SPEX Neurology 5

Question 1

A 40-year-old presents with episodic severe unilateral periorbital pain lasting 30–90 minutes, associated with ipsilateral lacrimation and rhinorrhea, occurring in clusters. What is the diagnosis?

Accepted Answer

Cluster headache

Answer

Cluster headaches are severe unilateral periorbital headaches with autonomic features (lacrimation, rhinorrhea, ptosis) occurring in temporal clusters.

Question 2

Which finding on EEG is pathognomonic for herpes simplex encephalitis?

Accepted Answer

Periodic lateralized epileptiform discharges (PLEDs) in temporal regions

Answer

HSV encephalitis classically produces periodic lateralized epileptiform discharges (PLEDs) in the temporal lobes on EEG.

Question 3

A patient with known epilepsy presents with continuous seizure activity lasting 30 minutes. What is the first-line treatment?

Accepted Answer

Lorazepam IV

Answer

Benzodiazepines such as lorazepam are first-line for status epilepticus because of rapid onset and efficacy in terminating seizures.

Question 4

Which sign is assessed by asking a supine patient to flex the hip to 90 degrees and then extend the knee, with pain or resistance indicating meningeal irritation?

Accepted Answer

Kernig's sign

Answer

Kernig's sign tests meningeal irritation by resistance or pain with knee extension after hip flexion to 90 degrees.

Question 5

A patient presents with asymmetric limb weakness, tongue fasciculations, hyperreflexia, and dysarthria. Which disease is most likely?

Accepted Answer

Amyotrophic lateral sclerosis

Answer

ALS involves simultaneous upper (hyperreflexia) and lower (fasciculations, atrophy) motor neuron degeneration without sensory loss.

SPEX Exam Practice Test

SPEX Exam Practice Test

SPEX Neurology 5