Free Specialty Certificate Examination in Neurology Practice Questions

Sample Practice Questions

Try these 10 sample questions from the Specialty Certificate Examination in Neurology practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1A woman at 32 weeks of pregnancy develops severe hypertension, proteinuria and a persistent headache, followed by a generalised convulsion. Which diagnosis best explains this combination?

   1. A.Cerebral venous thrombosis
   2. B.EclampsiaCorrect answer: B
   3. C.Idiopathic intracranial hypertension
   4. D.Reversible cerebral vasoconstriction syndrome

   Explanation: NHS – Pre-eclampsia states, "seizures (eclampsia)" The source lists this as a complication of pre-eclampsia. Hypertension and proteinuria establish the obstetric context; the convulsion identifies eclampsia rather than the other causes of headache.

   Reference: NHS – Pre-eclampsia — Complications of pre-eclampsia

2. 2A patient with excessive daytime sleepiness has brief episodes of bilateral knee buckling when laughing. Awareness is preserved throughout each episode. What is the name of these attacks?

   1. A.Atonic seizures
   2. B.CataplexyCorrect answer: B
   3. C.Sleep paralysis
   4. D.Vasovagal syncope

   Explanation: NINDS – Narcolepsy states, "Cataplexy—This symptom leads to sudden episodes of muscle weakness, often triggered by strong emotions such as laughter, fear, anger, stress, or excitement." Emotion-triggered weakness with preserved awareness matches cataplexy. Sleep paralysis occurs at sleep-wake transitions; syncope involves loss of consciousness. The characteristic emotional trigger supports cataplexy rather than an atonic seizure.

   Reference: NINDS – Narcolepsy — Symptoms of narcolepsy; Cataplexy

3. 3A neurologist requests structural imaging of the brain and cervical cord in a patient with suspected demyelination. Which imaging modality produces detailed tissue images using radio waves and a strong magnetic field?

   1. A.Computed tomography
   2. B.Magnetic resonance imagingCorrect answer: B
   3. C.Positron emission tomography
   4. D.Single-photon emission computed tomography

   Explanation: NINDS – Neurological Diagnostic Tests and Procedures states, "Magnetic resonance imaging (MRI) uses computer-generated radio waves and a powerful magnetic field to produce detailed images of body tissues." This identifies MRI. CT uses X-rays, whereas PET and SPECT use radiotracers. The question concerns the physical method, not an assertion that MRI alone establishes the diagnosis.

   Reference: NINDS – Neurological Diagnostic Tests and Procedures — Brain scans; Magnetic resonance imaging

4. 4A patient with an established migraine diagnosis asks about the usual upper duration of an aura symptom. According to NHS advice, persistence beyond which duration should prompt concern rather than routine reassurance?

   1. A.20 minutes
   2. B.60 minutesCorrect answer: B
   3. C.120 minutes
   4. D.180 minutes

   Explanation: NHS – Migraine states, "Aura symptoms should not last for longer than 1 hour." One hour is 60 minutes. This is an upper-duration question, not a claim that all auras last exactly one hour; the NHS advises seeking help if aura lasts longer.

   Reference: NHS – Migraine — Symptoms; aura duration

5. 5A patient has stereotyped brief episodes of intense déjà vu followed by right-hand jerking. He remains aware and can describe the entire event. Which seizure classification best fits?

   1. A.Generalised absence seizure
   2. B.Focal aware seizureCorrect answer: B
   3. C.Generalised atonic seizure
   4. D.Focal impaired-awareness seizure

   Explanation: NINDS – Epilepsy and Seizures states, "In some focal seizures, the person remains conscious during the seizure but may experience motor, sensory, or psychic feelings" The source includes déjà vu and movement of one hand. A focal onset with preserved awareness distinguishes the event from generalised seizures and focal impaired-awareness seizures.

   Reference: NINDS – Epilepsy and Seizures — Focal seizures; Symptoms

6. 6A patient with multiple sclerosis asks which structure is targeted by the characteristic inflammatory process in the central nervous system. Which answer is most accurate?

   1. A.Myelin surrounding central axonsCorrect answer: A
   2. B.Myelin surrounding peripheral axons
   3. C.Astrocytic aquaporin water channels
   4. D.Postsynaptic NMDA receptors

   Explanation: NINDS states, "In MS, the immune system attacks myelin in the central nervous system." The central location is essential. Peripheral myelin, aquaporin-4 and NMDA receptors are genuine immune targets in different neurological inflammatory disorders.

   Reference: NINDS – Multiple Sclerosis — Myelin and the immune system

7. 7A patient starting levodopa asks why carbidopa is included. Which action of carbidopa explains the combination?

   1. A.Reducing peripheral levodopa breakdown before brain entryCorrect answer: A
   2. B.Stimulating central dopamine receptors after brain entry
   3. C.Blocking central muscarinic receptors after brain entry
   4. D.Reducing central dopamine breakdown after brain entry

   Explanation: NINDS – Parkinson’s Disease states, "Carbidopa blocks levodopa breakdown in the body, so more levodopa can get into the brain." The distinction is peripheral protection of levodopa. Direct receptor stimulation, central antimuscarinic action and central inhibition of dopamine breakdown describe other Parkinson treatment mechanisms.

   Reference: NINDS – Parkinson’s Disease — Carbidopa-levodopa

8. 8After head trauma, imaging shows an extra-axial haematoma between the skull and dura mater. Which type of traumatic haemorrhage occupies this anatomical compartment?

   1. A.Subdural haematoma
   2. B.Epidural haematomaCorrect answer: B
   3. C.Subarachnoid haemorrhage
   4. D.Intracerebral haemorrhage

   Explanation: NINDS – Traumatic Brain Injury states, "Epidural hematomas, which involve bleeding into the area between the skull and the dura mater." The compartment defines the lesion. Subdural blood lies deep to the dura, subarachnoid blood in the CSF-containing subarachnoid space, and intracerebral blood within brain tissue.

   Reference: NINDS – Traumatic Brain Injury — Haematomas

9. 9A neurologist evaluates leg weakness that may be functional. Which bedside examination sign is specifically used to identify functional weakness in the legs?

   1. A.Romberg's sign
   2. B.Hoover's signCorrect answer: B
   3. C.Babinski's sign
   4. D.Gowers' sign

   Explanation: NINDS describes "Hoover’s sign (a physical test to identify functional weakness in the legs)" as a positive diagnostic signal. Romberg tests balance with altered visual input, Babinski assesses an extensor plantar response, and Gowers describes a manoeuvre compensating for proximal weakness.

   Reference: NINDS – Functional Neurologic Disorder — Diagnosing FND

10. 10An adult has had a suspected TIA and has no contraindication to aspirin. Under NICE NG128, what daily aspirin dose should be offered immediately?

    1. A.75 mg daily
    2. B.150 mg daily
    3. C.300 mg dailyCorrect answer: C
    4. D.600 mg daily

    Explanation: NICE – Stroke and TIA in over 16s (NG128) states, "300 mg daily" Recommendation 1.1.4 specifies this dose for immediate treatment after suspected TIA unless contraindicated. The other doses are not the recommendation being tested.

    Reference: NICE – Stroke and TIA in over 16s (NG128) — §1.1.4, pp. 6–7