:Post-mortem studies of Alzheimer's disease have shown -1

.A-Shrinkage of frontal and temporal gyri

.B-Enlarged frontal and temporal gyri
.C-Enlarged ventricles
.D-Shrinkage of the parietal and occipital lobes
.E-Enlarged parietal and occipital gyri

Which dementia is characterized by frontal lobe symptoms and a specific -2

?histology
.A-Parkinson disease
.B-Front-temporal dementia
.C-Vascular dementia
.D-Picks disease
.E-NPH

3-Which of the following is not a side effect commonly associated with memantine?

A-Depression

B-Mild sedation

C-Confusion

D-Dizziness

E-Blurred vision

4- A 71-year-old man has a six-month history of being apathetic, unmotivated with

poor judgment and inappropriate social behavior. These symptoms suggest
dysfunction of what part of the brain?

A. Parietal lobes.

B. Frontal lobes.

C. Limbic system.

D. Amygdala and its connections.

E. Occipital parietal association cortex.

5- An elderly patient has recently developed cognitive impairment , ataxia,

myoclonus and behavioural changes. Most likely diagnosis is:-

A) Alzheimer’s disease 
B) Parkinson’s disease 
C) Creutzfeldt Jacob Disease (CJD) 
D) Lewy body dementia 
E) Huntington’s disease.

6- What is the overall likelihood of relapse reduction using interferon beta if

someone with MS had been having one relapse per year for the previous two
years?
A-5%
B-10%
C-30%
D-50%
E-70%
7- The following are true about the synaptic potential:
A-The Na+ and K+ current occur simultaneously.
B-Is a gradual potential.
C-The channel is ligand gated.
D-The post synaptic potential is inhibitory when depolarizing.
E-The post synaptic potential is inhibitory when GABA bind to post synaptic
receptors.
8- Which of the following statements regarding multiple sclerosis is not correct:
A-MS is an immune mediated disorder
B-MS is the most common neurologic disorder affecting young adults
C-the male-female ratio in MS is 2:1
D-the risk for MS in a monozygotic twin is 25%-30%
E-the risk of MS in general population is 0.1%
9- Which of the following agents is NOT typically used to manage fatigue in patient
with MS?
A-Amantadine
B-Baclofen
C-Fluoxetine
D-Pemoline
E-Modafinil
10- The most common cause of myasthenic crisis is:
A-Intercurrent infection

b-Hypothyroidism

c-Hyperthyroidism

d-Drug under dose

e-Stress

11- The most sensitive test in generalize MG is:

A-AchR Ab
B-Edrophonium test
C-Anti Musk Ab
D-Repetitive nerve stimulation
E-Single fiber EMG
12- In MG which of the following statements is correct?
A-It is an autosomal dominant disease

B-The ocular muscles are spared in general type

C-Deep tendon reflexes are diminished

D-Tensilon test exacerbate cholinergic crisis

E-Muscle atrophy is an early feature

13- What sensory pathway carries light touch and proprioception?

A-Medial lemniscus
B-Lateral lemniscus
C-Spinothalamic tract
D-Chorda tympani
E-Corticospinal tract
14- Which of the following statements is correct regarding the non motor symptoms seen
in patients with idiopathic PD?

A-Shoulder pain in a patient with PD should prompt an extensive work-up for orthopedic
problems, as the pain would not be attributable to the PD itself.

B-Urinary frequency, urgency, and nocturia occur in male PD patients with prostatic
hypertrophy.
C-In a patient with parkinsonism and orthostatic hypotension, the diagnosis cannot be
idiopathic PD , it must be multiple system atrophy.

D-Constipation is a prominent symptom in patients with PD, and may predate the motor
symptoms for years.

E-REM sleep behavioral disorder in a patient with parkinsonism implies the diagnosis is DLB,
not idiopathic PD.

15- The followings are pain sensitive structure:

A-Trigeminal nerve
B-Glossopharyngeal n.
C-Oculomotor n.
D-Facial n.
E-Vestibulocochlear n.
16- All the following are cause hyperthermia in comatose patients:
A-Status epilepticus

B-Pontine hemorrhage

C-Hypothalamic lesion

D-Heat stroke

E-Sedative drug intoxication

17- Brown sequard syndrome:

A-Commonly cause by traumatic injury.

