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USMLE STEP 1 Neurology Exam Practice Questions and Answers

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USMLE STEP 1 Neurology Exam Practice Questions and Answers The notochord induces what to differentiate into what? - ANSWER-Induces overlying ECTODERM to differentiate into NEUROECTODERM and form NUERAL PLATE Neural plate then gives rise to? - ANSWER-Neural tube and neural crest cells Notochord...

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  • October 31, 2024
  • 143
  • 2024/2025
  • Exam (elaborations)
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USMLE STEP 1 Neurology Exam Practice

Questions and Answers


The notochord induces what to differentiate into what? - ANSWER✔✔-Induces overlying ECTODERM to

differentiate into NEUROECTODERM and form NUERAL PLATE


Neural plate then gives rise to? - ANSWER✔✔-Neural tube and neural crest cells


Notochord becomes what? - ANSWER✔✔-Nucleus pulposus of the intervertebral disks in adults


Alar Plate - ANSWER✔✔-Dorsal [Sensory]


Same orientation as spinal cord


Basal Plate - ANSWER✔✔-Ventral [Motor]


Same orientation as the spinal cord


How does FGF affect chordin and noggin? - ANSWER✔✔-FGF regulates chordin and noggin to down

regulate BMP which leads to neural plate induction


Three Primary Vesicles - ANSWER✔✔-1. Forebrain [Prosencephalon]



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2. Midbrain [Mesencephalon]


3. Hindbrain [Rhombencphaln]


The Forebrain gives rise to: - ANSWER✔✔-1. Telencephalon [Cerebral hemispheres, lateral ventricles]


2. Diencephalon [Thalamus, Third Ventricle]


The Midbrain gives rise to: - ANSWER✔✔-1. Mesencephalon [Midbrain, aqueduct]


The Hindbrain gives rise to: - ANSWER✔✔-1. Metencephalon [Pons, cerebellum, upper part of the fourth

ventricle]


2. Myelencephalon [Medulla, Lower part of the fourth ventricle]


CNS/PNS Origins - ANSWER✔✔-Neuroectoderm = CNS neurons, ependymal cell [Inner lining of

ventricles, makes CSF], oligodendrocytes, astrocytes


Neural crest cells = PNS, schwann cells


Mesoderm = Microglia [Like Macrophages, originate from Mesoderm]


Neural tube defects - ANSWER✔✔-NEUROPORES fail to fuse [4th week] → Persistent connection

between amniotic cavity and spinal canal


Associated with:



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1. Low folate levels before conception and during pregnancy


2. ↑ a-fetoprotein levels [AFP] in amniotic and maternal serum


3. ↑ AChE in amniotic fluid [Helpful confirmatory test]


-- Fetal AChe in CSF transudates across defect into amniotic fluid


Spina bifida occulta - ANSWER✔✔-Failure of bony spinal canal to close, NO STRUCTURAL HERNIATION


Usually seen at lower vertebral levels


DURA INTACT


Associated w/ tuft of hair or skin dimple at level of bony defect


NORMAL AFP


Meningocele - ANSWER✔✔-Meninges [BUT NO NEURAL TISSUES] herniates through bony defect


Meningomyelocele - ANSWER✔✔-Meninges and neural tissue herniate through bony defect


Associated w/ Arnold-Chiari Type II Malformation


Anencephaly - ANSWER✔✔-Malformation of the ANTERIOR NEURAL TUBE →


1. No forebrain



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2. Open calvarium


Clinical Findings:


1. ↑ a-fetoprotein levels [AFP]


2. Polyhydramnios [No swallowing center in brain]


3. Associated w/ MATERNAL TYPE I DIABETES


4. Maternal folate supplementation ↓ risk


Holoprosencephaly - ANSWER✔✔-Failure of LEFT AND RIGHT HEMISPHERES TO SEPARATE


Usually occurs during the 5th and 6th week


May be related to mutations in the SONIC HEDGEHOG signaling pathway


Moderate form = Cleft lip/palate


Severe form = Cyclopia


Seen in:


1. PATAU SYNDROME


2. FETAL ALCOHOL SYNDROME




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