OSCE Neurological Assessment

Question 1

In the Glasgow Coma Scale (GCS), what does a total score of 15 indicate?

Accepted Answer

Fully alert and oriented — normal neurological status

Answer

Moderate neurological impairment

Answer

Severe impairment requiring immediate intubation

Answer

Deep coma with no response

Question 2

Which cranial nerve is assessed by asking a patient to follow your finger through the six cardinal positions of gaze?

Accepted Answer

Cranial nerves III, IV, and VI (oculomotor, trochlear, abducens)

Answer

Cranial nerve II (optic)

Answer

Cranial nerve V (trigeminal)

Answer

Cranial nerve VIII (vestibulocochlear)

Question 3

A positive Babinski sign (upward fanning of toes when the plantar surface of the foot is stroked) in an adult indicates:

Accepted Answer

Upper motor neuron (UMN) lesion — pathological in adults

Answer

Normal reflexes — expected in adults

Answer

Lower motor neuron (LMN) lesion

Answer

Peripheral neuropathy

Question 4

During cranial nerve assessment, which test evaluates CN II (optic nerve) function?

Accepted Answer

Visual acuity, visual fields, and pupillary light reflex (afferent limb)

Answer

Corneal reflex

Answer

Gag reflex

Answer

Jaw clenching against resistance

Question 5

The Romberg test assesses:

Accepted Answer

Proprioception and posterior column function of the spinal cord

Answer

Cerebellar coordination

Answer

Upper motor neuron integrity

Answer

Cranial nerve function

Question 6

When testing the biceps reflex, which nerve root is being assessed?

Accepted Answer

C5–C6

Answer

C7–C8

Answer

L3–L4

Answer

S1–S2

Question 7

In a neurological exam, what does the finger-nose test assess?

Accepted Answer

Cerebellar coordination (intention tremor and dysmetria)

Answer

Proprioceptive sense

Answer

Motor strength of the upper limb

Answer

Cranial nerve XII function

Question 8

A patient presents with acute onset of right-sided facial droop involving both the upper and lower face, including the forehead. This most likely indicates:

Accepted Answer

Right-sided lower motor neuron (LMN) facial nerve palsy — Bell's palsy or peripheral CN VII lesion

Answer

Right-sided upper motor neuron facial weakness (stroke affecting left cortex)

Answer

Left-sided cerebellar lesion

Answer

Trigeminal neuralgia

Question 9

What is the purpose of testing for pronator drift during a neurological examination?

Accepted Answer

To detect subtle upper motor neuron weakness in the upper limbs

Answer

To assess cerebellar function

Answer

To test proprioceptive sense

Answer

To evaluate CN XI (accessory nerve) function

Question 10

When assessing light touch and pinprick sensation, a dermatome pattern of sensory loss suggests:

Accepted Answer

Nerve root (radicular) pathology — disc herniation or spinal cord level lesion

Answer

Peripheral polyneuropathy

Answer

Cranial nerve lesion

Answer

Psychogenic sensory loss