PANE Neurology Practice questions
1. A 45-year-old male presents with ascending weakness and areflexia (absence of reflexes) following a recent respiratory infection. What is the most likely diagnosis?
Answer: A. Guillain-Barré Syndrome
Explanation: Guillain-Barré Syndrome is a post-infectious condition that presents with rapidly progressive, symmetrical ascending muscle weakness and areflexia (absence of reflexes).
2. A 32-year-old female is prescribed carbamazepine for her seizures. Which of the following should be monitored regularly during her treatment?
Answer: A. Liver function tests and sodium levels
Explanation: Carbamazepine can cause liver toxicity and hyponatraemia, making it important to monitor liver function tests (LFTs) and sodium levels in patients taking this medication.
3. A 67-year-old male presents with sudden onset right-sided weakness, slurred speech, and facial droop. What is the most appropriate immediate investigation?
Answer: A. CT head
Explanation: A CT head is the first-line imaging technique used to confirm a stroke and determine if it is ischaemic or haemorrhagic, which is crucial for guiding appropriate treatment.
4. A 28-year-old female presents with ptosis, diplopia, and muscle weakness. What is the first-line investigation for diagnosing Myasthenia Gravis?
Answer: A. Acetylcholine receptor antibody test
Explanation: Myasthenia Gravis is often diagnosed by detecting acetylcholine receptor antibodies in the blood, which interfere with neuromuscular transmission, leading to muscle weakness.
5. A 40-year-old male presents with acute onset facial weakness on the left side. He is diagnosed with Bell's palsy. What is the first-line treatment?
Answer: A. Oral corticosteroids
Explanation: Bell's palsy is managed with oral corticosteroids to reduce inflammation and improve recovery. Early treatment with corticosteroids increases the likelihood of full recovery.
6. A 30-year-old male presents with severe unilateral headaches associated with lacrimation and nasal congestion. What is the first-line treatment for cluster headaches?
Answer: A. High-flow oxygen
Explanation: Cluster headaches are treated acutely with high-flow oxygen, which can provide rapid relief of symptoms. Sumatriptan is also effective as a rescue therapy if oxygen is not sufficient.
7. A 25-year-old female presents with recurrent episodes of throbbing headaches, nausea, and photophobia. What is the first-line acute treatment for migraines?
Answer: A. Triptans (e.g., sumatriptan)
Explanation: Triptans are first-line for the acute treatment of migraines. They act by constricting blood vessels and blocking pain pathways in the brain, providing effective relief from migraine symptoms.
8. A 50-year-old female presents with numbness and tingling in her hand, especially at night. She is diagnosed with carpal tunnel syndrome. What is the first-line treatment?
Answer: A. Wrist splints
Explanation: Wrist splints are the first-line treatment for carpal tunnel syndrome, particularly when symptoms are mild to moderate and worse at night. They help keep the wrist in a neutral position, reducing pressure on the median nerve.
9. A 55-year-old male presents with a sudden onset of a severe "thunderclap" headache. A CT scan reveals a subarachnoid haemorrhage (SAH). What is the next most appropriate step in management?
Answer: A. Nimodipine
Explanation: Nimodipine is used to prevent vasospasm, a common and serious complication of subarachnoid haemorrhage. It helps maintain cerebral blood flow and reduce the risk of delayed neurological deficits.
10. A 72-year-old female presents with a new-onset headache, jaw claudication, and visual disturbances. She is diagnosed with temporal arteritis. What is the first-line treatment?
Answer: A. High-dose corticosteroids
Explanation: Temporal arteritis is a medical emergency that requires immediate treatment with high-dose corticosteroids to prevent complications, particularly blindness. Prompt treatment is essential for preserving vision.
11. A 30-year-old female with a known diagnosis of multiple sclerosis presents with worsening weakness and visual disturbances over the past few days. What is the first-line treatment for her current relapse?
Answer: A. High-dose corticosteroids
Explanation: High-dose corticosteroids are administered to reduce inflammation during acute multiple sclerosis relapses, thereby speeding up recovery. They help decrease the severity and duration of the relapse symptoms.
12. A 65-year-old male presents with resting tremor, rigidity, and bradykinesia. He is diagnosed with Parkinson's disease. What is the most appropriate first-line pharmacological treatment?
Answer: A. Levodopa/Carbidopa
Explanation: Levodopa combined with Carbidopa is the most effective first-line treatment for alleviating the motor symptoms of Parkinson's disease. Levodopa replenishes dopamine, while Carbidopa prevents its premature conversion outside the brain, enhancing its effectiveness.
13. A 40-year-old female with frequent migraines is seeking preventive therapy. Which of the following is a first-line preventive treatment option?
Answer: A. Beta-blockers (e.g., propranolol)
Explanation: Beta-blockers such as propranolol are considered first-line preventive treatments for reducing the frequency and severity of migraine attacks. They help stabilize blood vessel tone and reduce neuronal excitability associated with migraines.
14. A 28-year-old male presents with sudden onset of double vision and limb weakness. He has a history of multiple sclerosis. What is the most appropriate next step in management?
Answer: A. High-dose corticosteroids
Explanation: High-dose corticosteroids are administered to reduce inflammation during acute multiple sclerosis relapses, thereby speeding up recovery. They help decrease the severity and duration of the relapse symptoms.
15. A 25-year-old male presents with recurrent generalized tonic-clonic seizures. He is diagnosed with epilepsy. What is the most appropriate first-line pharmacological treatment?
Answer: A. Valproate
Explanation: Valproate is considered the first-line pharmacological treatment for generalized tonic-clonic seizures in epilepsy due to its broad-spectrum efficacy. It helps stabilize neuronal membranes and reduce seizure activity.
Total Score: 0/15