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All 100 questions with answers

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  1. 1.
    In muscle spindle, the term annulospiral endings is given for
    Show answer and explanation
    Answer: A —
    Group la fibers
    Annulospiral endings are the primary sensory endings (Group Ia fibers) that wrap around the central portion of intrafusal muscle fibers.
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  2. 2.
    Which nucleus of amygdala has connections with hypothalamus?
    Show answer and explanation
    Answer: B —
    Centromedial
    The centromedial nucleus of the amygdala is the primary output nucleus that connects to the hypothalamus and brainstem.
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  3. 3.
    Neural groove is formed on Day
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    Answer: B —
    18
    The neural groove begins to form during the third week of development, approximately on day 18.
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  4. 4.
    34 year old male presents with progressive distal Right upper limb weakness in the distribution of median and ulnar nerves with no sensory symptoms. What is the likely diagnosis?
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    Answer: C —
    Multifocal motor neuropathy
    Multifocal motor neuropathy (MMN) typically presents with progressive, asymmetric distal weakness in the distribution of specific motor nerves without sensory involvement.
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  5. 5.
    A 45 year old male presents with weakness in left arm abduction and sensory loss over the lateral surface of the left upper arm and shoulder. Damage to which of the following structures of the brachial plexus may cause this presentation?
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    Answer: C —
    Posterior cord
    The posterior cord gives rise to the axillary nerve, which innervates the deltoid (abduction) and provides sensory supply to the lateral shoulder.
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  6. 6.
    A 62-year-old man is seen for subacute onset of generalized weakness and gait changes with diffuse decreased reflexes and CIDP is suspected. Which of the following clinical and laboratory findings is concerning for the diagnosis of POEMS syndrome as opposed to CIDP?
    Show answer and explanation
    Answer: D —
    Presence of lambda light chain
    POEMS syndrome is a paraneoplastic syndrome associated with a plasma cell dyscrasia, typically characterized by a monoclonal lambda light chain.
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  7. 7.
    A 44-year old man presents for evaluation of weakness. He reports the onset of difficulty in swallowing and weakness in his arms 3 year prior, which was initially attributed to statin therapy but has continued to progress off the statin. He reports progression of weakness and is detected to be diabetic. He has tongue and peri oral fasciculations, bilateral deltoid and iliopsoas weakness with atrophy and fasciculations. Absent ankle jerk; trace reflexes and flexor plantar and intact sensation. Which of the following additional features would be expected on examination?
    Show answer and explanation
    Answer: C —
    Gynecomastia
    The clinical presentation is consistent with Kennedy's disease (Spinobulbar muscular atrophy), which is an X-linked recessive disorder often associated with gynecomastia due to androgen insensitivity.
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  8. 8.
    A 13-year old boy presents with muscle pain and stiffness which is much worse in cold weather. In fact, few hours after exposure to cold, he felt quite weak as well as stiff. He had percussion myotonia at the thenar eminence and eye closure myotoria. Mutation in which of the following channels is mots likely responsible for his presentation?
    Show answer and explanation
    Answer: D —
    Sodium
    Paramyotonia congenita is a sodium channelopathy (SCN4A mutation) characterized by cold-induced myotonia and weakness.
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  9. 9.
    20-year-old male presents for evaluation of abnormal movements. He initially developed dystonia of his left leg at 10 year of age, associated with walking and running. No response to levodopa, and trihexyphenidyl. He was successfully treated with Botulinum injections. However, he progressed to have dystonia in his right arm. His 57 year old father has Write's cramp and his younger sister has recently developed suspected dystonia in her legs. Mutation in which of the following genes is the most likely cause of the dystonia?
    Show answer and explanation
    Answer: D —
    Torsin A
    Early-onset generalized dystonia (DYT1) is caused by a mutation in the TOR1A gene, which encodes the protein Torsin A.
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  10. 10.
    Which of the following is not a structure involved in the formation of new memories within the circuit of paper?
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    Answer: D —
    Fonix
    The Papez circuit includes the hippocampus, fornix, mammillary bodies, anterior thalamic nuclei, and cingulate gyrus. The mediodorsal nucleus is not part of the classic Papez circuit.
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  11. 11.
