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Free Practice Questions for Iran Specialty Board Neurology

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Key Facts: Iran Specialty Board Neurology Exam

152 MCQs

Written Exam Questions

Sanjesh Pezeshki Official Board Announcement

210 min

Written Exam Duration

Council for Medical and Specialized Education

70% (105/150)

Written Passing Score

Sanjesh Pezeshki Board Bylaws

No Negative Marking

Scoring Rule

Sanjesh Pezeshki Specialty Board Guidelines

100 MCQs

Practice Bank Study Items

OpenExamPrep

The Iranian Neurology Specialty Board (Sanjesh Pezeshki / MOHME) consists of a 152-question, 240-minute written examination with a strict 70% pass threshold (105/150) without negative marking, followed by multi-station clinical OSCE and oral viva assessments. This independent 100-question practice bank provides comprehensive English-language preparation for the written examination across all six core curriculum domains.

Sample Iran Specialty Board Neurology Practice Questions

Try these sample questions to review concepts for the Iran Specialty Board Neurology exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 64-year-old man presents with sudden-onset right hemiparesis and global aphasia. Symptoms began 110 minutes ago. Non-contrast head CT shows no acute hemorrhage or early ischemic changes (ASPECTS 10). Blood pressure is 172/96 mmHg, blood glucose is 138 mg/dL, and platelets are 210,000/mcL. What is the most appropriate next step in management?
A.Intravenous alteplase (0.9 mg/kg) infusion followed by CTA of head and neck
B.Immediate reduction of systolic blood pressure to below 140 mmHg with IV nicardipine
C.Oral aspirin 325 mg and clopidogrel 300 mg loading dose
D.Perform brain MRI with DWI prior to initiating any reperfusion therapy
Explanation: The patient meets all criteria for IV thrombolysis within the 0 to 4.5-hour therapeutic window (symptom onset under 3 hours, non-contrast CT ruling out hemorrhage, blood pressure <185/110 mmHg). Reperfusion with IV alteplase should be initiated immediately without delaying for multimodal MRI, accompanied or followed rapidly by CTA to assess for large vessel occlusion.
2A 58-year-old woman presents 7 hours after acute right middle cerebral artery stroke onset (NIHSS 16). Non-contrast CT reveals an ASPECTS of 8. CT angiogram confirms an occlusion of the M1 segment of the right MCA. Perfusion CT demonstrates a small ischemic core of 18 mL and a penumbral perfusion delay (Tmax >6s) of 95 mL. What is the standard evidence-based management?
A.Mechanical thrombectomy with a stent retriever and/or aspiration catheter
B.Intravenous alteplase at standard dose (0.9 mg/kg)
C.Conservative management with therapeutic subcutaneous low-molecular-weight heparin
D.Emergent decompressive hemicraniectomy within 12 hours
Explanation: Based on the DAWN and DEFUSE-3 trials, mechanical thrombectomy is strongly indicated in the 6-to-24 hour window for patients with large vessel anterior circulation occlusion and a favorable clinical-core or perfusion-core mismatch. This patient has a small core (18 mL) and large salvageable penumbra, meeting criteria for endovascular reperfusion.
3A 71-year-old man presents with sudden-onset vertigo, dysphagia, hoarseness, right-sided facial numbness, right hemiataxia, and left body sensory loss to temperature. Motor power is 5/5 in all extremities. Which arterial vessel is most likely occluded?
A.Basilar artery apex
B.Anterior spinal artery
C.Posterior inferior cerebellar artery (PICA)
D.Superior cerebellar artery (SCA)
Explanation: This clinical presentation defines lateral medullary (Wallenberg) syndrome, caused by occlusion of the vertebral artery or the posterior inferior cerebellar artery (PICA). Infarction involves the nucleus ambiguus (hoarseness, dysphagia), spinal trigeminal tract (ipsilateral facial analgesia), spinothalamic tract (contralateral body analgesia), inferior cerebellar peduncle (ipsilateral ataxia), and descending sympathetic fibers (ipsilateral Horner syndrome).
4A 52-year-old woman develops the 'worst headache of her life' followed by brief loss of consciousness. A non-contrast head CT performed 4 hours after onset is entirely normal. What is the mandatory next diagnostic step to evaluate for suspected subarachnoid hemorrhage?
A.Repeat non-contrast head CT in 24 hours
B.Non-contrast brain MRI with fluid-attenuated inversion recovery (FLAIR)
C.Lumbar puncture with spectrophotometry for xanthochromia
D.Electroencephalography to rule out non-convulsive status epilepticus
Explanation: When clinical suspicion for aneurysmal subarachnoid hemorrhage is high and non-contrast CT is negative, lumbar puncture is mandatory to rule out xanthochromia (bilirubin degradation of red blood cells) and persistent elevated red blood cell counts in sequential tubes. Spectrophotometry or visual centrifugation differentiates true subarachnoid blood from a traumatic tap.
5A 48-year-old patient with an acute aneurysmal subarachnoid hemorrhage underwent successful surgical clipping on day 1. On post-bleed day 6, the patient develops progressive confusion, lethargy, and mild right hemiparesis. Serum sodium is 137 mEq/L, and CT head shows no hydrocephalus or rebleeding. Transcranial Doppler reveals mean flow velocities of 215 cm/s in the left middle cerebral artery. What is the primary pharmacologic prevention and treatment agent indicated?
