Parkinson’s Disease (PD) Neurological II Practice Exam

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