Advancing Neurological Therapeutics 2016 | Pre-test

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Advancing Neurological Therapeutics 2016 | Pre-test - Quiz

This educational program aims to update practitioners on advances in the diagnosis and treatment of Parkinson’s disease, multiple sclerosis, stroke, dementia and related disorders. We will discuss evidence-based management, improvements in therapeutic rehabilitation, and updates on therapeutic theory and practice.


Questions and Answers
  • 1. 

    Which of the following new agents was the first disease modifying therapy to show positive benefit in primary progressive multiple sclerosis in clinical trials?

    • A.

      Daclizumab

    • B.

      Alemtuzumab

    • C.

      Ocrelizumab

    • D.

      Siponimod

    • E.

      Ofatumumab

    Correct Answer
    C. Ocrelizumab
    Explanation
    Ocrelizumab was the first disease modifying therapy to show positive benefit in primary progressive multiple sclerosis in clinical trials.

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  • 2. 

    Atrophy of which of the following layers on conventional optical coherence tomography (OCT) has been shown to mirror whole brain atrophy in patients with MS?

    • A.

      Outer plexiform layer

    • B.

      Photoreceptor inner segment

    • C.

      Inner nuclear layer

    • D.

      Ganglion cell + inner plexiform layer

    • E.

      Retinal pigment epithelium

    Correct Answer
    D. Ganglion cell + inner plexiform layer
    Explanation
    The ganglion cell + inner plexiform layer on conventional optical coherence tomography (OCT) has been shown to mirror whole brain atrophy in patients with MS. This layer is responsible for transmitting visual information from the retina to the brain, and its atrophy can indicate overall brain atrophy in MS patients. OCT is a non-invasive imaging technique that allows for the visualization of different layers of the retina, providing valuable information about the progression of MS and its impact on the central nervous system.

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  • 3. 

    What percentage of Alzheimer disease patients are not informed of their diagnosis?

    • A.

      10%

    • B.

      20%

    • C.

      30%

    • D.

      40%

    • E.

      50%

    Correct Answer
    E. 50%
    Explanation
    Approximately 50% of Alzheimer's disease patients are not informed of their diagnosis. This suggests that a significant number of individuals with Alzheimer's are not being made aware of their condition, which can have implications for their understanding of their symptoms, treatment options, and ability to plan for the future. Lack of communication about the diagnosis may also impact the support and resources available to these patients and their families.

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  • 4. 

    Which of the following is true about delivering a difficult diagnosis?

    • A.

      The provider should avoid betraying an emotional response

    • B.

      It important to “push past” the patients’ emotional expressions to focus on the facts of the case

    • C.

      Receiving a negative diagnosis is psychologically harmful to the patient

    • D.

      Medical terminology should be avoided unless necessary to promote understanding

    • E.

      The provider should get to the point (the diagnosis and plan) as quickly as possible

    Correct Answer
    D. Medical terminology should be avoided unless necessary to promote understanding
  • 5. 

    Which of the following is NOT a non-motor symptom associated with neurodegenerative disease:

    • A.

      Depression

    • B.

      Fatigue

    • C.

      Tremor

    • D.

      Apathy

    Correct Answer
    C. Tremor
    Explanation
    Tremor is not a non-motor symptom associated with neurodegenerative diseases. Non-motor symptoms refer to symptoms that do not involve movement, such as depression, fatigue, and apathy. Tremor, on the other hand, is a motor symptom characterized by involuntary shaking or rhythmic movements. Neurodegenerative diseases, such as Parkinson's disease, can cause motor symptoms like tremors, but they also commonly present with non-motor symptoms.

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  • 6. 

    The 2015 MDS Clinical Diagnostic Criteria for Parkinson’s disease include all of the following EXCEPT:

    • A.

      Retained motor parkinsonism as the core feature (bradykinesia plus rest tremor or rigidity)

    • B.

      Postural instability

    • C.

      Increasing recognition to non-motor manifestations

    Correct Answer
    B. Postural instability
    Explanation
    The 2015 MDS Clinical Diagnostic Criteria for Parkinson's disease include retained motor parkinsonism as the core feature (bradykinesia plus rest tremor or rigidity) and increasing recognition to non-motor manifestations. However, postural instability is not included in the criteria.

