skip to main content

Cryptococcal Meningitis — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

HardCNS InfectionsCryptococcal MeningitisSCE Neurology

A 58-year-old develops severe subacute pancerebellar ataxia, nystagmus and dysarthria. CT shows a small-cell lung cancer, and serum P/Q-type voltage-gated calcium-channel antibodies are strongly positive. Which additional examination finding would most specifically indicate a second antibody-related syndrome?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Post-exercise facilitation of proximal weakness with dry mouth

Explanation lettering: B = shown as A · D = shown as B · E = shown as D · A = shown as E

A suggests myelopathy rather than a linked VGCC disorder. B suggests sensory neuronopathy, classically associated with Hu antibodies in small-cell lung cancer. C suggests stiff-person spectrum disease. D suggests progressive supranuclear palsy. E is correct: P/Q-type VGCC antibodies may produce paraneoplastic cerebellar degeneration and Lambert–Eaton myasthenic syndrome; facilitation after exercise, autonomic symptoms and reduced reflexes should be sought. Demonstrating both syndromes changes symptomatic and oncological planning.

Reference: Paraneoplastic neurological syndromes: a practical approach: https://pn.bmj.com/content/22/1/19