A.Oral nimodipine 60 mg every 4 hours for 21 days
B.Intravenous high-dose methylprednisolone pulse therapy
C.Intravenous heparin continuous infusion targeted to aPTT 60-80 seconds
D.Intravenous magnesium sulfate infusion to supra-therapeutic levels
Explanation: Oral nimodipine (60 mg every 4 hours for 21 days) is the guideline-recommended pharmacologic therapy proven to reduce delayed cerebral ischemia (DCI) and improve neurological outcomes in aneurysmal subarachnoid hemorrhage. Vasospasm typically peaks between post-bleed days 4 and 14.
6A 68-year-old man presents with acute right putaminal hemorrhage (volume 28 mL) on non-contrast CT. He is on warfarin for non-valvular atrial fibrillation. His INR is 3.4. What is the most rapid and effective therapy for urgent anticoagulation reversal?
A.Four-factor prothrombin complex concentrate (4F-PCC) plus intravenous vitamin K
B.Fresh frozen plasma (FFP) 15 mL/kg alone
C.Intravenous vitamin K 10 mg alone
D.Idarucizumab 5 g intravenous bolus
Explanation: Four-factor prothrombin complex concentrate (4F-PCC) rapidly normalizes the INR within minutes because it contains concentrated, balanced vitamin K-dependent factors (II, VII, IX, X, and proteins C/S) in a small volume. IV vitamin K (10 mg) must be co-administered to maintain factor synthesis once PCC clearance occurs.
7A 30-year-old woman on oral contraceptive pills presents with a 4-day history of progressively worsening headache, bilateral papilledema, and a new right focal motor seizure. Brain MRI reveals absent flow void in the superior sagittal and right transverse sinuses, with high signal on T1 and T2 weighted sequences. What is the first-line therapy?
A.Therapeutic anticoagulation with low-molecular-weight heparin (or unfractionated heparin)
B.High-dose intravenous dexamethasone to reduce intracranial pressure
C.Immediate surgical thrombectomy and venous sinus stenting
D.Long-term antiplatelet therapy with dual aspirin and clopidogrel
Explanation: Therapeutic anticoagulation with full-dose low-molecular-weight heparin (or unfractionated heparin) is the first-line evidence-based therapy for cerebral venous sinus thrombosis (CVST), even in the presence of venous hemorrhagic infarction. It arrests thrombus propagation and facilitates recanalization.
8A 62-year-old woman experienced a minor ischemic stroke (NIHSS 3) 14 hours ago. Non-contrast CT excludes hemorrhage. Carotid duplex ultrasound reveals 25% non-stenotic carotid plaque. Which antithrombotic strategy is supported by the CHANCE and POINT clinical trials for early secondary stroke prevention?
A.Dual antiplatelet therapy with aspirin and clopidogrel initiated within 24 hours for 21 days
B.High-dose aspirin 325 mg monotherapy indefinitely without dual antiplatelets
C.Warfarin anticoagulation targeted to an INR of 2.0 to 3.0
D.Intravenous tissue plasminogen activator infusion
Explanation: The CHANCE and POINT trials demonstrated that in patients with minor acute ischemic stroke (NIHSS <= 3) or high-risk TIA (ABCD2 score >= 4), dual antiplatelet therapy (DAPT) with aspirin and clopidogrel initiated within 24 hours and continued for 21 days significantly reduces the risk of recurrent stroke compared to aspirin monotherapy, with acceptable bleeding risk.
9A 74-year-old hypertensive patient presents with pure motor hemiparesis involving the left face, arm, and leg equally, without aphasia, neglect, hemianopia, or sensory loss. Diffusion-weighted MRI reveals an 11 mm hyperintense focal infarct in the posterior limb of the right internal capsule. Which underlying microvascular pathology is most commonly responsible?
A.Lipohyalinosis and microatheroma of lenticulostriate penetrating arteries
B.Cardioembolic occlusion of the main stem M1 middle cerebral artery
C.Atherosclerotic plaque rupture in the right common carotid bifurcation
D.Arteriovenous malformation nidus micro-hemorrhage
Explanation: Pure motor hemiparesis is the most common lacunar stroke syndrome, classic for an infarct in the posterior limb of the internal capsule or basis pontis. The underlying pathophysiology of true lacunar infarcts is small vessel disease involving lipohyalinosis, fibrinoid necrosis, and microatheromas of deep penetrating arterioles (e.g., lenticulostriate arteries).
10A 56-year-old woman presents with sudden-onset expressive language impairment with intact comprehension and repetition. When asked to repeat complex phrases, she does so fluently and without error, but spontaneous speech is halting and non-fluent. Where is the causative ischemic lesion located?
A.Arcuate fasciculus in the deep parietal operculum
B.Left superior temporal gyrus (Wernicke area)
C.Left supplementary motor area or anterior watershed cortex sparing Broca area
D.Angular gyrus of the left dominant parietal lobe
Explanation: This clinical syndrome is transcortical motor aphasia, characterized by non-fluent speech, preserved comprehension, and strikingly preserved repetition. It occurs with lesions in the left frontal lobe outside the core Broca area, such as the supplementary motor area, dorsolateral prefrontal cortex, or anterior cerebral artery/MCA watershed territories.

