• 45 questions

NBME Neurology Shelf Practice Exam

Unofficial practice for the clinical neurology shelf: short cases on stroke, seizures, headache, nerves and muscle.

A 35-year-old man's father has Huntington disease. What was the man's chance of getting the gene?

Pick an answer, then press Check answer. Then you see Correct or Not quite, with the reason. Keys: A to D pick, Enter checks.

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Exam mode: 40 questions, 60 minutes.

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Unofficial practice questions, not affiliated with NBME (the National Board of Medical Examiners). Bank checked October 12, 2026.

The real exam, as NBME describes it

Length
110 questions in 2 hours 45 minutes, by NBME's Subject Examination Timing Chart dated July 2021. A tutorial adds 15 minutes on web exams.
Patient age
Birth to 17 in 10 to 15% of questions, 18 to 65 in 55 to 65%, 66 and older in 20 to 25%.
Site of care
Ambulatory 60 to 65% of questions, emergency department 25 to 30%, inpatient 5 to 15%.
Where
At the medical school in a proctored web-based session, or at a Prometric test center.

Checked October 12, 2026 against Clinical Neurology Subject Exam content outline and Subject Examination Timing Chart, nbme.org. Rules change, so confirm with the agency itself before your test.

NBME's own content outline

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All 45 questions

Cerebrovascular disease, trauma and intracranial pressure 5

  • A 15-year-old boy is knocked out briefly by a blow to the head, wakes and talks normally, then becomes unresponsive with one enlarged pupil. Which injury gives this pattern? MedlinePlus Medical Encyclopedia, Epidural hematoma, Symptoms. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • A 28-year-old obese woman has daily throbbing headaches that are worse in the morning, with blurred vision. Which condition is most likely? MedlinePlus Medical Encyclopedia, Idiopathic intracranial hypertension, Causes. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • A 67-year-old man had 20 minutes of right arm weakness and slurred speech that cleared completely. What does this transient ischemic attack mean for him? MedlinePlus Medical Encyclopedia, Transient ischemic attack. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • A 74-year-old man has trouble starting to walk, as if his feet were stuck to the ground, with urinary incontinence and forgetfulness. Normal pressure hydrocephalus is suspected. Which test is done? MedlinePlus Medical Encyclopedia, Normal pressure hydrocephalus, Exams and Tests. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • An 81-year-old man who drinks heavily fell three weeks ago and is now confused. CT shows a chronic subdural hematoma. Which vessels bled? MedlinePlus Medical Encyclopedia, Subdural hematoma, Causes. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
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Seizures, headache, pain and sleep 6

  • A 7-year-old girl has staring spells that last a few seconds and occur many times a day. She is unaware of them. Which seizure type is this? MedlinePlus Medical Encyclopedia, Absence seizure. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • A 19-year-old student has attacks of daytime sleep, and cataplexy when he laughs. Many people with this disorder have a low level of which chemical? MedlinePlus Medical Encyclopedia, Narcolepsy, Causes. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • A 26-year-old woman has throbbing headaches on one side of the head, with nausea and sensitivity to light and sound. Which headache is this? MedlinePlus Medical Encyclopedia, Migraine. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • A 35-year-old man has severe one-sided pain around the eye at the same time each day, with tearing and a stuffy nose. What can he breathe in to treat an attack? MedlinePlus Medical Encyclopedia, Cluster headache, Treatment. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • A 45-year-old woman has an unstoppable urge to move her legs that is worse at night when she lies down. Which blood problem may her provider test for? MedlinePlus Medical Encyclopedia, Restless legs syndrome, Exams and Tests. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • A 62-year-old woman has brief electric shock-like pains in one cheek, set off by chewing and brushing her teeth. Which medicine treats this condition? MedlinePlus Medical Encyclopedia, Trigeminal neuralgia, Treatment. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.

