1. After head trauma in the traffic accident 20 year old male presents with persistent f

  1. After head trauma in the traffic accident 20 year old male presents with persistent food-seeking behavior. He is obese and his classmates complain of  aggressive behaviors. If Hypothalamus is damaged in the traffic accident these clinical findings may be explained by a lesion in which of the following?A.Lateral B.Suprachiasmatic C.Supraoptic D.Anterior E.Ventromedial  2.A patient complying of losing sensation from the cheek for few months and now  he finds himself unable to chew his food. On physical examination, his jaw deviates to the right side. The nerve that has been affected in this patient exits the skull through which of the following foramina?A.Foramen rotundum B.Foramen ovale C.Foramen spinosum D.Foramen lacerum E. Jugular foramen   3.  A 50 -year-old male complains of double vision when reading the book. He has no other concerns. y. He jogs for 30 minutes every morning. His past medical history is significant for type 2 diabetes mellitus,which is well controlled with glyburide. A lesion of which of thefollowing structures is most likely responsible for this patient’s complaints?A.Optic nerve B.Oculomotor nerveC.Abducens nerve  D.Trochlear nerve ]E.Medial longitudinal fasciculus  4. A 48 old patient came for attention with right leg numbness. On the examination, you notice that he lifts his right foot higher than he does his left, and that his right foot slaps to the ground with each step. You also notice that he is unable to evert the right foot. Which of the following nerves has most likely been injured?A.Tibial B.Common peronealC.Superficial peroneal D.SuraIE.Obturator  5. A 75-year-old,right-handed man comes to the emergency department because of acute loss of vision in his right visual field. He denies headache, slurred speech, difficulty swallowing, weakness, numbness, and difficulty walking. His other medical problems include hypertension, atrial fibrillation, and hyperlipidemia. His blood pressure is 175/105 mm Hg and pulse is 92/min and irregular. Neurologic examination shows that he is awake, alert, and oriented. His speech is fluent, and he follows complex commands. Examination shows a right homonymous hemianopsia. The rest of the neurologic examination is within normal limits. Brain MRI reveals lesion of: A.Anterior cerebral artery B.Anterior choroidal artery C.Artery of Percheron D.Basilar artery E. Middle cerebral artery F.Posterior cerebral artery  6. A 30-year-old soccer player presents to your office complying of becoming clamps. He also complained that he cannot make distinguish if water is could or warm when he is washing his hands. Neurologic examination reveals 1+ biceps reflexes and 3+ patellar reflexes bilaterally,as well as decreased muscle strength in the bilateral upper and lower extremities. Which of thefollowing is the most likely cause of this patient’s problems?A.Amyotrophic lateral sclerosis B.Guillain-Barre syndrome  C.Syringomyelia D.Normal pressure hydrocephalus E.Multiple sclerosis F.Medulloblastoma  7. After viral infection in 55 year old man it was not possible to regulate BP that was previously well regulated by medications. Nerve that carry information from the carotid sinus was affected.Which of the following is most likely to be lost  in this patient?A. Taste sensation from the anterior two-thirds of thetongue B.General sensation from the tonsillar lining C.Salivary secretion from the submandibular gland D.Protrusion of thetongue ] 8. A 60-year-old,right-handed man comes to your attention because of recent onset throbbing, right-sided orbitofrontal headache and diplopia. He is also suffering hypertension and tobacco use for 45 years. On neurologic examination he is awake,alert,and oriented and follows commands. Testing of the cranial nerves reveals intact visual acuity and VF bilaterally. Examination shows anisocoria,with the right pupil being dilated and nonreactive to light and accommodation. Diplopia presents as vertical and horizontal binocular diplopia. The right eye is down and out with ipsilateral ptosis. The rest of the neurologic examination is unremacable. CT angiography of the head reveals a large aneurysm in the posterior fossa. A normal CT angiogram of the head is shown below.Which of the following identifiers from the angiogram indicates the cerebral vessel most likely to have an aneurysm causing this patient’s neurologic deficits? A.A B.B C.C D.D E.EF. F  9. Medical student asks why a man with Parkinson disease cannot be treated by IV dopamine. Which of the following cell communications account for the lack of responsiveness to dopamine? A. Desmosomes B. Hemidesmosomes C. Intermediate junctions D. Fenestrae E. Gap junctions F. Tight junctions 10. The following vignette applies to the next 2 items.A 70-year-old female ask for attention because of difficulty walking. It started this morning when she stood up from the bed. She also says that she cannot feel her right side. Physical examination reveals loss of touch sensation affecting the right upper and lower extremities and the right side of the face(1) This patient has most likely suffered a stroke affecting which of the followingA.Frontal cortex B.Internal capsule C.Base of the pons D.Caudate nucleus E. Thalamus  11.