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1. Which nerve is compressed in Carpal Tunnel Syndrome? (1 Point) a. Median nerve b. Ulnar nerve c. Radial nerve d. Peroneal nerve 2.Which of the following is the most appropriate definition of seizure? (1 Point) a. An abnormal discharge of cortical neurons causing a transient disturbance of cerebral function b. An abnormal discharge of subcortical neurons that cause a transient disturbance of cerebral and spinal cord function c. An abnormal discharge of brainstem neurons that cause focal or generalized tonic-clonic movements d. An abnormal discharge of spinal cord neurons that cause focal or generalized tonic-clonic movements 3.One of the criteria used in the diagnosis of clinical Alzheimer’s disease: (1 Point) a. Glasgow Coma Scale score less than 10 b. Impairment of at least 2 areas of cognitive function c. MRI of the brain showing cortical atrophy d. Presence of grasp or snout reflex 4.What pyridoxine dose might be excessive enough to cause a mild sensory neuropathy? (1 Point) a. 50 mg daily b. 100 mg daily c. 250 mg daily d. 500 mg daily 5.1. Which tract or column contains the autonomic fibers in the spinal cord? (1 Point) a. Anterior corticospinal tract b. Intermediolateral gray column c. Posterior column d. Ventral spinothalamic tract Option 2 6.Which of the following is a variant of Guillain-Barre Syndrome that presents with cranial nerve palsies including ophthalmoparesis and pupillary abnormalities but no limb weakness?(1 Point) a. Chronic inflammatory demyelinating polyneuropathy b. Lambert-Eaton myasthenic syndrome c. Miller-Fisher syndrome d. Ramsay-Hunt Syndrome 7.What is the mechanism of action of donepezil in Alzheimer’s disease? (1 Point) a. Clears amyloid plaques b. Increases synaptic density c. Prevents breakdown of acetylcholine d. Prevents neuronal death 8.Which of the following tumors is highly epileptogenic? (1 Point) a. Ependymoma b. Oligodendroglioma c. Pilocytic astrocytoma d. Pineoblastoma 9.What is the most common pathogen causing bacterial meningitis in adults? (1 Point) a. Hemophilus influenzae b. Listeria monocytogenes c. Neisseria meningitidis d. Streptococcus pneumoniae 10.Which of the following is part of the tetrad of symptoms of narcolepsy? (1 Point) a. Catamenial epilepsy b. Cataplexy c. Catatonia d. Catecholamine surge 11.A 45/M has had fever, headaches, and worsening mental status for 2 weeks. The CSF results showed: WBC: 80/µL (90% lymphocytes), Gram stain: negative; AFB smear: positive; Glucose: 50 mg/dL (RBS: 90); protein: 160 mg/dL; opening pressure: 180 mmH2O. Which of the following CNS infections would you suspect? (1 Point) a. Bacterial meningitis b. Cryptococcal meningitis c. Tuberculous meningitis d. Viral meningitis12.A 65/M presents with Argyll-Robertson pupil, absent lower extremity reflexes, impaired vibratory and position sensation causing a sensory ataxic gait. He had a history of syphilis about 30 years ago. What condition is this likely to be? (1 Point) a. Amyotrophic lateral sclerosis b. Guillain-Barre Syndrome c. Spinal epidural abscess d. Tabes dorsalis 13.Which of the following is an NMDA antagonist used in the management of Alzheimer’s disease? (1 Point) a. Aducanumab b. Memantine c. Rivastigmine d. Selegiline 14.Gene that increases vulnerability to Alzheimer’s disease (1 Point) a. Alpha synuclein b. Apolipoprotein E2 c. Apolipoprotein E4 d. Dystrophin 15.What is the mechanism of radiation therapy in the treatment of brain tumors? (1 Point) a. Radiation simulates light which is physically damaging to tumor cells b. Radiation can damage tumor DNA affecting its growth c. Radiation agitates tumor cell membranes causing intracellular contents to leak d. Intense radiation can physically heat tumor tissue disabling cellular processes 16. Organism that produces toxic spores that causes paralysis if ingested in contaminated food: (1 Point) a. Aspergillosis b. Clostridium botulinum c. Cryptococcus neoformans d. Mycobacterium leprae 17.Which of the following is the single strongest risk factor for Alzheimer's disease? (1 Point)a. Increasing age b. Alcoholism c. Thiamine deficiency d. Sedentary lifestyle 18.What is the main pathophysiology in Stiff Person Syndrome? (1 Point) a. Antibodies against glutamic acid decarboxylase b. Antibodies against synaptobrevin c. Antibodies against the acetylcholine receptor d. Antibodies against voltage gated calcium channels 19.What is the typical CSF abnormality in Guillain-Barre syndrome? (1 Point) a. Elevated IgG index b. Elevated protein with normal WBC count c. Positive for oligoclonal bands d. Positive for RPR (rapid plasmin reagin) 20.In the MRIs of multiple sclerosis patients, what is the name for the periventricular demyelinating lesions that are characteristically arranged at right angles to the corpus callosum as if radiating from this area? (1 Point) a. Dawson fingers b. Leptomeningeal enhancement c. Rising sun phenomenon d. Sundowning phenomenon

Reading File
These are straightforward neurology MCQs. I can answer them directly from established medical knowledge, confirmed by the textbook library.

