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MRCP Part 1 Neurology MCQs with Explanations

TL;DR

This article gives you a focused revision module on “mrcp part 1 neurology — 25 practice mcq with explanations”, providing high-yield neurology items, one worked mini-MCQ, and a practical study-tip checklist. Ideal for MRCP Part 1 candidates wanting to sharpen neurological reasoning.


Why this matters

Neurology frequently appears in the exam for MRCP Part 1 and yet many candidates are caught out by subtle localisation, drug-side-effect traps or atypical presentations. According to the official syllabus, MRCP Part 1 tests not just core knowledge, but the ability to apply it to clinical scenarios and common important disorders. Royal Colleges of Physicians UK+2ImgConnect+2By engaging with 25 targeted MCQs and explanations you consolidate both content and reasoning — a crucial step for exam-readiness. Additionally, using this article alongside our MRCP Part 1 overview hub and your active question bank practise ensures a more robust revision strategy.


Scope of Neurology for MRCP Part 1

High-yield neurological sub-topics

Here are five neurological themes that consistently feature in MRCP Part 1 and on which you should focus:

  1. Stroke & Vascular Neurology

    • Recognise classic lacunar syndromes (e.g., pure motor, ataxic hemiparesis).

    • Distinguish anterior vs posterior circulation signs.

    • Know secondary prevention (antiplatelets, statins, BP targets).

  2. Seizures & Epilepsy

    • Differentiate focal vs generalised seizures; understand first-line antiepileptic drugs.

    • Recognise drug interactions (for example enzyme induction/inhibition).

    • Note side-effects (e.g., valproate in women of childbearing age).

  3. Movement Disorders

    • Parkinson’s disease: motor + non-motor features; dopaminergic therapies and complications.

    • Essential tremor vs drug-induced vs Wilson’s disease.

    • Recognise investigational side-effects (e.g., levodopa-induced dyskinesia).

  4. Demyelination & Neuroimmunology

    • Multiple Sclerosis vs Neuromyelitis Optica: optic neuritis, longitudinally extensive lesions.

    • Pathophysiology, clinical presentation, basics of therapies (e.g., interferons, monoclonals).

    • Recognise red-flags for progressive forms.

  5. Neuromuscular & Peripheral Nervous System

    • Guillain‑Barré syndrome: ascending weakness, areflexia, albuminocytologic dissociation.

    • Myasthenia Gravis & Lambert-Eaton: fatigability, ocular involvement, response to edrophonium/anticholinesterases.

    • Recognise metabolic neuropathies (B12 deficiency, diabetic neuropathy) versus acute inflammatory ones.

Five common traps to watch

  • Mistaking crossed-sign brainstem lesions (ipsilateral cranial nerve + contralateral motor/sensory) for cortical ones.

  • Overlooking non-motor symptoms in movement disorders (e.g., RBD, orthostatic hypotension).

  • Treating headache questions as primary headaches without screening for raised intracranial pressure or secondary causes.

  • Memorising drug names without mechanisms or contraindications (e.g., enzyme induction, teratogenicity).

  • Relying purely on pattern recognition—not localisation logic. Many stems will disguise localisation cues subtly.


Quick outline of topics and revision tips

Here is a brief numbered list to structure your neurology revision for MRCP Part 1:

  1. Cranial nerve localisation: know brainstem cross-sections and facial nerve pathways.

  2. Cerebrovascular syndromes: map anterior/middle/posterior circulation and lacunar territory.

  3. Seizure types plus first-choice drugs and contraindications.

  4. Parkinson’s spectrum and movement-disorder mimics.

  5. Demyelinating disorders: presentation, imaging and antibody correlations.

  6. Peripheral neuropathies & neuromuscular junction: distinguishing features.

  7. Neuropharmacology: mechanisms, side-effects, drug-interactions.

  8. Headache/red-flag neurology: remember raised ICP, meningitis, temporal arteritis.

  9. Practical anatomy: spinal cord syndromes, myelopathy vs radiculopathy.

  10. Clinical reasoning: always localise before jumping to diagnosis.


Practical examples / mini-cases

Here are three illustrative MCQs with explanations designed in the “best of five” style you’ll meet in the exam.

MCQ 1A 52-year-old man develops sudden right-sided facial weakness (lower half), hemiparesis on the right side, and diminished sensation on the right side. He also has slurred speech. Cranial nerve findings show right LMN facial palsy (whole half of face).Question: Where is the likely lesion? A. Left internal capsuleB. Right facial nerve at stylomastoid foramenC. Left lateral pontine → Foville syndromeD. Right geniculate ganglionE. Left facial nucleus in the pons

Answer: C. Left lateral pontine (Foville region)Explanation: The combination of ipsilateral LMN facial palsy + contralateral hemiparesis and sensory loss suggests a brainstem lesion at the pons on the left side (affecting facial nerve nucleus/nerve and corticospinal/crossed sensory tracts). Recognition of “crossed signs” is key.

