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Clinical Neurology Trivia Quiz

Can you play the neurologist?

A multiple-choice quiz by Taxicab3. Estimated time: 7 mins.

Author
Taxicab3

Time
7 mins

Type
Multiple Choice

Quiz #
285,468

Updated
Dec 03 21

# Qns
10

Difficulty
Difficult

Avg Score
5 / 10

Plays
1231

One at a Time - Single Page - Timed Game

Question 1 of 10

1. A 30 year old man comes into your office complaining of drooping and not being able to move his lower face. Where is the lesion most likely to be? Hint

Substantia nigra

Trigeminal nerve

Cerebral Cortex

Olfactory nerve

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Question 2 of 10

2. A 55 year old man enters your office. As he walks in you notice that he is slamming his feet on the ground with each step as hard as he can. When you ask him to close his eyes with his feet together he begins to sway and you have to catch him to keep him from falling. Where is the likely lesion? Hint

Posterior Columns in the spinal cord

Trigeminal nucleus in the brain stem

Spinothalamic tract in the spinal cord

Lingula of occipital lobe

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Question 3 of 10

3. A 45 year old man is brought into your office by his wife who tells you that he became suddenly confused. You ask the patient how he is feeling and he replies, "Tuesday is a great day to chop the purple lettuce, Doc." What kind of aphasia is the man exhibiting? Hint

Wernicke's aphasia

Global aphasia

Broca's aphasia

Conduction aphasia

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Question 4 of 10

4. A 20 year old woman complains of knocking over garbage cans while driving. Upon further testing you discover that she has bilateral temporal hemianopsia (loss of temporal vision). Upon further questioning you discover that she has not had a period in 4 months. Where would the lesion that causes these symptoms be located? Hint

Posterior pituitary

Anterior pituitary

Hypothalamus

Thalamus

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Question 5 of 10

5. In a patient with a tumor on the anterior pituitary that causes amenorrhea, what is the likely hormone that is being produced in excess? Hint

Follicle stimulating hormone

Oxytocin

Prolactin

Vasopressin

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Question 6 of 10

6. A 70 year old man shuffles into your office complaining of uncontrollable shaking of his extremities. After proper evaluation, you diagnose the patient to be suffering from Parkinson's disease. What chemical substance is lacking in this patient? Hint

Acetylcholine

Fluorouracil

Dopamine

Testosterone

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Question 7 of 10

7. You are making rounds in the hospital one morning and come across a man who was admitted the night before because of a stroke. Your neurologic evaluation yields loss of pain and temperature to the right side of the face, loss of pain and temperature to the left arm and leg, ataxia (loss of proprioception and balance) on the right side, dysphagia (difficulty swallowing), hoarseness and constant hiccupping. Based on this consultation, what artery was likely occluded during this patient's stroke? Hint

Right posterior cerebral artery

Right posterior inferior cerebellar artery

Left posterior inferior cerebellar artery

Left posterior cerebral artery

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Question 8 of 10

8. A patient enters your office complaining of weakness in the left leg. The patient has a positive Babinski reflex (up-curling of toes when stroking the lateral foot) and is hyperreflexive. You conclude that these are lower motor neuron findings. Are you correct?

Yes

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Question 9 of 10

9. A 65 year old woman presents to you with loss of motor capabilities in her left leg and urinary incontinence. Without any further testing, where would you expect the lesion to be? Hint

Left cingulate cortex

Right precentral gyrus

Right paracentral lobule

Left precentral gyrus

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Question 10 of 10

10. In a patient that experiences simultaneous leg weakness and urinary incontinence, what artery would likely be occluded if the symptoms were attributable to a stroke? Hint

Middle Cerebral Artery

Hypophyseal Capillary Plexus

Anterior Spinal Artery

Anterior Cerebral Artery

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Quiz Answer Key and Fun Facts

1. A 30 year old man comes into your office complaining of drooping and not being able to move his lower face. Where is the lesion most likely to be?

Answer: Cerebral Cortex

A lesion in the seventh cranial nerve would affect both upper and lower face and would be known as "Bell's Palsy." Since the upper face has dual innervation from the cortex from both sides of the brain, a lesion on one side of the brain would be compensated for by the other. The lower face does not have this dual innervation, so a cerebral cortex lesion would affect it.

Answer: Posterior Columns in the spinal cord

The most likely place for this lesion would be the posterior columns. They contain "epicritic" sensation which is touch and proprioception. If you lose this sense in your legs, you are never sure when your feet are touching the ground and it is extremely hard to maintain balance.

The man is stomping hard in order to elicit "protopathic" or "pain" sensation so that he knows when his feet are hitting the ground.

Answer: Wernicke's aphasia

This man is exhibiting classic signs of Wernicke's aphasia. The lesion is likely affecting the superior temporal gyrus. In Wernicke's aphasia a patient will be fluent, but nonsensical. In Broca's we would find the patient not being able to speak or he may have an extremely limited vocabulary.

A global aphasia would involve not being able to speak or comprehend. A conduction aphasia would involve the patient not being able to repeat sentences.

Answer: Anterior pituitary

The likely lesion is a tumor of the anterior pituitary that secretes a hormone that causes these symptoms.

5. In a patient with a tumor on the anterior pituitary that causes amenorrhea, what is the likely hormone that is being produced in excess?

Answer: Prolactin

Prolactin is the likely candidate for a hormone that would cause a woman to become ammenorheic. Shortly after birthing a child, prolactin secretions that allow a woman to breast feed may serve as physiologic birth control, though this is an extremely unreliable method of contraception. This specific kind of tumor would be called a "prolactinoma."

Answer: Dopamine

Parkinson's disease results from degeneration of the substantia nigra, the area of the brain that produces the largest quantities of dopamine.

Answer: Right posterior inferior cerebellar artery

These finding are classic for lateral medullary syndrome (a stroke affecting the lateral medulla). The posterior inferior cerebellar artery (PICA) supplies the spinal trigeminal nucleus (ipsilateral pain and temperature loss in the face), spinothalamic tract (contralateral pain and temperature loss in arm and leg) and nucleus ambiguus (dysphagia, hoarseness and hiccupping).

Answer: no

Hyperreflexia and a positive Babinski sign are classically attributed to upper motor neuron findings (spinal cord or cortex lesion) as opposed to lower motor neuron findings (peripheral nerves).

9. A 65 year old woman presents to you with loss of motor capabilities in her left leg and urinary incontinence. Without any further testing, where would you expect the lesion to be?

Answer: Right paracentral lobule

The paracentral lobule contains motor areas for contralateral leg movement and bladder control. A lesion or stroke to this area would likely result in these symptoms.

10. In a patient that experiences simultaneous leg weakness and urinary incontinence, what artery would likely be occluded if the symptoms were attributable to a stroke?

Answer: Anterior Cerebral Artery

The anterior cerebral artery supplies the area of the brain containing the paracentral lobule.

Source: Author Taxicab3

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