PANCE Neurologic System 2

Question 1

A 68-year-old man presents with sudden onset of left-sided weakness and slurred speech that resolved completely within 45 minutes. MRI shows no infarct. What is the most appropriate next step?

Accepted Answer

Admit for urgent evaluation and stroke risk stratification

Answer

TIA carries high early stroke risk; urgent inpatient or rapid outpatient evaluation within 24 hours with ABCD2 scoring, imaging, and cardiac monitoring is indicated.

Question 2

Which dermatome corresponds to the umbilicus?

Accepted Answer

T10

Answer

T10 innervates the umbilicus, a landmark useful for assessing spinal cord injury level.

Question 3

A patient with Parkinson disease develops visual hallucinations after starting a new medication. Which drug is the most likely culprit?

Accepted Answer

Pramipexole

Answer

Dopamine agonists such as pramipexole are the most common cause of hallucinations in Parkinson disease patients.

Question 4

A 35-year-old woman has episodes of sudden muscle weakness triggered by laughter. She also reports excessive daytime sleepiness. What is the most likely diagnosis?

Accepted Answer

Narcolepsy with cataplexy

Answer

Narcolepsy with cataplexy presents with excessive daytime sleepiness and sudden loss of muscle tone triggered by strong emotions.

Question 5

On lumbar puncture in bacterial meningitis, which CSF finding best distinguishes it from viral meningitis?

Accepted Answer

Glucose < 45 mg/dL with elevated protein

Answer

Bacterial meningitis characteristically shows low CSF glucose (< 45 mg/dL or CSF:serum ratio < 0.4) and markedly elevated protein, unlike viral meningitis.

PANCE Test Practice Test

PANCE Test Practice Test

PANCE Neurologic System 2