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Neurological Board Examination （I I） 2014 09 20

B-type: For each numbered item, select the best heading most closely associated

with it. Each heading may be selected once, more than once, or not at all

Part 1 (1-4)

Match the clinical syndromes caused by skull base metastasis

( ) 1. Local pain, proptosis, sensory loss, diplopia, decreased vision (late)

( ) 2. Unilateral postauricular pain, hoarseness, dysphagia, sternocleidomastoid or

trapezius weakness

( ) 3. Stiff neck, unilateral tongue weakness

( ) 4. Facial numbness or pain , sometimes abducens or facial nerve palsy (VI, VII)

A. Parasellar

B. Jugular foramen

C. Cavity

D. Occipital condyle

E. Middle cranial fossa

解答：( C ) ( B ) ( D ) ( E )

題目之出處：Neurology in Clinical Practice, 6th, Ch52F, page 1198

Part 2 (5-8)

Match the spinal cord syndromes with its neurological findings

( ) 5. Anterior Cord Syndrome

( ) 6. Cauda Equina Syndrome

( ) 7. Central Cord Syndrome

( ) 8. Brown-Séquard Syndrome

A. Ipsilateral pyramidal deficit, position sense, and vibratory sensation, and loss

of pain and temperature sensation on the contralateral aspect of the body

B. Loss of all sensory modalities below level of lesion

C. Lower motor neuron involvement and asymmetrical motor impairment

D. Weakness in the upper extremities greater than the lower extremities, as well

as a variable degree of sensory disturbances and loss of bladder control

E. Loss of pain sense with preservation of vibration and joint position below

level of lesion

解答：( E ) ( C ) ( D ) ( A )

題目之出處： Neurology in Clinical Practice, 6th, Ch50C, page 959-962

Part 3 (9-12)

Match the right description with brain tumors below

( ) 9. Medulloblastoma

( ) 10. Glioblastoma

( ) 11. Hemangioblastoma

( ) 12. Meningioma

A. The most common form of primitive neuroectodermal tumor ( PNET)

B. The most common extraaxial brain and spinal tumor

C. The pineal region is the most common site of involvement

D. The most common primary cerebellar neoplasm in adults

E. The most common malignant primary brain tumor in adults

解答：( A ) ( E ) ( D ) ( B )

題目之出處：Neurology in Clinical Practice, 6th, Ch52B, page 1122-1134

Part 4 (13-16)

( ) 13.

3

( ) 14.

( ) 15.

( ) 16.

A. Medulloblastoma

B. Oligodendroglioma

C. Glioblastoma

D. Meningioma

E. CNS lymphoma

解答：( C ) ( D ) ( A ) ( B )

題目之出處： Neurology in Clinical Practice, 6th, Ch52B, page 1119-1131

Part 5 (17-19)

Please correlate the lesion site with the disease entity

( ) 17. Moyamoya disease

( ) 18. saccular aneurysm

( ) 19. cerebral amyloid angiopathy

A. Intima

B. elastin lamina

C. Smooth muscle layer

D. adventita

解答：( A ) (B ) ( D )

題目之出處：Bradley’s Neurology in Clinical Practice, 6th edition, p1057, p1071

Merritt’s Neurology, 12th ed., page 338

Adams and Victor’s Principle of Neurology, 10th edition, p.837,p861

Part 6 (20-22)

Side effect of the anti-platelet

( ) 20. Aspirin

( ) 21. Dypiridamole

( ) 22. Ticlopidine

A. Angioedema

B. Neutropenia

C. Headache

D. Ureteral stone

解答：( A) (C) (B)

題目之出處：台灣腦中風防治指引 2008

Part 7 (23-26)

Match the region of thalamic infarction with the following syndromes

( ) 23. posterolateral thalamic infarction

( ) 24. anterior thalamic infarction

( ) 25. paramedian thalamic infarction

( ) 26. dorsal thalamic infarction

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A. Homonymous quadrantanopia or horizontal sectoranopias.

B. Pure sensory stroke, sensorimotor stroke, and the thalamic syndrome of

ejerine-Roussy.