    Associative visual agnosia is caused by a lesion in the
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    Answer: C —
    Inferotemporal cortex
    Associative visual agnosia typically results from bilateral or unilateral lesions of the inferotemporal occipitotemporal regions.
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  12. 12.
    All the following statements are correct regarding Foville syndrome except:
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    Answer: D —
    Presence of Ipsilateral VI, VII, IX, X and contralateral ataxia
    Foville syndrome involves lesions in the pons affecting cranial nerves VI and VII along with Horner syndrome and contralateral hemiplegia or ataxia, but does not involve IX and X.
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  13. 13.
    Which of the following correlates with decorlicate rigidity?
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    Answer: D —
    Disinlibition of the red nucleus with facilitation of the rubrospinal tracts
    Decorticate rigidity is associated with lesions above the red nucleus, leading to disinhibition of the red nucleus and facilitation of the rubrospinal tracts.
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  14. 14.
    A 30-year-old lady is evaluated for recurrent episodes of severe, repetitive stabbing pain in the right forehead and temple that is associated with ipsilateral conjunctival injection, tearing and photophobia. The attacks last between 1 and 2 minutes and occur atleast 100 times daily. Which of the following preventive measure is most likely to be effective in this patient?
    Show answer and explanation
    Answer: C —
    Lamotrigine
    The clinical presentation is consistent with SUNCT/SUNA, for which lamotrigine is a recognized preventive treatment.
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  15. 15.
    A 16 year old girl has 6 months history of early night-time episodes characterized by sudden arousal from sleep, lifting her head and dystonic posturing of the extremities sometimes followed by getting out of bed and ambulating around the room for 1 to 2 minutes. There is a history of similar symptoms in her brother, father and paternal grandmother. Mutation of which of the following genes is most likely to be present in this patient?
    Show answer and explanation
    Answer: D —
    Neuronal nicotinic acetylcholine receptor
    The symptoms describe Autosomal Dominant Nocturnal Frontal Lobe Epilepsy (ADNFLE), which is often associated with mutations in the neuronal nicotinic acetylcholine receptor genes.
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  16. 16.
    A 64-year-old man presents with a 1 year history of progressive memory loss and more recent onset of abnormal movements of his arms, legs and trunk. Then he has obstructive sleep apnoea. His wife, who accompanies him describes odd movements during sleep in which he appears to be performing his previous work activities, such as threading wires. On examination, he has a vertical gaze palsy. What is the most likely diagnosis?
    Show answer and explanation
    Answer: B —
    Anti-EgLON 5 disease
    Anti-IgLON5 disease is characterized by sleep-related movement disorders, bulbar dysfunction, and often vertical gaze palsy.
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  17. 17.
    A girl presenting with DMD phenotype is most likely to be
    Show answer and explanation
    Answer: B —
    Sarcoglycanopathy
    Sarcoglycanopathies can present with a phenotype similar to Duchenne Muscular Dystrophy (DMD).
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  18. 18.
    Which is a CSF synaptic biomarker for Alzheimer's disease?
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    Answer: B —
    A beta-42
    While Neurogranin is a synaptic biomarker, A beta-42 is a core CSF biomarker for Alzheimer's disease.
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  19. 19.
    In which stage of intracerebral haemorrhage, both T1 and T2 MRI sequences are hyperintense?
    Show answer and explanation
    Answer: D —
    Late subacute
    In the late subacute stage of intracerebral hemorrhage, methemoglobin is intracellular and extracellular, causing hyperintensity on both T1 and T2 sequences.
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  20. 20.
    Which of the following is one among the earliest electrophysiological finding in Guillain Barre syndrome?
    Show answer and explanation
    Answer: A —
    F wave impersistence
    F-wave abnormalities, including impersistence, are often the earliest electrophysiological signs in GBS.
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  21. 21.
    Ear of lynx sign is seen in
    Show answer and explanation
    Answer: C —
    HSP type 11
    The 'ear of lynx' sign is a characteristic finding in SPG11 (HSP type 11).
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  22. 22.
    False regarding QSART
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    Answer: A —
    T ests preganglionic sympathetic fibres
    QSART (Quantitative Sudomotor Axon Reflex Test) tests postganglionic sympathetic fibers, not preganglionic.