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  • 7. 

    Botulinum toxin is Indicated for all of the following movement disorders EXCEPT

    • A.

      Sialorrhea

    • B.

      Dystonia

    • C.

      Spasticity

    • D.

      Spasmodic dysphonia

    • E.

      Motor Neuron Disease

    Correct Answer
    E. Motor Neuron Disease
    Explanation
    Botulinum toxin is indicated for the treatment of various movement disorders, including sialorrhea (excessive drooling), dystonia (involuntary muscle contractions), spasticity (muscle stiffness), and spasmodic dysphonia (voice spasms). However, it is not indicated for the treatment of Motor Neuron Disease, which is a progressive neurological disorder affecting the nerve cells responsible for controlling voluntary muscle movement. Botulinum toxin may not be effective in treating the specific symptoms and underlying pathology associated with Motor Neuron Disease.

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  • 8. 

    What is the approximately time from stroke onset to catheter based intervention (thrombectomy) for effectivness? 

    • A.

      3 hours

    • B.

      4.5 hours

    • C.

      6 hours

    • D.

      7 hours

    • E.

      12 hours

    Correct Answer
    D. 7 hours
    Explanation
    The approximate time from stroke onset to catheter-based intervention (thrombectomy) for effectiveness is 7 hours. Thrombectomy is a procedure used to remove a blood clot from a blood vessel, and it is most effective when performed within a certain time frame after the onset of a stroke. This time frame is crucial because the longer it takes to perform the procedure, the higher the risk of permanent brain damage. Therefore, it is important to act quickly and aim to perform thrombectomy within 7 hours of stroke onset to maximize its effectiveness.

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  • 9. 

    Which therapies are proven to improve outcomes in acute ICH?

    • A.

      Platelet transfusion

    • B.

      Acute SBP lowering < 140

    • C.

      Craniotomy

    • D.

      IV tPA

    • E.

      N/A

    Correct Answer
    E. N/A
    Explanation
    The correct answer is N/A because none of the therapies listed, including platelet transfusion, acute SBP lowering, craniotomy, and IV tPA, have been proven to improve outcomes in acute ICH.

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  • 10. 

    Which of the following statements is false regarding ATYPICAL forms of AD?

    • A.

      Patients are generally younger than 65 years

    • B.

      Atypical patients make up about 40% of AD cases

    • C.

      Hippocampal atrophy may be absent

    • D.

      Cortical atrophy may be more focal

    Correct Answer
    B. Atypical patients make up about 40% of AD cases
    Explanation
    The given statement that "Atypical patients make up about 40% of AD cases" is false. The correct answer is that atypical patients do not make up about 40% of AD cases.

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  • 11. 

    Amyloid imaging is appropriate in any of the following:

    • A.

      Patients with persistent or progressive unexplained MCI

    • B.

      To determine dementia severity

    • C.

      Patients with progressive dementia and atypically early age of onset (65 years or less in age)

    • D.

      Asymptomatic individuals

    • E.

      All of the above

    • F.

      A and C

    • G.

      B and D

    Correct Answer
    F. A and C
    Explanation
    Amyloid imaging is appropriate in patients with persistent or progressive unexplained MCI because it can help identify the presence of amyloid plaques in the brain, which are associated with Alzheimer's disease. It is also appropriate in patients with progressive dementia and atypically early age of onset because early-onset dementia can be caused by genetic mutations that lead to increased amyloid production. Therefore, amyloid imaging can help confirm the diagnosis in these cases.

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  • 12. 

    What is the most common early impairment in Alzheimer’s disease?

    • A.

      Visuospatial

    • B.

      Executive

    • C.

      Processing Speed

    • D.