About the Iran Specialty Board Neurology Exam

The Iranian Medical Specialty Board Examination in Neurology (آزمون دانشنامه تخصصی بیماریهای مغز و اعصاب / بورد تخصصی نورولوژی) is the definitive postgraduate professional qualification for clinical neurologists in the Islamic Republic of Iran, administered by the National Center for Health Assessment (Sanjesh Pezeshki) on behalf of the Ministry of Health and Medical Education (MOHME). Attaining this credential certifies advanced clinical acumen, mastery of diagnostic neuro-investigations, and evidence-based pharmacotherapy across the entire spectrum of neurological illness. Important disclosure: Attaining the official Daneshnameh credential requires accredited 4-year hospital residency training, formal thesis defense, verified procedure logbooks, and passing both the 152-question written examination and multi-station clinical OSCE/oral examinations. This 100-question practice bank is an independent English-language MCQ study adaptation authored by OpenExamPrep to facilitate focused revision of core neurological principles and board-level clinical vignettes. It is not an official Sanjesh Pezeshki examination, does not provide OSCE stations, and is not a substitute for formal accredited clinical residency training.

Exam sponsor: Secretariat of the Council for Medical and Specialized Education & Sanjesh Pezeshki (مرکز سنجش آموزش پزشکی). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

The Iranian Medical Specialty Board Examination in Neurology (آزمون دانشنامه تخصصی بورد نورولوژی) is conducted annually in two distinct stages under the auspices of the Secretariat of the Council for Medical and Specialized Education and the National Center for Health Assessment (Sanjesh Pezeshki / مرکز سنجش آموزش پزشکی): 1) Written Examination (آزمون کتبی): A single-session examination of 152 four-option multiple-choice questions administered over 240 minutes (4 hours). A minimum score of 70% (105 out of 150 written points) with no negative scoring is strictly required to pass and qualify for the clinical phase. 2) Practical / Oral Examination (آزمون شفاهی و بالینی): Conducted over multiple structured Objective Structured Clinical Examination (OSCE) stations, Patient Management Problem (PMP) computerized simulations, neuroimaging and clinical electrophysiology (EEG, EMG/NCS) interpretation stations, and oral viva voce examinations before an academic board jury. Candidates passing both stages are awarded the Daneshnameh Takhasosi (National Board Certification) in Neurology.