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  23. 23.
    Changing the filter settings on the EEG allows for all of the following except:
    Show answer and explanation
    Answer: D —
    Preferential amplification of epiletiform discharges
    Filter settings are used for frequency manipulation, not for the preferential amplification of specific discharge types.
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  24. 24.
    The intracellualr pathophysiological mechanism of an epiletiporm discharge is
    Show answer and explanation
    Answer: D —
    Paroxysmal depolarising shift
    The paroxysmal depolarizing shift (PDS) is the hallmark intracellular event underlying interictal epileptiform discharges.
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  25. 25.
    Insular Lobe seizures are characterized by all except
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    Answer: D —
    Complex gestural automatisms
    Complex gestural automatisms are more characteristic of temporal lobe seizures than insular lobe seizures.
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  26. 26.
    In Transient Global Aphasia (TGA), the following are correct except
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    Answer: A —
    Impairment in state of consciousness
    TGA is characterized by anterograde amnesia without impairment of consciousness or personal identity.
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  27. 27.
    The anatomic structures of central importance in memory functions are the following except?
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    Answer: D —
    Red nucleus
    The red nucleus is primarily involved in motor control, not memory functions.
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  28. 28.
    The following is an example of implicit memory except?
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    Answer: C —
    Learning new material
    Learning new material (declarative memory) is an example of explicit memory, not implicit memory.
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  29. 29.
    The following are related to features of depression except?
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    Answer: D —
    Qualitative changes in intellectual function
    Qualitative changes in intellectual function are not a standard feature of depression.
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  30. 30.
    The following are examples of subcortical dementias except?
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    Answer: D —
    Alzheimer's disease
    Alzheimer's disease is the classic example of a cortical dementia.
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  31. 31.
    Following Hemtopoietic Stem Cell Transplantation (HSCT) the following neurological complication can occur except?
    Show answer and explanation
    Answer: D —
    Subarachnoid haemorrage
    Subarachnoid hemorrhage is not a typical specific neurological complication associated with HSCT compared to the others listed.
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  32. 32.
    The following drugs will produce cerebellar syndrome
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    Answer: D —
    Vinblastine
    Question cancelled by KPSC.
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  33. 33.
    Botulinum toxin A bind to following synaptic vesicular protein
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    Answer: A —
    SNAP 25
    Question cancelled by KPSC.
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  34. 34.
    Clinical improvement after the use of Edrophonium are seen in the following conditions except?
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    Answer: D —
    Motor neuron disease
    Question cancelled by KPSC.
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  35. 35.
    Therapeutic options for ADEM are except
    Show answer and explanation
    Answer: D —
    Bone marrow transplantation
    Bone marrow transplantation is not a treatment for acute disseminated encephalomyelitis (ADEM).
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  36. 36.
    Reye Syndrome is characterized by following except
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    Answer: D —
    Oligo clonal bands
    Oligoclonal bands are not a feature of Reye syndrome, which is characterized by hepatic dysfunction and encephalopathy with normal CSF.
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  37. 37.
    Monoclonal antibodies are used in Multiple Sclerosis are the following except
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    Answer: D —
    Eculizumab
    Eculizumab is a complement inhibitor used in myasthenia gravis and neuromyelitis optica spectrum disorders, not Multiple Sclerosis.
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  38. 38.
    Evoked Potentials used in early stages of Multiple Sclerosis or spinal form of multiple sclerosis are following except
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    Answer: A —
    Readiness potential
    Readiness potential (Bereitschaftspotential) is a movement-associated cortical potential, not an evoked potential used for diagnosing demyelinating pathways like VEP, SSEP, or BAER.
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  39. 39.
    Multiple Sclerosis in conjunction with peripheral neuropathy indicative of following except
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    Answer: B —
    Due to primary disease
    Question cancelled by KPSC.
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  40. 40.
    Recurrent myelitis at one level of spinal cord without any other signs of demyelinating disease can be found in except?
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    Answer: B —
    Behcet disease
    Question cancelled by KPSC.
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  41. 41.
    JC Virus causing Progressive Multifocal Leukoencephalopathy by attacking which cells of brain?
