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High-yield NEET SS Medicine Neurology Questions

Feb 23, 2024

High-yield NEET SS Medicine Neurology Questions

Preparing for the NEET SS exam can feel like navigating a maze, but fear not! We have got the perfect strategy to help you gauge your readiness by giving you a sneak peek into the exam format.

Dive into the NEET SS high-yield questions to gain insight into what to expect. Get started by practicing the questions below, boost your confidence and fine tune your NEET SS Medicine preparation.

1. A 73-year-old man presented to the emergency room with slurred speech, vertigo, and incoordination. An exam showed dysarthria, left beating nystagmus, decreased sensation in the left face and right trunk/limbs, and left upper extremity ataxia. Head CT was normal but Brain MRI revealed a medullary infarct. On hospital day 2 he had to be transferred to the ICU for repeated episodes of prolonged central apneas during sleep. Which structures may have been damaged to result in this complication?

  1. The dorsal and ventral respiratory groups
  2. The raphe nuclei
  3. The ascending reticular activating system
  4. The chemoreceptor trigger zone

2.You are evaluating a 42-year-old woman for suspected intracranial hypotension due to a spontaneous cerebrospinal fluid leak. Because of some atypical features in the presentation you are considering performing a radioisotope cisternography to confirm your clinical suspicion. Which of the following is true regarding the use of radioisotope cisternography in the evaluation of patients with suspected intracranial hypotension secondary to spontaneous cerebrospinal fluid leaks?

  1. The radioisotope of choice is sodium-24
  2. The isotope is typically introduced into the subarachnoid space with a suboccipital cisternal puncture
  3. Following the injection of the isotope patients undergo two sets of imaging, typically performed at 4 and 8 hours
  4. By 24 hours, much of the radioisotope activity is located along the superior sagittal sinus

3. A 34-year-old man presents for a second opinion of an outside diagnosis of neurosarcoidosis. The main neurologic manifestations of his illness have been optic neuropathy and aseptic meningitis. He has been on daily oral corticosteroids for the last two years and any time his prednisone has been dropped to less than 25 mg per day his vision starts to decline and his headaches return. You review the outside workup and pathology agree with the diagnosis of neurosarcoidosis and offer him a trial of methotrexate as a steroid-sparing agent. What is the mechanism of action for this drug?

  1. It acts as an analog of endogenous purines
  2. It is a calcineurin inhibitor
  3. It is a dihydrofolate reductase inhibitor
  4. It is a DNA alkylating agent

4.A 36-year-old woman presents complaining of excessive sleepiness. She is having trouble staying awake at work and recently fell asleep while driving and crashed into a mail box. During the workweek she goes to bed at 1 AM and wakes up at 6 AM. She is unable to go to bed earlier because she works from 8 to 5 and takes night-time college classes. She needs to be up by 6 AM during the week to get her 2 children ready for school. Most weekends she works a second job to supplement her income and needs to be up by 5 AM on those days. If she is off she will sleep from 10 PM until 7-8 AM when her children wake up in the morning. Which of the following statements is true regarding her presentation?

  1. She is suffering from behaviorally-induced chronic sleep deprivation which can have long-term adverse consequences for her health.
  2. She should be prescribed a stimulant medication to help her cope with her busy schedule.
  3. Her daytime sleepiness means that she probably has a primary sleep disorder resulting in unrefreshing sleep such as obstructive sleep apnea.
  4. Getting 5-6 hours of sleep during the week is fine as long as she sleeps for at least 8 hours on weekend nights.

5.An 82-year-old gentleman man with chronic undertreated hypertension presents to the hospital with headache, confusion, and right-sided weakness. His initial blood pressure is 196/120 mm Hg. The initial Glasgow Coma Scale is 10. A CT of the head without contrast demonstrates left basal ganglia intraparenchymal hemorrhage without intraventricular extension. The calculated volume of the hematoma is 25 ml (based on the ABC/2 formula). Based on the data provided, what is his ICH score?

  1. 1
  2. 2
  3. 3
  4. 4

6.A 63-year-old woman presented with 6 weeks of paroxysmal, lancinating pain at the base of the tongue and the left tonsillar fossa, triggered by yawning and swallowing. Pain attacks lasted a few seconds at a time. General and neurological examinations were normal. Magnetic resonance imaging of the brain with and without contrast revealed no structural abnormalities. This patient’s pain is most likely due to which of these disorders?

