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1 Medicine MCQs - CNS

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CENTRAL NERVOUS SYSTEM TEST 1 8.

All are true about choreal movement


1. With which one of the following Lower except
Motor Neuron lesions are associated
a) Flaccid paralysis. a) Irregular
b) Hyperactive stretch reflex b) Jerky
c) Spasticity c) Present during sleep
d) Muscular incordination d) Quasipurposive.

2. Fasciculation is seen in 9. Hemibalismus is caused by lesions of


a) UMN type of lesion the
b) LMN type of lesion a) Caudate nucleus
c) Myoneural junction b) Contralateral subthalamic nucleus
d) Peripheral neuropathy. c) Putamen
d) Substantia Nigra
3. In pyramidal tract lesion all seen except
a) Claspknife rigidity 10. All are true about cerebellar disease
b) Babinski +ve except
c) Involuntary tremors a) Ataxia
d) None of the above b) Hypertonia
c) Intension tremor
4. Episodic generalized weakness can d) Dysmetria
occur due to all of the following acute
electrolyte disturbances, except: 11. Allodynia is
a) Hypokalemia a) Increased perception of painful
b) Hypocalcemia stimulus
b) Perception of non painful stimulus
c) Hoponatremia
as pain
d) Hypophosphatemia c) Pain felt as abnormal sensation
d) None
5. Episodic muscular weakness is seen in
a) K+ 12. A person cannot identify familiar
b) Lambert Eaton syndrome object when place in the palm when he
c) Myasthenia Gravis is blindfolded, this condition is called-
a) Aphonia
d) All of the above
b) Astereognosis
c) Aphasia
6. Hyperkinetic syndromes such as d) Aphakia
chorea and athetosis are usually
associated with pathological change in- 13. True about lesion of inferior frontal
a) Motor areas of cerebral cortex gyrus is
b) Anterior hypothalamus a) Compromised speech
c) Pathways for recurrent collateral b) Defective perception
c) Neologism
inhabitation in the special cord
d) Global aphasia
d) Basal ganglia complex

7. In metabolic encephalopathy, feature is


a) Tonic clonic seizures
b) Chorea
c) Asterixis
d) Paraplegia
14. Crossed aphasia means : d) Contralateral hemiparesis
a) Right hemispherical lesion in right
handed person 21. Wing beating tremor is seen in
b) Right hemispherical lesion in left a) Huntington disese
handed person
b) Wilson disease
c) Left hemispherical lesion in left
handed person c) Parkinsonism
d) Left handed lesion in right handed d) Thyrotoxicosis
person.
22. Flapping tremors are not seen in-
15. Jargon aphaisa is seen in : a) Wilsons disease
a) Wernickes aphasia b) Thyrotoxixosis
b) Brocas aphasia c) CO2 narcosis
c) Conduction aphasia d) Uremia
d) Kosarkoff psychosis
23. Pseudocoma results from infraction or
16. Prosopagnoisa haemorrhage in-
a) Inability to do fine movement a) Pons
b) Inability to recognize face b) Mid-brain
c) Seen in Baline syndrome c) Medulla
d) Associated with Grestman d) Hypothalamus
syndrome
24. Earliest, definite sign of death is
17. A medial temporal lesion produces a) Absent brain stem reflexes
a) Visual amnesia only b) Stoppage of mucosal ciliary action
b) Auditory amnesia in respiratory passage
c) Aparaxia c) Retinal anterior column break down
d) Anterograde learing problems d) None of these
18. Which of these can cause 3rd nerve 25. Pontine stroke is associated with all
paralysis : except:
a) Posterior communicating artery a) Bilateral pin point pupil
aneurysm b) Pyrexia
b) Tolosa Hunt syndrome c) Vagal palsy
c) Midbrain infarct d) Quadriparesis
d) All of the above
26. Best method to monitor intracranial
19. All of the following statements are true pressure is
about Benedikts syndrome, except- a) Intraventricular catheter
a) Contralateral tremor b) Subarachnoid bolt
b) 3rd nerve palsy c) Intraparenchymal catheter
c) Involvement of the penetrating d) Epidural catheter
branch of the basilar artery
d) Lesion at the level of the pons 27. The causes of systemic secondary
insult to injured brain include all of
20. Millard Gubler syndrome includes the the following except
following except- a) Hypercapnia
a) 5th Nerve palsy b) Hypoxaemia
b) 6th nerve palsy c) Hypotension
c) 7th nerve palsy d) Hypothermia
28. Which of the following is most prone to
hypoxic injury :
a) Thalamus
b) Hippocampus
c) Caudate nucleus
d) Cerebellum
CENTRAL NERVOUS SYSTEM TEST 2 35. The highest frequency wave in EEG is
29. Todds paralysis is seen in wave-
a) Head injury a) Alpha
b) Strokes b) Beta
c) Epilespsy c) Garmma
d) Subarachnoid hemorrhage d) Theta

