OSCE Neurological Assessment 2

Question 1

A patient presents with sudden-onset severe headache described as 'the worst headache of my life.' What is the priority assessment action?

Accepted Answer

Assess for nuchal rigidity and photophobia

Answer

Sudden severe headache requires immediate assessment for meningeal irritation signs (nuchal rigidity, photophobia) to evaluate for subarachnoid hemorrhage or meningitis.

Question 2

When assessing the oculomotor nerve (CN III), which finding indicates a complete palsy?

Accepted Answer

Down-and-out eye position with ptosis and dilated pupil

Answer

CN III palsy produces a 'down-and-out' eye position due to unopposed CN IV and VI action, along with ptosis and a dilated, non-reactive pupil from loss of parasympathetic fibers.

Question 3

During neurological assessment, a patient can identify objects placed in their hand by touch alone with eyes closed on the left but not the right. This deficit is called:

Accepted Answer

Astereognosis

Answer

Astereognosis is the inability to identify objects by touch alone, indicating a lesion in the contralateral parietal cortex processing somatosensory information.

Question 4

A patient has weakness of shoulder abduction and elbow flexion but preserved elbow extension and wrist function. Which nerve root level is most likely affected?

Accepted Answer

C5-C6

Answer

C5-C6 nerve root involvement explains weakness of shoulder abduction (deltoid, C5) and elbow flexion (biceps, C5-C6) while sparing C7-innervated triceps and wrist extensors.

Question 5

Which scale is most appropriate for rapidly communicating a patient's level of consciousness in a trauma setting?

Accepted Answer

Glasgow Coma Scale (GCS)

Answer

The Glasgow Coma Scale evaluates eye opening, verbal response, and motor response and is the standard tool for rapid, reproducible consciousness assessment in trauma.

OSCE Practice Test

OSCE Practice Test

OSCE Neurological Assessment 2