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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 30-year-old woman has recurrent episodes of vertigo lasting 20–30 minutes associated with tinnitus and low-frequency hearing loss. The most likely diagnosis is:

    Answer: Ménière disease

    Ménière disease presents with episodic vertigo (20 min–12 hr), fluctuating low-frequency sensorineural hearing loss, tinnitus, and aural fullness.

  2. A neonate develops seizures at 36 hours of life after a prolonged difficult delivery. Brain MRI shows restricted diffusion in watershed zones. What is the most appropriate intervention?

    Answer: Therapeutic hypothermia (whole-body cooling)

    Therapeutic hypothermia (33–34°C for 72 hours) is the standard of care for hypoxic-ischemic encephalopathy in neonates ≥ 36 weeks when initiated within 6 hours of birth.

  3. A 55-year-old man with small cell lung cancer develops ascending weakness and areflexia two weeks after chemotherapy. Anti-Hu antibodies are detected. This is an example of:

    Answer: Paraneoplastic encephalomyelitis/sensory neuronopathy

    Anti-Hu antibodies are associated with paraneoplastic sensory neuronopathy/encephalomyelitis, an immune-mediated syndrome triggered by SCLC.

  4. Which of the following features best differentiates essential tremor from Parkinson tremor?

    Answer: Essential tremor is an action/postural tremor that worsens at rest

    Essential tremor is a kinetic/postural tremor that occurs during movement and is suppressed at rest, whereas Parkinson tremor is a resting 'pill-rolling' tremor.

  5. A 19-year-old has her first generalized tonic-clonic seizure. Post-ictal she is confused and has a bitten tongue. EEG shows generalized spike-and-wave discharges at 3–4 Hz. What is the most appropriate initial medication?

    Answer: Valproic acid

    Valproic acid is first-line for juvenile myoclonic epilepsy and generalized epilepsies with tonic-clonic seizures; carbamazepine can worsen generalized epilepsies.

  6. A patient presents with sudden painless monocular vision loss lasting 10 minutes, described as a 'curtain coming down.' Fundoscopy during the episode shows a pale retina. What is the most likely diagnosis?

    Answer: Amaurosis fugax due to carotid artery stenosis

    Amaurosis fugax (transient monocular blindness) caused by cholesterol emboli from ipsilateral carotid artery stenosis produces the classic 'curtain' vision loss.

  7. A 45-year-old woman is brought in after a witnessed tonic-clonic seizure. She takes no medications. Blood glucose is 45 mg/dL. After dextrose administration, the seizure does not recur. What is the most appropriate next step?

    Answer: Treat underlying hypoglycemia cause; no antiepileptic drug needed

    A provoked seizure secondary to an identifiable metabolic cause (hypoglycemia) does not require antiepileptic drug therapy; correction of the underlying cause is sufficient.