skip to main content

Functional neurological disorder — SCE Acute Medicine MCQ

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

ModerateAcute Neurological PresentationsFunctional neurological disorderSCE Acute Medicine

A 35-year-old woman is assessed on the acute medical unit. She has recurrent limb weakness with inconsistency on examination and positive Hoover sign. MRI brain and spine are normal and symptoms fluctuate. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most likely diagnosis?

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

Reveal the answer and explanation

Correct answer: B — Functional neurological disorder

Functional neurological disorder is the best answer because positive internal inconsistency signs support functional neurological disorder rather than diagnosis by exclusion alone. Upper gastrointestinal bleeding is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Explain the diagnosis clearly and non-judgementally.

Reference: https://cks.nice.org.uk/#acute-medicine-order-91-1