PANRE Neurology 4

Question 1

A 62-year-old man with hypertension develops sudden left-sided weakness and slurred speech that resolves completely in 45 minutes. Workup includes ECG showing atrial fibrillation. Best long-term stroke prevention strategy?

Accepted Answer

Anticoagulation with a DOAC

Answer

Atrial fibrillation-related TIA requires anticoagulation (preferably a DOAC) to prevent cardioembolic stroke; antiplatelet therapy is insufficient for this indication.

Question 2

A 25-year-old woman has episodes of muscle weakness triggered by rest after exercise and is improved by eating. Potassium level is low during attacks. Diagnosis?

Accepted Answer

Hypokalemic periodic paralysis

Answer

Hypokalemic periodic paralysis is characterized by episodic weakness with low serum potassium, often triggered by rest after exercise or carbohydrate-rich meals.

Question 3

Which imaging finding is pathognomonic for diffuse axonal injury after traumatic brain injury?

Accepted Answer

Petechial hemorrhages at gray-white junction on MRI

Answer

Diffuse axonal injury is best seen on MRI as petechial hemorrhages or signal changes at the gray-white matter junction, corpus callosum, and brainstem from rotational shear forces.

Question 4

A patient on isoniazid therapy develops peripheral neuropathy. Which supplement is deficient?

Accepted Answer

Vitamin B6 (pyridoxine)

Answer

Isoniazid competitively inhibits pyridoxine (B6) metabolism, causing a sensory-predominant peripheral neuropathy that is prevented by B6 supplementation.

Question 5

A 70-year-old man presents with urinary incontinence, gait apraxia, and cognitive decline. MRI shows enlarged ventricles disproportionate to sulcal atrophy. Treatment?

Accepted Answer

Ventriculoperitoneal shunt

Answer

The triad of gait apraxia, cognitive decline, and urinary incontinence with disproportionate ventriculomegaly is normal pressure hydrocephalus, treated with VP shunt placement.

PANRE Test Practice Test

PANRE Test Practice Test

PANRE Neurology 4