36. Carbmazepine is the drug of choice in :


30. EEG spike and dome pattern is a) Absence attacks
characterstic of Epilepsy b) Partial complex seizures
a) Jacksonian c) Myoclonus
b) Grandmal d) Infantile spasms
c) Petitmal
d) Temporal lobe 37. The drug of choice for absence
seizures-
a) Valproate
31. Bano Begum, 45 years old lady has b) Gabapentin
typical hand & limb movements with c) Carbamazepine
abnormal smell sensation. She was not d) Phenytoin
able to recall any events afterwards.
Her most probable diagnosis: 38. Neurosurgical treatment of epilepsy
usually involves, removal of epileptic
a) Temporal lobe epilepsy
focus from which lobe
b) Dislocation disorder a) Frontal lobe
c) Fugue b) Temporal lobe
d) Conversion reaction. c) Occipital lobe
d) Parietal lobe
32. Which one of the following is the
characteristic feature of juvenile 39. Drug of choice in status epilepticus is
a) Diazepam
myoclonic epilepsy?
b) Phenobarbitone
a) Myoclonic seizures frequently occur c) Phenytoin sodium
in morning d) Carbamazapine
b) Complete remission is common
c) Response to anticonvulsants is poor 40. The only thrombolytic agent approved
d) Associated absence seizures are for the treatment of acute ischemic
present in majority of patients. stroke is-
a) Tissue plasminogen activator
b) Streptokinase
33. True about juvenile mycoclonic epilepsy c) Urokinase
except : d) Pro-urokinase
a) Focal Seizure
b) Generalized seizure 41. Lacunar infarcts manifests as :
c) Myoclonus present a) Pure sensory weakness
b) Pure motor weakness
d) Responses to Sodium Valproate
c) Ataxicparesis
d) All of the above
34. Investigation of choice to diagnose
epilepsy is- 42. Most common cause of stroke in
a) MRI young women in India among OCP
b) EEG users
c) CT Scan a) Cortical vein thrombosis
b) Moyamoya disease
d) Angiogram
c) Atherosclerosis
d) All
43. Ipsilateral 3rd nerve palsy with contra- a) Vertebral artery
lateral hemiplegia is known as : b) Middle cerebral artery
a) Millard gobbler syndrome c) Junction of anterior
b) Webers syndrome
communicating & anterior cerebral
c) Foville syndrome
d) Benedicts syndrome aretery
d) Basilar artery
44. Lateral medullary syndrome is
associated with Sudden excruciating headache is seen in
a) Ipsilateral pain & temp loss a) Subarachnoid haemorrhage
b) Contralateral vibration loss b) Aneurysmal bleeding
c) Contralateral pain and temp loss c) Epilepsy
d) Ipsilateral hemiplegia d) Intracerebral haemorrhage
e) Histeria
45. Presence of hemiplegia with
diminution of vision in the 50. True about Alzheimers disease-
contralateral eye suggests occlusion of a) Mutation in APP gene
a) Middle cerebral artery b) Aluminium is a risk factor
b) Basilar artery c) Viral infection has ed risk
c) Anterior cerebral artery d) Hereditary
d) Internal carotid artery e) All of the above