      Memory

    Correct Answer
    D. Memory
    Explanation
    Memory impairment is the most common early impairment in Alzheimer's disease. Alzheimer's disease is a neurodegenerative disorder that primarily affects memory and cognitive functions. As the disease progresses, individuals with Alzheimer's experience difficulty in remembering recent events, learning new information, and recalling previously learned information. This impairment in memory is one of the hallmark symptoms of Alzheimer's disease and is often the earliest and most noticeable sign of the condition. Other cognitive functions, such as visuospatial abilities, executive functions, and processing speed, may also be affected in later stages of the disease, but memory impairment is typically the initial and most prominent symptom.

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  • 13. 

    What is the most common early cognitive impairment in Parkinson’s disease?

    • A.

      Visuospatial

    • B.

      Executive

    • C.

      Processing Speed

    • D.

      Memory

    Correct Answer
    B. Executive
    Explanation
    Executive dysfunction is the most common early cognitive impairment in Parkinson's disease. This refers to difficulties in planning, organizing, problem-solving, and decision-making. It can manifest as decreased attention, impaired working memory, and reduced ability to switch between tasks. This impairment is often seen in the early stages of Parkinson's disease and can have a significant impact on daily functioning and quality of life for individuals with the condition.

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  • 14. 

    True of False: Dual Task Testing is vital because it provides more information of real world performance and of potential for adverse events such as falls.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Dual Task Testing is vital because it involves assessing a person's ability to perform two tasks simultaneously, which closely mimics real-world scenarios where individuals often have to multitask. By evaluating their performance in dual task situations, it provides a more accurate measure of their real-world capabilities. Additionally, dual task testing can help identify individuals who may be at risk for adverse events such as falls, as it requires a higher level of cognitive and physical functioning. Therefore, the statement that Dual Task Testing is vital because it provides more information on real-world performance and potential for adverse events such as falls is true.

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  • 15. 

    Caregiver stress is an under-recognized and undertreated health risk that can lead to poor outcomes for both caregivers and patients with dementia. 

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Caregiver stress is a significant health risk that is often overlooked and not adequately addressed. This stress can have negative effects on both caregivers and patients with dementia. When caregivers are under stress, they may experience physical and mental health problems, reduced quality of life, and decreased ability to provide effective care. Additionally, the stress experienced by caregivers can also impact the well-being and outcomes of the patients they are caring for. Therefore, recognizing and addressing caregiver stress is crucial for the overall well-being and outcomes of both caregivers and patients with dementia.

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  • 16. 

    What is considered the most common and debilitating symptom per the majority of MS patients in the research? 

    • A.

      Weakness

    • B.

      Pain

    • C.

      Fatigue

    • D.

      Cognitive impairment

    Correct Answer
    C. Fatigue
    Explanation
    Fatigue is considered the most common and debilitating symptom among the majority of MS patients, according to research. Fatigue in MS refers to a profound and persistent lack of physical and mental energy, often resulting in exhaustion. It can significantly impact daily activities, productivity, and quality of life for individuals with MS. This symptom is reported by a large number of MS patients and is recognized as one of the most challenging and disabling aspects of the disease.

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  • 17. 

    Which technology has been well documented in literature to demonstrate functional benefits in voice, articulation and intelligibility?

    • A.

      SpeechVive

    • B.

      LSVT

    • C.

      Expiratory Muscle Trainers

    • D.

      Buck Rogers Walkie Talkies

    Correct Answer
    B. LSVT
    Explanation
    LSVT stands for Lee Silverman Voice Treatment, which is a well-documented technology in literature that has shown functional benefits in voice, articulation, and intelligibility. LSVT is a speech therapy program that focuses on improving vocal loudness and clarity in individuals with Parkinson's disease and other neurological conditions. It has been extensively researched and proven effective in enhancing speech and communication abilities, making it the correct answer to the question.

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  • 18. 

    Which of the following is an unaided communication system?

    • A.

      Paper and pencil

    • B.

      Speech generating Device

    • C.

      Sign Language

    • D.

      Smartphone

    Correct Answer
    C. Sign Language
    Explanation
    Sign Language is considered an unaided communication system because it does not require any external tools or devices to convey messages. It relies solely on the use of hand gestures, body movements, and facial expressions to communicate meaning. Unlike the other options listed, such as a speech generating device or smartphone, Sign Language does not rely on technology or aids to facilitate communication.

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