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NBME Clinical Mastery Neurology Form 1 questions

24040 Views 11 Replies 10 Participants Last post by  rayray
Hey everyone...if you could please help me answer the following questions that I got wrong on the Neuro Form 1....

1) A previously healthy 62 year old man is brought to the physician by his wife because of confusion for 3 hrs. During breakfast, he stopped eating and asked his wife the day's date and plans for the day. He repeated his questions six times despite receiving the correct information from his wife each time. He is now oriented and clear in thinking. He doesn't recall any aspect of the morning since breakfast. Physical and mental status exam show no abnormalities. Which of the following is the most likely diagnosis?

A) Communicating hydrocephalus
B) Concussion
C) Dementia, Alzheimer's
D) Herpes Simplex Encephalitis
E) Hypoxic Ischemic Encephalopathy
F) Hysterical amnesia
G) Transient global amnesia
H) Wernicke-Korsakoff syndrome

2) An unkempt 49 year old man is brought to ED in a confused and lethargic state. No history is obtainable. The sclera are icteric. When his arms are held extended irregular lapses of postural tone are observed. Test of stool for occult blood is positive.

What is the most likely diagnosis?
A) Acute alcohol intoxication
B) Epidural hematoma
C) Hepatic encephalopathy
D) Uremic encephalopathy
E) Wernicke- Korsakoff syndrome

3) A previous healthy 37 year old man comes to ED because of 4 hour history of paralysis of left side of his face. When he awoke this morning he noticed a facial droop that has progressed to include his left eyebrow. He takes no medications and does not smoke. He exercises regularly by biking. He is 180 cm and weight 84 Kg (185 lb), BMI is 26kg/m2. His temp is 37 C, pulse is 56/min and BP is 110/72. Examination shows loss of the left nasiolabial fold. He has difficulty closing the left eyelid. The pupils are equal are equal and react to light. Hearing is intact. The tympanic membrane and pharynx appear normal and the remainder of exam shows no abnormities. Which of the following is the approximate next step in diagnosis?

A) MRI of brain
B) Tensilon test
C) Lumbar puncture
D) Nerve conduction studies
E) No further testing

5) A 57 year old woman comes to the physician because of a 6 week history of progressive hearing loss in her right ear. 5 years ago she underwent a successful surgical removal of left acoustic neuroma. Her temp is 37 C. Physical exam including exam of skin and tympanic membrane shows no abnormalities. Neuro exam show decreased hearing in right ear, hearing in left ear is normal. Air conduction is better than bone conduction bilaterally. A tuning fork is held over the forehead and laterlizes to right ear. Which of the following is the most likely diagnosis?
A) Cholesteatoma
B) Neurofibramatosis
C) Otitis media
D) Otosclerosis
E) Presbycusis
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1- transient global amnesia.
2- Hepatic encephalopathy
3- No further testing
5- Neurofibramatosis

these answers are for sure 100%.
good luck.
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drhma

@drhma are u sure about neurofibramotosis
presbycusis causes snhl as well . webers lateralises to better ear.

Presbycusis is bilateral, so i wonder nf to be right as well..but just to be sure..did u mark it correctly in the online test?? or mohd ali talking '

just kidding
i agree !Why answer Neurofibramatosis:scared:skin and tympanic membrane shows no abnormalities??????????????
@drhma are u sure about neurofibramotosis
presbycusis causes snhl as well . webers lateralises to better ear.

Presbycusis is bilateral, so i wonder nf to be right as well..but just to be sure..did u mark it correctly in the online test?? or mohd ali talking '

just kidding
too young for presbycusis, and that is a progressive bilateral symmetrical age-related sensorineural hearing loss, but biggest clue to NF is that there was an acoustic neuroma surgery a few years ago on the left side! and presents with sensory loss this time on the other side.... bilteral hearing loss, and not presbecusis ==> NF2.

i answered it in the test and it didn't tell me it was worng, too
explination

whats your explanation for question 3?

1- transient global amnesia.
2- Hepatic encephalopathy
3- No further testing
5- Neurofibramatosis

these answers are for sure 100%.
good luck.
whats your explanation for question 3?
Because its a clinical diagnosis. Even though nerve conduction study is the most accurate test, but it's not needed.
Queston 5

1- transient global amnesia.
2- Hepatic encephalopathy
3- No further testing
5- Neurofibramatosis

these answers are for sure 100%.
good luck.
In q 5, it says "hearing in the left ear if normal" - so how can it be bilateral hearing loss? Please can you explain.
answers

Hey guys,

can anyone please share the answers for NBME mastery series?

Thanks
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