Packrat exam 100% VERIFIED ANSWERS 2026/2027 PERFECT

Packrat exam 100% VERIFIED ANSWERS 2026/2027 PERFECT

NEUROLOGY
Diagnosis/Neurology
Bradykinesia is most commonly associated with
A. Wernicke's syndrome.
B. Hashimoto's thyroiditis.
C. Cushing's disease.
D. Parkinson's disease.
Explanations
(u) A. Patients with Wernicke's syndrome demonstrate confabulation and difficulty understanding normal speech.
(u) B. Hashimoto's thyroiditis (hypothyroidism) can cause puffiness of the face and eyelids and thinning of the outer
halves of the eyebrows.
(u) C. Cushing's disease causes a moon-like facies.
(c) D. Patients with Parkinson's disease have resting tremor, bradykinesia, lack of facial expression, and
micrographia.

Diagnosis/Neurology
A 68 year-old male who is obese has a 50 pack-year history of smoking. He experienced a sudden and total
loss of vision in his right eye, which resolved after 20 minutes. Which of the following is the most likely
diagnosis?
A. Optic neuritis
B. Retinal detachment
C. Macular degeneration
D. Transient ischemic attack
Explanations
(u) A. Optic neuritis usually has a more insidious onset.
(u) B. Retinal detachment most often presents with a history of sudden onset of flashing lights, floaters, or blurred
vision in one eye, quickly becoming progressively worse.
(u) C. Macular degeneration is a slowly progressive disease leading to blindness and is most often bilateral.
(c) D. This history of sudden onset of a unilateral neurological deficit in a patient with risk factors for vascular disease
suggests vascular ischemia. By definition, a transient ischemic attack is a neurological deficit that resolves
quickly.

Clinical Therapeutics/Neurology
Of the following drugs, the appropriate treatment of myasthenia gravis is
A. donepezil (Aricept).
B. quinidine (Quinidex).
C. neostigmine (Prostigmin).
D. edrophonium (Tensilon).
Explanations
(u) A. Donepezil is an acetylcholinesterase inhibitor and used in the treatment of Alzheimer's disease.
(u) B. Quinidine is an antidysrhythmic agent and has no place in the treatment of myasthenia gravis.
(c) C. Neostigmine is useful in the treatment of myasthenia gravis.
(u) D. Edrophonium is useful in diagnosing myasthenia gravis but is too short acting for the treatment of the disorder.

Clinical Intervention/Neurology
A 30 year-old male has a history of weakness without pain on the left side of his face for the past 4 days.
Physical examination of the face reveals unilateral weakness to the left side, but not complete paralysis. The
left eye does not close completely. The most appropriate initial treatment is to
A. reassure the patient and provide patient education.
B. recommend a nonsteroidal anti-inflammatory medication.
C. recommend tricyclic antidepressants.
D. recommend physical therapy.
Explanations
(c) A. Bell's palsy will resolve completely without treatment in approximately 60% of all cases.
(u) B. Nonsteroidal anti-inflammatory medications can be used to relieve pain only.
(u) C. Tricyclic antidepressants are indicated in post-herpetic neuralgia, not Bell's palsy.
(u) D. Physical therapy would not provide any benefit. 

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