C. Optic ataxia, psychic paralysis of fixation, simultanagnosia

D. Decreased level of consciousness, memory loss, vertical-gaze abnormalities.

E. Neuropsychological disturbances, emotional-facial paresis, occasional

hemiparesis, and visual-field deficits.

解答：( B ) ( E ) ( D ) ( A )

題目之出處： Bradley’s Neurology in Clinical Practice, 6th edition, P 1016

Part 8 (27-30)

( ) 27. Gene related to CADASIL

( ) 28. Gene related to Marfan syndrome

( ) 29. Gene related to homocysteinuria

( ) 30. Gene related to cerebral amyloid angiopathy

A. Cystatin C

B. NOTCH3

C. Fibrillin

D. MTHFR

E. α- galactosidase

解答：( B ) ( C ) ( D ) ( A )

A. 題目之出處： Merritt’s Neurology, 12th ed., page 282-285

Part 9 (31-34)

What is the typical lesion site of the following syndrome

( ) 31. Alexia with Agraphia

( ) 32. Opercular syndrome

( ) 33. Achromatopsia

( ) 34. Cortical deafness

A. Bilateral Heschl gyri lesion

B. Bilateral perisylvian cortex or subcortical connection lesion

C. Bilateral inferomedial occipital and temporal lobe lesion

D. Right frontal lobelesion

E. Inferior parietal lobe, especially the angular gyrus lesion

解答：( E) ( B ) ( C) ( A )

題目之出處：Merritt’s Neurology, 12th ed., page 282-285

Bradley’s Neurology in Clinical Practice, 6th edition, P 128, 143, 152

Adams and Victor’s Principle of Neurology, 9th edition, p. 454

Part 10 (35-38)

In addition to treatment of epilepsy, which AED may have its specific benefit?

( ) 35. Gabapentin

( ) 36. Lamotrigine

( ) 37. Oxcarbazepine

( ) 38. Topiramate

A. Bipolar disorder

B. Mood stabilizer

C. Neuropathic pain

D. Migraine

E. Psychosis

解答：( C ) ( A ) ( B ) ( D )

題目之出處：Handbook of Epilepsy Treatment , 3 rd edition, 2010, P 85

台灣癲癇醫學會「癲癇治療指引」2013版

Part 11 (39-42)

Match the long term side effect of the following AEDs

( ) 39. Topiramate

( ) 40. Valproic acid

( ) 41. Vigabatrin

( ) 42. Phenytoin

A. Visual field defect

B. Gum hypertrophy

C. Body weight loss

D. Emotional instability

E. Hand tremor

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解答：( C ) ( E ) ( A ) ( B )

題目之出處：Handbook of epilepsy, 4th edition, 2008, P184

台灣癲癇醫學會「癲癇治療指引」2013版

Part 12 (43-46)

Match the clinical characteristic feature with the following seizure or epilepsy

( ) 43. Jacksonian motor seizure

( ) 44. Gelastic seizure

( ) 45. Volvular epilepsy

( ) 46. Epilepsia procursiva (Cursive seizure)

A. Run

B. Walk repetitively in small circles

C. Laughter

D. Seizure spreads from the hand, up the arm, and to the face

E. Abdominal borborygmus

解答：( D) (C) (B) (A)

題目之出處：Adam p.309-311

Part 13 (47-50)

Match the characteristic clinical feature with the following epilepsy

( ) 47. Juvenile myoclonic epilepsy

( ) 48. Lennox-Gastaut Syndrome

( ) 49. Rolandic epilepsy

( ) 50. West Syndrome

A. Lapse of consciousness as the core clinical manifestation

B. Sudden flexor or extensor spasms involving the head, trunk and limbs

simultaneously

C. Atonic or astatic seizure

D. Generalized tonic-clonic seizure upon awakening

E. Clonic contractions of one side of the face, less often of one arm or leg

解答：(D) (C) (E) (B)

題目之出處： Merritt’s Neurology, 12th

edition. P929; Adam p.307-313

Part 14 (51-54)

