PANRE Neurology 2

Question 1

A 68-year-old man presents with sudden onset of the worst headache of his life. CT head is negative. What is the next best step?

Accepted Answer

Lumbar puncture

Answer

A negative CT does not rule out subarachnoid hemorrhage; lumbar puncture is required to detect xanthochromia or RBCs that persist after centrifugation.

Question 2

Which medication is first-line for absence seizures in a 10-year-old child?

Accepted Answer

Ethosuximide

Answer

Ethosuximide is first-line for childhood absence epilepsy because it targets thalamic T-type calcium channels responsible for spike-and-wave discharges.

Question 3

A patient with multiple sclerosis develops painful, unilateral vision loss with a central scotoma. Which structure is most likely inflamed?

Accepted Answer

Optic nerve

Answer

Optic neuritis — inflammation of the optic nerve — is a common initial presentation of MS and causes monocular vision loss with pain on eye movement.

Question 4

A 55-year-old presents with resting tremor, bradykinesia, and cogwheel rigidity. Which neurotransmitter pathway is most affected?

Accepted Answer

Nigrostriatal dopaminergic

Answer

Parkinson disease results from degeneration of dopaminergic neurons in the substantia nigra pars compacta, disrupting the nigrostriatal pathway.

Question 5

A 72-year-old woman on warfarin falls and loses consciousness. CT shows a lens-shaped hyperdense collection. Which vessel is most likely injured?

Accepted Answer

Middle meningeal artery

Answer

An epidural hematoma has a biconvex (lens-shaped) appearance and typically results from rupture of the middle meningeal artery after temporal bone fracture.

PANRE Test Practice Test

PANRE Test Practice Test

PANRE Neurology 2