PANRE Neurology 5

Question 1

A 55-year-old with a history of small cell lung cancer presents with proximal muscle weakness, reduced reflexes that improve with repeated stimulation, and autonomic dysfunction. Diagnosis?

Accepted Answer

Lambert-Eaton myasthenic syndrome

Answer

Lambert-Eaton myasthenic syndrome is a paraneoplastic disorder most associated with small cell lung cancer; reflexes and strength paradoxically improve with repetitive activity.

Question 2

A 40-year-old woman presents with severe unilateral periorbital pain, lacrimation, rhinorrhea, and ptosis occurring in clusters over weeks. Best acute treatment?

Accepted Answer

High-flow 100% oxygen

Answer

High-flow 100% oxygen via non-rebreather mask is the most effective abortive treatment for acute cluster headache attacks, providing relief within 15–20 minutes.

Question 3

A patient with a right MCA stroke has difficulty speaking but understands language perfectly. Which type of aphasia is this?

Accepted Answer

Broca aphasia

Answer

Broca aphasia (expressive/non-fluent aphasia) involves damage to Broca's area in the left frontal lobe, producing halting speech with preserved comprehension.

Question 4

Which of the following is an absolute contraindication to thrombolytic therapy in acute ischemic stroke?

Accepted Answer

Recent intracranial surgery within 3 months

Answer

Recent intracranial surgery, head trauma, or prior stroke within 3 months is an absolute contraindication to IV tPA because of the risk of catastrophic hemorrhage.

Question 5

A 35-year-old presents with episodic severe headache, diaphoresis, palpitations, and hypertension. Which test confirms the diagnosis?

Accepted Answer

24-hour urine catecholamines and metanephrines

Answer

Pheochromocytoma presents with paroxysmal hypertension, diaphoresis, and headache; diagnosis is confirmed by elevated 24-hour urine metanephrines and catecholamines.

PANRE Test Practice Test

PANRE Test Practice Test

PANRE Neurology 5