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    Answer: B —
    Glial cells
    JC virus primarily infects and destroys oligodendrocytes (glial cells) leading to demyelination in PML.
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  42. 42.
    In SSPE histopathological changes are not observed in following part of brain?
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    Answer: D —
    Cerebellum
    Subacute sclerosing panencephalitis (SSPE) typically spares the cerebellum while extensively affecting the cortex, subcortical white matter, and brainstem.
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  43. 43.
    Infections that follow neurosurgery or the insertion of cranial appliances are usually due to
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    Answer: B —
    Staphylococcus
    Post-neurosurgical meningitis and shunt infections are most frequently caused by Staphylococcus species (such as Staphylococcus aureus and coagulase-negative staphylococci).
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  44. 44.
    Eosinophilic meningitis is caused by following except
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    Answer: C —
    Coccidioidmycosis
    Question cancelled by KPSC.
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  45. 45.
    Drugs used for treating CNS toxoplasmosis are except
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    Answer: D —
    Levamisole
    Levamisole is an immunomodulator and antihelminthic, not used in toxoplasmosis treatment.
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  46. 46.
    CNS Aspergillosis can occur as a complication of the following except?
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    Answer: D —
    Meningitis
    CNS aspergillosis typically arises via extension from paranasal sinusitis, skull base osteomyelitis, or hematogenous spread, rather than typical bacterial meningitis causes.
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  47. 47.
    Risk of stroke is implicated with polymorphism of which chromosome?
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    Answer: B —
    12
    Genetic studies have linked stroke risk loci and polymorphisms to chromosome 12p13 (e.g., NINJ2 region).
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  48. 48.
    CHADS2 and CHA2DS2-VASC are scoring system to predict the risk of stroke following
    Show answer and explanation
    Answer: A —
    Atrial Fibrillation
    CHADS2 and CHA2DS2-VASc scores are standard clinical prediction rules for estimating stroke risk in patients with non-valvular atrial fibrillation.
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  49. 49.
    Hollenhorst plaque is get in which organ?
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    Answer: B —
    Retina
    Hollenhorst plaques are cholesterol microemboli visualized in the retinal arterioles, originating from atherosclerotic plaques in the carotid arteries or aorta.
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  50. 50.
    Blood supply of Globus Pallidum is by
    Show answer and explanation
    Answer: A —
    Anterior Choroidal artery
    Question cancelled by KPSC.
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  51. 51.
    Transmantle sign is seen in the Magnetic Resonance imaging of which of the following conditions causing epilepsy?
    Show answer and explanation
    Answer: C —
    Focal Cortical Dysplasia T ype IIb
    The transmantle sign (a funnel-shaped area of signal abnormality extending from the cortex to the ventricle) is a hallmark of Focal Cortical Dysplasia Type IIb.
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  52. 52.
    Which among the following statements is/are true regarding responsive Neurostimulation (RNS) treatment in epilepsy? I. It is synonymous with adaptive Deep Brain Stimulation II. Epilepsy arising from loci in the eloquent cortex is the major contra-indication for RNS III. It is a form of closed-loop neurostimulation IV. Useful in those with poorly localised or multi-focal epilepsy in whom resective surgery is contra-indicated
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    Answer: A —
    Only statement III is correct
    Responsive Neurostimulation (RNS) is a closed-loop system that detects abnormal electrographic activity and delivers stimulating pulses, differing from adaptive DBS in system design.
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  53. 53.
    Synaptic Vesicle Protein 2A (SV2A) mediates the anticonvulsant effects of which of the following anti-seizure medications? I. Lacosamide II. Levetiracetam III. Rufinamide IV. Stiripentol
    Show answer and explanation
    Answer: D —
    Only II
    Levetiracetam (and brivaracetam) binds specifically to synaptic vesicle protein 2A (SV2A).
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  54. 54.
    Which among the following statements is true regarding Gastaut Syndrome?
    Show answer and explanation
    Answer: B —
    T ypical age of seizure onset is at 7-10 years of age
    Gastaut syndrome (benign childhood occipital epilepsy) typically presents between 3 to 10 years of age, most commonly around 7-10 years.
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  55. 55.
