AANP BOARD EXAMINATION TEST 2026
COMPREHENSIVE QUESTIONS AND ANSWERS
ALREADY PASSED GRADED A+
◉ Myasthenia Gravis Tests. Answer: -Tensilon Test (anticholinesterase
allowing for Ach) looking for improved muscle responses in 5 minutes*
- also check RA and ANA for coexisting autoimmune disease
-EMGs
◉ Myasthenia Gravis Complications. Answer: -slowly progressive- can
lead to fatal aspiration
◉ Myasthenia Gravis Treatment. Answer: -Anticholinesterase drugs:
Neostigmine QID*
-Prednisone high dose then taper
-Thymectomy (thymus may be abnormal)
-Plasmapheresis (get rid of antibodites against Ach receptors)
◉ Never give this class of meds in Myasthenia Gravis. Answer: -
Aminoglycosides (gentomycin, tobramycin, neomycin)- they exacerbate
disease leading to difficulty swallowing and aspiration
,◉ What Hz tuning fork to use for Weber Test. Answer: 512
◉ Disease caused by Pituitary Adenoma. Answer: -Acromeagly-excess
growth hormone
-Cushings- stim adrenal to increase cortisol
-Diabetes Insipidous- decreased antidiuretic hormone (vasopressin)
(caution: in pts being treated for hypothyroid with no response to high
synthroid doses order CT to r/o pituitary adenoma)
◉ Anasacoria. Answer: One pupil bigger then other
-can occur with M.S. and other coniditions-needs investigated
◉ #1 symptom presentation in MS. Answer: -ocular symptoms*
-bursts of light and dark, anasacoria
-pallor of optic disc on microscopic exam
◉ Diagnostics for MS. Answer: MRI- progressive demylinization of
white matter*; Autoimmune
◉ Symptoms of MS. Answer: -remission and attacks- symptoms
aggravated by physical and emotional stress
-sensory and vision abnormalities (anasacoria)
-symptoms on opposite side of body then brain demylinzation
,-intention tremor
-onset 20-30years
-balance and speech affected
-hyperreflexia +4
-babinski may be present on one foot (stroke lateral foot upward and
watch big toe)
-Lhermitte's sign
-incontinence- may have frequent UTI (>3 a year)
◉ Lhermitte's sign*. Answer: -diagnostic of MS
-lay supine and flex neck- this causes electric shock down both arms
◉ MS Treatments. Answer: Acute (both cause weight gain):
-Glucocorticoids
-Baclofen for spasticity
Reduce relapses:
-SQ Betaseron (Interferon beta 1b) QOD
-IM Avonex (Interferon beta 1a) Qweek
◉ Guillian Barre Polyneuropathy. Answer: Acute prob involving
PROXIMAL limb SYMMETRICAL weakness that often begins in the
legs and ASCENDs quickly; unknown cause; Areflexia and facial
, paralysis and respiratory paralysis may results; Maximum deficit BY 7
days; Tx: plasmapharesis or IgG
MONO IS A RISK FOR GB so watch for it in pt's you are treating for
mono- MUST document achilles reflex when you make the diagnosis of
mono to get baseline; GB will have ascending loss of reflexes
-can start as tingling in the feet
◉ Achilles DTR*. Answer: S1, L5
◉ Patellar DTR*. Answer: L3, L4
◉ Brachioradialis*. Answer: C5, C6
◉ Biceps*. Answer: C5, C6
◉ Triceps*. Answer: C7, C8
◉ Prolonged recovery of the achilles reflex supports the diagnosis of*.
Answer: Hypothyroid
◉ Acromeagly. Answer: -Nose, hands, bones getting larger d/t pituitary
adenoma- excessive growth hormone
-provider could be mistreating for hypothyroid
COMPREHENSIVE QUESTIONS AND ANSWERS
ALREADY PASSED GRADED A+
◉ Myasthenia Gravis Tests. Answer: -Tensilon Test (anticholinesterase
allowing for Ach) looking for improved muscle responses in 5 minutes*
- also check RA and ANA for coexisting autoimmune disease
-EMGs
◉ Myasthenia Gravis Complications. Answer: -slowly progressive- can
lead to fatal aspiration
◉ Myasthenia Gravis Treatment. Answer: -Anticholinesterase drugs:
Neostigmine QID*
-Prednisone high dose then taper
-Thymectomy (thymus may be abnormal)
-Plasmapheresis (get rid of antibodites against Ach receptors)
◉ Never give this class of meds in Myasthenia Gravis. Answer: -
Aminoglycosides (gentomycin, tobramycin, neomycin)- they exacerbate
disease leading to difficulty swallowing and aspiration
,◉ What Hz tuning fork to use for Weber Test. Answer: 512
◉ Disease caused by Pituitary Adenoma. Answer: -Acromeagly-excess
growth hormone
-Cushings- stim adrenal to increase cortisol
-Diabetes Insipidous- decreased antidiuretic hormone (vasopressin)
(caution: in pts being treated for hypothyroid with no response to high
synthroid doses order CT to r/o pituitary adenoma)
◉ Anasacoria. Answer: One pupil bigger then other
-can occur with M.S. and other coniditions-needs investigated
◉ #1 symptom presentation in MS. Answer: -ocular symptoms*
-bursts of light and dark, anasacoria
-pallor of optic disc on microscopic exam
◉ Diagnostics for MS. Answer: MRI- progressive demylinization of
white matter*; Autoimmune
◉ Symptoms of MS. Answer: -remission and attacks- symptoms
aggravated by physical and emotional stress
-sensory and vision abnormalities (anasacoria)
-symptoms on opposite side of body then brain demylinzation
,-intention tremor
-onset 20-30years
-balance and speech affected
-hyperreflexia +4
-babinski may be present on one foot (stroke lateral foot upward and
watch big toe)
-Lhermitte's sign
-incontinence- may have frequent UTI (>3 a year)
◉ Lhermitte's sign*. Answer: -diagnostic of MS
-lay supine and flex neck- this causes electric shock down both arms
◉ MS Treatments. Answer: Acute (both cause weight gain):
-Glucocorticoids
-Baclofen for spasticity
Reduce relapses:
-SQ Betaseron (Interferon beta 1b) QOD
-IM Avonex (Interferon beta 1a) Qweek
◉ Guillian Barre Polyneuropathy. Answer: Acute prob involving
PROXIMAL limb SYMMETRICAL weakness that often begins in the
legs and ASCENDs quickly; unknown cause; Areflexia and facial
, paralysis and respiratory paralysis may results; Maximum deficit BY 7
days; Tx: plasmapharesis or IgG
MONO IS A RISK FOR GB so watch for it in pt's you are treating for
mono- MUST document achilles reflex when you make the diagnosis of
mono to get baseline; GB will have ascending loss of reflexes
-can start as tingling in the feet
◉ Achilles DTR*. Answer: S1, L5
◉ Patellar DTR*. Answer: L3, L4
◉ Brachioradialis*. Answer: C5, C6
◉ Biceps*. Answer: C5, C6
◉ Triceps*. Answer: C7, C8
◉ Prolonged recovery of the achilles reflex supports the diagnosis of*.
Answer: Hypothyroid
◉ Acromeagly. Answer: -Nose, hands, bones getting larger d/t pituitary
adenoma- excessive growth hormone
-provider could be mistreating for hypothyroid