MCQ 2 A 30-year-old woman presents with intermittent diplopia and bilateral leg weakness. MRI shows multiple periventricular white-matter lesions; lumbar puncture shows oligoclonal bands. Which antibody is most likely if this were neuromyelitis optica rather than typical MS?A. Anti-MOGB. Anti-AQP4 (aquaporin-4)C. Anti-NMDA receptorD. Anti-GAD65E. Anti-LGI1

Answer: B. Anti-AQP4 (aquaporin-4)Explanation: Neuromyelitis optica (NMO) is associated with aquaporin-4 antibodies and often presents with optic neuritis and long-segment spinal cord lesions. Distinguishing MS from NMO is a frequently tested point in neurology for MRCP Part 1.

MCQ 3A 28-year-old man is given a new drug for his focal seizures. After 3 months he reports gingival hyperplasia and increased facial hair. Which drug is the most likely cause? A. Sodium valproateB. PhenytoinC. CarbamazepineD. LamotrigineE. Levetiracetam

Answer: B. Phenytoin Explanation: Phenytoin is well-known for side-effects including gingival hyperplasia and hirsutism. MRCP questions often test not just the first-line drug but also its characteristic adverse effects, so be alert to drug-specific clues.


Doctor’s desk setup with neurology study notes and online MRCP Part 1 question bank on tablet.

Study checklist — how to master neurology for MRCP Part 1

Use this checklist to structure your preparation efficiently:

  • ✅ Build a revision timetable: allocate neurology one-week blocks within your broader revision.

  • ✅ Use a high-quality question bank for timed practice (e.g., from our Free MRCP MCQs or other providers).

  • ✅ After each session, review explanations deeply. Ask: why each distractor is wrong and why the right answer is best.

  • ✅ Map anatomical pathways as diagrams (brainstem, spinal cord, cranial nerves).

  • ✅ Summarise each sub-topic in one page (e.g., “Parkinson-spectrum revision map”).

  • ✅ Weekly error review: revisit the questions you got wrong and categorise by sub-topic.

  • ✅ Simulate full-length mock papers under timed conditions (via Start a mock test ideally).

  • ✅ In the final four weeks, shift towards spaced repetition of your weakest neurology areas and practise mixed speciality sets to mirror exam conditions.


Common mistakes & fixes

  • Mistake: Jumping to a diagnosis without localisation logic. Fix: First ask “Where is the lesion?” before “What is the diagnosis?”

  • Mistake: Memorising diagnoses but ignoring drug mechanisms/side-effects. Fix: For every drug, list mechanism + two key adverse effects + one major interaction.

  • Mistake: Treating headache questions as simple migraine when temporal arteritis or raised ICP may be present. Fix: Always check for red-flags (age > 50, scalp tenderness, papilloedema).

  • Mistake: Confusing central vs peripheral neuropathy features. Fix: Tabulate central vs peripheral signs (reflexes, distribution, acuity).

  • Mistake: Reviewing questions passively—reading answers but not probing them. Fix: After each MCQ, ask: “Why were the other four options wrong?”

  • Mistake: Avoiding full mock tests until last minute. Fix: Schedule at least two full-length mocks before exam date to build stamina and timing.


FAQs

Q1. How many neurology questions typically appear in MRCP Part 1?Approximately 14–17 questions of 200 may focus on neurology, as per subject-weight breakdowns. studymrcp.com+1

Q2. Do neurology MCQs in MRCP Part 1 test pure anatomy or clinical localisation?

They typically test clinical localisation and reasoning—recognising symptom patterns and mapping them anatomically is more important than rote anatomy.

Q3. Should I prioritise neurology early or late in my revision schedule?

It depends on your comfort level, but given neurology’s complexity and high-yield status, early coverage then spaced-repetition revision works best.

Q4. Are there negative marks in MRCP Part 1 MCQs?

No. Each correct answer awards one mark; there is no negative marking. Royal Colleges of Physicians UK+1

Q5. Are images used in MRCP Part 1 neurology questions?

Traditionally MRCP Part 1 does not heavily rely on images in neurology questions; the emphasis remains on clinical scenario and reasoning. ImgConnect+1


Call to action

Now is the time to integrate neurology into your revision with precision. Dive into the MRCP Part 1 overview hub for full syllabus coverage, explore our Free MRCP MCQs to sharpen reasoning, and Start a mock test to simulate exam conditions with neurology-rich content. Crack Medicine is here to support your MRCP-focussed journey.


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