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Neurology USMLE Exam Questions with Correct Verified Answers 2026/2027 Latest Updated

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Excel in your Neurology USMLE exams with this comprehensive study guide featuring exam questions and correct verified answers for 2026/2027. Master all essential neurology topics including neuroanatomy and physiology (kinesins anterograde transport away from cell body, dyneins retrograde transport toward cell body, Nissl substance rough ER, microtubules intermediate filaments microfilaments size comparison, ligand-gated nicotinic receptors, SA node depolarization calcium-dependent, overshoot hyperpolarizing afterpotential), neuroembryology and developmental disorders (neural tube formation anterior posterior neuropores, anencephaly, spina bifida occulta meningocele meningomyelocele, ataxia telangiectasia cerebellar atrophy DNA break repair IgA deficiency, fragile X syndrome CGG repeats gene methylation, mitochondrial diseases MERRF MELAS Leber ragged red fibers maternal inheritance), neurodegenerative and movement disorders (Alzheimer neurofibrillary tangles, Parkinson substantia nigra Lewy bodies, Huntington caudate atrophy CAG repeats, Friedrich ataxia, Wilson disease), neuro-oncology and tumor syndromes (craniopharyngioma Rathke pouch anterior pituitary origin, NF2 chromosome 22 bilateral acoustic schwannomas, NF1 chromosome 17 neurofibromin, VHL hemangioblastomas, Li-Fraumeni p53, RB1 retinoblastoma osteosarcoma), cerebrovascular disease and stroke (liquefactive necrosis, lacunar infarcts, middle cerebral artery syndromes, watershed infarcts), infectious diseases (meningitis routes N meningitidis pharynx blood choroid plexus, H influenza pharynx lymphatics, S pneumoniae middle ear contiguous, Staph aureus traumatic, TB primary lung blood, enterovirus aseptic meningitis, complement deficiency C5b-C9 Neisseria infections, IgA protease H influenza N meningitidis), neuroimmunology and demyelinating disease (MS oligoclonal bands IgG, lipid-laden macrophages, progressive multifocal leukoencephalopathy JC virus), neuro-ophthalmology (visual pathway lesions, bitemporal hemianopia pituitary adenoma, macular degeneration drusen wet vs dry, scotoma, arcuate scotomas, binaal hemianopia carotid calcification), neuro-otology (vertigo, tinnitus, hearing loss, acoustic neuroma), spinal cord syndromes (cauda equina vs conus medullaris, S2-S4 saddle anesthesia anocutaneous reflex, S1-S2 ankle jerk reflex), cranial nerves (trigeminal middle cerebellar peduncle, facial dorsolateral pontomedullary, trochlear inferior colliculus, hypoglossal preolivary sulcus, tongue innervation anterior 2/3 trigeminal chorda tympani posterior 1/3 glossopharyngeal root vagus), neuropharmacology (valproic acid absence tonic-clonic seizures neural tube defect risk, carbamazepine complex partial agranulocytosis aplastic anemia, mood stabilizers lithium valproate acute mania), neurophysiology (membrane potential, equilibrium potential chloride -90, potassium efflux repolarization), and neuroepidemiology (incidence prevalence mortality rate calculations, lead time bias, selection bias, observer bias). Perfect for USMLE Step 1, Step 2, and neurology clerkship exams.

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NEUROLOGY USMLE EXAM

QUESTIONS WITH CORRECT VERIFIED
ANSWERS 2026/2027 LATEST UPDATED




Kinesins move (toward/away) cell body while Dyneins move (Toward/away)
cell body of neuron. - CORRECT ANSWER>>>>Microtubular motor proteins.
Kinesins move away from the cell body toward the axon, carrying vesicles and
organelles in anterograde transport. Dyneins move toward cell body carrying
things in retrograde transport. Dyneins also function in ciliary and flagellar
movement. Hydrolyze ATP to move.



What is Nissl substance? - CORRECT ANSWER>>>>The Rough ER of
neuron which is in the

cell body. Does not extend to axons.



Which is larger microfilament, microtubule, intermediate filament? -
CORRECT ANSWER>>>>Microtubule. Then intermediate filament. Then
microfilament.




Page 1 of 41

,bias can occur with inappropriate (non random) methods or through selective
attrition of study participants. - CORRECT ANSWER>>>>Selection bias. It
creates a population that does not accurately represent the real population. Can
result in erroneous conclusions.



The odds ratio approximates the when disease prevalence is low. -
CORRECT

ANSWER>>>>Relative risk.

can be defined as teh tiem between the initial detection of a disease and a
specific outcome or measured endpoint. - CORRECT ANSWER>>>>Lead
time. Lead time bias occurs when comparing two different tests for the same
disease when one of the tests can accurately detect the disease at an earlier stage




A 24 year old male is evaluated for chronic headaches and visual changes.
Intracranial calcified mass is seen on MRI. Gross insp shows cystic spaces w
thick brownish fluid rich in cholesterol. The mass most likely shares a common
origin w which:

A. Choroid plexus

B Pineal gland

C. Pituitary gland

D. Cerebellar vermis

E. Retina - CORRECT ANSWER>>>>Pituitary gland. Calcified cystic
mass in a young adult w no other risks is likely a Craniopharyngioma.
Suprasellar region. Cystic or partially cystic w solid areas. LM shows stratefied

Page 2 of 41

,squamous epith and possibly Keratin pearls. Cysts are filled w yeloow viscous
fluid rich in cholesterol crystals.

Derived from Rathke's pouch remnants. Rathke's pouch is an evagination of the
ectoderm that lines the fetal oral cavity. It protrudes up to form the anterior
pituitary gland. Posterior pit is neuroectoderm.

are calcified cystic tumors that derive from Rathke's pouch, whcih is an
embryonic

precursor to the anterior pituitary. Commonly cause HA, growth failure,
bitemporal hemianopia.

- CORRECT ANSWER>>>>Craniopharyngiomas




bias occurs when comparing two different tests for the same disease when
one

of the tests can accurately detect the disease at an earlier stage - CORRECT

ANSWER>>>>Lead time bias. A study comparing disease survival times may
erroneously

conclude that using the earlier-detection test prolongs survival, when in
actuality, the increased

survival is solely due to earlier detection of disease.



bias occurs when someone misclassifies data secondary to individual

differences in interpretation or preconceived expectations regarding the study. -
CORRECT

Page 3 of 41

, ANSWER>>>>Observer bias. It can be reduced w a double blind study and
having multiple

encoders of data.



Are the nicotinic receptors on skeletal muscle endplate ligand gated or voltage
gated and how do

they initiate signaling? - CORRECT ANSWER>>>>Ligand gated (ACh binds)
and they open

Na and K channels.



Does the initial upstroke in the SA node depend on Na or Ca? - CORRECT

ANSWER>>>>Calcium. Everywhere else, skletal muscle, smooth muscle,
cardiac muscle in purkinje fibers, it depends on sodium.

Calcium does flood in when the depolarization from opening Na and K channels
leads to VGCC activation.



A 4 year old boy w difficulty walking. PMH shows frequent respiratory
infections. Cultured cells from the patient show a high rate of radiation induced
genetic mutation. This patient is likely to experience which of the following?
Neurofibrillary tangles in neocortex

Cerebellar atrophy

Loss of neurons in substantia nigra Atrophy of caudate nucleus

Posterior column degeneration



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