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FCPS Part 1 Neurophysiology MCQs
Neurophysiology questions test receptors and sensory pathways, spinal cord tracts and lesions, reflexes, the motor system, cerebellum and basal ganglia, the autonomic nervous system and cerebrospinal fluid.
Below are 5 free single-best-answer questions drawn from the most frequently examined neurophysiology concepts, each with the answer and a rationale for every option. The full bank has 151 neurophysiology concepts, each asked several different ways.
Free neurophysiology questions
Question 1
Stab wound to one half of the cord: ipsilateral weakness and vibration loss, contralateral pain loss. Diagnosis?
- A. Posterior cord syndrome
- B. Brown-Séquard syndrome
- C. Anterior spinal artery syndrome
- D. Central cord syndrome
- E. Syringomyelia
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Answer: B. Brown-Séquard syndrome
Dorsal columns ascend ipsilaterally, so vibration and proprioception are lost on the side of the lesion, as are motor functions. The spinothalamic tract crosses within one or two segments, so pain and temperature are lost contralaterally.
Why not the others: Syringomyelia: bilateral suspended pain and temperature loss, vibration intact. Central cord: arms affected more than legs. Posterior cord: vibration and proprioception lost only. Complete transection: all modalities lost bilaterally.
High-yield: Crossed pattern, ipsilateral motor and vibration with contralateral pain and temperature = Brown-Séquard.
Question 2
Distinguishing two different colours of the same modality is called:
- A. Sensory discrimination
- B. Sensory threshold
- C. Sensory adaptation
- D. Sensory integration
- E. Sensory perception
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Answer: A. Sensory discrimination
Sensory discrimination is the ability to distinguish between two stimuli of the same modality, for example two colours or two touch points. Two-point discrimination is its clinical test for touch.
Why not the others: Sensory threshold: the minimum detectable stimulus. Sensory adaptation: falling response to a sustained stimulus. Sensory perception: the conscious interpretation. Sensory integration: combining inputs from several sources.
High-yield: Discrimination = telling two stimuli apart; threshold = smallest detectable stimulus.
Question 3
Loss of vibration and position sense confined to the legs implicates which spinal tract?
- A. Dorsal spinocerebellar tract
- B. Fasciculus cuneatus
- C. Rubrospinal tract
- D. Fasciculus gracilis
- E. Anterior spinothalamic tract
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Answer: D. Fasciculus gracilis
The fasciculus gracilis carries vibration, proprioception and fine touch from the lower limb and lower trunk to the nucleus gracilis in the medulla. The fasciculus cuneatus serves the upper limb.
Why not the others: Fasciculus cuneatus: same modalities but from the upper limb. Spinothalamic tracts: pain and temperature. Dorsal spinocerebellar tract: unconscious proprioception. Rubrospinal tract: motor.
High-yield: Lower limb only = gracilis (medial); upper limb = cuneatus (lateral).
Question 4
The trigger for the myogenic response of arteriolar smooth muscle to a rise in pressure is:
- A. Nitric oxide release
- B. Hypercapnia
- C. Stretch
- D. Sympathetic stimulation
- E. Hypoxia
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Answer: C. Stretch
A sudden rise in intravascular pressure stretches vascular smooth muscle, opening stretch-activated channels so the muscle contracts and flow stays constant. Stretch is likewise the stimulus for the spindle and for Frank–Starling length-dependent force.
Why not the others: Hypoxia: dilates vessels (metabolic control). Hypercapnia: vasodilator, a metabolic signal. Sympathetic stimulation: neural vasoconstriction, not intrinsic. Nitric oxide: endothelial dilator, not the myogenic trigger.
High-yield: Myogenic autoregulation = stretch of vascular smooth muscle.
Question 5
Simplest measure to limit rise in ICP after supratentorial tumour resection:
- A. Elevating head of bed to 30°
- B. Hypotonic dextrose infusion
- C. Prophylactic hyperventilation to PaCO2 25 mmHg
- D. Head-down tilt
- E. Routine prophylactic mannitol
Show answer
Answer: A. Elevating head of bed to 30°
Head elevation to about 30° aids jugular venous drainage and lowers cerebral venous volume, reducing ICP without lowering cerebral perfusion materially. Neck must stay neutral to avoid venous obstruction.
Why not the others: Hyperventilation: cerebral vasoconstriction risks ischaemia, only temporising. Mannitol: reserved for active raised ICP, not prophylaxis. Head-down: raises ICP. Hypotonic fluids: worsen oedema.
High-yield: First-line ICP control = head up 30°, neutral neck, normocapnia, avoid hypotonic fluids.
Keep going with neurophysiology
Anaesgen brings every concept back on a spaced-repetition schedule timed to your exam date, as a different question each time, with full mock papers for Paper 1 and 2.
Get full access Try the 5 sample questionsHigh-yield neurophysiology one-liners
The most-tested neurophysiology concepts, as a clue and the answer it points to:
- Hemisection, ipsilateral motor/vibration, contralateral pain/temperature → Brown-Séquard.
- Two colours, two touch points, two smells → sensory discrimination.
- Lower limb vibration, proprioception, two-point loss → fasciculus gracilis.
- Myogenic tone, spindle Ia, Frank–Starling → stretch.
- Post-craniotomy, raised ICP, venous drainage → head-up 30°, neck neutral.
- Pinprick, sharp, localised, fast pain, lamina I → A-delta fibres.
- Progressive memory loss, lost in familiar places, hippocampal atrophy → Alzheimer.
- SA node upstroke, exocytosis, low level → tetany → calcium.
- Hypothyroid, pregnancy, RA, weak thumb abduction, thenar wasting → carpal tunnel syndrome.
- Weakness, skilled hand movement, MCA stroke, hemisection → corticospinal tract.
- Failed rapid alternating pronation-supination, clumsy buttoning → dysdiadochokinesia.
- Ptosis, miosis, anhidrosis, apical tumour → Horner syndrome.
- Cancer, proximal weakness improving with use, anti-VGCC → Lambert-Eaton.
- Anorexia, weight loss, loss of thirst, feeding centre → lateral hypothalamus.
- Recurrent unilateral throbbing, nausea, aura, photophobia → migraine.
- 3 Na out, 2 K in, 1 ATP; digoxin target → Na⁺/K⁺-ATPase.
- Nigral dopamine loss, rigidity, rest tremor, akinesia → Parkinsonism.
- Fast irregular EEG, atonia, PGO spikes → REM sleep → penile erection.
- Raised prolactin, amenorrhoea, galactorrhoea, bitemporal hemianopia → pituitary gland.
- Broad bizarre QRS, no P wave, compensatory pause, bigeminy → PVC.
Other FCPS Part 1 subjects
AnatomyPharmacologyPathologyBiochemistry & GeneticsCardiovascularMicrobiologyHaematologyGeneral PhysiologyImmunologyEndocrineRespiratoryEmbryologyObstetrics & GynaeRenal & Acid-BaseHistologyGI & LiverPhysicsBiostatistics
New to the exam? Read the FCPS Part 1 exam guide: dates, format and a 12-week study plan.