Typical EEG findings

( ) 51. Period sharp wave complex with interval of 0.5-2 seconds

( ) 52. Bisynchronous triphasic wave

( ) 53. Period spike and wave complex at a rate 4 to 10 seconds

( ) 54. General polyspike wave in the normal background rhythm

A. Subacute sclerotic panencephalitis

B. Lennox-Gastaut syndrome

C. Juvenile myoclonic epilepsy

D. Creutzfeldt Jakob disease

E. Hepatic failure

解答：(D) (E) (A) (C)

題目之出處：Merritt’s Neurology, 12th edition,p74-78

Part 15 (55-58)

Match the following eye sign and disease

( ) 55. Horner’s syndrome

( ) 56. Hyperthyroidism

( ) 57. Myasthenia gravis

( ) 58. Oculomotor nerve palsy

A.

B.

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C.

D.

E.

解答：( D ) (A ) ( C ) ( E )

題目之出處：Dejong’s the neurologic examination 7th

edition chapter 14

Part 16 (59-62)

please match the following EMG

( ) 59.

( ) 60.

( ) 61.

( ) 62.

A. neuromyotonia

B. myokymia

C. end-plate spikes

D. cramps

E. multiplets

解答：( B) ( D ) ( A ) ( E )

題目之出處：Electromyography and neuromuscular disorders.

Clinical-electrophysiologic correlations 2nd

edition p.209-212

Part 17 (63-66)

Please match the clinical presentation with most probable disease

( ) 63. Prominent weakness but less muscle wasting

( ) 64. Prominent muscle wasting but less weakness s

( ) 65. True hypertrophy

( ) 66. Pseudohypertrophy

A. Polymyositis

B. Miyoshi myopathy

C. Corticosteriod myopathy

D. Duchenne dystrophy

E. Thomsen’s disease

解答：( A ) ( C ) ( E ) ( D )

題目之出處： DeJong’s The Neurologic Examination, 6th

edition, p.401-407

Part 18 (67-72)

Match the following nystagmus to their most probable main location of pathology

( ) 67. Upbeat nystagmus

( ) 68. Seesaw nystagmus

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( ) 69. Ocular bobbing

( ) 70. Convergence-retraction nystagmus

A. Ant. third ventricle

B. Cerebellar vermis or medulla

C. Pons

D. Rostral midbrain, pretectum, post. Commissure, post. third ventricle

E. Frontal lobe

解答：(B ) (A ) (C ) (D )

題目之出處：DeJong’s The Neurologic Examination (P. 223) 2012 edition

Part 19 (71-76)

Match the major features of extrapyramidal syndromes ?

( ) 71. Character of alteration of muscle tone

( ) 72. Involuntary movements

( ) 73. Babinski sign

( ) 74. Distribution of hypertonus

A. Muscle tone increase with clasp-knife effect

B. Muscle tone increase equally throughout passive movement

C. Absent

D. Present

E. Generalized hypertonus, but predominates in flexors of limbs

解答：( B) ( D ) ( C ) ( E)

題目之出處：Principles of Neurology 9th Edition 2009, Chapter 4

Part 20 (75-78)

For each ocular sign, select the most likely lesion

( ) 75. Ocular bubbing

( ) 76. Ocular dipping

( ) 77. Down, and inward gaze

( ) 78. Absence of optokinetic nystagmus

A. Thalamic hemorrhage

B. Bilateral pontine damage

C. Medulla lesion

D. Diffuse cortical anoxic change

E. Parietal lobe lesion

解答：(B) (D) (A) (E)

Part 21 (79-82)

For each pathological status, select the most compatible MRI signal intensity

( ) 79. Edema

( ) 80. Fat embolism

( ) 81. Subacute hemorrhage (>1 week)

( ) 82. Acute hemorrhage (<12 hours)

A. High TIW, low T2W, low FLAIR

B. High TIW, high T2W, low FLAIR

C. Low TIW, high T2W, high FLAIR

D. Medium TIW, high T2W, high FLAIR

E. High TIW, low T2W, medium FLAIR

解答：(C) (E) (A) (D)

Part 22 (83-86)

Match the major characteristics of Charcot Marie Tooth disease (Hereditary Motor

Sensory Neuropathies)

( ) 83. CMT1A

( ) 84. Hereditary Liability to Pressure Palsies (HNPP)

( ) 85. CMT1B

( ) 86. CMTX-linked, (GJB1)

A. Most of patients are normal in deep tendon reflex.

B. Stroke-like episodes are precipitated by exposure to altitude or

hyperventilation.

