Neurology PANCE Questions and Answers
(Latest Update 2024)
A 73 year-old male presents to the clinic with his wife. His
wife has noticed that he has developed a resting tremor in his
right hand and a shuffling gait over the last year. What
finding on physical examination would support your
suspected diagnosis?
A Chorea
B Dystonia
C Masked facies
D Hyperreflexia - Correct Answer ✅ C
The patient symptoms are consistent with Parkinsonism.
Physical exam findings include masked facies, micrographia,
decreased arm swing, and monotonous speech.
A patient with an upper motor neuron lesion would exhibit
which of the following findings?
A Fasciculations
B Areflexia
C Muscular atrophy
D Spasticity - Correct Answer ✅ D
,Neurology PANCE Questions and Answers
(Latest Update 2024)
Spasticity is an upper motor neuron lesion finding.
Fasciculations, areflexia and muscle atrophy are consistent
with lower motor neuron lesions.
What test is the single most useful test in establishing the
diagnosis of multiple sclerosis?
A Cerebral spinal fluid cell count and protein level
B Cerebral spinal fluid immunoglobulin studies
C Evoked potentials
D Magnetic Resonance Imaging - Correct Answer ✅ D
The presence of plaques on MRI is a key finding in
establishing the diagnosis of MS. While cerebral spinal fluid
cell count, protein levels, and immunoglobins may be
abnormal they are not specific for multiple sclerosis.
Evoked potentials are most useful in the detection of
subclinical involvement of neuropathways in MS, but does not
establish the diagnosis.
, Neurology PANCE Questions and Answers
(Latest Update 2024)
A 22-year-old male presents to the clinic complaining of
excessive daytime somnolence and strong desires to sleep at
inappropriate times. He came in today because he had an
episode of "feeling paralyzed" as he was falling asleep
yesterday. What is the most appropriate diagnostic test to
confirm this patient's diagnosis?
A MRI of the brain
B Electroencephalogram
C Multiple sleep latency test
D Overnight polysomnography - Correct Answer ✅ C
Multiple sleep latency test is required to observe the abrupt
transition to REM sleep and establish the diagnosis of
narcolepsy.
A 54-year-old male smoker presents to the clinic complaining
of frequent vague headaches with associated vomiting that
awaken him from sleep occasionally and have been present
upon awakening for about two weeks. The headache typically
resolves about an hour into his morning routine. The patient
is afebrile. What is the most likely cause of this patient's
headaches?
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