FCPS IMM Neurology MCQs: High-Yield Practice Questions & Prep

Sample FCPS IMM Medicine neurology MCQs on stroke, epilepsy, meningitis, neuromuscular disease, brain tumours and spinal cord disease, with explanations.

Neurology in IMM is localisation and management: which vessel, which lesion, which drug. Epilepsy, meningitis, stroke, neuromuscular disease and raised intracranial pressure carry most of the marks. Here are sample questions with explanations.

Sample Neurology MCQs

1. A patient presents with generalised tonic clonic seizures in emergency. Her CT scan shows a 5 cm multicentric mass lesion in the right frontal lobe with vasogenic oedema. What will be your diagnosis?

A) Glioblastoma ✅
B) Ependymoma
C) Astrocytoma
D) Schwannoma

Why: A large multicentric enhancing frontal mass with vasogenic oedema in an adult is glioblastoma multiforme, the commonest primary brain tumour.

2. A patient got up in the morning with an acute attack of vertigo associated with vomiting and ataxia with hypotonia. What is the most likely diagnosis?

A) Post fossa tumour
B) Meniere disease
C) Cerebellar infarction ✅
D) Acoustic neuroma

Why: Acute vertigo with vomiting, ataxia and hypotonia (ipsilateral to the lesion) suggests a cerebellar stroke, which needs urgent imaging.

3. A young female was using a computer at late night. She developed blurred vision, blacked out and then she slept for the next 12 hours. What is the diagnosis?

A) Migraine
B) SAH
C) Benign intracranial hypertension
D) Epilepsy ✅

Why: Transient loss of awareness followed by prolonged sleep (postictal state), triggered by sleep deprivation and screen stimulation, suggests a seizure.

4. A patient presented with headache and red eye with ptosis. What is your diagnosis?

A) Cluster headache ✅
B) Migraine
C) Glaucoma
D) Cavernous sinus thrombosis

Why: Cluster headache may cause transient ipsilateral ptosis and miosis (partial Horner syndrome) with a red, watering eye.

5. A patient presented with complaints of headache, fever, neck stiffness and seizures of one side of body. Investigation of choice would be?

A) EEG
B) MRI brain
C) CT brain ✅
D) CSF analysis

Why: With seizures or focal neurology, CT head should be done before lumbar puncture to exclude a mass lesion or raised ICP.

6. A patient presents with spastic paraparesis and mood lability. What is the diagnosis?

A) Friedrich ataxia
B) Vit B12 deficiency
C) Pseudobulbar palsy ✅
D) ALS

Why: Emotional lability with spastic weakness is typical of pseudobulbar palsy from bilateral upper motor neuron lesions.

7. A 35-year-old female with history of vision problem one year back presents with difficulty in walking. On examination there is increased tone in both lower limbs with exaggerated reflexes. What is the diagnosis?

A) GBS
B) Subacute combined degeneration of cord
C) Transverse myelitis
D) Multiple sclerosis ✅

Why: Optic neuritis a year earlier followed by spastic paraparesis (dissemination in time and space) is multiple sclerosis.

8. A 15-year-old boy develops weakness of lower limbs following by weakness in upper limbs. NCVs show acute axonal motor neuropathy. What is the best treatment for him?

A) IV immunoglobulins ✅
B) IV methylprednisolone
C) Thymectomy
D) Interferon beta
E) Observe

Why: Ascending weakness with acute axonal motor neuropathy is a variant of Guillain-Barre syndrome, treated with IV immunoglobulin or plasma exchange (steroids are ineffective).

How to Approach Neurology for IMM

Practise stroke syndromes by artery, because vignettes describe deficits and ask for the vessel.
Know first-line and pregnancy-safe antiepileptics for each seizure type.
For meningitis, memorise the CSF pattern for bacterial, viral, tuberculous and fungal disease, plus contact prophylaxis.

Browse every Neurology question on its own: Neurology MCQs.

Keep Practising

These questions come from HighYield's FCPS IMM Medicine QBank, which holds over 2,400 clinical-vignette MCQs with an explanation for every answer. The first 20 questions are free in Tutor mode, so you can judge the explanation quality before unlocking the full bank.