1- A 50-year-old right-handed man has presented to a neurologist because of gradually progressive

hearing loss of the right ear. He denies worsening balance or ringing in his ears. There is no
associated pain. A vibrating tuning fork is applied to the center of his forehead. The sound is louder
in his left ear. This finding suggests which of the following?

a. Bilateral sensorineural hearing loss.

b. Bilateral conductive hearing loss.

c. Right ear conductive hearing loss.

d. Left ear sensorineural hearing loss.

e. Right ear sensorineural hearing loss ***

2 -A 42-year-old woman is being evaluated for gait difficulties. On examination, it is found that her
ability to walk along a straight line touching the heel of one foot to the toe of the other is impaired.
This finding is most common with which of the following?

a. Cerebellar dysfunction ***

b. Parietal lobe damage

c. Temporal lobe damage

d. Ocular motor disturbances

e. Dysesthesias in the feet

3- A 72-year-old retired school teacher has the abrupt onset of right face and hand weakness,
disturbed speech production, and a right homonymous hemianopsia. This is most likely attributable
to occlusion of which of the following arteries?

a. Left middle cerebral artery ***

b. Left anterior cerebral artery

c. Left vertebrobasilar artery

d. Right anterior choroidal artery

e. Left posterior inferior cerebellar artery (PICA

4-A 43-year-old man presents with a left CN III deficit and headache. The ocular symptoms began

with papillary dilation and then progressed to oculomotor impairment. Which of the following is the
 most likely site of the lesion responsible for this presentation?

a. Anterior communicating artery

b. Posterior communicating artery***

c. Anterior cerebral artery

d. Brainstem white matter

e. Posterior cerebral artery

5- A 22-year-old dance instructor routinely develops headaches on the weekend. The headaches

are almost always limited to the right side of her head and centered about the right temple. She
knows that a headache is coming because of changes in her vision that precede the headache by 20-
to-30 minutes. She sees scintillating lights just to the left of her center of vision. This visual
aberration then expands and interferes with her vision. The blind spot that it creates appears to
have a scintillating margin. As the blind spot clears, the headache starts. It rarely lasts more than 1
hour, but is usually accompanied by nausea and vomiting. The most likely diagnosis is :

a. Classic migraine***

b. Cluster headache

c. Common migraine

d. Trigeminal neuralgia

e. Sinusitis

6- A 35-year-old man has severe throbbing pain waking him from sleep at night and persisting into
the day. This pain is usually centered about his left eye and appears on a nearly daily basis for
several weeks or months each year. It occurs most prominently at night within a few hours of falling
asleep and is associated with a striking personality change in which the man becomes combative
and agitated. He never vomits or develops focal weakness. The most likely diagnosis is :

a. Classic migraine

b. Cluster headache***

c. Common migraine

d. Trigeminal neuralgia

e. Sinusitis