Infectious, immunologic and neuromuscular disorders 5

  • A 29-year-old woman has had two attacks of neurologic symptoms separated by a remission. Which test is important to help diagnose multiple sclerosis and follow its progress? MedlinePlus Medical Encyclopedia, Multiple sclerosis, Exams and Tests. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • A 31-year-old woman has double vision and drooping eyelids. Her weakness gets worse with activity and better with rest. Tumors of which organ are linked to this disease? MedlinePlus Medical Encyclopedia, Myasthenia gravis, Causes. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • A 40-year-old woman has confusion and seizures from encephalitis. Which virus is the leading cause of the more severe cases at all ages? MedlinePlus Medical Encyclopedia, Encephalitis, Causes. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • A 60-year-old man has trouble climbing stairs, and his weakness improves for a while after exercise. Lambert-Eaton myasthenic syndrome is diagnosed. Which cancer is it often associated with? MedlinePlus Medical Encyclopedia, Lambert-Eaton myasthenic syndrome, Causes. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • After a Campylobacter stomach infection, a 34-year-old man has weakness that began in his legs and is spreading to his arms, with lost tendon reflexes. Which diagnosis fits? MedlinePlus Medical Encyclopedia, Guillain-Barre syndrome, Symptoms. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.

Degenerative and movement disorders 5

  • A 35-year-old man's father has Huntington disease. What was the man's chance of getting the gene? MedlinePlus Medical Encyclopedia, Huntington disease, Causes. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • A 58-year-old man has muscle weakness and twitching that began in one hand, and now has trouble swallowing. What does amyotrophic lateral sclerosis leave unaffected? MedlinePlus Medical Encyclopedia, Amyotrophic lateral sclerosis (ALS), Symptoms. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • A 60-year-old woman who has taken metoclopramide for years has facial grimacing, tongue thrusting and rapid blinking. What is done once tardive dyskinesia is diagnosed? MedlinePlus Medical Encyclopedia, Tardive dyskinesia, Treatment. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • A 68-year-old woman's hands shake when she writes or drinks from a cup, and less at rest. Her mother had the same shaking. A small amount of alcohol eases it slightly. Which diagnosis fits? MedlinePlus Medical Encyclopedia, Essential tremor, Symptoms. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • A 76-year-old woman has memory loss that has slowly worsened for three years. Which structures in the brain mark Alzheimer disease? MedlinePlus Medical Encyclopedia, Alzheimer disease, Causes. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.

Cranial and peripheral nerves, tumors and congenital disorders 8

  • A 9-year-old boy has eight coffee-with-milk spots on his skin and freckles in the underarms. Which inherited disorder forms tumors of nerve tissue? MedlinePlus Medical Encyclopedia, Neurofibromatosis-1, Symptoms. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • A 38-year-old man wakes with one side of his face drooping and cannot close that eye. Swelling of which nerve is thought to cause Bell palsy? MedlinePlus Medical Encyclopedia, Bell palsy, Causes. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • A 44-year-old typist has numbness and tingling in the thumb and the two fingers next to it. Which nerve is under pressure at the wrist? MedlinePlus Medical Encyclopedia, Carpal tunnel syndrome. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • A 52-year-old woman has slowly worsening hearing loss and ringing in one ear, with loss of balance. MRI shows a slow-growing tumor. Which nerve does an acoustic neuroma grow on? MedlinePlus Medical Encyclopedia, Acoustic neuroma. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • A 63-year-old woman has spinning that lasts seconds when she moves her head. Which bedside test may be done to diagnose benign positional vertigo? MedlinePlus Medical Encyclopedia, Benign positional vertigo, Exams and Tests. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • A 64-year-old man has several tumors in the brain that spread from a cancer elsewhere. Which of these cancers rarely spreads to the brain? MedlinePlus Medical Encyclopedia, Metastatic brain tumor, Causes. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • A newborn has a fluid-filled sac on the lower back where the backbone and spinal canal did not close. Low levels of which vitamin in early pregnancy play a part in this defect? MedlinePlus Medical Encyclopedia, Myelomeningocele, Causes. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.
  • After a fracture of the fibula, a 30-year-old man's toes drag and his foot slaps the floor with each step. Which nerve is injured? MedlinePlus Medical Encyclopedia, Common peroneal nerve dysfunction, Causes. Outline: NBME Clinical Neurology subject exam, Nervous System & Special Senses.

