KMU Past Paper Practice

Question: A 32-year-old man has developed two episodes of wrist drop after sleeping with his arm compressed and one episode of foot drop after prolonged leg crossing. His symptoms improved between episodes, and several relatives report similar attacks. Which disorder best explains the repeated focal palsies?

Question: An 8-year-old child has repeated painless burns and ulcers on the feet. Examination reveals markedly impaired pain and temperature sensation, while strength is relatively preserved. Similar problems occurred in an older sibling. Which hereditary neuropathy category is most appropriate?

Question: A 24-year-old woman has burning discomfort in both soles and reduced pinprick sensation, but vibration sense, muscle power and tendon reflexes are preserved. Routine nerve conduction studies are normal. What is the most appropriate interpretation?

Question: A 29-year-old farmer presents with a pale skin patch that has reduced sensation, together with enlargement of a nearby peripheral nerve. He also reports weakness of intrinsic hand muscles. Which acquired cause should be included prominently in the assessment?

Question: A 41-year-old man develops acute ascending weakness and generalized areflexia after an infection. Lumbar puncture performed on the second day shows normal CSF protein and no significant pleocytosis. Which conclusion is best?

Question: A hospitalized patient has progressive symmetric weakness and areflexia consistent with Guillain–Barré syndrome. The team discusses disease-directed treatment. Which regimen should not be used as the sole specific therapy for typical GBS?

Question: A 37-year-old man with rapidly progressing suspected Guillain–Barré syndrome develops a weak cough and choking when drinking water. Which additional neurological involvement is the immediate concern?

Question: A 46-year-old typist has tingling in the thumb, index and middle fingers and intermittent nighttime waking. Power is preserved and symptoms are mild. Which initial treatment best addresses the likely local nerve compression?

Question: A 52-year-old carpenter has progressive thenar muscle wasting and weakness of thumb opposition, along with longstanding numbness in the median nerve distribution. Symptoms persist despite conservative measures. What is the most appropriate next management step?

Question: A 49-year-old woman has progressive sensory symptoms. The examination shows reduced pinprick and temperature sensation in both feet but preserved joint position sense. Which clinical finding most strongly indicates that small sensory fibres predominate?

Question: A 68-year-old man presents with unexplained progressive sensorimotor polyneuropathy. Common metabolic and nutritional tests are unrevealing. Examination and clinical history raise concern for an underlying abnormal circulating protein. Which further test category is most relevant?

Question: A 44-year-old patient has chronic burning pain attributed to acquired peripheral neuropathy. Paracetamol has provided minimal relief. Which alternative is specifically used to treat neuropathic pain rather than simply ordinary nociceptive pain?

Question: A 58-year-old woman with severe distal sensory loss accidentally develops a blister after using a hot-water bottle. She did not feel the heat. Which preventive advice most directly addresses the mechanism of injury?

Question: A 13-year-old boy has slowly progressive pes cavus, hammer toes and difficulty with running. Neither parent has apparent neurological symptoms. Which statement about an inherited neuropathy is most accurate?

Question: A 10-year-old girl is suspected of having a hereditary motor and sensory neuropathy. Examination confirms distal wasting and foot deformity. Which additional history most directly clarifies the impact of the disease at her age?

Question: A 14-year-old boy with a hereditary neuropathy develops difficulty manipulating buttons and pencils because of progressive intrinsic hand muscle weakness. Which supportive service is most closely matched to his new limitation?

Question: A 12-year-old with inherited neuropathy develops painful rigid foot deformity despite footwear modification and rehabilitation. The deformity increasingly restricts walking. What is the most appropriate next consideration?

Question: A 55-year-old man diagnosed with peripheral neuropathy has worsening gait instability and several recent falls. His underlying metabolic condition is already being treated. Which additional intervention best addresses a major source of preventable disability?

Question: A 34-year-old woman developed numbness and weakness after several weeks of progressive nerve symptoms. She has a known hereditary neuropathy but has also recently developed laboratory-confirmed vitamin B12 deficiency. Which clinical principle is most appropriate?

Question: Parents of two children with the same inherited neuropathy ask whether both will inevitably lose walking ability at the same age. Which response best reflects appropriate counselling?