(2) The patient was diagnosed with a pure sensory stroke and received the appropriate treatmentHer symptoms improved. Six years later she dies due to MI. On autopsy there were 3 cavities deep in the brain filed with transparent fluid. Which of the following describes the finding?A.Carotid atheosclerosis B.Malignant cell infiltration C.Mitral valve disease D.Oligodendrocyte apoptosis E.Small vessel lipohyalinosis  12.  A 50 year-old man presented with the  disease that started in childhood with theappearance of multiple hyperpigmented skin macules. At the age of 45 a lot of cutaneous tumors appeared and started to increase in size all over the body surfaceThe cells composing these skin tumors most likely originated from which of the following structures? A.Surface ectodermB.Neuroectoderm C.Neural crest D.Mesoderm E.Endoderm F. Notochord  13. Below is presented cerebral arteriography of 50 year old man. Occlusion of the artery signed by ‘X’ would most likely result in an inability to:  A. Climb stairs B.Grip C.Whistle D.Swallow food  14. A 60-year-old male presents with left arm weakness. On examination motor strength was 3/5 with increased muscle tone in the left arm and “clasp knife spasticity”. Which letter presents on the picture location of the lesion in this patient? A.A B.B C.C D.D E. E  15. A 58-year-old man is brought by his colleagues to the emergency department after he suffer one attack of seizure during the work.  He is teacher in primary school, and he has never syncope nor seizure. Hiss colleagues told that in the last few months he was complaining of headache from time to time and few times he disturbs colleagues by warning that there is smell of burning woods, afraid that close to them it might start fire. Brain imaging shows a solitary mass within the right temporal lobe. Which of the following visual field defects is most likely present in this patient?                 16. A 58-year-old man is brought to the emergency department highly agitated due to inability to identify one’s own finger on the right hand. On the examination he speaks clearly but without comprehension, on commands he shows right left confusion and he was not able to calculate a simple arithmetic task.  Branch occlusion of which of the following arteries is most likely responsible for this patient’s condition?A.Anterior cerebral artery B.Anterior inferior cerebellar artery C.Middle cerebral artery D.Posterior cerebral artery E.Posterior inferior cerebellar artery  17. A 54 year old man comes to your attention due to drop of his right hand. On the examination it was noticed that patient can not extend his right hand in the wrist, although sensation was intact.  The affected nerve was most likely injured at which of the following locations?A.Carpal tunnel B.Hook of the hamate C.Surgical neck of the humerus D.Head of the radius E.Coracobrachialis  18. A 56-year-old woman with often complains of racing heart and irregular use of medication, today complains of problem with vision She complains that she started bumping on the furniture at her home soon after she felt headache. On the examination she was presenting lesion in the visual field. Result of VF examination is presented below. This patient most likely has occlusion of which of the following arteries?A.Anterior cerebral B.Central retinal C.Middle cerebral D.Posterior cerebralE.Posterior inferior cerebellar  19. Patient was diagnosed with bilateral stroke in thalamus. Which sensory pathway is not affected by the stroke?A. Proprioception B. Pain C. Smell D. Vision E. Hearing F. Taste 20. A 50 year old man complains on hearing problems. On otoscopy you find that patient have problem with cerumen, but when you insert the speculum  to the external auditory meatus in close contact with its posterior wall the patient faints during the procedure. Irritation of which of the following nerves was most likely induced by the procedure?A. Vestibulocochlear B. Vagal C. Trigeminal D. Facial E. Accessory 21. A 24 year medical student was studying for exams up to late at night. He was afraid when he felt problem with vision. When he close left eye he clearly saw the text in front him, but when he close the right eye he saw only gray. In the morning he run to the doctor’s office. After the examination physician suspect to retrobulbar neuritis on the left optic nerve. Which of the following is most likely physician’s finding on physical examination?   