Neurology PANCE Exam Questions With correct answers
2025\2026
A 73 year-old male presents to the clinic with his wife. His wife has noticed
that he has developed a resting tremor in his right hand and a shuffling gait
over the last year. What finding on physical examination would support your
suspected diagnosis?
A Chorea
B Dystonia
C Masked facies
D Hyperreflexia: C
The patient symptoms are consistent with Parkinsonism. Physical exam findings in-
clude masked facies, micrographia, decreased arm swing, and monotonous speech.
1. A patient with an upper motor neuron lesion would exhibit which of the
following findings?
A Fasciculations
B Areflexia
C Muscular atrophy
D Spasticity: D
Spasticity is an upper motor neuron lesion finding. Fasciculations, areflexia and
muscle atrophy are consistent with lower motor neuron lesions.
2. What test is the single most useful test in establishing the diagnosis of
1/
10
, multiple sclerosis?
A Cerebral spinal fluid cell count and protein level
B Cerebral spinal fluid immunoglobulin studies
C Evoked potentials
D Magnetic Resonance Imaging: D
The presence of plaques on MRI is a key finding in establishing the diagnosis of
MS. While cerebral spinal fluid cell count, protein levels, and immunoglobins may be
abnormal they are not specific for multiple sclerosis.
Evoked potentials are most useful in the detection of subclinical involvement of
neuropathways in MS, but does not establish the diagnosis.
3. A 22-year-old male presents to the clinic complaining of excessive daytime
somnolence and strong desires to sleep at inappropriate times. He came in
today because he had an episode of "feeling paralyzed" as he was falling
asleep yesterday. What is the most appropriate diagnostic test to confirm this
patient's diagnosis?
A MRI of the brain
B Electroencephalogram
2/
10
2025\2026
A 73 year-old male presents to the clinic with his wife. His wife has noticed
that he has developed a resting tremor in his right hand and a shuffling gait
over the last year. What finding on physical examination would support your
suspected diagnosis?
A Chorea
B Dystonia
C Masked facies
D Hyperreflexia: C
The patient symptoms are consistent with Parkinsonism. Physical exam findings in-
clude masked facies, micrographia, decreased arm swing, and monotonous speech.
1. A patient with an upper motor neuron lesion would exhibit which of the
following findings?
A Fasciculations
B Areflexia
C Muscular atrophy
D Spasticity: D
Spasticity is an upper motor neuron lesion finding. Fasciculations, areflexia and
muscle atrophy are consistent with lower motor neuron lesions.
2. What test is the single most useful test in establishing the diagnosis of
1/
10
, multiple sclerosis?
A Cerebral spinal fluid cell count and protein level
B Cerebral spinal fluid immunoglobulin studies
C Evoked potentials
D Magnetic Resonance Imaging: D
The presence of plaques on MRI is a key finding in establishing the diagnosis of
MS. While cerebral spinal fluid cell count, protein levels, and immunoglobins may be
abnormal they are not specific for multiple sclerosis.
Evoked potentials are most useful in the detection of subclinical involvement of
neuropathways in MS, but does not establish the diagnosis.
3. A 22-year-old male presents to the clinic complaining of excessive daytime
somnolence and strong desires to sleep at inappropriate times. He came in
today because he had an episode of "feeling paralyzed" as he was falling
asleep yesterday. What is the most appropriate diagnostic test to confirm this
patient's diagnosis?
A MRI of the brain
B Electroencephalogram
2/
10
