NEURO NBME EXAM QUESTIONS WITH
CORRECT ANSWERS 2025/2026
LP with elevated RBCs and WBCs (mostly lymphocytes)
+ elevated temperature
+ FND
+ normal CT
EEG shows repetitive complexes over the right temporal region - CORRECT ANSWER -HSV
encephalitis
- confirm dx via PCR of CSF for HSV
acute onset eye pain & headache
+ blurred vision
+ diffuse redness of conjunctiva w/ circumcorneal prominence
+ pupil is midrange and nonreactive to lgiht
Likely dx - CORRECT ANSWER -Acute angle closure gluacoma
- tonemetry is next step in magement
Treatment of Acute Angle Closure GLaucoma - CORRECT ANSWER -= emergency use of topical
ophthalmic medications to reduce IOP
===> drugs may include a beta-blocker, an alpha agonist, and an agent to produce miosis.
- suggest systemic medication to decrease IOP, which may include oral or intravenous (IV)
acetazolamide or IV mannitol
Once the acute attack is controlled, definitive treatment for angle-closure glaucoma is a laser
peripheral iridotomy to provide a small drainage hole through the iris.
,Treatment of Carpal Tunnel - CORRECT ANSWER -1. wrist splint 2. anti-inflammatory meds
(NSAIDs)
3. local corticosteroid injection
4. surgical release
Treatment of Restless Leg syndrome - CORRECT ANSWER -pramipexole or ropinirole
= Dopamine agonists
Boy with episodes of falling asleep during day
+ acute weakness of neck and knee muscles randomly
likely dx - CORRECT ANSWER -Narcolespy
= Daytime sleepiness, Cataplexy
- cataplexy usually affects a group of muscles (ie: Knees buckling)
- Cataplexy is a sudden and transient episode of muscle weakness accompanied by full
conscious awareness, typically triggered by emotions such as laughing, crying, or terror
Exam shows proptosis + opthalmoplegia + partial vision loss on right
= double vision,
+ headache
in setting os sinus infection... - CORRECT ANSWER -Cavernous Sinus Thrombosis
57 yo with fatigeue and AMS
,- hx of vokda pints per day
- Liver LFTs are WNL
- BUN is normal
Large ascieties
Likely dx and treatment - CORRECT ANSWER -Lactulose = Hepatic Encephalopathy
- INR >1.5 is indicator of late stage liver dz (not LFTs)
- lactulose binds ammonium
immigrant
+ numb hands
+ mildy coarsened features
- loss of pinprick and light touch sesnation, esp. over tip of nose and ears
- common peroneal nerves feel thickened
Likely Dx - CORRECT ANSWER -Leprosy
--> treat with rifampin + dapsone add colfazamine
WOman with intermittent numbness of left shin and foot
+ decreased sensation to pinprick over dorsal left foot and left lateral shin
+ weakened dorsiflexion
What is likely Dx and cause - CORRECT ANSWER -Peroneal nerve damage
==> common in females from leg crossing
, Treatment of Sciatica w/o Red Flag signs - CORRECT ANSWER -for non urgent backpain:
= start with conservative treatment (NSAIDs + exercise) for 4 weeks. If things don't improve, do
imaging (XR/MRI)
Treatment of psychosis/hallucinations from higher dose levidopa therapy in a parkinsons
patient - CORRECT ANSWER -Use low potency antipsychotics with minimal D2 antagonism:
Quetiapine, Clozapine, Pimavanserin.
vs, not Haloperidol BC can make the Parkinson's worse
Most common locations of saccular aneurysm - CORRECT ANSWER -Saccular aneurysms are
most common in the anterior communicating artery (ACoA) or anterior cerebral artery (ACA) in
men, whereas the junction of the ICA with the posterior communicating artery (PCoA) is the
most common site for saccular aneurysms in women".
Urinary incontinence and paraplegia after falling 35 feet.
What is cause of the incontinence - CORRECT ANSWER -Spinal shock
= occurs within 24 hrs of spinal cord injury results in loss of all reflexes and autonomic
dysreflexia.
