Practice Test GeeksPANCE Test Practice Test
← All PANCE Flashcard Decks

Neurologic System Flashcards

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

Read the first 7 Neurologic System flashcards as text

  1. A 72-year-old woman presents with a 6-month history of progressive memory loss, gait disturbance, and urinary incontinence. CT shows enlarged ventricles out of proportion to cortical atrophy. What is the diagnosis?

    Answer: Normal pressure hydrocephalus

    Normal pressure hydrocephalus presents with the triad of gait apraxia, cognitive decline, and urinary incontinence with ventriculomegaly disproportionate to atrophy.

  2. A patient is found to have a Horner syndrome (ptosis, miosis, anhidrosis) on the right side. Which of the following is the most concerning etiology?

    Answer: Carotid artery dissection

    Carotid artery dissection can interrupt the sympathetic fibers traveling along the carotid sheath and is a life-threatening cause of Horner syndrome requiring urgent imaging.

  3. A 28-year-old woman presents with optic neuritis and a prior episode of transverse myelitis. MRI shows periventricular white matter lesions disseminated in time and space. Which treatment reduces long-term disability?

    Answer: Disease-modifying therapy (e.g., interferon beta or natalizumab)

    Disease-modifying therapies reduce relapse rate and MRI lesion burden in relapsing-remitting MS; IV steroids treat acute attacks but do not alter long-term disease course.

  4. A 45-year-old construction worker develops slowly progressive bilateral hand weakness with wasting of thenar and hypothenar muscles, fasciculations, and hyperreflexia. The most likely diagnosis is:

    Answer: Amyotrophic lateral sclerosis

    ALS presents with combined upper (hyperreflexia, spasticity) and lower (fasciculations, weakness, atrophy) motor neuron signs without sensory involvement.

  5. A patient taking phenytoin for seizures presents with nystagmus, ataxia, and diplopia. Serum phenytoin level is 28 mcg/mL (therapeutic 10–20). What is the best management?

    Answer: Reduce phenytoin dose

    Phenytoin toxicity causes nystagmus, ataxia, and diplopia at supratherapeutic levels; dose reduction is the appropriate management.

  6. A 60-year-old man has sudden severe 'thunderclap' headache reaching peak intensity in seconds. CT head is negative. What is the next best step?

    Answer: Lumbar puncture to evaluate for xanthochromia

    A negative CT does not rule out subarachnoid hemorrhage; LP is required to detect xanthochromia or blood in the CSF when CT is negative.

  7. Which cranial nerve is responsible for the corneal reflex afferent limb?

    Answer: CN V (ophthalmic branch)

    The afferent limb of the corneal reflex is mediated by CN V1 (ophthalmic branch of trigeminal nerve); the efferent limb is CN VII (facial nerve).