A lesion in which nerve would not allow the patient to make the ‘OK’ sign with the thumb and index finger?



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Neuromuscular Questions



  1. A lesion in which nerve would not allow the patient to make the ‘OK’ sign with the thumb and index finger?




  1. In a Bell’s Palsy you would expect to find weakness in all the following muscles except?

    1. Orbicularis oculi

    2. Orbicularis oris

    3. Platysmus

    4. Masseter




  1. The genetic defect in Hereditary Neuropathy with Liability to Pressure Palsies is?

    1. Deletion on PMP 22

    2. Duplication on PMP 22

    3. Deletion on P Zero

    4. Duplication on P zero




  1. In Stiff person syndrome you would expect to find the following except?

    1. Equal incidence in men and women

    2. Proximal distribution of stiffness

    3. Development of lordosis

    4. Diabetes

    5. Seizures are not seen




  1. After an episode of Optic Neurits the best predictor of MS is?

    1. CSF studies

    2. Age of the patient

    3. Brain MR

    4. Family history




  1. The following are consistent with the diagnosis of LEMS except?

    1. History of cancer

    2. Dry mouth and constipation

    3. Proximal weakness

    4. Decrement on rapid stimulation

    5. All of the above




  1. In cervical stenosis you could find the following signs or symptoms except?

    1. Absence of pain

    2. Mixture of upper and lower motor neuron signs

    3. Loss of distal reflexes

    4. Fasiculations and wasting in the lower extremity



  1. In congenital myotonic dystrophy you can find all the following except?

    1. Cardiac arrhythmias

    2. Hypotonia

    3. Contractures

    4. myotonia

    5. Poor suck




  1. On a Brain MRI lesions in the gray-white matter are more characteristic with ?

    1. MS

    2. Metachromic leukodystrophy

    3. Vasculitis

    4. PML

  2. The following are true of adrenoleukodystrophy except

    1. X-linked disorder

    2. Defect of beta oxidation

    3. Only exist as a childhood form

    4. Accumulation of very-long chain fatty acids




  1. A child with acute or subacute descending paralysis and sluggish pupils most likely is suffering from:

    1. Botulism

    2. Spinal muscular atrophy

    3. Nonketotic hyperglycemia

    4. Myotonic dystrophy




  1. Perifascicular atrophy on muscle biopsy is most consistent with the diagnosis of:

    1. Polymyositis

    2. Dermatomyositis

    3. Inclusion Body Myositis

    4. Statin Myopathy




  1. Vasculitis has been associated with all the following except:

    1. Amphetamine use

    2. Polyarteritis nodosa

    3. Rheumatoid

    4. Wegener’s granulomatosis

    5. Polymyalgia rheumatica




  1. The following are true in GBS electrophysiological studies except

    1. Slowing of peripheral conduction velocity

    2. Increased central conduction time

    3. Prolonged F-waves and distal motor latencies

    4. Sparing of the sural nerve SNAP

    5. All are true




  1. In Facioscapulohumeral dystrophy patients have all the following except:

    1. Facial, shoulder and upper arm weakness

    2. Relative sparing of the deltoids

    3. Foot dorsiflexion weakness

    4. Symptoms are asymmetrical