Time Limit

240 minutes

Passing Score

70% of the written total (105 of 150 points)

Exam / Certification Fees

Prescribed by Sanjesh Pezeshki / Ministry of Health and Medical Education bylaws

Exam sponsor website

Reported exam pass rate: Approximately 70%. Candidates must achieve at least 105 of the 150 written points (70%) in the written examination without negative scoring in order to advance to the clinical OSCE and oral viva evaluation. This describes exam candidates, not OpenExamPrep users or results from using our resources. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

20%

Cerebrovascular Diseases & Stroke

Ischemic stroke syndromes, vascular territories, IV thrombolytic therapy (alteplase, tenecteplase) and mechanical thrombectomy indications, blood pressure targets, intracerebral hemorrhage, aneurysmal subarachnoid hemorrhage, cerebral venous thrombosis, and secondary antithrombotic therapy.

18%

Epilepsy & Paroxysmal Disorders

ILAE seizure classification, status epilepticus staged protocols, antiseizure drug pharmacology, drug-resistant epilepsy, electroencephalography (normal rhythms, epileptiform transients, encephalopathy patterns), and sleep-related paroxysmal disorders.

16%

Movement Disorders

Parkinson's disease diagnosis, dopamine replacement therapy, motor complications, atypical parkinsonian syndromes (PSP, MSA, CBD, DLB), hyperkinetic movement disorders, dystonia, chorea, tremors, hereditary ataxias, and Wilson's disease.

16%

Demyelinating & Autoimmune Diseases

2017 McDonald criteria for multiple sclerosis, disease-modifying therapies, neuromyelitis optica spectrum disorder (anti-AQP4), MOG antibody-associated disease (MOGAD), acute disseminated encephalomyelitis (ADEM), and autoimmune synaptic encephalitis.

16%

Neuromuscular Disorders & Peripheral Neuropathies

Myasthenia gravis, Lambert-Eaton syndrome, amyotrophic lateral sclerosis, Guillain-Barré syndrome variants, CIDP, hereditary neuropathies, inflammatory myopathies, muscular dystrophies, and electromyography/nerve conduction studies.

14%

Neuro-Oncology, Neuro-Infectious, Cognitive Impairment & Dementia

Primary and metastatic brain tumors, paraneoplastic syndromes, acute bacterial meningitis, viral encephalitis, neurotuberculosis, neurobrucellosis, prion disease, Alzheimer's disease, frontotemporal dementia, vascular dementia, and normal pressure hydrocephalus.

Preparing for the Iran Specialty Board Neurology Exam

What You Need to Know

  • Passing score: 70% of the written total (105 of 150 points)
  • Assessment: The Iranian Medical Specialty Board Examination in Neurology (آزمون دانشنامه تخصصی بورد نورولوژی) is conducted annually in two distinct stages under the auspices of the Secretariat of the Council for Medical and Specialized Education and the National Center for Health Assessment (Sanjesh Pezeshki / مرکز سنجش آموزش پزشکی): 1) Written Examination (آزمون کتبی): A single-session examination of 152 four-option multiple-choice questions administered over 240 minutes (4 hours). A minimum score of 70% (105 out of 150 written points) with no negative scoring is strictly required to pass and qualify for the clinical phase. 2) Practical / Oral Examination (آزمون شفاهی و بالینی): Conducted over multiple structured Objective Structured Clinical Examination (OSCE) stations, Patient Management Problem (PMP) computerized simulations, neuroimaging and clinical electrophysiology (EEG, EMG/NCS) interpretation stations, and oral viva voce examinations before an academic board jury. Candidates passing both stages are awarded the Daneshnameh Takhasosi (National Board Certification) in Neurology.
  • Time limit: 240 minutes
  • Exam / certification fees: Prescribed by Sanjesh Pezeshki / Ministry of Health and Medical Education bylaws Official sources

