Parkinson’s Disease (PD) Neurological II Practice Exam

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• Shoulder abduction is primarily mediated by which nerve roots and muscle?
• What is the normal Babinski plantar response?
• Which gait is typically associated with foot drop and peripheral motor unit disease (neuropathy)?
• Which tremor is seen in cerebellar pathway disorders such as multiple sclerosis?
• Testing _________ extremity, support the patient's thigh with one hand, grasp the foot with the other and flex and extend the patient's knee and ankle on each side
• Which tract transmits the sensation of vibration?
• Spasticity indicates a problem in which neural pathway?
• Which type of increased tone is commonly associated with Parkinson's disease?
• What two sexually transmitted diseases can cause neurological disorders?
• In the point localization test, what is the procedure?
• Unlike other hyperkinetic dyskinesias and epileptic seizures, tics may be temporarily suppressed.
• A dermatomal distribution is most consistent with disease affecting which structure?
• Paresis is defined as which clinical finding?
• Upper motor neuron lesions are associated with which descriptor?
• Which dermatome is on the inner aspect of the forearm?
• When prolonged inactivity results in the muscles getting smaller, what is this process called?
• Pseudohypertrophy is due to replacement of muscle by which tissue?
• If the anocutaneous reflex is absent, which neural region is most likely affected?
• Writer's cramp, blepharospasm, and spasmodic torticollis are examples of which movement disorder?
• Chorea is most commonly associated with which disease?
• Thumb abduction is primarily mediated by which nerve root levels via the Abductor pollicis brevis?
• Which term describes the cumulative sensory input to the CNS from mechanoreceptors that sense body position and limb movement?
• Which physical examination maneuver is used to assess metabolic encephalopathy?
• If a patient cannot stand with feet together regardless of eye status, this suggests a lesion in which region?
• An abnormality on which test shows slow, irregular, clumsy movements and is associated with cerebellar disease, basal ganglia disease, and upper motor neuron disease?
• A hallmark of lower motor neuron involvement is which combination of findings?
• DTR score 3+ corresponds to which finding?
• Which structure is the 'little brain' at the rear of the brainstem, coordinating movement and balance?
• Spasticity is primarily due to pathology in which tract?
• Which tool is used to rate level of consciousness in brain-injury patients?
• Which event results in a persistent deficit due to brain injury?
• The finger flexor reflex, also described as the Babinski of the hand, is most appropriately categorized as which reflex?
• Weakness affecting both legs is described as which term?
• Abnormal stereognosis and graphesthesia indicate a lesion in which brain region?
• Why do patients with spastic hemiparesis circumduct their leg when walking?
• In spastic hemiparesis, what is the typical posture of the ankle?
• If a corticospinal tract lesion is on the left side of the brain, the hypertonia is seen on the limbs of the:
• Tics are associated with a premonitory feeling that is relieved by the tics.
• Which action is performed by the Hamstrings?
• Where are lower motor neurons located?
• Which sign is used to assess the plantar reflex during a neurological examination?
• Movements that are involuntary, brief, rapid, jerky, irregular, and unpredictable, involving distal limbs, trunk, and face, and that seldom repeat; this describes which disorder?
• Which term describes a disease affecting multiple nerves, commonly seen in diabetic neuropathy with stocking-glove distribution?
• Pattern describing sensory loss in distal extremities is which?
• Which gait is typically present with loss of position sense and a positive Romberg test?
• Elbow flexion is mainly performed by which nerve roots and muscles?
• A corticospinal tract lesion on the right side would cause hypertonia on which side?
• Which dermatome is on the thumb?
• Thenar atrophy suggests which condition?
• Which assessment tool is specifically designed to quantify a patient's response to stimuli in a coma?
• Which statement corresponds to a muscle score of 5?
• Which DTR score corresponds to hyperactive reflexes?
• What term describes rhythmic oscillatory movements of the body?
• Which gait is characteristic of Parkinson disease due to basal ganglia defects?
• CVA stands for which medical event?
• Flaccidity and weakness, floppy arms, and hyperextensible muscles are associated with which level of muscle tone?
• Which movement pattern is described by arms stiffly extended, adducted, internally rotated, and legs stiffly extended with plantar flexion?
• What are neurons located in the brain and brainstem whose axons descend to synapse in the spinal cord called?
• Which seizures are triggered by brain irritants and are also known as psychogenic or pseudo-seizures?
• Which dermatome corresponds to the dorsum of the foot?
• Which term describes loss of muscle tone, resulting in a floppy limb?
• The rapid head rotation test assesses which reflex?
• Hip adductor weakness would most likely reflect involvement of which nerve roots?
• Knee flexion is mediated by which nerve roots via the Hamstrings?
• To quantify level of consciousness in a comatose patient, which assessment would you use?