    5. Genetic detection is not commercially available




  1. The following can be seen in Inclusion Body Myositis except:

    1. Distal upper extremetiy weakness

    2. Occurs more frequently in younger patients

    3. Muscle biopsy shows inflammatory changes and deposition of amyloid

    4. EMG shows diffuse irritability and fibrillation potentials.




  1. In HNPP the genetic defect is found on which chromosome?

    1. 4

    2. 11

    3. 17

    4. 20

    5. 22




  1. The main distinguishing feature between GBS and CIDP is:

    1. Demyelinating neuropathies

    2. CSF findings

    3. Symptoms

    4. Interval between symptoms and disease plateau

  2. Myotonic Dystrophy has the following characteristics except:

    1. Cardiac conduction defects

    2. Early cataracts

    3. Hypogammaglobulinemia

    4. Proximal weakness




  1. The best way to assess the facial nerve proximal to the stylomastoid forearm is by performing:

    1. Routine facial nerve studies

    2. SSEP’s

    3. Blink reflexes

    4. Can not be assessed




  1. Which are true in a Martin-Gruber anastomosis:

    1. It occurs in 15-30 % of the population

    2. It consist of a communicating branch between the anterior interosseous to the ulnar nerve in the forearm

    3. The nerve fibers are destined usually to the 1stDIO

    4. All are true




  1. Which are the following drugs would not be used in MG

    1. Prednisone

    2. pyridostigmine

    3. azathiaprine

    4. Mycophenolate

    5. 3,4-diaminopyridine

  2. Which of the following conditions have not been associated as possible risk factors in brachial neuritis

    1. Vaccinations

    2. Stress

    3. Surgery

    4. Strenuous physical exertion

    5. Upper respiratory tract infections

    6. All have been associated

  3. A patient with predominant proximal weakness, cataracts and baldness is more likely to have:

    1. Myotonic dystrophy (DM1)

    2. Proximal myotonic dystrophy (DM2)

    3. Paramytonia congenital

    4. Myotonia congenital

  4. The drug of choice for the treatment of neurogenic orthostatic hypotension is:

    1. Fluorocortisone

    2. Spirolactone

    3. Ephedrine

    4. Midodrine




  1. Which of the following muscular dystrophies is most consistent with weakness in the posterior calves

    1. Limb girdle dystrophy- calpain deficiency

    2. Myotonic dystrophy

    3. Miyoshi myopathy

    4. Central core

  2. In leprosy neuropathy which is not correct

    1. Usually a large fiber neuropathy

    2. Caused by Mycobactrerium leprae

    3. Usually involves the nose and ears

    4. Demyelination can be seen on nerve conductions

  3. You should consider what deficiency in a patient with subacute pyramidal tract and dorsal column impairment:

    1. Zinc

    2. Copper

    3. Lead

    4. Vitamin E


  1. The following are true for LEMS except:

    1. Autoimmune disorder

    2. Associated with postsynaptic antibodies

    3. Proximal weakness

    4. Increment of CMAP with 50hz stimulation




  1. The following are true of Nemaline myopathy except:

    1. Congenital hypotonia

    2. Progressive weakness

    3. Normal intelligence

    4. Normal extra-ocular muscles




  1. T or F In Duchene MD treatment with prednisone has prolonged ambulation

by 2-3 years.

