SPEX Neurology 4

Question 1

A patient presents with pill-rolling tremor at rest, cogwheel rigidity, and bradykinesia. Which area of the brain is most affected?

Accepted Answer

Basal ganglia

Answer

The cardinal features of Parkinsonism result from dopamine depletion in the basal ganglia, specifically the substantia nigra.

Question 2

Which cranial nerve is responsible for the corneal reflex (afferent limb)?

Accepted Answer

CN V (ophthalmic branch)

Answer

The afferent limb of the corneal reflex is carried by the ophthalmic branch (V1) of the trigeminal nerve (CN V); the efferent limb is CN VII.

Question 3

A 55-year-old presents with progressive proximal muscle weakness without sensory loss. CK is markedly elevated. What is the most likely diagnosis?

Accepted Answer

Polymyositis

Answer

Polymyositis causes proximal muscle weakness with elevated CK and is an inflammatory myopathy without sensory involvement.

Question 4

In myasthenia gravis, repetitive nerve stimulation typically shows which pattern?

Accepted Answer

Decremental response

Answer

Repetitive nerve stimulation in myasthenia gravis shows a decremental response in compound muscle action potential amplitude due to depletion of available acetylcholine.

Question 5

A patient with a pontine lesion presents with ipsilateral facial weakness and contralateral hemiplegia. What is this pattern called?

Accepted Answer

Millard-Gubler syndrome

Answer

Millard-Gubler syndrome results from a ventral pontine lesion causing ipsilateral CN VI/VII palsies and contralateral hemiplegia.

SPEX Exam Practice Test

SPEX Exam Practice Test

SPEX Neurology 4