• Which action is performed by the Gastrocnemius and Soleus?
• To test __________ extremities, instruct your patient to relax their muscles. Hold one of your patient's hands with yours, while supporting the elbow, flex and extend the patient's fingers, wrist, elbow and put the shoulder through moderate range of motion. Perform on both sides
• An abnormal Doll's Eyes Test finding would most likely indicate which of the following?
• Which modalities are used to assess dorsal column function?
• Pathological reflexes are indicative of lesion in which neural pathway?
• Which of the following is an example of a tic?
• In Babinski test, downward toe indicates what?
• Pins and needles sensation is described as which term?
• If an arm is rigid, how does resistance to movement respond to changes in velocity or direction?
• Does the Romberg test assess cerebellar function?
• Which tract is responsible for voluntary refined movements of distal extremities?
• Which test involves extending the arms forward with palms up, keeping them out with eyes closed, and briskly tapping the arms downward to assess subtle drift?
• The Doll's Eyes Reflex may be normal in which group?
• Paralysis of all four limbs is called:
• Which gait is described as slow to start, with short steps, and reduced arm swing?
• Which dermatome is on the outer aspect of the forearm?
• Lightly stroke the anus on both sides with a cotton-tipped applicator. Which reflex is this testing?
• Which tract controls all voluntary movement for speech production and descends from the motor cortex to terminate at cranial nerves?
• Hip adduction is primarily mediated by which nerve roots via the Adductors?
• In the Doll's Eyes Test, what is a normal eye movement when the head is rotated?
• Finger extension is achieved by which nerve and muscle?
• What does a muscle score of 2 indicate in the described grading scale?
• Which action is performed by the Quadriceps muscle group?
• Where do the corticospinal tracts cross over?
• During the general approach to deep tendon reflex testing, what should the patient do to prepare?
• An abnormal pronator drift test suggests a lesion of which motor neuron in the corticospinal tract?
• Slight paralysis or weakness affecting one side of the body is called?
• What is the normal finding in the pronator drift test?
• Which gait is seen in cerebellar disease?
• Monoplegia describes paralysis of how many limbs?
• Peripheral nervous system disease or spinal cord injury is typically associated with which change in muscle tone?
• Which tremor appears when maintaining a posture and can be seen in hyperthyroidism, anxiety, and benign essential tremor?
• A positive Romberg test indicates loss of balance, with ataxia that is sensory in nature. Which option best reflects this interpretation?
• Which gait is associated with wide-based, unsteady gait with dysmetria and intention tremor?
• Which term is most associated with Parkinson's disease due to basal ganglia involvement?
• Which statement describes a normal finding of the Doll's Eyes Test?
• Which dermatome is associated with the anterior thigh?
• The described balance test, performed with eyes closed to assess proprioception, is called what?
• Which event is transient with no dead tissue?
• The DTR score for a normal knee-jerk reflex is which number?
• Which dermatome is on the inner aspect of the forearm?
• Which dermatome is on the outer aspect of the forearm?
• In Babinski test, what does upward toe indicate?
• Finger extension is primarily produced by which nerve and muscle?
• Which dermatome is on the front of both thighs?
• Winking, grimacing, and shoulder shrugging are typical examples of which movement phenomena?
• Which movement disorder is characterized by slower, twisting, writhing movements with large amplitude, often involving the face and distal extremities?
• Which gait is described as scissors gait, commonly seen in cerebral palsy?
• The Babinski sign is used to assess which neural pathway?
• Which statement about rigidity is true?
• Which sign or test is primarily used to assess brainstem function in a coma by turning the head?
• Which tract carries the sensation of pain and temperature?
• Which movement disorder is characterized by sudden, rapid, recurrent motor tics that can be suppressed temporarily?
• What function does stereognosis test evaluate?
• Aging and lower motor neuron pathologies can cause what change in the muscle?
• The cremasteric reflex is elicited by stimulating the proximal inner thigh and causes elevation of the testicle on the same side. The reflex tests which nerve?
• Paralysis of one side of the body with the arm flaccid and the leg externally rotated describes which condition?
• In the Hoffman reflex, what type of response is seen with flexion of the terminal phalanx of the thumb or index finger?
• Which dermatome is on both shoulders?
• The Babinski reflex is considered normal in children up to how many years old?
• The straight leg raise maneuver is used to test for which condition?
• In which population is the Doll's Eyes Reflex considered to be normal despite potential brain injury?
• Which of the following sets comprises standard meningeal signs?
• DTR score 2+ corresponds to which finding?
• An upper motor neuron lesion typically leads to which cluster of muscle signs?
• During the abdominal reflex test, a quick horizontal stroke toward the umbilicus elicits contraction of the abdominal muscles with the umbilicus deviating toward the stimulus. Which reflex is being tested?