22. Patient complains of vision problems. First, he noted that he can not read the book, some rows of the letters were upper in front one eye. When he enters the car to drive to the doctor, he was not capable to drive because he saw double road in front of him. On examination when he was asked to look strait his right eye was turned down and out. MRI shows an aneurysm involving the right posterior communicating artery.  Which of the following muscles is most likely to remain functionally intact in this gatient A.inferior oblique B.Inferior rectus C.Lateral rectus D.Levator palpebrae E. Medial rectus F.Superior rectus  23.  A 60 year old patient complain of intermittent headaches that are worse in the morning. Physician perform VF examination, results are presented below and perform swinging light test which shows dilatation of the left pupil when light swing in front of the left eye. Where is the lesion?  A.Frontal eye fields B.Lateral geniculate nucleus C.Meyer’s loop D.Optic radiation E.Optic tract F.Visual cortex  24. After suffering flu, 30 year old female became very sensitive to sound, even whisper was painful for her. Injury of which cranial nerves might be responsible?A. Hypoglossal B. Facial C. Accessory D. Vagal E. Glossopharyngeal 25. 30 year old mother brought baby to your attention due to irritability, poor feeding and unusually increased head for 5 months old child. MRI of the head reveals significant dilation of the lateral ventricles. Which of the following is the most likely long-term complication of this patient’s condition?A. Infection B. Tumor C. Muscle hyper tonicity D. Lower extremity hypo reflexia E. Subarachnoid hemorrhage 26.  A 30 year female was brought to ED after traffic accident. She was on the co-driver seat and was wounded by dislocated driver seat. She is alert and fully oriented. There are a number of  bruises on her head. Neurologic examination suggests a spinal cord injury at the level shown in the illustration below  Which of the following spinal cord levels is most likely to be injured? A.C1 B.C7 C.T4 D.L5 E.S2  27. A 25 year old woman was sent to the PET scan examination due to involuntary dancing movements. On the examination abnormal metabolic activity  in the caudate nucleus was faund. Which of the following on the gross brain section slide corresponds to the location of the abnormalities in this patient?A. A B. B C. C D. D E. E  28. A 3-day-old infant born small for a date by  vaginal delivery develops a decreased level of consciousness and hypotonia. Infant was still in the neonatal intensive care unit and cranial ultrasound was immediately done.  It reveals blood in the lateral ventricles. Which of the following   structures is the most likely source of the bleeding?A.Bridging corticalveins B.Germinal matrix C.Meningeal arteries D.Sagittal sinus E.Vessels of the circle of Willis 29.  A 48 year old man suffered a sudden weakness of his left arm and leg which caused him to fall while standing. On the examination patient was alert, There was a spastic paresis with a positive Babinski sign in the left extremities and loss of vibratory and positional sense on the left and weakness on one part of his face . Pain and temperature sensations were normal. He has dysmetria and dysdiadochokinesia. Which of the following cranial nerves is most likely to arise from this level of the brainstem? A. Facial B.Hypoglossal C.Oculomotor D.TrigeminalE. Trochlear  30. A 35 year woman rush to her doctor due to worsening headaches, confusion,and intermittent vomiting. After neurologic examination physician immediately asked for CT. On CT:enlargement of the lateral and third ventricles and a normal-sized fourth ventricle. Where is the most likely site of obstruction in this patient?A.lnterventricular foramina of Monro  B.Cerebral aqueduct C.Medial foramen of Magendie D.Lateral foramina of Luschka E.Arachnoid villi  31. A 45year-old male presents to the doctor’s office with back pain after helping his friend to move in other apartment. Pain was radiating from the gluteal region to the foot on the same side.Physical examination reveals symmetric knee reflexes, but the ankle jerk reflex is slightly diminished on the right.  