OSCE OSCE Neurological Assessment 5

Question 1

A patient with Parkinson's disease is asked to walk across the room. Which gait abnormality would you most likely observe?

Accepted Answer

Shuffling gait with reduced arm swing and festination

Answer

Parkinson's disease produces a shuffling, festinating gait with reduced arm swing, stooped posture, and difficulty initiating movement due to basal ganglia dysfunction.

Question 2

During a neurological OSCE, you test for the presence of clonus at the ankle. Sustained clonus (>5 beats) most likely indicates:

Accepted Answer

Upper motor neuron lesion

Answer

Sustained clonus indicates pathological hyperreflexia due to an upper motor neuron lesion releasing inhibition on the stretch reflex arc.

Question 3

A patient demonstrates pronator drift when asked to hold arms outstretched with palms up and eyes closed. What does this indicate?

Accepted Answer

Subtle contralateral upper motor neuron weakness

Answer

Pronator drift occurs when subtle corticospinal tract weakness allows the arm to pronate and drift downward, indicating a contralateral UMN lesion.

Question 4

When performing the NIHSS in a stroke OSCE scenario, which domain assesses visual fields?

Accepted Answer

Item 3 — visual fields

Answer

NIHSS Item 3 assesses visual fields in each quadrant using confrontation, scored 0 (normal) to 3 (bilateral blindness).

Question 5

A patient has loss of pain and temperature from the level of T4 bilaterally with preserved proprioception. Which spinal cord syndrome best explains this?

Accepted Answer

Anterior cord syndrome

Answer

Anterior cord syndrome causes bilateral loss of pain and temperature (spinothalamic tracts) while preserving dorsal column function (proprioception and vibration).

OSCE Practice Test

OSCE Practice Test

OSCE OSCE Neurological Assessment 5