OVERVIEW
This page is dedicated to organizing various examples of standardized exam questions whose answer is narcolepsy. While this may seem a odd practice, it is useful to see multiple examples of how narcolepsy will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
QUESTION EXAMPLES
Question # 1
A 21 year old college student comes to the student health clinic complaining of sleep problems for the past 4 months. The patient explains that school has been more stressful, and he has been feeling more fatigue since his girlfriend broke up with him 1 month ago. he si very sleepy and flagged during the day, and feels embarrassed in front of other students as he will often fall asleep during class. The patient goes to bed at midnight, and wakes up at 8 am. After school he avoids socializing with the others students, and returns straight home to nap. The patient describes “weird things happening when I fall asleep, I hear voices and see colorful animals”. He reports other unusual occurrences, mainly suddenly feeling weakness in his face and knees, which makes him feel like he has lost control of his body. The patient drinks beer with his friends, but denies any substance use. He has a history of depression during his childhood that responded to psychotherapy. His physical exam is unremarkable. What is the most likely diagnosis for this patient?
Question # 2
A 26 year old man comes to the clinic with his wife because of a 9 year history of fatigue. He explains that her has difficulty staying awake whoever he sits down to “take a load off”. He has never been able to drive for more then 30 minutes without becoming sleepy, and then has to pull the car over and stop to rest. His wife says that about once every 3 months he gets up in the middle of the night and is unresponsive when she is calling his name. She says that he has never snored. The patient explains that back in middle school he trained himself not to laugh because when he did, he felt weak and cousin not remain standing. He has no notable past medical history. Physical exam is unremarkable. mental status exam reveals a concerned paint that has a reactive affect. He is alert and oriented. What is the most likely diagnosis?
Question # 3
A 27 year old man comes tot he clinic because of increasing daytime sleepiness over the past 4 years. He has started to fall asleep unexpectedly at work, and he is concerned that his boss will think “he is a slacker” if this behavior continues. Recently he stopped driving because he is afraid that he might fall asleep at the wheel and have an accident. He sleeps well at night. He explains that he avoids exercise, caffeine, and television at night to try and prevent having difficulty with sleeping. He’s wife explains that he does not snore or have restless leg movements when he is sleeping. He admits tho having vivid dream-like “visions” right before falling asleep or waking up. He describes that his mood is overall good, however he is worried about the security of his job. What is the likely diagnosis?
Question # 4
A 23 year old graduate student comes tot he clinic with complaints of falling asleep during class. He explains that he has the “overwhelming urge” to fall asleep during the middle of the day, and that these urges occur unpredictably. He is concerned because sometimes he will fall asleep during his examinations, and his grades have suffered as a result of this. he sleeps an average of 8 hours a night, and feels refreshed when he wakes up in the morning. He explains that he ahas noticed that he often has frightening auditory hallucinations right before falling asleep. During the interview he explains that he recently was in a traffic collision, and sustained a minor ankle sprain during the accident. He does not smoke, drink alcohol, or use any illicit drugs. His physical exam is within normal limits. What is the likely diagnosis for this patient?
Question # 5
A 18-year-old man comes to the clinic because he has been falling asleep at inappropriate times. The patient states that he has fallen asleep while eating and driving. He is confused by this because he feels as though he is getting enough sleep at night. He explains that often when he wakes up, he is unable to move for the first 15 minutes.. He notes that sometimes he can even fall asleep while standing, and has been told by others that sometimes he will simply drop to the floor suddenly. He is fitted with a portable monitor, and it is found that during these episodes he enters an REM sleep stage immediately. Which of the following is the most likely diagnosis?
Question # 6
A 23-year-old man comes to the clinic because of excessive daytime fatigue. He states that for the past 3 months he becomes so sleepy that he even falls asleep during important business meetings. These “sleep epsiodes” occur every day and the patient must sleep for ~30 minutes each time they occur. The patient explains that on several occasions he has had a sudden loss of muscle tone during which his knees become weak and he drops to the floor, often right after his coworkers make him laugh with a funny joke. He remains conscious when this happens, but is scared that they may be the result of a serious heart complication. He denies any substance abuse or medical problems. What is the likely diagnosis?
Question # 7
For the past 3 years a 30-year-old man has found himself in many dangerous and embarrassing situations because of his habit of falling asleep in the middle of important activities. Once he got in a traffic collision because he fell asleep while driving. His girlfriend still teases him for falling asleep while they are having sex. The man explains that he starts dreaming as soon as his eyes close. He is not able to move for 10-20 minutes after waking up, but after this period of time he feels wide awake and very refreshed. What is the likely diagnosis?
Page Updated: 09.18.2016