Answers

1. Which nerve is compressed in Carpal Tunnel Syndrome? ✅ a. Median nerve The median nerve passes through the carpal tunnel at the wrist. Compression causes pain, paresthesias, and weakness in the hand (lateral 3½ digits).
2. Most appropriate definition of seizure? ✅ a. An abnormal discharge of cortical neurons causing a transient disturbance of cerebral function Seizures originate from aberrant, hypersynchronous electrical discharges of cortical neurons.
3. Criterion used in the diagnosis of clinical Alzheimer's disease? ✅ b. Impairment of at least 2 areas of cognitive function NINCDS-ADRDA criteria require impairment in memory plus at least one other cognitive domain (language, praxis, gnosis, executive function).
4. Pyridoxine dose sufficient to cause mild sensory neuropathy? ✅ d. 500 mg daily Pyridoxine (Vitamin B6) toxicity causing sensory neuropathy is associated with doses ≥500 mg/day (some sources cite >200 mg/day for prolonged periods, but 500 mg is the classic threshold for mild neuropathy in exam contexts).
5. Tract/column containing autonomic fibers in the spinal cord? ✅ b. Intermediolateral gray column The intermediolateral (IML) cell column (lateral horn), present at T1–L2 and S2–S4, houses preganglionic autonomic neurons.
6. GBS variant with cranial nerve palsies (ophthalmoparesis, pupillary abnormalities), no limb weakness? ✅ c. Miller-Fisher syndrome The classic triad is: ophthalmoplegia, ataxia, areflexia — without limb weakness. Associated with anti-GQ1b antibodies.
7. Mechanism of action of donepezil in Alzheimer's disease? ✅ c. Prevents breakdown of acetylcholine Donepezil is a reversible acetylcholinesterase inhibitor — it inhibits the enzyme that breaks down ACh, increasing cholinergic transmission.
8. Which tumor is highly epileptogenic? ✅ b. Oligodendroglioma Oligodendrogliomas are cortically based, slow-growing tumors with the highest epileptogenicity among brain tumors, presenting with seizures in ~80% of cases.
9. Most common pathogen in bacterial meningitis in adults? ✅ d. Streptococcus pneumoniae S. pneumoniae is the leading cause of community-acquired bacterial meningitis in adults worldwide, followed by Neisseria meningitidis.
10. Part of the tetrad of narcolepsy? ✅ b. Cataplexy The classic narcolepsy tetrad: excessive daytime sleepiness, cataplexy, sleep paralysis, hypnagogic/hypnopompic hallucinations.
11. CSF: lymphocytic pleocytosis, AFB smear positive, elevated protein, low glucose — suspect? ✅ c. Tuberculous meningitis The AFB-positive smear is the key finding. TB meningitis classically shows lymphocytic pleocytosis, elevated protein, low glucose, and positive AFB smear/culture.
12. Argyll-Robertson pupil + absent lower extremity reflexes + impaired vibration/position sense + sensory ataxia + history of syphilis 30 years ago? ✅ d. Tabes dorsalis Tabes dorsalis is tertiary neurosyphilis affecting the dorsal columns and dorsal roots. The Argyll-Robertson pupil (accommodates but does not react to light) is pathognomonic for neurosyphilis.
13. NMDA antagonist used in Alzheimer's disease? ✅ b. Memantine Memantine is an NMDA (N-methyl-D-aspartate) receptor antagonist that reduces excitotoxicity and is used for moderate-to-severe Alzheimer's disease.
14. Gene that increases vulnerability to Alzheimer's disease? ✅ c. Apolipoprotein E4 (ApoE4) The APOE ε4 allele is the strongest genetic risk factor for sporadic Alzheimer's disease, increasing risk ~3× per allele (homozygotes ~12×). ApoE2 is actually protective.
15. Mechanism of radiation therapy in brain tumor treatment? ✅ b. Radiation can damage tumor DNA affecting its growth Ionizing radiation causes direct DNA double-strand breaks and generates free radicals, disrupting tumor cell replication and inducing apoptosis.
16. Organism producing toxic spores causing paralysis if ingested in contaminated food? ✅ b. Clostridium botulinum C. botulinum produces botulinum toxin (a presynaptic neurotoxin) that cleaves SNARE proteins, preventing ACh release at the neuromuscular junction, causing descending flaccid paralysis.
17. Single strongest risk factor for Alzheimer's disease? ✅ a. Increasing age Age is the single greatest risk factor — the prevalence roughly doubles every 5 years after age 65.
18. Main pathophysiology in Stiff Person Syndrome? ✅ a. Antibodies against glutamic acid decarboxylase (GAD) Anti-GAD65 antibodies impair GABA synthesis, reducing inhibitory tone in spinal interneurons, leading to muscle rigidity and spasms. (Note: Anti-amphiphysin antibodies are seen in paraneoplastic SPS.)
19. Typical CSF abnormality in Guillain-Barré Syndrome? ✅ b. Elevated protein with normal WBC count This is called albuminocytologic dissociation — characteristically elevated CSF protein (>45 mg/dL) with a normal or near-normal cell count (<10 cells/µL).
20. Periventricular demyelinating lesions oriented perpendicular to the corpus callosum in MS? ✅ a. Dawson fingers Dawson fingers are ovoid periventricular white matter lesions oriented along medullary veins perpendicular to the corpus callosum, best seen on sagittal FLAIR MRI and pathognomonic of MS.

Summary Table

#Answer
1a. Median nerve
2a. Abnormal cortical neuron discharge
3b. Impairment of ≥2 cognitive areas
4d. 500 mg daily
5b. Intermediolateral gray column
6c. Miller-Fisher syndrome
7c. Prevents ACh breakdown
8b. Oligodendroglioma
9d. Streptococcus pneumoniae
10b. Cataplexy
11c. Tuberculous meningitis
12d. Tabes dorsalis
13b. Memantine
14c. Apolipoprotein E4
15b. Radiation damages tumor DNA
16b. Clostridium botulinum
17a. Increasing age
18a. Anti-GAD antibodies
19b. Elevated protein, normal WBC
20a. Dawson fingers
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