Which of the following nerve roots is most likely affected in this patient?A.L2 B.L3 C.L4 D.L5 E.S1  32. Neighbors invite police due to unpleasant odor spreading from one apartment in the building. Police find in the apartment 60 year old woman unconsciousness with empty bottles of alcohol around her. She was brought to the hospital and was started on intravenous fluids with dextrose and alcohol detoxication. Over the next few days, she recovers, but , neurologic examination shows substantial difficulty with short-term memory, nystagmus, ophthalmoplegia and ataxia.  Which of the following identifiers from the brain image indicates the neural structure most likely to be damaged in this patient?A.A B.B C.C D.DE. E F.F  33  A 30 year old female complains of painful ulcers in her mouth. She complains also of fatigue, fever, joint pain with stiffness and swelling. On the examination it is remarkable butterfly-shaped rash on her face that covers the cheeks and bridge of the nose. She told that skin lesions appear or worsen with sun exposure (photosensitivity). The pain sensation from his ulcer is carried by which CN?A.Chorda tympani B.Glossopharyngeal nerve C.Mandibular division of thetrigeminal nerve D.Maxillary division of thetrigeminal nerve E.Vagus nerve   34. A boy was brought to your attention because of pain, limited mobility of the mandible, spasticity of the masticatory muscles and sound that is produced in the joint during mandibular movement   because of an underdeveloped mandible. Development of which of the following structures is likely also impaired in this patient?A.Styloid process B.Lesser horn of the hyoid C.Stapes D.Malleus E.Thyroid cartilage  35. Patient complains of fatigue, lack of appetite or abdominal pain. You find that patient has jaundice and brown ring on the cornea. Part of the brain mostly affected in this disease is pointed on the picture by arrow. Which of the following corresponds to the most affected structure?       A.Globus pallidus B.Putamen C.Internal capsule D.Caudate nucleus E.Amygdala 36. . A 40-year-old male undergoes brain MRI for a long history of complex neurological complaints. The findings from the imaging study are shown below. You suspect that this patient initially suffered from which of the following?A. Tinnitus and unilateral deafness B. Headaches and anosmia C. Progressive leg weakness and spasticity D. Unilateral ptosis and gaze palsy E. Bitemporal visual field defects 37. A 50 year old man with uncontrolled hypertension was brought to ED after his colleagues could not understand what he is talking. Patient was frustrated and anxious due to his speech and his blood pressure rises from 165/100 to 180/100. On examination patient obey the commands and was obvious that patient understand what is told to him. Which of the are presented on the picture is affected? A.A B.B C.C D.D E.E  38. A 40 year old man was brought to ED after he slipped on the ice covered pavement and failed on the gluteal area. Passing by people helped him to reach ED because he was in terrible pain.  Examination shows pain in the low back region with flexing of the back and raising of the legs. Pinprick in the perianal area does not cause rapid contraction of the anal sphincter. Which of the following nerve roots is most likely to be injured in this patient?A. T12 B.L2 C.L4 D.L5 E. S1 F.S4  39. A 60 year old man complains of weakness and tenderness in the hand, tingling in the palm and fourth and fifth fingers. Damage of which of the following nerves has most likely cause the symptoms? A.Ulnar B.Median C.Radial D.Musculocutaneous E.Axillary  40. A 30 year old man come to your attention due to headache. On examination you find that patient has dark spots on his body and bumps in and under the skin and on the right-sided hearing loss, an asymmetric smile, and decreased corneal reflex in her right eye. You suspect of an intracranial mass located in which of the following locations?A.Between the medulla and the cerebellar hemispheres B.Above the diaphragma sellae C.Over the lateral hemispheric fissure D.Between the cerebellum and the lateral pons E.In the parasagittal aspect of the brain convexity F.Between the cerebellar peduncles  41. A 23 year old woman complain of amenorrhea for few months and white secretion from her breasts. On examination you confirm that she is not pregnant and her visual field shows heteronymous hemianopsia. Which of the following dopaminergic pathway disturbances are most likely responsible for this patient’s symptoms?A.Mesolimbic-mesocortical B.Nigrostriatal C.Tuberoinfundibular D.Periventricular E.lncertohypothalamic  42. A 45 year old patient is on the chemotherapy after operated breast cancer. She complains of nausea and vomiting after each chemotherapy treatment. Which of the