    Epileptogenic Zone is most accurately defined as
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    Answer: C —
    Zone whose resection is necessary and sufficient to eliminate seizures
    The epileptogenic zone is defined as the area of cortex whose resection or disconnection is necessary and sufficient to render the patient seizure-free.
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  56. 56.
    Mutations in which among the following genes is related to Autosomal Dominant Epilepsy with Auditory Features (ADEAF)?
    Show answer and explanation
    Answer: D —
    Leucine-Rich Glioma Inactivated-1 (LG/1) gene
    Autosomal dominant lateral temporal epilepsy (ADLTE / ADEAF) is caused by mutations in the LGI1 (Leucine-rich glioma-inactivated 1) gene.
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  57. 57.
    Select the correct statement/statements regarding the physiology of sleep and wakefulness. I. Cholinergic neurons located close to mesopontine junction are involved in maintenance of wakefulness. II. The major neurotransmitter for sleep-wake cycle, hypocretin, comes from neurons in the tuberomammillary nucleus. III. Neurons in the median preoptic nucleus are involved in the initiation of sleep. IV. Neurons in the lateral hypothalamus form the major source of histamine in the physiology of sleep
    Show answer and explanation
    Answer: B —
    I and III are correct
    Mesopontine cholinergic neurons promote wakefulness, and median preoptic nucleus neurons play a key role in sleep initiation.
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  58. 58.
    Which among the following is classified as a parasomnia in the international classification of Sleep Disorders?
    Show answer and explanation
    Answer: A —
    REM Sleep Behaviour Disorder
    REM Sleep Behavior Disorder is categorized as a parasomnia, whereas narcolepsy is a central disorder of hypersomnolence and RLS is a sleep-related movement disorder.
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  59. 59.
    The "3P Model" or the Spielman model is the most widely accepted theoretical model of
    Show answer and explanation
    Answer: A —
    Insomnia
    The Spielman 3P model (Predisposing, Precipitating, and Perpetuating factors) explains the pathophysiology of chronic insomnia.
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  60. 60.
    The neurotoxin beta-N-oxalylamino-L-alanine (L-BOAA), responsible for lathyrism, is a:
    Show answer and explanation
    Answer: C —
    AMPA Glutamate Receptor agonist
    L-BOAA is an AMPA and kainate glutamate receptor agonist responsible for the excitotoxic motoneuron injury seen in lathyrism.
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  61. 61.
    Skewed Lyonization impacts the clinical manifestations of which among the following diseases?
    Show answer and explanation
    Answer: B —
    Kennedy disease
    Kennedy disease is an X-linked recessive disorder where skewed X-inactivation (lyonization) in heterozygous females can occasionally lead to mild manifestations.
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  62. 62.
    Which among the following statements regarding Upper Motor Neuron (UMN) Disorders is correct? I. Spastic Paraplegia 2 due to PLP1 mutations is inherited as an autosomal recessive condition. II. Konzo is a myelopathy predominantly seen in T anzania and results from Human T Lymphotropic Virus T ype 2 infection. III. Primary Lateral Sclerosis is a diagnosis of exclusion. IV. Magnetic Resonance Spectroscopy shows reduction in choline relative to N-acetyl aspartate in patients with UMN syndrome in motor neuron disease.
    Show answer and explanation
    Answer: D —
    Only III is correct
    Primary Lateral Sclerosis (PLS) is a pure UMN disorder that remains a diagnosis of exclusion after ruling out other conditions.
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  63. 63.
    T ofersen is a novel drug being tried in the treatment of Amyotrophic Lateral Sclerosis resulting from mutation in which among the following genes?
    Show answer and explanation
    Answer: D —
    SOD1
    Tofersen is an antisense oligonucleotide designed to treat ALS associated with mutations in the SOD1 gene.
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  64. 64.
    Which among the following medications modulates the splicing of the Survival Motor Neuron 2 (SMN2) pre-mRNA?
    Show answer and explanation
    Answer: C —
    Nusinersen
    Nusinersen is an antisense oligonucleotide that alters the splicing of SMN2 pre-mRNA to increase the production of full-length functional SMN protein.
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  65. 65.
