SECTION A: Read each question carefully and record the answer "TRUE" or "FALSE": 1.

The following statements about the cerebrospinal fluid a healthy person are correct: a) Opening pressure is 50-180 mm/H20. b) Glucose is usually <25% of blood level. c) Protein content is usually <0.5 g/L. d) White cell count is usually <4 mm 3 . e) Oligoclonal TgG bands are absent. 2. Pyramidal lesions may be associated with the following signs a) Ankle clonus b) Babiniski sign c) Exaggerated abominal reflex d) Clasp Knife spastiticty e) Kog Wheel rigidity 3. Upper motor neuron Involvement Is characterised by a) extensor plantar responses b) absent abdominal reflexes c) muscle fasciculation d) increased muscle tone and tendon reflexes e) plantar flexion of the great toe in response to rapid dorsiflexion of the toes 4. Lower motor neuron involvement Is characterised by a) flaccid muscle tone b) the rapid onset of muscle wasting c) absent or decreased tendon reflexes d) clones e) weakness affecting adductors more than abductors of shoulder

5. Recognised features of extrapyramidal tract disease Include a) intention tremor b) 'clasp-knife' rigidity c) choreoathetosis d) delayed relaxation of the tendon reflexes e) delayed initiation of movements 6. The lateral spinothalamic tract of the spinal cord a) transmits pain sensation from the same side of the body b) crosses to the opposite side in the medial lemniscus c) transmits contralateral light touch sensation d) stratifies fibres from the lowest spinal segments innermost e) crosses from the thalamus to the contralateral parietal lobe 7. Loss of tendon reflexes Is characteristic of a) proximal myopathy b) peripheral neuropathy c) syringomyelia d) myasthenia gravis e) tabes dorsalis 8. The segmental innervation of the following tendon reflexes Is a) biceps jerk-C5-C6 b) triceps ierk--C6-C7 c) supinator jerk-C5-C6 d) knee jerk-L3-L4 e) ankle jerk--L5-S1

9. Typical findings in cerebellar disease Include a) dysmetria b) dysarthria c) intention tremor d) increased muscle tone e) pendular nystagmus

10. Right homonymous hemianopia usually results from damage to the a) left optic tract b) left optic radiation c) optic chiasma d) right lateral ganiculate body e) left optic nerve 11. Features suggesting a third cranial nerve palsy include a) paralysis of abduction b) absence of facial sweating c) complete ptosis d) pupillary dilatation e) absence of the accommodation reflex 12. Paralysis of the sixth cranial nerve a) produces impaired adduction of the eye b) produces enophthalmos c) is a characteristic feature of Wernicke's encephalopathy d) results from disease of the upper pons e) is a recognised feature of posterior fossa tumour 13. Drooping of the upper eyelid results from a lesion of the a) levator palpebrae superioris b) third cranial nerve c) cervical sympathetic outflow d) seventh cranial nerve e) parabducens nucleus

14. Features of an Intracranial lower motor neuron lesion of the facial nerve Include a) inability to wrinkle the forehead b) increased lacrimation on the affected side c) upward deviation of the eye on attempted eyelid closure d) deafness due to loss of the nerve to the stapedius muscle e) loss of taste over the anterior two-thirds of the tongue 15. Characteristic features of pseudobulbar palsy include a) dysarthria b) dysphagia c) emotional liability d) wasting and fasciculation of the tongue e) absence of the jaw jerk 16. The characteristic features of trigeminal neuralgia Include a) pain lasting several hours at a time b) pain precipitated by touching the face and/or chewing c) absence of the comeal reflex d) predominance in young females e) response to anticonvulsants 17. Wasting and fasciculation of the tongue is a feature of a) pseudobulbar palsy b) myasthenia gravis c) motor neuron disease d) nasopharyngeal carcinoma e) Paget's disease of the skull

18. There is a major risk of cerebral embolism associated with a) calf vein thrombosis b) atrial fibrillation c) atrial myxoma d) infective endocarditis e) acute rheumatic fever 19. Typical causes of transient cerebral ischaemic attacks Include a) carotid artery stenosis b) atrial fibrillation c) hypotension d) intracerebellar haemorrhage e) intracerebral tumour 20. Typical manifestations of brain stem infarction Include a) pin-point pupils b) vertigo and diplopia c) sensory dysphasia d) severe headache e) bidirectional jerking nystagmus 21. Functional recovery following stroke is more likely to be poor if a) coma is prolonged for more than 3 days b) the stroke is haemorrhagic rather than embolic in origin c) associated hypertension is severe d) there is a conjugate gaze palsy e) hemiplegia is left sided rather than right-sided

22. Recognized causes of paraplegia include a) intracranial parasagittal meningioma b) vitamin B12 deficiency c) tuberculosis of the thoracic spine d) anterior spinal artery thrombosis e) spinal neurofibromas and gliomas SECTION B: Only one Item appropriately applies to the Statement. 23. A 65 year-old man presents with "hand tremors". This may be eventually attributed to the following conditions EXCEPT: a) Senility b) Thyrotoxicosis c) Cerebellar neuroblastoma d) Ischemic injury to the Subthalmic nucleus e) Chronic liver disease 24. A brisk knee left jerk may be encountered in the following condition: a) Brain tumor involving the left temporal lobe b) Vascular lesion affecting the right internal capsule c) Right cervical hemispinal lesion leading to Brown Sequard syndrome d) Leprotic motor polyneuropathy e) Duchenne myopathy 25. Which of the following motor abnormalities does NOT indicate extrapyramidal disease? a) Cog wheel rigidity b) Flaccidity c) Clasp knife spaslicity d) Lead pipe rigidity e) Static tremors

26. The following oral sign(s) may be manifestations of vitamin deficiency: a) Angular stomatitis b) Halitosis c) Galzed tongue d) Peg-like teeth e) All of the above 27. All the following statements are true about the Trigeminal nerve EXCEPT: a) Conveys general sensation from the anterior two thirds of the tongue b) Conveys general sensation from the anterior two thirds of the scalp c) Provides motor supply to the Buccinator d) Provides motor supply to the tensor tympani e) Provides parasympathetic supply to the lacrymal gland 28. A syringomyelic cavity in the cervical cord can cause the following disorders In sensation: a) Jacket hypoesthesia b) Hypoesthesia with a level c) Dissociated sensory loss d) Hemihypoesthesia e) All of the above

29. Migrenious headache is often characterized by the following EXCEPT: a) Being throbbing b) Being unilateral c) Associated with projectile vomiting d) Associated with nervous tension e) May be associated with visual disturbances

30. Sensory loss with a level at the umbilicus: a) Is characteristic of syringomyelia b) Occurs in cervical Brown Sequard syndrome c) May occur with extramedullary dorsal myelopathy d) Is often associated with parietal lobe lesions e) Indicates cord compression at D1 2 31. All of the following can occur with motor neuron disease except; a) Lateral sclerosis. b) Pseudobulbar palsy. c) Progressive muscular atrophy. d) Peripheral neuropathy. 32. The most common cause of meningitis is: a) Viral c) Bacterial b) T. B d) malignancy

33. CSF protein level is normal in the following type of meningitis: a) Viral C) Bacterial 34. In T.B meningitis (one answer); a) CSF Glucose level is normal b) It is more frequent in AIDS patients c) 3 months antituberculous drug regimen is the best treatment d) Steroids has no therapeutic role b) T.B d) malignant

35. Viral encephalitis is most commoniy due to: a) HIV c) Herpes simplex b)Poliomyelitis d)herpes zoster

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