B-Ipsilateral motor deficit.

C-Contralateral impairment of vibration and position sense.

D-Contralateral loss of pain and temp.

E-Prognosis for motor recovery is good.

18- In klumpke paralysis, all the followings are true EXCEPT:

A-It cause paralysis and wasting of the small muscles of the hand.
B-Its due to injury involved C5 C6 roots.
C-Horner syndrome is an associated finding.
D-It often follow a fall.
E-It result from traction on the abducted arm.
19- A patient has the sudden onset of inability to talk. He understands what is said
to him but can only say "if only" and "oh no." Where is the lesion?

A. Left superior temporal gyrus.

B. Left parietal lobe - angular gyrus of the parietal lobe.

C. Left inferior frontal gyrus.

D. Both the superior temporal gyrus and inferior frontal gyrus on the left.

E. Left inferior temporal gyrus.

20- With a lesion of the corticospinal tract the greatest deficit will be noted in
which one of the following areas?

A. The foot.

B. The hand.

C. The shoulder girdle muscles.

D. The pelvic girdle muscles.

E. The axial muscles.

21- A patient is unconscious and is noted to have extension of both the upper and
lower extremities. This type of posture is most consistent with a lesion at which
one of the following levels?

A. Cerebral hemispheres.

B. Midbrain.

C. Medulla.

D. Cervical spinal cord.

E. Cerebellum.

22- The labyrinthine artery most frequently originate from which artery?

A-Basilar artery

B-Anterior inferior cerebellar artery

C-Superior cerebellar artery

D-Posterior inferior cerebellar artery

E-Posterior cerebral artery

23- Contraindications in intravenous immunoglobulin (IVIG) treatment in a patient

with myasthenia gravis include:

A-Past history of stroke.

B-Past history of renal disease.

C-Decreased IgA levels.

D-Age over 65.

E-patients on steroid.

24- Which of the following drug is approved to treat chorea associated with
Huntington disease:

A-Clonazepam

B-Halloperidone

C-Deutetrabenazine

D-Reserpine

E-Amantadine

25- The rubrospinal tract originate where?

A-Nucleus accumbens.
B-Occulomotor nucleus.
C-Substantia nigra
D-Dentate nucleus.
E-Red nucleus.
26-  Neurotransmitter synthesis normally occurs in which part of the cell?
A-Golgi apparatus.
B-Nucleus
C-Cell membrane
D-Cytosol
E-Rough endoplasmic reticulum
27- There is approximately how many ml of CSF in the body?
A-100 ml
B-150 ml
C-200 ml
D-250 ml
E-500 ml
28- In a patient with right internuclear ophthalmoplegia:
A-The lesion is in the right MLF.
B-The convergence is abnormal.
C-There is right adduction deficit.
D-Left abductor nystagmus.
E-The saccadic movement of left eye is normal.
29- The following area are involved in the initiation of a saccadic eye movement:
A-Inferior colliculus.
B-Superior colliculus.
C-Posterior parietal cortex.
D-Frontal eye field.
E-Dorsal prefrontal cortex.
30- The following are true about the CSF circulation:
A-Is produced by the modified ependymal cells of the choroid plexus.
B-The ventricular system communicates with the subarachnoid space through the
roof of the third ventricle.
C-Is absorbed mainly through the arachnoid granulations in the superior sagittal
sinus.
D-The arachnoid granulation is in contact with the endothelium of the venous sinus.
E-Blockage of the arachnoid granulation causes communicating hydrocephalus.
31- Upper quadrant hemianopia is due to lesion in:
A-Temporal lobe
B-Optic chiasm
C-Occipital lobe
D-Parietal lobe
E-Frontal lobe
32- Ulnar nerve is formed by the anterior roots of the spinal nerves:
A-C2-C3

B-C4-C5

C-C5-C8

D-C8-T1

E-T1-T2

33- Nothnagel syndrome occur due to lesion in:

A-Mid brain
B-Pons
C-Medulla oblongata
D-Cerebellum
E-Thalamus
34- Most common diabetic neuropathy includes:
A-Diabetic truncal radiculopathy
B-D. sensorimotor polyneuropathy
C-D. lumbosacral radiculoplexopathy
D-3rd cranial N. palsy
E-6th cranial N. palsy
35- Common nerve involved in hereditary neuropathy with liability to pressure palsy
(HNPP):

A-Ulnar

B-Radial

C-Peroneal

D-Media

E-Sciatic

36- Regarding innervation of selected muscle of the upper limb, the followings are
true Except:
A-Deltoid – C5.
B-Extensor carpi radialis longus – C6 C7.
C-Flexor carpi radialis – C6C7.
D-Extensor digitorum – C8
E-Flexor carpi ulnaris – C8.
37- Regarding the superficial abdominal reflex, the following are true EXCEPT:
A-It depend on the integrity of T8-T12.
B-May be absent in patient with upper motor neuron lesion affecting the same side.
C-Segmental loss may be related to disease of the abdominal wall.
D-It absent in elderly.
E-Bilateral absent response is usually significant.
38- The followings cause predominantly motor neuropathy:
A-Organophosphorus
B-Porphyria
C-Diphtheria
D-Arsenic
E-Thallium
39- A 34-year old woman presents to A+E with a two days history of increasing
headache and confusion. She has a temperature of 38.2 degrees. Whilst in the
emergency department she has a tonic-clonic seizure. MRI shows increased signal
in the temporal lobes on T2 imaging. What is the most likely cause?
A. Alcohol intoxication
B. Severe pneumonia
C. Viral encephalitis
D. Subarachnoid haemorrhage
E. Hepatic encephalopathy
40- A 51-year-old man with diabetes develops features of an autonomic
neuropathy. Which of the following symptoms does not occur in an autonomic
neuropathy?
A. Erectile dysfunction
B. Urinary urgency
C. Postural hypotension
D. Stridor
E. Constipation
41- A 67-year-old man has motor neurone disease. Which of the following features is NOT
seen in a pseudobulbar palsy?

A. Tongue wasting and fasciculations

B. Dysphagia

C. Brisk jaw jerk

D. Spastic tongue

E. Exagerated gag reflex

42- A 53-year-old woman presents to the neurology clinic with a six months history of
difficulty getting up from a chair. More recently she has noticed difficulty lifting things. On
examination she has a rash over the dorsum of her hands and both eyelids. What is the
most likely diagnosis?

A. Motor neurone disease

B. Vitamin B12 deficiency

C. Dermatomyositis

D. Myotonic dystrophy

E. Myasthenia gravis

43- A 45-year-old man develops proximal limb weakness. Which of the following
disorders may NOT cause a myopathy?
A. Cushing’s disease
B. Hypothyroidism
C. Acromegaly
D. Thyrotoxicosis
E. Turner’s syndrome
44- Which of the following treatment options has evidence to support its use for
GBS?
A-Intravenous immunoglobulins (IVIGs) combined with steroid
B-steroid alone
C-Plasmapheresis combined with steroid
D-IVIG combined with steroid
E-IVIGs or plasmapheresis
45- What characterizes steroid myopathy?
A- Weakness is mainly distally localized
B- The severity of symptoms is related to the duration of therapy
C- The EMG shows fibrillations
D- Biopsy disclose secondary inflammatory cells
E- Serum CPK is usually normal
:Muscle fatigue is due to -46
.A- Inability of the action potential to spread over the muscle
.B- Failure of transmission in the motor nerve
.C- Failure of neuro-muscular transmission
D- Depletion of energy store
E-None of the above
47- The following symptoms are the most common in cauda equine affection:
A- Burning ache in legs
B- Spastic paraplegia in legs
C- Anesthesia in lower extremities & perineum
D- Bladder dysfunction
E- Flaccid paraplegia in legs

48- In the examination of the pupils, All the following are true Except:
A- Normal pupils are typically 3-4 mm in diameter.
B- Thalamic pupils slightly large about 5-7 mm.
C- Fixed dilated pupils greater than 7 mm in diameter.
D- Fixed midsized pupils is approximately 5mm in diameter.
E- Pinpoint pupils is 1-1.5 mm in diameter.