following brain sites is responsible for her symptoms after chemotherapy?A.A B.BC.CD.D E.E      A 72-year-old man presented with headache, vomiting and diminution of vision. One year ago he had sudden right arm weakness. In that time Vital signs were in normal limits. On examination the visual acuity was reduced, pupils were 3 mm and reacting to light. MRI reveals multiple small lobar hemorrhages in the right occipital and left parietal areas. This patient most likely suffers from which of the following?A. Carotid artery atherosclerosisB.Cardiac embolismC.Hypoxic encephalopathyD.Hypertensive encephalopathy E.Cerebral amyloid angiopathy F.Arteriovenous malformationG.Saccular aneurysmH.Charcot-Bouchard aneurysm  A 60-year-old male was diagnosed with intracerebral neoplasm located in the frontal lobe. Diagnosis was confirmed by CT. If the biopsy was done and it reveals neoplastic cells that stain positive for synaptophysin and negative for glial fibrillary acidic protein, these neoplastic cells most likely originate from:A.AstrocytesB.OligodendrogliaC.Ependymal cellsD.Meningothelial cells E.Neurons 6 weeks after started to suffer mild retrosternal pain, for which he did not ask for attention, 77 year old man died. His BP on examinations was very low and he was complying of claudication for a years. Autopsy findings is presented below. Which of the following most likely produced the lesion seen on the slide?   A.Lysosomal digestion of the tissue B.Early fibroblast migration to the area of injuryC.Granulomatous reaction in the area of necrosis D.Firm coagulation in the area of necrosisE.Hemorrhage into the necrotic area A 69-year-old man with the past history of hyperlipidemia, hypertension and cervical radiculopathy presented to the emergency department with onset involuntary, flying, right upper extremity movements that started several hours ago. Which of the following areas of the brain is most likely affected?A.Lentiform nucleusB.Substantia nigraC.Caudate nucleusD.Internal capsuleE.Subthalamic nucleus F.Nucleus of thethalamus A 48-year-old woman suffer a sudden and severe headache. She tried to drive to ED but when enter the car she could not move her head nor left nor right, she felt stiffness and pain in the neck. Her neighbor took her to ED. Her temperature was 97.88 F, blood pressure is 165/95 mm Hg and pulse was 90/min. Her pupils are symmetric and reactive to light and accommodation. CT of her head is shown below. What is the diagnosis  A.Carotid artery atherosclerosis B.Cardiac embolismC.Hypoxic encephalopathyD.Hypertensive encephalopathy E.Large vessel arteritisF.Hypertensive arteriolar sclerosis G.Cerebral amyloid angiopathyH. Rupture of saccular aneurysm I. Charcot-Bouchard aneurysm A 61-year-old man is brought into the doctor’s office for memory loss and confusion. He suffer from early anterograde memory loss. Brain magnetic resonance imaging (MRI) is most likely to show atrophy of which of the following structures? A. A B. B C. C D. D  E. E You are examining 10 years old boy with scoliosis. His calves seems over developed, but on testing Gower’s sign he could not stand up from kneeling. To stand up from the floor he had to support his legs with his hands. Biopsy of the calf is most likely to show which of the following?A.Hypertrophic muscle fibersB.Multiple lipid droplets within muscle fibers C.Prominent inflammatory infiltrate D.Fibrofatty muscle replacement  E.Ragged red fibers A 25-year-old woman presented to general practitioner with a 9-month history of low back pain and difficulty in walking, difficulty ascending and descending stairs, as well as getting in and out of chairs. After all findings were unremarkable, a malignancy workup including chest radiograph, mammogram, and CT of the abdomen were done and was positive for lung cancer.  This patient’s condition is most likely associated with which of the following?A.Segmental axonal demyelinationB.Antibodies against presynaptic calcium channelsC.Antibodies against postsynaptic acetyl choline receptorsD.Medication-induced muscle fiber atrophy   E.Perifascicular muscle inflammation A 28-year-old woman with peripheral paresis of the facial nerve, balance disturbance, hearing loss for many years is presented to her family doctor. CT scan is presented below. This patient’s condition is most likely associated with a mutation involving which of the following genes? A. on chromosome 5B.NF1 on chromosome 17C.NF2 on chromosome 22D.p53 on chromosome 17E. RB1 on chromosome 13F.VHL on chromosome 3 A 12 years old boy presented with complaints of difficulty in swallowing. History dates back to 5 years with frequent falls during walking, clumsy staggering