C. The means of the median and ulnar MNCVs were significantly lower than

those in CMT1A patients.

D. Motor Nerve conduction velocities are usually normal and sensory nerve

action potentials are absent.

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E. The most common type of hereditary neuropathy.

解答：( E ) ( A ) ( C ) ( B )

題目之出處： Neurology in Clinical Practice, 6th

Edition p 1938-1942

Part 23 (87-90)

Please select the antibody in relation with the following diseases

( ) 87. Multifocal motor neuropathy

( ) 88. Miller-Fisher syndrome

( ) 89. Stiff person syndrome

( ) 90. Distal acquired demyelinating symmetrical neuropathy

A. Anti-GAD (glutamic acid decarboxylase) Antibody

B. Anti-GQ1b ganglioside Antibody

C. Anti-ganglionic acetylcholine receptor Ab

D. Anti-GM1 ganglioside Antibody

E. Anti-myelin associated glycoprotein Ab

解答：( D ) ( B ) ( A ) ( E )

題目之出處：NICP 6th

Edition p751-755, p1925(table 76.2)

Part 24 (91-94)

Please match the following disease with the most related skin, nail or hair

manifestation

( ) 91. Ichthyosis

( ) 92. Angiokeratoma

( ) 93. Skin hyperpigmentation

( ) 94. Mees’ line

A. Fabry disease

B. Leprosy

C. Refsum disease

D. Arsenic intoxication

E. Osteosclerotic myeloma (POEMS syndrome)

解答：( C ) ( A ) ( E ) ( D )

題目之出處：NICP 6th

Edition p1922

Part 25 (95-99)

Please match the following serological or pathological findings with the corresponding

diseases

( ) 95. Anti- Jo1 antibody

( ) 96. β -amyloid protein

( ) 97. Endomysial inflammation

( ) 98. Perifasicular fiber atrophy

( ) 99. Ragged red fibers

A. polymyositis

B. dermatomyositis

C. interstitial lung disease

D. inclusion body myositis

E. Zidovudine(ZVD)-induced myopathy

解答：(C) (D) (A) (B) (E)

題目之出處：Principles of Neurology, 9e. Chap. 4

Part 26 (100-103)

Please match the following diseases/disorders with the ion channel that is affected

( ) 100. hypokalemic periodic paralysis

( ) 101. tetrodotoxin intoxication

( ) 102. myotonia congenita

( ) 103. Andersen disease

A. sodium channel

B. chloride channel

C. calcium channel

D. potassium channel

解答：(C) (A) (B) (D)

題目之出處：Principles of Neurology, 9e. Chap. 54 and Merritt’s textbook of

Neurology, Chap. 179

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Part 27 (104-107)

Which myopathy may result from the defects in the following proteins?

( ) 104. Dystrophin

( ) 105. Fukutin

( ) 106. Dysferlin

( ) 107. Calpain-3

A. Fukuyama type muscular dystrophy

B. Miyoshi myopathy

C. Limb girdle muscular dystrophy 1A

D. Limb girdle muscular dystrophy 2A

E. Becker muscular dystrophy

解答：( E ) ( A ) ( B ) ( D )

A. 題目之出處：NICP, 5th ed, p2408

Part 28 (108-112)

Which is the characteristic manifestation of the following toxins on the nervous

system?