46. Which of the following is not involved in 51. Senile plaques in brain is a feature of-
lateral medullary syndrome a) Multiple sclerosis
b) Parkinsonism
a) Sympathetic tract
c) Alzheimers desease
b) IX, X, XI th cranial nerves d) Wilsons disease
c) XIIth cranial nerve
d) Spinothalamic tract
CENTRAL NERVOUS SYSTEM TEST 3
47. A 45 years old hypertensive male
presented with sudden onset severe 52.Drug used to treat Alzeimers
headache, vomiting and neck stiffness. disease is:
On examination he did not have any a) Folinic acid
focal neurological deficit. His CT b) Choline
showed blood in the Sylvian fissure. c) Melatonin
d) Tetrahydroamineacrine
The probable diagnosis is :
a) Meningitis 53. Localised regional cerebral atrophy is
b) Ruptured aneurysm seen in
c) Hypertensive bleed a) Alzheimers disease
d) Stroke b) Frontotemporal dementia
c) PML
48. Commonest site of aneurysm is d) C.J. disease
a) Middle cerebral artery
b) Vertbrobasilar system 54. Triad of normal pressure
c) Anterior communicating artery hydrocephalus is
d) Internal carotid artery a) Dementia, bladder sphincter
involvement, gait abnormality
49. Least common site for berry aneurysms b) Dementia, gait abnormality,
aphasia
is:
55. Punch drunk state is associated with 62. Juvenile huntingtons disease is
a) Alcoholism marked by-
b) Chorea a) Chorea
c) Parkinonism b) Athetosis
d) All c) Tremors
d) Tics
56. All are seen in Parkinsonism except :
a) Akinessia-Bradykinesia 63. Degenerative changes are seen in
b) Rigidity Huntington chorea in :
c) Postural reflexes preserved a) Cerebellum
Resting tremors b) Caudate nucleus
c) Red nucleus
57. Frequency of Rest tremor in Pons
Parkinsons disease is
a) 2/s 64. The drug of choice for phenothiazine
b) 14/sec
dyskinesia is-
c) 4-6/sec
d) 8/sec a) Imipramine
b) Diphenhydramin
58. Ropinirole is the most useful for the c) Diazepam
treatment of d) Prochlorperazine
a) Parkinsons disease
b) Wilsons disease 65. Absent ankle jerk and extensor
c) Hoffmans syndrome
plantar response is found in-
d) Carpal tunnel syndrome
a) Friedreichs ataxia
59. Lewy bodies in neurons of brain is seen b) Tabes dorsalis
in c) SACD
a) Huntingtons disease d) Vit B deficiency
b) Parkinsons disease
c) Niemanns picks disease 66. In ataxia telengiectasia which is seen
d) None of the above
a) Ig G absent
60. A 65 Year old man presents with b) Ig M absent
ataxia, opthalmoplegia and recurrent c) Ig A absent
falls. The probable diagnosis is d) Ig A absent
a) Shy dragger syndrome
b) Huntingtons chorea 67. A middle aged man presents with
c) Parkinsons disease
progressive atrophy and weakness of
d) Progressive supranuclear palsy
hands & forearms. On examination
61. A family consist of husband, wife and 2 he is found to have sight spasticity of
children .Wifes father has Huntigtons the legs, generalized hyper-reflexia
chorea. Which statement is true and increased signal in the cortico-
a) Chance of getting disease in child is spinal tracts on T2 weighted MRI. The
1:4 most likely diagnosis is-
b) Can occur upto age of 50
a) Multiple sclerosis
c) If wife does not get disease till age
50 children are not affected. b) Amyotrophic lateral sclerosis
d) Huntingtions chorea is due to point c) Subacute combined degeneration
mutation in gene d) Progressive spinal muscular
atrophy.
68. Fasciculation is seen in : 76. to the hospital with external
a) Motor neurone disese injuries .CT brain showed No midline
b) Tetanus shift. Basal cistern were compressed
c) Tetany with multiple small haemorrhages.
Myasthe What is the likely diagnosis:-
a) Cerebral contusion
69. Spinomuscular atrophy is seen in b) Cerebral laceration
lesion of- c) Multiple infarcts
a) Anterior Horn d) Diffuse Axonal injuries
b) Peripheral nerve
c) N.M.J. 77. Glasgow coma scale is based on all
Any of the above except-
a) Sensory loss
70. Drug of choice in the treatment of b) Motor response
Trigeminal neuralgia is c) Vocal response
a) Carbamazepine d) Eye opening
b) Phenobarbitone
c) Chioropromazine 78. Best prognostic factor for head injury
d) Indomethacin is-
a) Glasgow coma scale
71. Bilateral facial palsy is seen in- b) Age
a) Myaesthania gravis c) Mode of Injury
b) Guillain Barre d) CT
c) Muscular dystrophy
d) Duchnene muscular dystrophy 79. Which of the following is the most
common type of glial tumors?
72. Anterior spinal artery thrombosis is a) Astrocytomas
characterized by all except : b) Medulloblastomas
a) Loss of pain & touch c) Neurofibromas
b) Loss of vibration sense d) Ependymomas
c) Loss of power in lower limb
d) Sphincter dysfunction 80. Primary CNS lymphoma is
characterized by all except-
73. In Brown-sequard syndrome
a) uncommon in AIDS
sensation, that is lost at the same side
b) Is of diffused histiocytic type
of lesion is
c) Chemotherapy is the treatment of
a) Pain
choice
b) Touch
d) Multicentric with brain and
c) Temperature
meaningeal involvement
d) Proprioception