    A 65-year-old lady comes to you with frequent headaches which are exclusively nocturnal. The headaches wake her up from sleep almost every night around midnight. The headache may last from 20-30 minutes, sometimes up to 2 hours. No medical comorbidities were reported. No abnormalities were found on clinical examination and baseline laboratory tests and MR imaging of brain were reported normal. Which among the following medications is likely to help this patient?
    Show answer and explanation
    Answer: B —
    Caffeine
    The clinical description is characteristic of hypnic headache, which typically responds well to evening doses of caffeine or lithium.
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  66. 66.
    Which among the following neurons in the cerebellum are glutaminergic and excitatory?
    Show answer and explanation
    Answer: A —
    Granule cells
    Cerebellar granule cells are the only glutamatergic (excitatory) neurons within the cerebellar cortex; Purkinje, Golgi, and basket cells are GABAergic (inhibitory).
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  67. 67.
    All the following Spinocerebellar Ataxias (SCAs) are caused by polyglutamine-coding CAG repeat expansions, EXCEPT
    Show answer and explanation
    Answer: C —
    SCA10
    SCA10 is caused by a pentanucleotide (ATTCT) repeat expansion, unlike polyglutamine CAG repeat disorders like SCA6, SCA7, and SCA17.
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  68. 68.
    Select the correct statement/statements regarding autosomal recessive ataxias. I. In Ataxia T elangiectasia Like Disorder, serum Alphafeto Protein (AFP) levels are typically normal. II. Serum AFP levels are elevated in Ataxia with Oculomotor Apraxia T ype 2. III. Lymphoid cancer risk in Ataxia with Oculomotor Apraxia T ype 2 is even higher than Ataxia T elangiectasia. IV. Ataxia with Oculomotor Apraxia T ype 1 is associated with immunodeficiency.
    Show answer and explanation
    Answer: D —
    I and II are correct
    Ataxia telangiectasia-like disorder has normal AFP levels, whereas AOA2 is characterized by elevated serum AFP levels.
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  69. 69.
    The delayed-start study design is used to:
    Show answer and explanation
    Answer: B —
    Separate disease-modifying effects of study-drug, from its effects on symptoms
    Delayed-start (or salt-withdrawal) clinical trial designs are employed to distinguish true disease-modifying effects from pure symptomatic effects in neurodegenerative disorders.
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  70. 70.
    Which among the following "apraxias" is most likely to occur as a treatment-related complication in patients with Parkinson's diease undergoing bilateral subthalamic nucleus deep brain stimulation?
    Show answer and explanation
    Answer: B —
    Apraxia of eye lid opening
    Apraxia of eyelid opening is a well-known movement disorder manifestation that can emerge or worsen following bilateral subthalamic nucleus deep brain stimulation in Parkinson's disease.
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  71. 71.
    Which among the following is a 3 Repeat (3-R) tauopathy?
    Show answer and explanation
    Answer: C —
    Pick's disease
    Pick's disease is the classic prototype of a predominantly 3-repeat (3R) tauopathy.
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  72. 72.
    The landmark clinical trial, PD-MED, whose results were published in 2014, compared which of the following therapies in Parkinson's disease?
    Show answer and explanation
    Answer: A —
    Levodopa, Dopamine agonists and Monoamine Oxidase-B inhibitors
    The PD-MED trial compared the three main classes of initial drug therapy (levodopa, dopamine agonists, and MAO-B inhibitors) in early Parkinson's disease.
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  73. 73.
    What is the approximate penetrance in DYT-TOR1A (TOR-1A Associated dystonia)
    Show answer and explanation
    Answer: D —
    Around 30%
    DYT-TOR1A early-onset generalized dystonia exhibits reduced penetrance of approximately 30-40%.
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  74. 74.
    Which among the following is the most characteristic histological features linking the different types of Multiple System Atrophy?
    Show answer and explanation
    Answer: D —
    Glial cytoplasmic inclusions
    Glial cytoplasmic inclusions (GCIs), composed of aggregated alpha-synuclein in oligodendrocytes, are the neuropathological hallmark of Multiple System Atrophy (MSA).
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  75. 75.
    Ambroxol, which has been tried as a candidate drug for repurposing for the treatment of Parkinson's disease, acts on which of the following mechanisms?
