SPEX Neurology 2

Question 1

A 60-year-old presents with sudden onset of the worst headache of his life. CT head is negative. What is the next best step?

Accepted Answer

Lumbar puncture

Answer

A negative CT does not rule out subarachnoid hemorrhage; lumbar puncture is required to detect xanthochromia or red blood cells.

Question 2

Which dermatome corresponds to the area over the nipple line?

Accepted Answer

T4

Answer

T4 supplies the nipple line and is a classic landmark for dermatome mapping.

Question 3

A patient with MS develops a painful, unilateral loss of vision with an afferent pupillary defect. What is the most likely diagnosis?

Accepted Answer

Optic neuritis

Answer

Optic neuritis causes painful vision loss and a relative afferent pupillary defect (RAPD), and is strongly associated with MS.

Question 4

Which of the following is characteristic of a lower motor neuron (LMN) lesion?

Accepted Answer

Fasciculations

Answer

LMN lesions cause flaccid paralysis, hyporeflexia, atrophy, and fasciculations.

Question 5

A 45-year-old woman presents with bilateral leg weakness, saddle anesthesia, and urinary retention after a fall. What is the most likely diagnosis?

Accepted Answer

Cauda equina syndrome

Answer

Cauda equina syndrome presents with saddle anesthesia, bowel/bladder dysfunction, and lower extremity weakness due to compression of lumbar nerve roots.

SPEX Exam Practice Test

SPEX Exam Practice Test

SPEX Neurology 2