  1. Trigeminal neuralgia
  2. Persistent idiopathic facial pain
  3. Nervus intermedius neuralgia
  4. Glossopharyngeal neuralgia

7.A 28-year-old woman with relapsing-remitting multiple sclerosis presents for evaluation of 2 days of right leg weakness. Her exam shows normal vital signs, mild right leg spasticity, moderate right ankle dorsiflexor weakness, and decreased vibration in the right foot. She denies recent fever of chills, upper respiratory symptoms or dysuria but admits to increased urinary frequency in the past 3 days. What is the next best step in management?

  1. Start IV methylprednisolone
  2. Check a urinalysis
  3. Start oral prednisone
  4. Referral for rehabilitation

8.A 68-year-old male with a history of treated hypothyroidism and controlled hypertension presents with insidious onset of memory decline, language difficulties, and impaired judgment. Neurological examination reveals asymmetrical atrophy of the temporal and parietal lobes. Genetic testing confirms the absence of the apolipoprotein E (APOE) ε4 allele. In addition to managing his cognitive symptoms, which of the following factors should be considered as a potential modifiable risk factor for the progression of Alzheimer's disease in this patient?

  1. Achievement of tight glycemic control in diabetes mellitus.
  2. Intensive treatment of subclinical hypothyroidism.
  3. Initiation of high-dose statin therapy for hyperlipidemia.
  4. Implementation of an anti-inflammatory diet rich in omega-3 fatty acids.

9. A 72-year-old man developed a left hand tremor at rest around two years ago, that then progressed to include his left foot. He has pain and stiffness in his left shoulder. His right side is not affected. He has difficulty reading the newspaper and using the remote control because the letters appear blurry. His balance is poor, and he has fallen several times in the past year. His wife thinks his sense of smell has been diminished for at least 15 years. Which of the following findings in this case is a red flag for an atypical Parkinsonian syndrome?

  1. Convergence insufficiency (blurred vision)
  2. Falls
  3. Loss of smell
  4. Shoulder pain

10. A 77-year-old woman with a history of hypertension has a 10-minute episode of left-sided weakness and slurred speech. On further questioning, she relates 3 brief episodes in the past month of sudden impairment of vision affecting her right eye. Today, her examination is normal. What is the most appropriate diagnostic test?

  1. Creatine phosphokinase
  2. Visual evoked responses
  3. Carotid artery Doppler ultrasound
  4. Conventional cerebral angiography

11. A three-year-old girl is referred to you for evaluation of several months of progressive gait issues. There is no abnormality on the skin examination over her lumbosacral spine, but imaging reveals a low-lying conus medullaris, consistent with tethered cord syndrome.

Which of the following is an occult spinal dysraphism associated with tethered cord?

  1. Hemimyelomeningocele
  2. Lipomyelomeningocele
  3. Meningocele
  4. Myelomeningocele

12. A 22-year-old Japanese woman presents to your office. She describes 2 months of decreased vision out of her left eye. Her vision declined over several days and by one week she had lost all vision out of the left eye. She has mild associated periorbital pain. She has had no recovery of her vision since this time. A physical exam of the left eye shows light perception only with a relative afferent pupillary defect. Which of the following characteristics of this case make it atypical for optic neuritis?

  1. Age
  2. Lack of spontaneous recovery
  3. Gender
  4. Periorbital pain

13. A 32-year-old female presents with progressive muscle weakness, fatigue, and myalgias for the past several years. She reports difficulty releasing her grip after shaking hands and has noticed a "worsening stiffness" in her facial muscles. Family history reveals similar symptoms in her father, who died of cardiac complications. Physical examination shows bilateral ptosis, facial weakness, and a "hatchet-like" facies. Serum creatine kinase levels are elevated. Genetic testing confirms a trinucleotide repeat expansion. What is the most likely diagnosis in this patient?