    Show answer and explanation
    Answer: B —
    Glucocerebrosidase pathway
    Ambroxol acts as a chaperone to increase glucocerebrosidase (GCase) activity, making it a candidate for Parkinson's disease therapy.
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  76. 76.
    Identify the correct statement
    Show answer and explanation
    Answer: D —
    All are correct
    All the listed statements regarding viral peripheral neuropathies (VZV, HCV-associated cryoglobulinemic neuropathy, and WNV anterior horn cell disease mimicking AMAN) are correct.
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  77. 77.
    Identify the incorrect combination.
    Show answer and explanation
    Answer: D —
    Rapid acetylators - high risk for INH polyneuropathy
    Slow acetylators are at a significantly higher risk for isoniazid (INH)-induced peripheral neuropathy due to slower drug clearance.
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  78. 78.
    Predominant upper limb motor involvement is the typical pattern in all except
    Show answer and explanation
    Answer: D —
    Familial Amyloid neuropathy
    Familial amyloid polyneuropathy typically presents with a length-dependent, painful sensorimotor neuropathy starting in the lower limbs, unlike upper limb predominant motor neuropathies.
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  79. 79.
    A 32-year, premorbidly normal lady, developed gait unsteadiness followed by double vision and drooping of eyelids. She had mild sore throat a week ago and clinical examination revealed bilateral external ophthalmoplegia, subtle bifacial weakness and ataxia. The most likely diagnosis.
    Show answer and explanation
    Answer: B —
    Miller Fisher syndrome
    The classic triad of ophthalmoplegia, ataxia, and areflexia following an infection points to Miller Fisher syndrome, a variant of Guillain-Barré syndrome.
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  80. 80.
    In Hereditary Neuropathy with Liability to Pressure Palsies (HNPP), the most frequently affected never is
    Show answer and explanation
    Answer: A —
    Fibular nerve
    In HNPP (PMP22 deletion), compression-prone nerves are vulnerable; the fibular (peroneal) nerve at the fibular head is among the most frequently involved.
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  81. 81.
    Features of Musk-Antiboidy Myasthenia Gravis include all except
    Show answer and explanation
    Answer: D —
    Have prominent thymic changes
    Unlike AChR-antibody positive myasthenia gravis, MuSK-antibody positive myasthenia gravis typically does not feature thymic hyperplasia or thymoma.
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  82. 82.
    "Ice pack test" in Myasthenia Gravis
    Show answer and explanation
    Answer: A —
    Has high sensitivity and specificity
    The ice pack test applied to ptosis in myasthenia gravis has high sensitivity and specificity for diagnosis.
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  83. 83.
    Thymectomy for Myasthenia Gravis (MG)
    Show answer and explanation
    Answer: D —
    Thymectomy should be considered in all early-onset AChR MG patients
    Thymectomy is recommended for non-thymomatous generalized early-onset anti-AChR antibody positive myasthenia gravis to improve long-term clinical outcomes.
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  84. 84.
    Which of the following statement is wrong about Lambert-Eaton Myasthenia (LEM)?
    Show answer and explanation
    Answer: C —
    Anti VGCC Antibodies are usually negative Non-Cancer Associated LEM
    Anti-voltage-gated calcium channel (VGCC) antibodies are present in the vast majority of both small-cell lung cancer associated and non-cancer associated Lambert-Eaton myasthenic syndrome.
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  85. 85.
    Incorrect statement about Congenital Myasthenic Syndrome
    Show answer and explanation
    Answer: D —
    Episodic respiratory crises occur only in choline acetylcholinesterase (ChAT) deficiency
    Episodic apnea/respiratory crises can occur in several forms of congenital myasthenic syndromes (such as slow-channel syndrome or Dok7 mutations), not solely in ChAT deficiency.
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  86. 86.
    In the treatment of Duchenne Muscular Dystrophy (DMD) which of the following is incorrect?
    Show answer and explanation
    Answer: C —
    Eteplirsen offer curative therapy
    Eteplirsen is an exon-skipping therapy that modifies disease progression but is not a curative therapy.
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  87. 87.
    Sudden death secondary to fatal arrhythmias is common in
    Show answer and explanation
    Answer: B —
    LGMD 1B
    LGMD 1B (caused by LMNA mutations) is well known for early cardiac conduction defects and sudden cardiac death.