  1. When suspecting myotonic dystrophy in a new born the most reliable way to test is:

    1. Muscle biopsy

    2. EMG

    3. CPK

    4. Exam mother

  2. The following are all trinucleotide repeats except:

    1. Huntington’s

    2. Fragile X mental retardation

    3. Myotnic dystrophy

    4. SCA 6

    5. All are

  3. In patients with a ryanodine receptor (RYR1 gene) mutation you would expect:

    1. Sensitivity to halothane and succinylcholine

    2. Malignant hyperthermia

    3. Central core myopathy

    4. None of the above

    5. All of the above

  4. The following are true for AZT aassociated muscle disease except:

    1. AZT causes inhibition of reverse transcriptase and mitochondrial DNA polymerase

    2. Occurs at low doses of less than 400 mg/day

    3. Diagnosed by muscle biopsy

    4. Resolves after stopping the drug

  5. Which of the following drugs may exacerbate MG

    1. Nifedipine

    2. Bromocriptine

    3. Chloraphenicol

    4. Gabapentin

  6. Cooper Deficiency has been associated with all the following except:

    1. Iron supplementation

    2. Zinc overdose

    3. Gastric bypass

    4. Over use of denture creams

  7. Malignant hyperthermia is associated with except:

    1. Autosomal recessive inheritance

    2. Hypermetabolic state induced by inhalational and depolarizing muscle relaxants

    3. Increased carbon dioxide production

    4. Muscle breakdown

  8. Which of the following is specific for hyperkalemic periodic paralysis

    1. Sodium channel abnormality

    2. Induced by exercise

    3. Last a few hours

    4. Eyelid myotonia




  1. Which are the following proteins/structures are found on the presynaptic membrane?

    1. Agrin

    2. Muscle-specific kinase

    3. Dihydropyridine receptors

    4. Voltage-gated calcium channels

  1. In the flexed and pronated forearm which muscle is the most powerful supinator?

  1. Supinator

  2. Flex Carpi Radialis

  3. Biceps

  4. Triceps

  1. Lesions of the fifth lumbar nerve root would be expected to cause abnormalities in the following except:

  1. EHL

  2. Tibialis Anterior

  3. Tibialis Posterior

  4. Paraspinal Muscles

  5. gracilis

  1. Innervation to the diaphragm is through all the following roots except?

  1. C3

  2. C4

  3. C5

  4. C6

  1. The subscapular nerve innervates?

  1. Teres major

  2. Teres minor

  3. Levator Scapulae

  4. Rhomboids



  1. In a patient with sero negative ocular myasthenia which other antibody should be tested?

  1. Agrin

  2. Voltage-gated calcium antibodies

  3. Muscle-specific kinase

  4. Gaba antibodies

  1. Radiculopathy involving the C5 root would cause weakness in all the following except:

  1. Biceps

  2. Brachialis

  3. Supraspinatus

  4. Rhomboid

  5. Pronator

  1. Single-fiber EMG is most sensitive for detecting MG in which muscle?

  1. Trapezius

  2. Frontalis

  3. Sternocleidomastoid

  4. Hand intrinsic

  1. Which of the following does not influence nerve conduction results?

    1. gender

    2. Lower Body temperature

    3. Place on the body

    4. Thickness of the nerve

    5. Age over 60



  1. What is a distinguishing clinical feature between GBS and CIPD

  1. CSF results

  2. Pattern of weakness

  3. Loss of reflexes

  4. Interval between onset of symptoms and disease plateau



  1. Which findings is not consistent with Inclusion Body Myositis?

    1. Weakness of forearms and quadriceps

    2. Fibrillations and positive waves on EMG

    3. Large motor unit potential on EMG

    4. Occurs in older patients

  1. Which is the only muscle proximal to the knee is innervated by the peroneal nerve?

  1. Vastus lateralis

  2. Bicep femoris-long head

  3. Biceps femoris-short head

  4. Gracilis

  1. The L5 root is the major contributor to which muscle?

  1. Tibialis anterior

  2. gastrocnemius

  3. quadriceps

  4. gluteus medius



  1. The H-reflex is the electrophysiological equivalent of:

  2. The pronator quadratus is?

    1. Responsible for pronation of the forearm when the elbow flexed

    2. Supplied by the posterior interosseous nerve

    3. Supplied by a branch of the median nerve

    4. Responsible for pronation of the arm with the arm extended

    5. A and C are correct

    6. B and D are correct

  3. In compression of the cauda equina you would be expected to find:

    1. Saddle anesthesia

    2. Sphincter loss

    3. Loss of ankle reflexes

    4. All the above

  4. What do you expect to see in polymyositis?

    1. EMG may demonstrate fibrillations and small polyphasic potentials

    2. Proximal weakness

    3. Elevated creatinekinase levels

    4. All are seen

  5. Which of the following muscle is innervated by the glossopharyngeal nerve?

    1. Stapedius

    2. Buccinators

    3. Posterior belly of the digastric

    4. Stylopharygeus

  6. The trigeminal nerve innervates all the following except?

    1. Masseter

    2. Temporalis

    3. Medial and lateral pterygoids

    4. Tensor velipalati

    5. Anterior belly of digastric

    6. Mylohyoid

  7. The radial nerve innervates all the following except:

    1. Abductor pollicis brevis

    2. Extensor pollicis longus

    3. Extensor pollicus brevis

    4. Extensor digitorium longus

    5. All the above are innervated by the radial

  8. Matching

    1. Onion bulb or hypertrophy neuropathy 1. Werdnig-Hoffman

    2. Perifascicular atrophy 2. CMT

    3. Group atrophy 3.Dermatomyositis

    4. Ragged red fiber 4.Inclusion Body Myositis

    5. Rimmed Vacuole 5.Mitochondrial myopathy



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