gait, difficulty in climbing stairs, difficultyin holding objects and deterioration of hand writing. Patient’s maternal uncle also had similar complaints. MRI of the brain and spine shows degeneration of the posterior columns and spinocerebellar tracts. This patient’s condition is most closely mimicked by which of the following?A  Lead intoxicationB. Vitamin E deficiency C. Thiamine deficiency D. Prion diseasesE. PoliomyelitisF. Acute intermittent porphyria A 25-year-old female asked for attention due to amenorrhea. Pregnancy tests were negative. Shewas also worried due to milky discharge from her breasts, but on mammography done on her insisting there were no changes in the breasts. Her physician asked for VF assessment and it was found that she has changes. This patient most likely suffers from which of the following?A.Pilocytic astrocytomaB.PinealomaC.Pituitary adenomaD.MedulloblastomaE.Vestibular schwannomaF.Ependymoma A 5 year-old boy was presented with unstable walking and a headache lasting for more than 10 days. ON neurological examination cerebellar ataxia and  finger-to-nose test were positive, the muscle strength was normal. Preoperative brain magnetic resonance imaging (MRI) revealed a cerebellar mass.Biopsy of the tumor reveals a well-differentiated neoplasm comprised of spindle cells that have hair-like glial processes and are associated with microcysts. Based on these findings, the most likely diagnosis is which of the following?A.Pilocytic AstrocytomaB.Glioblastoma multiformeC.MedulloblastomaD.EpendymomaE.Neuroblastoma A 12-year-old boy from a low socioeconomic family, presented with fever, moderate to high grade for 4 days. For 3 weeks he had headache repeated falls due to abnormal jerky -myoclonus and diplopia. He had decreased school performance due to inability to remember his lessons. Neurological examination showed moderate mental retardation, bilateral decreased visual acuity with bilateral lateral rectus palsy. This patient most likely suffers from which of the following?A.General paresisB.Progressive multifocal leukoencephalopathyC.Subacute sclerosing panencephalitisD.Creutzfeldt-Jakob diseaseE.Central pontine myelolysisF. Progressive supranuclear palsyG.Multiple sclerosisH. Guillain-Barre syndrome A male immigrants aged 43 presented at your office due to ‘weakness’ of the left leg, the right leg becoming involved few days later, he experienced no much pain but complained of a ‘frozen feeling’ affecting the left leg up to the knee. 10 years ago, he had STD that was cured in that time. You did lab work up and assess also CSF of the patient. His cerebrospinal fluid is VDRL positive. Which of the following spinal cord segments is most likely damaged in this patient?   A AB.BC.CD.DE. EF. F A 30-year-old man presented with painless decrease of vision in the right eye. Right eye fundus examination revealed significant macular edema with lipid exudates. Systemic examination, including MRI of the brain, renal ultrasonography, and CT of the abdomen revealed kidney cysts. The differential diagnosis must includeA.Von Recklinghausen’s diseaseei B.Neurofibromatosis type 2 C.Sturge-Weber syndrome D.Von Hippel-Lindau disease E. Tuberous sclerosisF.Osler-Weber-Rendu syndrome The patient is a 64-year-old woman with progressive decline in daily function, but she told that she is in good mood. The patient’s history is also significant for Hypertension and DM. Which of the following activities would best assess this patient’s concentration?A. Asking the patient to write a sensible sentenceB. Following a four-step commandC. Recalling three unrelated words after 5 minutesD. Reciting months of the year backwardsE. Remembering past events Baby is born with affected facial features, closely spaced eyes, small head size, and clefts of the lip and roof of the mouth. MRI reveals fused cerebral hemispheres. This neonate’s condition was the result of A.Deformation B.Malformation C.DisruptionD.SequenceE.Agenesis 68-year-old Asian man presents to the emergency department after he fall from a standing height. The patient was unable to provide a history, and it was unclear if this was due to a language barrier or altered mental status. His BP is 185/100 mm Hg and pulse is 66/min. His CT scan of the head is shown below. Which of the following is the most likely cause of his symptoms?  