( ) 108. Organophosphates

( ) 109. Mercury

( ) 110. Lead

( ) 111. Lathyrism

A. Upper motor neuron impairment

B. Motor neuropathy

C. Delayed polyneuropathy 2-3 weeks after acute exposure

D. Sensory disturbances due to impairment of sensory cortex or dorsal root

ganglia

E. Polyneuropathy in children and acute encephalopathy in adults

解答：(C) (D) (B) (A)

題目之出處：Neurology in Clinical Practice, 5th

ed p. 1657-1664

Part 29 (112-116)

Lower motor neuron disorders include a variety of diseases. Please choose the most

appropriate description or feature for each lower motor neuron disorder

( ) 112. Multifocal motor neuropathy

( ) 113. Hirayama disease

( ) 114. Kennedy’s disease

( ) 115. Spinal muscular atrophy

A. Homozygous deletions of survival motor neuron gene on chromosome 5

B. Abnormal CAG expansion in gene encoding estrogen receptor protein

C. Segmental cervical cord atrophy without significant spinal canal stenosis

D. Markedly abnormal sensory conduction findings

E. Profound weakness in muscles with relatively preserved muscle bulk

解答：( E ) (C ) (D ) (A )

題目之出處：NICP 5th ed p. 2193-2201

Part 30 (116-119)

Please match the best or most likely effective treatment according to the headache

diagnosis

( ) 116. Hypnic headache

( ) 117. Chronic migraine

( ) 118. Hemicrania continua

( ) 119. Giant cell arteritis

A. Indomethacin

B. Dihydroergotamine

C. Lithium

D. Topiramate

E. Corticosteroid

解答：( C ) (D) (A) (E)

題目之出處：Neurology in Clinical Practice 6th

Chapter 69, Page 1703-1744

Part 31 (120-123)

Please match the typical imaging finding with different etiologies of thunderclap

headache

( ) 120. Reversible cerebral vasoconstriction syndrome

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( ) 121. Sinus thrombosis

( ) 122. Meningitis

( ) 123. Spontaneous intracranial hypotension

A.

B.

C.

D.

E.

解答：(D ) ( C ) ( B ) ( A )

Part 32 (124-127)

Match the disease with its most likely patient. Use each answer only once

( ) 124. 12-year-old boy with left otitis media develops severe left facial pain, and

left abducens nerve palsy

( ) 125. 30-year-old woman presents with headache, malaise, arthralgia, fever, body

weight loss, and limb claudication

( ) 126. 45-year-old man develops acute right temporal headache, right abducens

nerve palsy, and right sided Horner syndrome

( ) 127. 40-year-old woman develops headache, hypertension, confusion, seizures

and visual disturbance after treatment with Tacrolimus

A. Temporal arteritis

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B. Takayasu’s arteritis

C. Reversible posterior leukoencephalopathy syndrome

D. Gradenigo syndrome

E. Internal carotid artery dissection

解答：(D) (B) (E) (C)

題目之出處：Adams and Victor’s Principles of Neurology, 9th edition, p795, p827,

p1173, p1327–28

Part 33 (128-131)

In terms of genetic basis of Alzheimer’s disease, please match the followings to

chromosomes?

( ) 128. Amyloid precursor protein

( ) 129. Presenenin I

( ) 130. Presenin II

( ) 131. Alzheimer’s disease in Adult Down Syndrome

A. Chromosome 1

B. Chromosome 4

C. Chromosome 14

D. Chromosome 19

E. Chromosome 21

解答：( E ) ( C ) ( A ) ( E )

題目之出處：Merritt’s Neurology 12th

ed. Chap. 13, Page 717

Part 34 (132-136)

Choose the related anatomic area for each of the following symptoms

( ) 132. Finger agnosia

( ) 133. Prosopagnosia

( ) 134. Pure word deafness

( ) 135. Dressing apraxia

A. Right temporal lobe

B. Left temporal lobe

C. Right frontal lobe

D. Right parietal lobe

E. Left parietal area

解答：( E ) ( A ) ( B) ( D)

題目之出處：Merritt’s neurology, 11th

edition,p8-13

Part 35 (136-139)

Which genetic mutation may cause following disease?

