This document contains 12 multiple choice questions about neurology. The questions cover topics such as the effects of pyramidal tract involvement, diagnosis of headache types, use of rtPA in ischemic stroke treatment, common causes of seizures in AIDS patients, signs of various muscular dystrophies, effects of demyelination in multiple sclerosis, findings in Alzheimer's disease brain examination, inclusion bodies seen in progressive myoclonic epilepsy, location of hypertensive hemorrhage, effects of lithium, drug of choice for generalized tonic-clonic seizures in pregnancy, and the probable diagnosis for a patient presenting with weakness, rash, and elevated CK. Answer keys are provided for each question.

1. MCQs in Medicine
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Neurology
1. Involvement of pyramidal tract leads to all of the following except
A) Hyper-reflexia
B) Spasticity
C) Positive Babinski sign
D) Fasciculations
2. A 28-year-old man presents with history of headache for 6 months which is mainly on frontal region
occasionally associated with nausea. He has been taking paracetamol 3g per day, hydroxycodeine 50 mg
3 times a day and aspirin 300 mg 3 timesa day for headaches, but only with temporary relief from
symptoms. No focal signs on neurological examination. He also has history of depression and is on
treatment for 2 year with paroxetine now. What is the diagnosis?
A) Cluster headache
B) Depression associated headache
C) Migraine
D) NSAIDs oversue/Analgesic abuse headache
3. Intravenous rtPA is indicated in ischemic stroke within how many hour/s of onset of disease process-
A) 1 hour
B) 3 hours
C) 12 hours
D) 6 hours
4. The most common cause of seizures in a patient of AIDS is-
A) CNS lymphoma
B) Toxoplasmosis
C) Progressive multifocal leucoencephalopathy
D) Cryptococcal meningitis
5. Wheel chair sign of Quinn is used as a typical red flag sign in -
A) Idiopathic parkinsonism
B) Becker's dystrophy
C) Duchenne muscular dystrophy

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D) Thomson disease
6. A 25-year old woman experiences loss of sensation in her legs and weakness in her limbs. A
neurological examination indicates some spasticity of the limbs as well. The neurologist examination
indicates some spasticity of the limbs as well. The neurologist makes a preliminary diagnosis of
early multiple sclerosis (MS). Assuming that this diagnosis is correct, which of the following best
accounts for the diminution of sensory and motor functions?
A) An overall loss of dopaminergic release throughout the brain and spinal cord
B) Loss of peripheral cholinergic neurons
C) Loss of Schwann cells in peripheral neurons
D) Demyelination of CNS neurons
7. An analysis was undertaken of the histological, pathological, and neurochemical alterations in
the brains of patients who died of Alzheimer disease. Following examination of the brain. Which
of the following would most likely be present in the affected regions?
A) Marked retrograde degeneration in sensory neurons of the brainstem
B) A decrease in substance P in the hypothalamus and brainstem reticular formation
C) Marked degeneration of most myelinated pathways
D) Amyloid deposits and neurofibrillary tangles
8. Inclusion bodies seen in progressive myoclonic epilepsy -
A) Lafora bodies
B) Buschino bodies
C) Hirano bodies
D) Lewy bodies
9. Hypertensive hemorrhage is most commonly seen in?
A) Basal ganglia
B) Cerebrum
C) Thalamus
D) Brain stem
10. Lithium causes-
A) Hypokalemia
B) Hypocalcemia

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C) Hyperkalemia
D) Hypercalcemia
11. DOC of GTCS in pregnancy?
A) Valproate
B) Levetiracetam
C) Lamotrigine
D) CBZ
12. A 67-year-old woman is evaluated for weakness. She has had several weeks of difficulty brushing
her teeth, combing her hair, climbing steps. She has also noted a rash on her face. Examination is
notable for erthyematous flat topped papules on interphalangeal joints. Serum creatinine kinase
(CK) is elevated. What is the probable diagnosis?
A) Myaesthenia Gravis
B) Inclusion body myositis
C) Polymyositis
D) Dermatomyositis

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Answer Keys
Question Answer Question Answer
1 D 7 D
2 D 8 A
3 B 9 A
4 B 10 A
5 A 11 C
6 D 12 D