• Which tremor is most prominent at rest and often diminishes with voluntary movement?
• An abnormality in point-to-point movements suggests impairment of which brain structure?
• Which statement best distinguishes chorea from tics?
• Which are considered types of reflexes?
• Knee extension is mediated by which nerve roots via the Quadriceps?
• What technique should be used when reflexes are diminished or absent (0 or 1+) to increase reflex activity?
• Abnormal findings on stereognosis and graphesthesia indicate a lesion in which brain region?
• Which gait arises from loss of position sense in the legs due to polyneuropathy or posterior column damage?
• Which gait is associated with cerebral palsy?
• Which dermatome is on the pinky toe?
• Paralysis of both legs is called?
• If any Deep Tendon Reflexes (DTRs) are hyperreflexive, what should be tested next?
• Which description fits a focal seizure?
• What feature distinguishes chorea from tremors and tics?
• Choreiform movements typically involve which body regions?
• Stocking-glove distribution describes sensory loss in which condition?
• What term describes distribution of symptoms distributed along nerve root segments?
• Rapid alternating movements test primarily assesses which aspect of motor function?
• To perform stereognosis testing, what should you do?
• Which movement pattern is described by arms adducted and flexed with wrists and fingers flexed, and legs extended with internal rotation?
• DTR score 0 corresponds to which finding?
• Patchy areas of lost sensation can be seen in which disease?
• The slow, pill-rolling tremor is classically seen in which disease?
• A cerebellar dysfunction would most affect which movement task?
• Weakness localized to a single body region is best described as which term?
• Stocking-glove distribution is most characteristic of which condition?
• Hip flexion is primarily mediated by which nerve roots via the Iliopsoas?
• Which tract transmits pain and temperature sensations?
• Which tract transmits sensory information about vibration?
• Which system is responsible for balance and coordinating movements of the eyes, head, and body?
• Hip abduction is primarily mediated by which nerve roots via the Gluteus medius and minimus?
• Which elements are essential to ask when evaluating a possible seizure?
• Which dermatome is on the dorsum of the foot?
• Which dermatome is on the ankle at the medial malleolus?
• In Hoffman reflex testing, which movement constitutes a positive response when the terminal phalanx of the thumb or index finger is stimulated?
• Which best defines clonus?
• Which test involves tracing a large number on the palm to identify it?
• Which term best describes rhythmic, oscillatory involuntary movement often seen in Parkinson's disease?
• During the cremasteric reflex, what observation indicates a positive response?
• Which type of seizure involves the entire brain and typically causes loss of consciousness?
• Which of the following is an arousal stimulus used in coma assessment?
• Lower motor neuron lesions lead to what in the muscle?
• A positive Hoffman reflex is typically associated with involvement of which neural pathways?
• Irregular movements resembling athetosis or tremor, often with abnormal postures that limit voluntary movement and can be painful, are characteristic of which movement disorder?
• Which action constitutes reinforcement to increase reflex activity?
• An abnormal Doll's Eyes Test finding would indicate which of the following?
• DTR score 1+ corresponds to which finding?
• Which system integrates all information to produce rhythmic movement and steady posture?
• Which tract terminates at cranial nerve motor nuclei to influence bulbar musculature?
• Which movement is primarily tested by the deltoid muscle?
• What is the abnormal Babinski plantar response?
• Which dermatome is on the medial aspect of each buttock (anal wink)?
• Approximately how many cycles per second does the classic resting tremor in Parkinson's disease occur?
• Which nervous system area is primarily responsible for proprioception and position sense?
• Which instruments are described for eliciting the abdominal reflex?
• Kernig sign is most commonly associated with which condition?
• Pseudohypertrophy of a muscle is characteristic of which disease?
• Fasciculations can be healthy, or signify which type of motor neuron disease?
• Which sign is not a standard meningeal sign?
• Corticobulbar tract terminates at cranial nerve motor nuclei located in which region?
• Ankle dorsiflexion is mediated by which nerve roots via the Tibialis anterior?
• Which event features a deficit that continues after onset?
• What does muscle score 1 indicate?
• Which of the following is NOT a standard arousal stimulus described for comatose patients?
• Which tremor is absent at rest but appears with movement and worsens as the target gets closer?
• What does graphesthesia test evaluate?
• Which movement disorder is described as slower, twisting, and writhing movements with large amplitude, often affecting the face and distal extremities?
• Which action is performed by the Tibialis anterior?
• A parkinsonian gait suggests a lesion in which brain structure?
• Which movement disorder features grimacing, pursing of the lips, and protrusions of the tongue and may be a late complication of antipsychotic drugs?
• Which nerve is most likely affected in thenar atrophy?
• Which gait is seen in foot drop due to peripheral motor unit disease?