Man gets pale and sweaty than collapses to floor
+ jerking/twitching movements of the extremities and trunk
+ recovers after and not confused
likely dx? - CORRECT ANSWER -Sycope
- can have convulsions
CORRECT ANSWERS 2025/2026
LP with elevated RBCs and WBCs (mostly lymphocytes)
+ elevated temperature
+ FND
+ normal CT
EEG shows repetitive complexes over the right temporal region - CORRECT ANSWER -HSV
encephalitis
- confirm dx via PCR of CSF for HSV
acute onset eye pain & headache
+ blurred vision
+ diffuse redness of conjunctiva w/ circumcorneal prominence
+ pupil is midrange and nonreactive to lgiht
Likely dx - CORRECT ANSWER -Acute angle closure gluacoma
- tonemetry is next step in magement
Treatment of Acute Angle Closure GLaucoma - CORRECT ANSWER -= emergency use of topical
ophthalmic medications to reduce IOP
===> drugs may include a beta-blocker, an alpha agonist, and an agent to produce miosis.
- suggest systemic medication to decrease IOP, which may include oral or intravenous (IV)
acetazolamide or IV mannitol
Once the acute attack is controlled, definitive treatment for angle-closure glaucoma is a laser
peripheral iridotomy to provide a small drainage hole through the iris.
,Treatment of Carpal Tunnel - CORRECT ANSWER -1. wrist splint 2. anti-inflammatory meds
(NSAIDs)
3. local corticosteroid injection
4. surgical release
Treatment of Restless Leg syndrome - CORRECT ANSWER -pramipexole or ropinirole
= Dopamine agonists
Boy with episodes of falling asleep during day
+ acute weakness of neck and knee muscles randomly
likely dx - CORRECT ANSWER -Narcolespy
= Daytime sleepiness, Cataplexy
- cataplexy usually affects a group of muscles (ie: Knees buckling)
- Cataplexy is a sudden and transient episode of muscle weakness accompanied by full
conscious awareness, typically triggered by emotions such as laughing, crying, or terror
Exam shows proptosis + opthalmoplegia + partial vision loss on right
= double vision,
+ headache
in setting os sinus infection... - CORRECT ANSWER -Cavernous Sinus Thrombosis
57 yo with fatigeue and AMS
,- hx of vokda pints per day
- Liver LFTs are WNL
- BUN is normal
Large ascieties
Likely dx and treatment - CORRECT ANSWER -Lactulose = Hepatic Encephalopathy
- INR >1.5 is indicator of late stage liver dz (not LFTs)
- lactulose binds ammonium
immigrant
+ numb hands
+ mildy coarsened features
- loss of pinprick and light touch sesnation, esp. over tip of nose and ears
- common peroneal nerves feel thickened
Likely Dx - CORRECT ANSWER -Leprosy
--> treat with rifampin + dapsone add colfazamine
WOman with intermittent numbness of left shin and foot
+ decreased sensation to pinprick over dorsal left foot and left lateral shin
+ weakened dorsiflexion
What is likely Dx and cause - CORRECT ANSWER -Peroneal nerve damage
==> common in females from leg crossing
, Treatment of Sciatica w/o Red Flag signs - CORRECT ANSWER -for non urgent backpain:
= start with conservative treatment (NSAIDs + exercise) for 4 weeks. If things don't improve, do
imaging (XR/MRI)
Treatment of psychosis/hallucinations from higher dose levidopa therapy in a parkinsons
patient - CORRECT ANSWER -Use low potency antipsychotics with minimal D2 antagonism:
Quetiapine, Clozapine, Pimavanserin.
vs, not Haloperidol BC can make the Parkinson's worse
Most common locations of saccular aneurysm - CORRECT ANSWER -Saccular aneurysms are
most common in the anterior communicating artery (ACoA) or anterior cerebral artery (ACA) in
men, whereas the junction of the ICA with the posterior communicating artery (PCoA) is the
most common site for saccular aneurysms in women".
Urinary incontinence and paraplegia after falling 35 feet.
What is cause of the incontinence - CORRECT ANSWER -Spinal shock
= occurs within 24 hrs of spinal cord injury results in loss of all reflexes and autonomic
dysreflexia.
Man gets pale and sweaty than collapses to floor
+ jerking/twitching movements of the extremities and trunk
+ recovers after and not confused
likely dx? - CORRECT ANSWER -Sycope
- can have convulsions