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  88. 88.
    Asymmetric weakness, deltoid sparing and Positive Beevor sign seen in
    Show answer and explanation
    Answer: A —
    FSHD
    Facioscapulohumeral muscular dystrophy (FSHD) characteristically presents with asymmetric weakness, relative sparing of deltoids, and a positive Beevor sign.
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  89. 89.
    Incorrect about Immune mediated Myopathy associated with Anti-HMGCoA Reductase antibodies
    Show answer and explanation
    Answer: D —
    Immunotherapy is ineffective
    Immune-mediated necrotizing myopathy associated with anti-HMGCR antibodies responds to aggressive immunotherapy.
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  90. 90.
    Muscle infiltration with aberrant large granular T lymphocytes may be seen in which of the following?
    Show answer and explanation
    Answer: A —
    Inclusion Body Myositis
    Inclusion Body Myositis (IBM) muscle biopsies characteristically show infiltration by clonally expanded cytotoxic T lymphocytes expressing large granular lymphocyte markers.
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  91. 91.
    Which of the following is not known to produce 'secondary pseudotumor cerebri'?
    Show answer and explanation
    Answer: C —
    T opiramate
    Topiramate is a carbonic anhydrase inhibitor that can actually be used to lower intracranial pressure, whereas tetracycline, lithium, and sulfa drugs are linked to idiopathic intracranial hypertension (pseudotumor cerebri).
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  92. 92.
    Low cerebellar tonsils, crowding of the posterior fossa, small prepontine cistern and inferior displacement of the optic chiasm are seen in
    Show answer and explanation
    Answer: C —
    Spontaneous spinal CSF leaks
    Spontaneous intracranial hypotension from spinal CSF leaks causes downward displacement of intracranial structures, mimicking Chiari malformation and causing posterior fossa crowding.
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  93. 93.
    Which of the following is not an anti-migraine agent?
    Show answer and explanation
    Answer: C —
    Felodipine
    Felodipine is a dihydropyridine calcium channel blocker used for hypertension, whereas verapamil and flunarizine are used in migraine/cluster headache prophylaxis.
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  94. 94.
    Identify the incorrect statement about SUNCT and SUNA.
    Show answer and explanation
    Answer: A —
    Indomethacin effective in 50% of patients
    SUNCT and SUNA are typically unresponsive to indomethacin (unlike hemicrania continua or paroxysmal hemicrania).
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  95. 95.
    Pain felt deep in the auditory canal is suggestive of
    Show answer and explanation
    Answer: B —
    Geniculate neuralgia
    Geniculate neuralgia (neuralgia of the sensory branch of the facial nerve / nervus intermedius) causes lancinating pain deep within the ear canal.
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  96. 96.
    Treatment for self-multilation in Autistic Spectrum Disorders include all of the following except
    Show answer and explanation
    Answer: D —
    Clonidine
    Question cancelled by KPSC.
    Report a mistake
  97. 97.
    Which of the following is not an atypical features in Dyslexia?
    Show answer and explanation
    Answer: A —
    Male gender
    Male gender is much more commonly affected in developmental dyslexia, making it a typical rather than atypical feature.
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  98. 98.
    Which of the following could be permitted for use in patients with Porphyria?
    Show answer and explanation
    Answer: B —
    Chlorpromazine
    Phenobarbitone, metoclopramide, and methyldopa can precipitate acute porphyria attacks, whereas certain phenothiazines like chlorpromazine are considered safe.
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  99. 99.
    A 16-year-old was operated for vestibular schwannoma on both sides within a span of 2 years. What is ophthalmological finding most commonly encountered?
    Show answer and explanation
    Answer: C —
    Posterior subcapsular cataracts
    Bilateral vestibular schwannomas indicate Neurofibromatosis type 2 (NF2), which is characteristically associated with juvenile posterior subcapsular lens opacities/cataracts.
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  100. 100.
    Which of the following is atypical for Panayiotopoulos Syndrome?
    Show answer and explanation
    Answer: B —
    Prominent visual phenomena
    Prominent elementary visual hallucinations are characteristic of Gastaut type occipital epilepsy, whereas Panayiotopoulos syndrome is dominated by autonomic symptoms.
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