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AMC MCQ · Neurology

AMC Neurology MCQ Practice — 350+ Questions for IMGs

Stroke, epilepsy, MS, headache and neuromuscular disease — AMC MCQ neurology practice mapped to Australian guidelines.

379 questions in the full bank · 5 free samples below · Spaced repetition + AI explanations on the free tier.

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Why Neurology matters in AMC MCQ

Neurology contributes 10–14 questions to AMC MCQ, ranging from acute stroke triage and thrombolysis windows to first-seizure management, multiple sclerosis disease-modifying therapy, migraine prophylaxis, and peripheral neuropathy work-up. The AMC blueprint expects every IMG to confidently localise a lesion to the cortex, brainstem, spinal cord or peripheral nerve based on a focused history and examination findings.

Mostly Medicine’s neurology bank is mapped to the Stroke Foundation Clinical Guidelines, Therapeutic Guidelines: Neurology, and the Australian and New Zealand Association of Neurologists (ANZAN) consensus statements. You’ll see vignettes on tPA eligibility windows, thrombectomy for large-vessel occlusion, antiplatelet versus anticoagulation choice in cardioembolic stroke, status epilepticus algorithms, and natalizumab/ocrelizumab indications in relapsing-remitting MS. Headache vignettes regularly test the SNOOP red flags and the differential between cluster, migraine, tension and medication-overuse headache.

AMC neurology stems are notorious for blending a focused neurological exam (cranial nerve findings, dysarthria pattern, sensory level, brisk reflexes) with imaging clues, then demanding the single best next step. Practising 250+ Australian-aligned neurology MCQs builds the pattern-recognition speed you need on exam day. Sign up free to unlock the full bank.

5 free Neurology sample MCQs

Below are five sample questions taken straight from the Mostly Medicine neurology bank. The correct answer is highlighted, with the worked explanation tucked inside a collapsed panel so you can self-test first.

Question 1Headache · medium

A 35-year-old woman presents with sudden severe headache she describes as 'the worst headache of my life', neck stiffness and photophobia. CT head is normal. What is the NEXT most important investigation?

  1. A.MRI brain with contrast
  2. B.Lumbar punctureCorrect
  3. C.EEG
  4. D.Carotid Doppler
  5. E.Discharge with analgesics and review in 24 hours
Show explanation

Thunderclap headache + normal CT = LP is mandatory to exclude SAH. CT misses up to 5% of SAH. LP looks for xanthochromia at 12 hours post-onset. Never discharge without excluding SAH.

Question 2Stroke · medium

A 68-year-old man presents with acute onset right-sided weakness and dysphasia for 1.5 hours. CT head shows no haemorrhage. His BP is 185/105. What is the most appropriate management?

  1. A.Aggressive BP lowering to <140 before thrombolysis
  2. B.IV alteplase if no contraindicationsCorrect
  3. C.Aspirin 300mg immediately and observe
  4. D.Wait for MRI before any intervention
  5. E.Heparin infusion
Show explanation

Ischaemic stroke within 4.5 hours — IV alteplase is indicated if no contraindications. BP should only be lowered to <185/110 before thrombolysis (not aggressively lower). Aspirin alone is inadequate in the thrombolysis window.

Question 3Stroke · hard

A 70-year-old man presents with sudden onset right-sided weakness and expressive aphasia. CT head is normal. Onset was 90 minutes ago. BP 168/95. He is on warfarin (INR 1.6) for AF. What is the most appropriate management?

  1. A.IV tPA (alteplase) is contraindicated due to warfarin
  2. B.IV alteplase if INR <1.7, then consider mechanical thrombectomyCorrect
  3. C.Mechanical thrombectomy only — no thrombolysis
  4. D.Aspirin 300 mg loading dose
  5. E.Heparin infusion for cardioembolic stroke
Show explanation

IV alteplase can be given if INR ≤1.7 (acceptable coagulation status). CT shows no haemorrhage. Time window: up to 4.5 hours for thrombolysis. CTA/MRI if thrombectomy candidate (large vessel occlusion). Do not give antiplatelet or anticoagulant within 24h of thrombolysis. Maintain BP <185/110 before thrombolysis.

Question 4Stroke · medium

A 65-year-old woman presents with a TIA — 30-minute episode of right-sided arm weakness and slurred speech, now resolved. ABCD² score is 5. What is the most appropriate management?

  1. A.Discharge with follow-up in 4 weeks
  2. B.Admit for urgent investigation and dual antiplatelet therapyCorrect
  3. C.Start aspirin and lifestyle advice only
  4. D.Start warfarin immediately
  5. E.MRI brain in 3 months
Show explanation

TIA is a medical emergency. Risk of early stroke after TIA is 10–20% at 7 days. ABCD² ≥4 = high risk. Admit for urgent investigation (MRI brain, carotid imaging, echo, ECG/Holter) and start dual antiplatelet (aspirin 300 mg + clopidogrel 300 mg loading for 21 days, then clopidogrel alone) or aspirin alone. Treat modifiable risk factors urgently.

Question 5Epilepsy · hard

A 28-year-old woman with juvenile myoclonic epilepsy (JME) presents for medication review. She wants to start a family. She is on valproate 1000 mg/day with good seizure control. What is the most appropriate advice?

  1. A.Continue valproate — most effective for JME and safe in pregnancy
  2. B.Switch to lamotrigine or levetiracetam before conceptionCorrect
  3. C.Stop all AEDs — seizure risk in pregnancy low
  4. D.Reduce valproate dose by 50%
  5. E.Switch to carbamazepine
Show explanation

Valproate in pregnancy: highest teratogenicity risk (neural tube defects 1–2%, facial dysmorphia, cognitive impairment — 'fetal valproate syndrome'). Must be avoided in women of childbearing potential unless no alternatives. Switch to lamotrigine or levetiracetam for JME preconceptually. Carbamazepine also teratogenic. All women on AEDs: high-dose folic acid 5 mg/day from pre-conception.

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Neurology FAQ

What is the AMC stroke thrombolysis window?

Intravenous alteplase is recommended within 4.5 hours of symptom onset for eligible patients per Stroke Foundation guidelines. Endovascular thrombectomy is offered up to 24 hours for selected large-vessel occlusion patients with favourable imaging.

How is first-seizure management tested?

Expect vignettes on whether to start an antiepileptic after a single unprovoked seizure (generally no, unless EEG/MRI abnormalities or high recurrence risk), driving restrictions under Austroads (6 months off private driving), and pregnancy planning with valproate avoidance.

Which headache red flags should I memorise?

Use SNOOP: Systemic symptoms, Neurological signs, Onset sudden (thunderclap), Older age >50, Pattern change. Any positive flag mandates urgent imaging and CSF if SAH is suspected.

Is peripheral neuropathy on the AMC blueprint?

Yes. Common stems cover diabetic peripheral neuropathy, B12 deficiency subacute combined degeneration, alcohol-related neuropathy, Guillain-Barré syndrome (rising paralysis + albuminocytological dissociation), and carpal tunnel syndrome.

How many neurology MCQs are free on this page?

Five sample neurology MCQs with explanations are shown below. The full 250+ bank unlocks with a free Mostly Medicine account.