( ) 136. Alzheimer’s disease

( ) 137. Parkinson’s disease

( ) 138. Hungtinton’s disease

( ) 139. Spinocerebellar ataxia

A. Calcium channel, voltage-dependent, P/Q type, α-1A subunit; CACNA1A

B. Presenilin 1; PSEN1

C. Leucine-rich repeat kinase 2; LRRK2

D. Progranulin; PGRN

E. Huntingtin; HTT

解答：(B) (C) (E) (A)

題目之出處：NICP, 5th

ed

Part 36 (140-143)

What is the clinical features of the following chromosomal anomalies or genetic

syndromes/diseases?

( ) 140. TRISOMY 21

( ) 141. Prader-Willi Syndrome

( ) 142. Fabry Disease

( ) 143. Niemann-Pick Disease

A. Delayed psychomotor development and childhood obesity

B. Simian crease in the palm and unusual hand- and footprints

C. An autosomal dominant disorder in which the skin, kidney, peripheral and

autonomic nervous systems, and blood vessels store trihexosylceramide.

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D. Vertical supranuclear-gaze palsy is characteristic.

E. Characteristic hyperkeratotic, macular and maculopapular skin lesions with a

predilection for the groin, buttocks, scrotum, and umbilicus

解答：( B ) ( A ) ( E ) ( D )

題目之出處：Merritt’s Neurology 12th ed. Chapter 88 & Chapter 93

Part 37 (144-147)

Correlate the following characteristics with dystonic syndromes

( ) 144. Diurnal fluctuations with improvement after sleep. Parkinsonian symptoms

become part of the clinical picture over time

( ) 145. The earliest symptom is usually an action-induced dystonia in the leg or arm.

In 70% of patients, dystonic movements spread to the trunk and other limbs,

and generalized over about 5 years

( ) 146. Mutations in the ε-sarcoglycan gene. Affected individuals have myoclonus

as the primary sign

( ) 147. An X-linked recessive disorder causing progressive dystonia and

parkinsonism, tremor, chorea, myoclonus, affects Filipino adult men

A. Dopa-responsive dystonia (DYT5)

B. Rapid- onset dystonia- Parkinsonism (DYT12)

C. Myoclonus-dystonia (DYT11)

D. Lubag dystonia (DYT3)

E. Oppenheim dystonia (DYT1)

解答：( A ) ( E ) ( C ) ( D )

題目之出處：Bradley’s Neurology in Clinical Practice 6th

edition, P.1791~1795

Part 38 (148-151)

Choose the most appropriate correlation for the following condition of sleep disorders

( ) 148. Fatal familial insomnia

( ) 149. undesirable physical or behavioral phenomena that occur predominantly

during sleep

( ) 150. violent dream enactment

( ) 151. insomnia, paresthesia in the legs and an urge to move

A. RLS

B. Dyssomnia

C. Parasomnia

D. REM sleep behavior disorder

E. a prion disease

解答：( E ) ( C ) ( D ) ( A )

題目之出處：Merritt’s Neurology, 12th

edition, P.971- 973

Part 39 (152-155)

Please match the tilting table findings in patients with syncope or fainting spell

( ) 152. HR up to 120 bpm without orthotstatic hypotension

( ) 153. HR and BP drop abruptly after 10 minutes tilting

( ) 154. 2 or 3rd

degree AV block

( ) 155. Postural hypotension with marked HR increase

A. Orthostatic intolerance or POTS

B. Vasovagal syncope

C. Cardiogenic syncope

D. Anemia

E. Multiple system atrophy

解答：(A ) (B ) (C ) ( D )

題目之出處： Principles of Neurology, 8 ed., Chap. 18, p322-331

Part 40 (156-159)

Please match the following diseases with corresponding serological or pathological

findings

( ) 156. Multiple system atrophy

( ) 157. Myasthenia gravis

( ) 158. Acute autonomic neuropathy

( ) 159. Parkinson disease with autonomic failure

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A. antibodies to AchR α-1 subunits

B. argyrophilic glial cytoplasmic inclusions in oligodendroglia

C. antibodies to AchR α-3 subunits

D. Lewy bodies in peripheral autonomic ganglia

E. antibodies to GQ1b

解答：( B ) ( A ) ( C ) ( D )

題目之出處：Merritt’s textbook of Neurology, Chap. 159