Musculoskeletal system 5

  • A 17-year-old boy has occasional episodes of muscle weakness, as his father does. During an episode, the blood level of which mineral is very low? MedlinePlus Medical Encyclopedia, Hypokalemic periodic paralysis, Causes. Outline: NBME Clinical Neurology subject exam, Musculoskeletal System.
  • A 50-year-old woman has weakness in the shoulders and hips, with trouble climbing stairs and raising her arms over her head. Polymyositis is confirmed by muscle biopsy. What is the initial treatment? MedlinePlus Medical Encyclopedia, Polymyositis - adult, Treatment. Outline: NBME Clinical Neurology subject exam, Musculoskeletal System.
  • A 70-year-old woman has pain and stiffness in both shoulders and the hips that is worse in the morning, with a high sedimentation rate. Polymyalgia rheumatica may occur before or with which disease? MedlinePlus Medical Encyclopedia, Polymyalgia rheumatica, Causes. Outline: NBME Clinical Neurology subject exam, Musculoskeletal System.
  • After a crush injury, a 25-year-old man has cola-colored urine and a very high creatine kinase level. Which organ is at risk from the myoglobin his muscles released? MedlinePlus Medical Encyclopedia, Rhabdomyolysis, Causes. Outline: NBME Clinical Neurology subject exam, Musculoskeletal System.
  • Two patients have inflamed, weak muscles. Which finding separates dermatomyositis from polymyositis? MedlinePlus Medical Encyclopedia, Dermatomyositis. Outline: NBME Clinical Neurology subject exam, Musculoskeletal System.

Other systems, behavioral health and social sciences 11

  • A 7-year-old boy who was given aspirin during the flu has repeated vomiting, then confusion. Which two organs does Reye syndrome damage? MedlinePlus Medical Encyclopedia, Reye syndrome. Outline: NBME Clinical Neurology subject exam, Other Systems, Including Multisystem Processes & Disorders.
  • A 9-year-old boy has had many motor tics and one vocal tic. Which behavioral conditions can occur with Tourette syndrome? MedlinePlus Medical Encyclopedia, Tourette syndrome, Symptoms. Outline: NBME Clinical Neurology subject exam, Behavioral Health.
  • A 24-year-old woman has leg paralysis that began after a trauma, and tests find no other disease. Which statement about functional neurological disorder is correct? MedlinePlus Medical Encyclopedia, Functional neurological disorder, Causes. Outline: NBME Clinical Neurology subject exam, Behavioral Health.
  • A 45-year-old man who drank windshield wiper fluid has blurred vision. Which antidote is given for methanol poisoning? MedlinePlus Medical Encyclopedia, Methanol poisoning, What to Expect at the Emergency Room. Outline: NBME Clinical Neurology subject exam, Other Systems, Including Multisystem Processes & Disorders.
  • A 58-year-old man with cirrhosis becomes drowsy and confused. Which poison, normally cleared by the liver, typically builds up in the blood? MedlinePlus Medical Encyclopedia, Loss of brain function - liver disease, Causes. Outline: NBME Clinical Neurology subject exam, Other Systems, Including Multisystem Processes & Disorders.
  • A 64-year-old woman with newly diagnosed amyotrophic lateral sclerosis wants relief from symptoms while she continues treatment. Which care can begin at diagnosis, alongside treatment? MedlinePlus Medical Encyclopedia, What is palliative care?, The Difference Between Palliative Care and Hospice. Outline: NBME Clinical Neurology subject exam, Social Sciences, Including Death and Dying and Palliative Care.
  • A 66-year-old woman with pernicious anemia has tingling, numbness and weakness of the legs. Lack of which vitamin causes subacute combined degeneration? MedlinePlus Medical Encyclopedia, Subacute combined degeneration, Causes. Outline: NBME Clinical Neurology subject exam, Other Systems, Including Multisystem Processes & Disorders.
  • A 72-year-old woman has a new throbbing headache on one side, a tender scalp and jaw pain when she chews. Which complication makes giant cell arteritis urgent? MedlinePlus Medical Encyclopedia, Giant cell arteritis, Symptoms. Outline: NBME Clinical Neurology subject exam, Other Systems, Including Multisystem Processes & Disorders.
  • A 75-year-old man with atrial fibrillation asks why he has been given a blood thinner. What is it for? MedlinePlus Medical Encyclopedia, Atrial fibrillation and atrial flutter, Treatment. Outline: NBME Clinical Neurology subject exam, Other Systems, Including Multisystem Processes & Disorders.
  • A healthy 78-year-old man says that recalling names takes longer than it used to. He manages his own affairs. Which statement matches normal aging of the nervous system? MedlinePlus Medical Encyclopedia, Aging changes in the nervous system. Outline: NBME Clinical Neurology subject exam, General Principles, Including Normal Age-Related Findings.
  • On a cold morning four members of a family with a faulty heater all have headache and dizziness. What does carbon monoxide do in the bloodstream? MedlinePlus Medical Encyclopedia, Carbon monoxide poisoning, Symptoms. Outline: NBME Clinical Neurology subject exam, Other Systems, Including Multisystem Processes & Disorders.