• Which movement disorder is classically seen in cerebral palsy?
• For vibration and position sense, test the ______ and ______ first. If results are normal, can assume the more ______ areas are also normal
• What is the term for a subset of tics involving repetitive vocal sounds that lack social function?
• Which test involves stroking the lateral aspect of the sole from heel to ball and then across the ball?
• Brief, repetitive, stereotyped, coordinated movements occurring at irregular intervals are characteristic of which phenomenon?
• Wrist extension is primarily due to which nerve and muscles?
• What is the main difference between spasticity and rigidity?
• Weakness on one side of the body is called?
• Transient ischemic attack is commonly known as which term?
• Which category includes reflexes elicited by tapping a tendon?
• What term describes sudden, transient disturbances in brain function due to abnormal firing of nerve impulses?
• What does muscle score 0 indicate?
• What term describes rapid, continuous twitching of resting muscle without movement?
• Which seizures are psychogenic or pseudo-seizures?
• The anocutaneous reflex involves afferent and efferent pathways from which spinal segments?
• What is shrinkage of a paralyzed muscle due to loss of neural connection called?
• In sensory testing with a tuning fork, which statement is correct?
• Causes include Sydenham chorea and Huntington's disease. Which movement disorder does this pertain to?
• Absence of strength ends in which suffix?
• Which pathway is primarily evaluated by the pronator drift test when abnormal?
• Which movement is primarily associated with the first dorsal interosseous and abductor digiti minimi muscles?
• Which statement best describes the Romberg test?
• Which finding is most closely associated with posterior column damage causing sensory ataxia?
• Which gait pattern is typical in bilateral leg spasticity with adductor spasm?
• Elbow extension involves which nerve roots and muscle?
• If pain sensation is intact, which sensation test may be omitted during a sensory exam?
• Asterixis is commonly described on exam as what sign?
• A wide-based stance with inability to stand with feet together regardless of eyes open or closed points to a lesion in which region?
• Finger abduction is associated with which nerve and muscles?
• Ankle plantar flexion is mediated by which ligament root level via the Gastrocnemius and Soleus?
• Which statement corresponds to a muscle score of 3?
• What instrument is commonly used to test temperature sensation?
• Hip extension is primarily mediated by which nerve root level through the Gluteus maximus?
• Spastic hemiparesis is best described as:
• Partial paralysis of one limb is called which term?
• Which structure contains sensory fibers that transmit the sensation of light touch?
• Which option contains the sensory fibers that transmit the sensation of light touch?
• Essential tremor is best described as which type of tremor?
• Which gait is described as toe clearance issues with dorsiflexor weakness and a high-stepping walk?
• Which movement abnormality is most classically associated with Huntington's disease?
• Which neuron has its cell body in the anterior horn of the spinal cord and sends axons to peripheral muscles?
• Ankle clonus must be present to rate a reflex as which grade?
• Which dermatome corresponds to the medial malleolus?
• What is the abnormal finding observed during the asterixis test?
• Abnormal findings in nuchal rigidity, Brudzinski sign, or Kernig sign may indicate which conditions?
• Hyperreflexia of DTRs and clonus suggests a lesion in which neural pathway?
• What is the term for a subset of tics that involves repetitive jerking movements of a specific muscle group?
• What is the oculocephalic reflex commonly called?
• Doll's Eyes Test findings suggesting severe brainstem damage correspond to which option?
• Sensation reduced or completely absent is described as which term?
• Which increased tone remains the same throughout ROM and is not velocity dependent, commonly seen in basal ganglia disorders such as Parkinson's disease?
• Elbow extension relies on which nerve roots and muscle?
• Which type of increased muscle tone is velocity dependent and worsens with extremes of ROM, typically seen with corticospinal tract lesions?
• Dermatomal distribution is best explained by involvement of which anatomical structure?
• If a patient can stand with feet together with eyes open but cannot with eyes closed, damage is to which structure and gait?
• Loss of sensation or pain due to peripheral neuropathy commonly seen in diabetes is described as which distribution?
• Which statement best reflects the involvement of the corticospinal tract in a positive Babinski sign?
• What term describes the sense of body position and limb movement?
• Which dermatome is on the pinky finger?
• Scissors gait is most commonly associated with which condition?
• Spasticity indicates a problem in which neural pathway?
• Patchy areas of sensory loss are characteristic of which disease?
• When a muscle is relaxed and has intact nerve supply, there is a slight residual tension known as ______________
• Wrist extension is mediated by which nerve and muscles?
• Graphesthesia testing is typically performed with the patient’s eyes closed.
• Scissors gait is described as stiff gait with legs crossing forward on each step, seen in bilateral lower-extremity spasticity, most commonly associated with which condition?
• Which nerve innervates the first dorsal interosseous muscle?