Using Our Practice Resources

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

Iran Specialty Board Neurology: Suggested Study Strategy

1Target high-yield stroke reperfusion criteria: Commit the 0-4.5 hour IV thrombolysis window, strict blood pressure targets (<185/110 mmHg pre-thrombolysis, <180/105 mmHg post-thrombolysis), and ASPECTS/CT perfusion criteria for mechanical thrombectomy to memory.
2Master ILAE seizure classifications and EEG hallmarks: Distinguish focal vs generalized epilepsies, recognize 3 Hz spike-and-wave discharges, periodic lateralized epileptiform discharges (LPDs), and memorize the first-, second-, and third-line medication algorithms for status epilepticus.
3Differentiate atypical parkinsonian syndromes from Parkinson's disease: Focus on distinguishing clinical signs such as early falls and vertical supranuclear gaze palsy (PSP), early severe dysautonomia and cerebellar signs (MSA), and asymmetric dystonia with cortical sensory loss or alien limb phenomenon (CBD).
4Systematize demyelinating disease biomarkers: Master the 2017 McDonald criteria for dissemination in space and time, test indications and MRI patterns for AQP4-positive NMOSD (longitudinally extensive transverse myelitis, area postrema syndrome), and MOGAD (bilateral optic neuritis, conus lesions).
5Review neuromuscular electrodiagnosis: Thoroughly understand how to differentiate demyelinating polyneuropathies (prolonged distal latencies, conduction velocity slowing, conduction block, temporal dispersion) from axonal neuropathies (reduced compound muscle action potential amplitudes with preserved velocity).

Frequently Asked Questions

What is the official structure of the Iranian Specialty Board Examination in Neurology?

The examination is conducted annually by Sanjesh Pezeshki in two consecutive stages: a written examination consisting of 152 four-option multiple-choice questions administered over 240 minutes (4 hours), followed by a structured clinical/oral examination for those who pass the written stage. The clinical phase incorporates Objective Structured Clinical Examination (OSCE) stations, Patient Management Problem (PMP) computerized scenarios, neuroimaging/electrophysiology review, and oral viva voce assessments.

What is the passing score for the written stage of the Iranian Neurology Board?

The passing cut-off for the written board examination is strictly 70% of the total available score, which corresponds to at least 105 points out of a written total of 150. Importantly, there is no negative marking (penalty for incorrect responses) in the Iranian specialty board examinations.

What is the difference between the Gonavahi (Pre-Board) and Daneshnameh (National Board)?

The Gonavahi (گواهینامه تخصصی) is the university exit certificate awarded upon completing 4 years of residency and passing the university exit examination; it permits general specialist practice. The Daneshnameh (دانشنامه تخصصی / بورد تخصصی) is the prestigious national board certification awarded by the Ministry of Health (Sanjesh Pezeshki); it is mandatory for academic faculty appointments, department leadership, and eligibility for subspecialty fellowship training.

What reference textbooks are used to formulate the Iranian Neurology Board questions?

The national examination board specifies premier international neurology reference works as the core curriculum source material, primarily Bradley's Neurology in Clinical Practice and Adams and Victor's Principles of Neurology, supplemented by contemporary international practice guidelines from the American Academy of Neurology (AAN) and European Academy of Neurology (EAN).

How are candidates evaluated during the clinical and oral stage?

Candidates who score 105 or higher on the written paper advance to the practical exam. This involves multi-station OSCE evaluations assessing focused history taking and physical examination techniques, computer-based clinical problem solving (PMP), rapid interpretation of brain and spine MRI/CT scans, EEG and EMG tracings, and an in-person clinical interview with a panel of university neurology professors.

Is this OpenExamPrep practice bank an official Sanjesh Pezeshki product?

No. This practice question bank is an independent educational resource created by OpenExamPrep. It adapts the theoretical curriculum and high-yield topics of the Iranian Neurology Board into 100 comprehensive English-language practice questions with detailed pedagogical rationales to aid residents in their written exam preparation. It does not replace accredited clinical residency training or official Sanjesh Pezeshki materials.