluent aphasia with good comprehension

Answer

Pure word deafness with intact reading

Answer

Global aphasia with intact repetition