74. Dissociated anesthesia is seen in


81. Meningioma arises from
a) Motor neuron disease
a) Extra dural arteries
b) Syringomyelia
b) Extra cranial muscles
c) Tabes dorsalis
c) Venous sinuses
d) Fredricks ataxia
d) Arachnoid cap cells
75. A young male is brought unconscious
82. Lisch nodules in neurofibromatosis a) N. meningitides
are- b) H. influenza
a) Iris pearls c) Staphylococcus
b) Hamartomas d) Streptococcus
c) Granulomas e) E. coli
d) None of the above
89. In a patient with Listeria meningitis
83. Babloo a 4 years old boy, presents with who is allergic to penicillin. The
history of seizures. On examination antimicrobial of choice is-
there is hypopigmented patches on his
a) Vancomycin
face. There is mental retardation also.
What is the most likely diagnosis- b) Gentamicin
a) Neurofibromatosis c) Trimethoprim sulphamethoxazole
b) Tuberous sclerosis d) Ceftriaxone
c) Sturge weber syndrome
d) Incontinentia pigmenti 90. Aseptic meningitis is caused by all
except-
84. Commonest cancer in which a) Polio virus
metastasis is seen in the brain is- b) Measles virus
a) Breast c) Mumps virus
b) Lung d) Coxsackie A virus
c) Kidney
d) Intestines 91. The most common cause of sporadic
viral encephalitis is-
85. The MR imaging in multiple sclerosis a) Japanese B encephalitis
will show lesions in:- b) Herpes simplex encephalitis
a) White Matter c) Human immunodeficiency virus
b) Grey matter encephalitis
c) Thalamus d) Rubeola encephalitis
d) Basal ganglia
92. Herpes simplex encephalitis affects
86. Most common presenting finding of which lobe ?
multiple sclerosis is- a) Temporal
a) Intranuclear ophthalmoplegia b) Parietal
b) Optic neuritis c) Occipital
c) Transverse myelitis d) Frontal
d) Cerebellar 93. A patient with fever had a lumbar
puncture done as part of workup for
87. Treatment for multiple sclerosis- fever. The CSF revealed high proteins
a) Interferon alpha with normal sugar and marked
b) Interferon beta increase in lymphocytes. The
c) Infliximab
diagnosis is likely to be-
d) Interferon gamma
a) Tubercular meningitis
88. Acute meningitis in adolescents and b) Bacterial
young adults is caused by c) Viral meningitis
d) Partially treated pyogenic infection
e) Neurocysticercosis
94. EEG is usually abnormal in all of the patient is-
following except- a) Histoplasma
a) Subacute sclerosing panencephalitis b) Cryptococcosis
b) Looked in state c) Coccidiomycosis
d) Candida albicans
c) Creutzfoldt Jackob disease
d) Hepatic encephalopathy 101. True about Creutzfeldt-Jacobs
disease is
95. Commonest site of brain abscess- a) Corneal implants can transmit
a) Temporal disease
b) Frontal b) Caused by RNA containing
c) Parietal organism
c) Caused by DNA containing
d) Occipital
organism
d) Arthropod borne disease
96. Intellectual deterioration in a 8 year
boy with myoclonus is seen in 102. Subacute combined degeneration
a) SSPE due to to Vit B deficiency mainly
b) C-J disease involves-
c) GSS a) Peripheral nerve
b) Posterior column
d) Kuru
c) Spinocerebellar tract
d) Spinothalamic tract
97. Multifocal leucocephalopathy is due
a) JC virus 103. Examples of PRION disease include
b) Prion a) Creutzfeldt-Jakob disease
c) Measles b) Subacute sclerosing
panencephalitis
d) Chicken pox
c) Alzheimers disease
d) None of the above
98. A young female patient with long
history of sinusitis presented with 104. Prions disease, all are true except:
frequent fever along with personality a) Protenaceous infectious particle is
changes and headache of recent origin. the cause
The funds examination revealed b) Brain biopsy gives specific
diagnosis
papilledema. The most likely diagnosis
c) 10% of patients have associated
is- myoclonus
a) Frontal lobe abscess d) None
b) Meningitis
c) Encephalitis
d) Frontal bone osteomyelitis

99. Which of the following is the most


common location of intracranial
neurocysticercosis-
a) Brain parenchyma
b) Subarachnoid space
c) Spinal cord
d) Orbit

100. The important organism causing


meningtis in Immunocompromised

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