PAPER 2026 FULL QUESTIONS AND
CORRECT ANSWERS GRADED A+
⩥ History & Physical/Neurology
A patient with an upper motor neuron lesion would exhibit which of the
following findings?
Answers
A. Fasciculations
B. Areflexia
C. Muscular atrophy
D. Spasticity. Answer: Explanations
(u) A. Fasciculations, areflexia and muscle atrophy are consistent with
lower motor neuron lesions.
(u) B. See A for explanations.
(u) C. See A for explanation.
(c) D. Spasticity is an upper motor neuron lesion finding.
⩥ Diagnostic Studies/Neurology
What test is the single most useful test in establishing the diagnosis of
multiple sclerosis?
Answers
,A. Cerebral spinal fluid cell count and protein level
B. Cerebral spinal fluid immunoglobulin studies
C. Evoked potentials
D. Magnetic Resonance Imaging. Answer: Explanations
(u) A. While cerebral spinal fluid cell count, protein levels, and
immunoglobins may be abnormal they are not specific for multiple
sclerosis.
(u) B. See A for explanation.
(u) C. Evoked potentials are most useful in the detection of subclinical
involvement of neuropathways in MS, but does not establish the
diagnosis.
(c) D. The presence of plaques on MRI is a key finding in establishing
the diagnosis of MS.
⩥ Diagnostic Studies/Neurology
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?
Answers
A. MRI of the brain
B. Electroencephalogram
C. Multiple sleep latency test
,D. Overnight polysomnography. Answer: Explanations
(u) A. See C for explanation.
(u) B. See C for explanation.
(c) C. Multiple sleep latency test is required to observe the abrupt
transition to REM sleep and establish the diagnosis of narcolepsy.
(u) D. See C for explanation.
⩥ Diagnosis/Neurology
A 54 year-old male smoker presents to the clinic complaining of
frequent vague headaches with associated vomiting that awaken him
from sleep occasionally and have been present upon awakening for
about two weeks. The headache typically resolves about an hour into his
morning routine. The patient is afebrile. What is the most likely cause of
this patient's headaches?
Answers
A. Cluster headaches
B. Depression
C. Glioblastoma
D. Giant cell arteritis. Answer: Explanations
(u) A. Cluster headaches can awaken patients, but are not usually
"vague".
(u) B. See C for explanation.
, (c) C. Morning headaches associated with vomiting are indicative of
increased intracranial pressure and raise concern of a CNS tumor such as
a glioblastoma.
(u) D. Giant cell arteritis presents in the older patient with headache in
the temporal region and loss of vision.
⩥ Diagnosis/Neurology
A 28 year-old female presents to the clinic complaining of a "prickly
sensation" that started bilaterally in her feet two days ago and difficulty
walking. She now has the dysesthesia from her mid-thigh down to her
toes. On physical examination she has diminished pain and temperature
sensation, absent reflexes, loss of proprioception in her legs bilaterally,
and muscle strength is 1+/5+ in the lower extremities and 5+/5+ in the
upper extremities. What is the most likely diagnosis?
A. Guillain-Barré syndrome
B. Multiple sclerosis
C. Myasthenia gravis
D. Spinal cord compression. Answer: Explanations
(c) A. The pattern of sensory, motor and reflex findings is consistent
with the pathophysiology of peripheral nerve demyelination that occurs
in Guillain-Barré syndrome.
(u) B. Multiple sclerosis does not present as a symmetrical ascending
paralysis.