A.Rupture of middle meningeal artery B.Rupture of cortical bridging veinsC.Rupture of lateral striate arteries D.Rupture of berry aneurysmE. Rupture of posterior communicating artery A 56 year old woman presented to the family doctor with a 1 month history of dizziness, imbalance, and a hearing disturbance. After some physical exertion, the room started spinning. This patient’s condition is most likely the result of:A. Demyelinating process in the CNSB. Increased volume of endolymph in the inner earC. Mass lesion at the cerebellopontine angleD. Inflammation of the vestibular labyrinthE.Sclerosis of the ossicles A 38 year old man presents to your office with unilateral, no throbbing headache, nasal stuffiness and lacrimation. The patient reports having had several similar episodes one year. The most likely diagnosis is:A. Tension headacheB. Migraine without aura C. Cluster headacheD. Subarachnoid hemorrhageE. Arterial hypertension F. lntracranial neoplasm G. Trigeminal neuralgia Medical student was asked what she suspect if under microscopy can find neurons with shrunken nuclei, and without Nissl substance but with intensely eosinophilic cytoplasm. What was her right answer?A. Compensatory hypertrophyB.Axona l regeneration C.Compression atrophy D.Irreversible cell injuryE. Metabolic encephalopathyF.Normal aging A 50 year old man had a 25-year history of regular alcohol intake, and now he gradually increased his alcohol intake. His family stated that for the last 2 years he started his mornings with his usual “eye opener,” and he had not been eating enough or regularly. He is admitted to the hospital where he undergoes acute confusion.  On examination it was noted horizontal nystagmus and bilateral abducens palsy. Which of the following most likely precipitated this patient’s condition?A.Excessive hydrationB.DiureticsC.Vitamin supplementationD.AnticoagulantsE.AntibioticsF. Glucose infusion The patient, a 60-year-old Caucasian female, was brought to the emergency room (ER) by her husband for the assessment of strange behavior. She was reportedly having frequent verbal arguments with her husband and inappropriate jokes in front of the guests on one celebration. This patient most likely has a condition involving which of the following?A.Substantia nigra B.Nucleus caudatus C.Parietal cortexD.HippocampusE. Frontal cortexF. Subthalamic nucleus A 45-year-old man presented with a 3-day history of progressive lower limb weakness and urinary retention. Three days prior to this visit, he had fever and symptoms of upper respiratory tract infection. On examination blood pressure was 130/78 mmHg, heart rate 92 bpm, temperature 37°C,. His lower limb examination revealed a muscle power of 0/5, absent tendon reflexes at the patellas and ankles, bilateral plantar response was normal and reduced sensation to soft touch and pin prick. This patient’s condition is most likely associated with which of the following?A.Endoneural inflammatory infiltrationB.Toxin penetration through blood-nerve barrierC.Endoneurial arteriole hyalinizationD.Mutations of a muscle structural protein geneE.Endomysial inflammatory infiltration A 60-year-old man presented to his primary care physician with new right-sided subjective sensory abnormalities. General physical and neurological exams were normal. CT and MRI images of the brain were obtained and presented mass lesion. Biopsy is presented below. The patient most likely suffers from: A.Pilocytic astrocytomaB.GlioblastomaC.Pleomorphic xanthoastrocytomaD.OligodendrogliomaE. EpendymomaF.Colloid cystG.MedulloblastomaH. Primary CNS lymphomaI. MeningiomaJ.CraniopharyngiomaK. SchwannomaL. Pituitary adenoma A 40-year-old male presented with complaints of bilateral burning type calf pain and neck pain since a few month ago.  The patient also complained of restricted movement of the back, difficulty in walking and gait ataxia. MRI reveals cerebellar tonsils extending into the vertebral canal. This patient’s condition is most likely:A.Single gene disorderB.Congenital malformation C.Secondary to traumaD.Secondary to neoplasiaE.Autoimmune diseaseF.Vascular disease 51-year-old woman suffers from an inability to walk. Her past medical history is positive to gastric problems. Neurological examination is presented with hypertonicity and inability for two point discrimination. Myelin layer of the spinal cord presents vacuolization and axonal degeneration involving the posterior columns and the lateral corticospinal tracts. Which of the following is the most likely cause of this patient’s condition?A. SyringomyeliaB. Tabes dorsalisC. Multiple sclerosisD. Amyotrophic lateral sclerosisE. PoliomyelitisF. Vitamin B12 deficiencyG. Thiamine deficiencyH. Anterior spinal artery syndrome A 3-year-old boy presents with gait instability. His examination is significant for proximal muscle weakness, and calf enlargement. Diagnostic studies are significant for elevated levels of enzyme, creatinine kinase. This patient’s conditio

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