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Clinical Neurology Flashcards

7 cards from real NBME practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A 30-year-old woman has recurring unilateral pulsating headaches with nausea, photophobia, and preceding visual scotoma. Acute treatment with which agent is most appropriate?

    Answer: Sumatriptan

    Triptans (serotonin 5-HT1B/1D agonists) are first-line acute therapy for moderate-to-severe migraine with or without aura.

  2. A 45-year-old man has severe unilateral periorbital pain lasting 45 minutes occurring nightly, with ipsilateral lacrimation and ptosis. What prophylactic medication is most effective?

    Answer: Verapamil

    Verapamil is the first-line prophylactic agent for cluster headache; high doses (240-960 mg/day) are often required.

  3. Autopsy of a 78-year-old with progressive memory loss shows neocortical neuritic plaques and neurofibrillary tangles. Which protein forms the tau tangles?

    Answer: Hyperphosphorylated tau

    Neurofibrillary tangles in Alzheimer's disease are composed of hyperphosphorylated tau protein arranged in paired helical filaments.

  4. A 28-year-old woman has two episodes of optic neuritis and a spinal cord lesion separated by time and space on MRI. CSF shows oligoclonal bands. Which diagnostic criteria confirm MS?

    Answer: McDonald criteria (2017)

    The 2017 McDonald criteria require dissemination in space (DIS) and time (DIT) demonstrated by MRI or clinical events to diagnose MS.

  5. A 60-year-old diabetic has symmetric stocking-glove sensory loss with reduced ankle reflexes and NCS showing reduced sensory amplitudes with normal conduction velocity. What type of neuropathy is this?

    Answer: Length-dependent axonal polyneuropathy

    Diabetic peripheral neuropathy is typically a length-dependent axonal polyneuropathy with reduced amplitudes on NCS and preserved conduction velocity.

  6. A 70-year-old man presents with the triad of gait ataxia, urinary incontinence, and dementia. MRI shows ventriculomegaly out of proportion to sulcal atrophy. Lumbar puncture reveals improvement in gait. What is the diagnosis?

    Answer: Communicating hydrocephalus (NPH)

    Normal pressure hydrocephalus presents with Hakim's triad (wet, wobbly, wacky) and ventriculomegaly; gait improvement after LP tap test supports VP shunt candidacy.

  7. A 22-year-old obese woman has daily bifrontal headaches, pulsatile tinnitus, and papilledema. Opening pressure on LP is 32 cmH2O with normal CSF. What is the first-line treatment?

    Answer: Acetazolamide and weight loss

    Idiopathic intracranial hypertension (pseudotumor cerebri) is treated first with acetazolamide (CSF production reduction) and weight loss in obese patients.