49- A 22-year-old woman suffering from bilateral weakness of her lower limbs.
Which of the following represent the most likely location of this lesion?
A- A lesion rostral to the pyramidal decussation.
B- The left genu of internal capsule.
C- The right posterior limb of internal capsule.
D- A lesion caudal to the pyramidal decussation.
E- The right genu of internal capsule.
50- A 72-year-old man presented with frequent fall over the past 8 months.
On examination, He has generalized rigidity, bradykinesia, exaggerated gag reflex
and difficulty with vertical gaze. What is the most likely diagnosis?
A- Corticobasal degeneration.
B- MSA
C- P.D
D- Lewy body dementia
E- PSP

51- Which of the following neuromuscular disease, is NCS and EMG the first choice
as a diagnostic test?
A- Duchenne muscular dystrophy.
B- Mitochondrial myopathy.
C- Spinal muscular atrophy.
D- Hereditary motor sensory neuropathy.
E- AIDP.

52- Mortality is higher in meningitis due to:

A- S.Pneumonae.
B- H.Influenzae.
C- L.monocytogene.
D- N.menigitidis.
E- Viral meningitis.

53- Less common cause of viral meningitis is:

A- Enterovirus.
B- Arbovirus.
C- Adenovirus.
D- HSV-2.
E- CMV.

54- In bacterial meningitis, the goal is to begin antibiotic therapy within what times
of patients arrival to ER:
A- 1 hr.
B- 3 hrs.
C- 6 hrs.
D-12 hrs.
E- 24 hrs.

55- Which of the following is atypical CSF profile in viral meningitis?

A- Lymphocytic pleocytosis 25-500 cells /microliter.
B- Normal protein.
C- Slightly elevated protein 20-80 mg/dl.
D- Reduce glucose concentration.
E- Normal or mildly elevated pressure 100-350 mm H2O.
56- Which of the following structures exhibit atrophy in patient with moderate
stage of Alzheimer disease?
A- Thalamus.
B- Substantia nigra.
C- Hippocampus.
D- Hypothalamus.
E- Raphe nucleus.

57- Combination of parkinsonism and profound dementia is characteristically

found in:
A- PD.
B- Alzheimer disease.
C- Diffuse lewy body disease.
D- MSA.
E- Spinocerebellar degeneration.

58- The following factors are predict poor outcome in patients with GBS:
A- Mean age above 60.
B- Prodromal diarrhea.
C- Bulbar weakness.
D- Presence of autonomic symptoms.
E- Albumino- cytological dissociation in CSF.

59- The following are causes of carpal tunnel syndrome:

A- Rheumatoid arthritis.
B- Acromegaly.
C- Addison disease.
D- Pregnancy.
E- D.M.

60- Meralgia parasthetica is due to compression of:

A- Lateral cutaneous N.
B- Median N.
C- Radial N.
D- Axillary N.
E- Sural N.

61- The following are typically showing sensory neuropathy:

A- Sjogren disease.
B- Porphyria.
C- Alcoholism.
D- D.M
E- Carcinoma.
62- Which of the following is NOT a cause of toxic polyneuropathy?
A- Manganese.
B- Lead.
C- Mercury.
D- Arsenic.
E- Organophosphorus.

63- The following are a non- motor symptoms of P.D:

A- Non-REM sleep disorder.
B- Hallucination.
C- Psychosis.
D- Autonomic disturbance.
E- Pain.

64- The following are TRUE in miller-fisher syndrome:

A- It occurs approximately in 5% of cases.
B- Typically presented with progressive ataxia.
C- Associated with AntiGQ1b antibody.
D- Ophthalmoplegia.
E- Power and sensation are usually affected.

65- Gower sign seen in which of the following:

A- Osteoarthritis.
B- Congenital myopathy.
C- Duchenne muscular dyatrophy.
D- GBS.
E- All of the above.

