UKMLA PLAB AMC USMLE Prometric MCQ

A 65-year-old man presents with a 4-month history of dysarthria and progressive difficulty in swallowing. Examination reveals a weak fasciculating tongue, a brisk gag reflex, and jaw jerk. 

What is the most likely diagnosis?

A.  Basilar artery thrombosis 

B.  Multiple sclerosis 

C.  Miller Fisher syndrome 

D.  Amyotrophic lateral sclerosis 

E.  Wernicke's encephalopathy

orrect answer: D
Amyotrophic lateral sclerosis is characterised by a combination of upper and lower motor neuron signs as described in this scenario.