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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.

Read the first 7 Clinical Neurology flashcards as text

  1. A 55-year-old man with small cell lung cancer has proximal limb weakness that improves with repeated muscle use. Reflexes are reduced. Anti-VGCC antibodies are positive. What is the diagnosis?

    Answer: Lambert-Eaton myasthenic syndrome

    Lambert-Eaton myasthenic syndrome (LEMS) is caused by anti-VGCC antibodies, often paraneoplastic with SCLC, and shows strength facilitation with repetitive activity.

  2. A 5-year-old boy has calf pseudohypertrophy, Gowers' sign, and CK >10,000 U/L. Genetic testing shows a frameshift deletion in dystrophin exon 50. What is the mode of inheritance?

    Answer: X-linked recessive

    Duchenne muscular dystrophy is caused by frameshift mutations in the dystrophin gene on chromosome Xp21, inherited in an X-linked recessive pattern.

  3. A patient suffers a spinal cord injury and has loss of pain and temperature bilaterally below the lesion, with preserved proprioception and vibration. Upper motor neuron signs are present. Which syndrome is this?

    Answer: Anterior cord syndrome

    Anterior cord syndrome disrupts the spinothalamic tracts (pain/temperature) bilaterally while sparing the posterior columns (proprioception/vibration); typically from anterior spinal artery infarction.

  4. A 3-year-old child presents with fever, neck stiffness, and petechial rash. CSF shows glucose 30 mg/dL (serum 90), protein 180 mg/dL, WBC 1,200 (90% PMN). What organism is most likely?

    Answer: Neisseria meningitidis

    N. meningitidis classically causes bacterial meningitis with petechial/purpuric rash in children and young adults and is the most common cause of epidemic meningitis.

  5. A 35-year-old man presents 3 weeks after GI illness with ascending weakness, areflexia, and albuminocytologic dissociation on CSF (elevated protein, normal cell count). What is the most important acute complication to monitor?

    Answer: Autonomic cardiac arrhythmia and respiratory failure

    Guillain-Barré syndrome can cause life-threatening respiratory failure and autonomic instability (arrhythmias, BP fluctuations) requiring close ICU monitoring.

  6. A 52-year-old man has painless progressive weakness in his right hand with fasciculations, hyperreflexia, and an extensor plantar response. Tongue fasciculations are noted. What diagnosis fits?

    Answer: Amyotrophic lateral sclerosis

    ALS involves both upper (hyperreflexia, extensor plantar) and lower (fasciculations, atrophy) motor neuron signs across multiple body regions with bulbar involvement.

  7. A 45-year-old man has acute low back and left leg pain radiating to the lateral foot. He has weakness in left ankle dorsiflexion and reduced sensation on the dorsum of the foot. Which nerve root is compressed?

    Answer: L5

    L5 radiculopathy presents with weakness of ankle dorsiflexion and toe extension, and sensory loss over the dorsum of the foot and lateral lower leg.