66- Which of the following cranial nerve has the longest intracranial course?
A- Facial n.
B- Occulomotor n.
C- Abducens n.
D- Trochlear n.
E- Vagus n.

67- Which tract is the main mediator of nystagmus and conjugated gaze?
A- Central tegmental fasciculus.
B- Lateral vestibulospinal tract.
C- Dorsal longitudinal fasciculus.
D- Tectospinal tract.
E- Medial longitudinal fasciculus.

68- Truncal ataxia is seen in patient with lesion of:

A- VPL of thalamus.
B- Vermis.
C- Pons.
D- Cerebellar hemisphere.
E- STN.

69- In deep brain stimulation, which of the following is best target for the
treatment of essential tremor?
A- STN.
B- Caudate N.
C- Thalamus.
D- GPi.
E- GPe.

70- Which of the following complications is associated with diabetic neuropathy?

A- foot ulcers

B- arthropathy affecting the ankles

C- sensory ataxia

D- acute third nerve palsy

E- All of the above

71- Which of the following conditions does not present as mononeuritis multiplex?

A- vasculitic neuropathy
B- diabetes
C- Gillian-barre syndrome
D- cryoglobulinemic vasculitis
E- neuropathy associated with HIV
72- The presence of lasegue sign suggest damage to the:
A- Spinal root L2-L3
B- Spinal root C5-C8 or radial nerve
C- Spinal root L5-S1 or sciatic nerve
D- Anterior horns at the level L5-S1
E- Spinal root T10
73- What sensory pathway carries light touch and proprioception?
A- Medial lemniscus
B- Lateral lemniscus
C- Spinothalamic tract
D- Chorda tympani
E- Corticospinal tract
74- Fasciculation is seen in:
A- Myasthenia gravis
B- MND
C- GBS
D- Proximal myopathy
E- Hypokalemic cramps
:Vitamine B12 deficiency can give rise to all of the following Except -75
A- Myelopathy
B- Optic atrophy
C- Peripheral polyneuropathy
D- Myopathy
E- All of the above
76- The temperature & pin sense loss usually develops with disease in:
A- Lateral horn of spinal cord
B- Anterior horn of spinal cord
C- Posterior column of spinal cord
D- Posterior horn of spinal cord
E- Internal capsule

77- Which of following treatment of immune mediated neuropathies are NOT

proven in controlled studies:
A- IVIG in CIDP
B- Prednisolone in GBS
C- IVIG in multifocal neuropathy
D- Plasmapheresis in GBS
E- Prednisolone in CIDP

78- The patient with apraxia cannot:

A- Speak fluently
B- Name his fingers
C- Carry out an imagined act
D- Obey command
E- Draw simple diagram

79- A 39 year old woman presents with left Horner's , vertigo, ataxia and sensory
changes on the left side face and right side of the body. Which of the following is
most likely cause:
A- Left carotid artery dissection.
B- Right carotid artery dissection.
C- Left vertebral artery dissection.
D- Right vertebral artery dissection.
E- Right MCA occlusion.
80- Hypothermia occur in coma caused by the followings:
A- Ethanol intoxication.
B- Renal encephalopathy.
C- Hepatic encephalopathy.
D- Myxedema
E- Wernicke encephalopathy

THE KEYS
1-A
2-D
3-A
4-B
5-C
6-C
7-D
8-C
9-B
10-A
11-E
12-D
13-A
14-D
15-E
16-E
17-C
18-B
19-C
20-B
21-B
22-B
23-C
24-C
25-E
26-D
27-B
28-B
29-A
30-B
31-A
32-D
33-A
34-B
35-C
36-D
37-E
38-A
39-C
40-D
41-A
42-C
43-E
44-E
45-E
46-A
47-B
48-B
49-D
50-D
51-D
52-A
53-C
54-A
55-D
56-C
57-C
58-E
59-C
60-A
61-B
62-A
63-A
64-E
65-C
66-D
67-E
68-B
69-C
70-E
71-C
72-C
73-A
74-B
75-D
76-D
77-B
78-C
79-C
80-B