  1. Duchenne muscular dystrophy.
  2. Myotonic Dystrophy Type I.
  3. Polymyositis.
  4. Mitochondrial myopathy.

14. A 50-year-old male presents with progressive weakness, muscle atrophy, and fasciculations. He reports difficulty with fine motor skills and frequent tripping. Electromyography (EMG) reveals denervation changes in multiple muscle groups, supporting the diagnosis of amyotrophic lateral sclerosis (ALS). A lumbar puncture is performed, and cerebrospinal fluid (CSF) analysis shows an increased level of Neurofilament Light Chain (NfL). What does the elevated NfL level in CSF indicate in the context of ALS?

  1. Active inflammation in the central nervous system.
  2. Degeneration of axons and neuronal damage.
  3. Impaired myelination of nerve fibers.
  4. Synaptic dysfunction at the neuromuscular junction.

15. A 12-year-old boy with a history of myoclonic and generalized seizures is transferred from an outside hospital after presenting there with clusters of myoclonic seizures resulting in treatment with a number of IV medications. He is sleepy on arrival, but able to follow commands and the most striking abnormality on his exam is proximal arm and leg weakness. His AST, ALT, and ammonia are markedly elevated. Which diagnostic test is likely to have the highest yield in this patient?

  1. Electroencephalogram
  2. Genetic testing for laforin and malin mutations
  3. Liver ultrasound
  4. Muscle biopsy

16. A 35-year-old female is brought to the emergency department by her friend in an unconscious state following a head injury in a road traffic accident. She is afebrile, has a blood pressure of 70/40 mmHg, a pulse rate of 47 beats per minute, and a respiratory rate of 12 breaths per minute. Her GCS is 7/15. On an MRI scan, she is found to have a Panda sign. Which of the following describes the Panda sign in this patient?

Bilateral and sign of anterior cranial fossa fracture
  1. Unilateral and sign of anterior cranial fossa fracture
  2. Bilateral and sign of anterior cranial fossa fracture
  3. Unilateral and sign of posterior cranial fossa fracture
  4. Bilateral and sign of posterior cranial fossa fracture

17. A 65-year-old woman with behavioral variant frontotemporal dementia comes for a follow-up visit. You obtain collateral history from her husband of 40 years and then she asks to be examined without him in the room. In his absence she tells you that she knows that her husband has been stealing money from her and spending it on his new girlfriend and to protect herself she has resorted to hiding any money she gains access to. Assuming that you are able to confirm that her claims are false, this phenomenon would represent which of the following?

  1. Erotomania
  2. Grandiose delusion
  3. Referential delusion
  4. Persecutory delusion 

18. A 24-year-old woman is 14 weeks pregnant and presents to the emergency department with irregular, dance-like movements of her arms that started two days prior. For the past several weeks, her husband thinks she has been more “fidgety”. The movements disappear during sleep. She has had one prior miscarriage, but she has no other known medical history and no family history of similar symptoms. Complete metabolic profile, thyroid studies, and infectious studies are normal. Brain magnetic resonance imaging is unremarkable. What is the most likely diagnosis?

  1. Basal ganglia hemorrhage
  2. Chorea gravidarum
  3. Huntington disease
  4. Nonketotic hyperglycemia

19. A 65-year-old man with a history of hypertension presents to his primary care physician complaining of headaches. He had “migraines” as a teenager but had been headache-free for many years until one month ago when he developed frequent generalized, dull headaches, often present on waking, with associated nausea and “blurred vision.” He has not paid much attention to position but when asked he thinks that the headaches may be worse when is lying as opposed to when he is sitting or standing. He does not snore and denies daytime sleepiness. Which of the following is the most appropriate next step in the management of this patient?

  1. Brain MRI with and without contrast
  2. Initiate amitriptyline at 25 mg PO q hs
  3. Initiate ibuprofen 600 mg PO at headache onset
  4. Lumbar puncture with opening and closing pressures

20. A 14-month-old boy is newly diagnosed with tuberous sclerosis based on skin findings, family history, and genetic testing, but is otherwise normal. At what time would a brain MRI be recommended?

  1. Soon after diagnosis
  2. Defer until abnormal neurological exam findings
  3. Perform when developmental delay is apparent or following his first seizure
  4. Prior to onset of puberty

Hope you found this blog helpful for your NEET SS neurology preparation. For more informative and interesting posts like these, keep reading PrepLadder’s blogs. 

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