How this list was compiled: Our own questions, written to the content outline of the Clinical Neurology Subject Exam that NBME publishes (https://www.nbme.org/institutions/assess-learn/subject-exams/clinical-science/clinical-neurology/, read 2026-10-12). Systems and their ranges: General Principles, Including Normal Age-Related Findings and Care of the Well Patient 1-5%, Behavioral Health 3-7%, Nervous System & Special Senses 60-65%, Musculoskeletal System 10-15%, Other Systems, Including Multisystem Processes & Disorders 15-20%, Social Sciences, Including Death and Dying and Palliative Care 1-5%. The bank holds 1, 2, 29, 5, 7 and 1 questions in that order, 45 in all. Every fact was read on 2026-10-12 in the MedlinePlus Medical Encyclopedia (National Library of Medicine) article the question names. Licence: Questions, choices and explanations are original work of this site.

How it works

Here is a free NBME neurology shelf practice exam: 45 short patient cases of our own for the Clinical Neurology Subject Exam. It is unofficial and is not affiliated with or endorsed by NBME, the National Board of Medical Examiners.

Read the full guide

What the shelf covers

The Clinical Neurology content outline on nbme.org, read October 12, 2026, gives the nervous system and special senses 60 to 65% of the exam. The bank follows it: 29 of its 45 cases are nervous system, 5 musculoskeletal, 7 on other systems and 2 on behavioral health, plus one each on aging and palliative care.

A neurology shelf exam study guide

As a neurology shelf exam study guide, the nervous system cases are grouped by the outline's headings, from cerebrovascular disease to congenital disorders, and each answer names its MedlinePlus article and section.

Pace

The timed test on this page asks 40 questions in 60 minutes: one and a half minutes a question, the real exam's pace.

  • More than half the exam asks for a diagnosis: the outline gives diagnosis 55 to 60% and management 25 to 30%.

Questions and answers

Are these real NBME neurology shelf questions?

No. NBME's examinee page calls its exam materials confidential and forbids reproducing them. These cases are our own, written from the public content outline and MedlinePlus, and none repeats or rewords a sample item.

How long is the neurology shelf exam?

2 hours 45 minutes for 110 questions, by the Subject Examination Timing Chart that NBME links from its examinee page. A tutorial before a web exam adds 15 minutes.

What is on the neurology shelf exam besides the nervous system?

By the outline, 10 to 15% is the musculoskeletal system, 15 to 20% other systems and multisystem disorders, 3 to 7% behavioral health, and 1 to 5% each general principles and social sciences, which include death, dying and palliative care.

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