Nervous System Pathology 2

2.

A patient presents with paralysis in her feet and is beginning to notice weakness in her hands. She has diminished reflexes in her lower limbs as well. You do a thorough case history and find she was ill 3 weeks ago with a viral infection. What should you rule out first?

Multiple sclerosis
Parkinson disease
Huntington disease
Guillain-Barre syndrome

Correct Answer

A. Guillain-Barre syndrome

Explanation

Paralysis of the feet and the beginning of paralysis of the hands is indicative of ascending paralysis, which is highly associated with Guillan-Barre syndrome...especially after a viral infection.

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3.

Which of the following is NOT true regarding Parkinson's disease?

It is a hypokinetic disorder
Dopamine deficiency is believed to be the main cause
Lewis bodies are often present in the diagnosis
A decrease in acetylcholine is present
A COMT agonist would be a poor treatment option

Correct Answer

A. A decrease in acetylcholine is present

Explanation

Acetylcholine is normal in Parkinsonism. (Her lecture notes say elevated). COMT breaks down dopamine..so an agonist would make the disease symptoms worse.

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4.

Which of the following statements about Multiple sclerosis are true? (Select 2)

Is autoimmune with T-Cell involvement
CNS axons are destroyed
A symptom is a shock like sensation when the patient flexes their neck (Lhermitte's sign)
Grey matter in the CNS is selectively destroyed, but not in the PNS.

Correct Answer(s)

A. Is autoimmune with T-Cell involvement
A. A symptom is a shock like sensation when the patient flexes their neck (Lhermitte's sign)

Explanation

White matter of CNS is destroyed. CNS myelin is destroyed, axons are generally left alone.

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5.

The most common primary brain tumor of adults is

Atrocytoma
Meningioma
Pituitary adenoma
Craniopharyngioma

Correct Answer

A. Atrocytoma

Explanation

Astrocytoma is the most common primary brain tumor in adults. It originates from astrocytes, which are star-shaped cells that support and nourish neurons in the brain. Astrocytomas are classified into different grades based on their aggressiveness, with grade IV astrocytoma, also known as glioblastoma, being the most malignant. These tumors can cause a variety of symptoms depending on their location and size, such as headaches, seizures, and neurological deficits. Treatment options for astrocytoma include surgery, radiation therapy, and chemotherapy, although the prognosis for this type of tumor can vary widely depending on the grade and individual factors.

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6.

Chloroquine use is associated with which type of disease?

Myasthenia Gravis
Parkinson's disease
Muscular dystrophy
CIPD

Correct Answer

A. Myasthenia Gravis

Explanation

Chloroquine is an antibiotic associated with MG. Seem's nitpicky but I have a feeling she'll ask it.. she harped on it.

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7.

Alzheimer's disease (Select 2)

Is associated with destruction of dopaminergic neurons
Shows Beta-amyloid plaques, Lewis bodies, and neurofibrillary tangles
Will initially show loss of long term memory
Can be treated by blocking the action of Cholinesterase
Can be treated by activating the NMDA receptor

Correct Answer(s)

A. Shows Beta-amyloid plaques, Lewis bodies, and neurofibrillary tangles
A. Can be treated by blocking the action of Cholinesterase

Explanation

Is associated with a destruction in cholinergic neurons, not dopaminergic. Will initially show loss of short term memory. Overactivation of NMDA receptor is part of the problem, so we need an NMDA antagonist, not agonist.

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8.

A Tensilon test is used to help in the diagnosis of which disease and why? (Select 2)

Myasthenia Gravis
Duchenne Muscular Dystrophy
Guillan-Barre Syndrome
It will temporarily increase the amount of acetylcholine available and show temporary decreased clinical symptoms
It will temporarily activate the AchE enzyme and temporarily decrease the clinical symptoms of the disease

Correct Answer(s)

A. Myasthenia Gravis
A. It will temporarily increase the amount of acetylcholine available and show temporary decreased clinical symptoms

Explanation

A Tensilon test is used to help in the diagnosis of Myasthenia Gravis because it temporarily increases the amount of acetylcholine available, which is necessary for muscle contraction. In Myasthenia Gravis, there is a deficiency of acetylcholine receptors, leading to muscle weakness and fatigue. By temporarily increasing the amount of acetylcholine, the test can show a temporary decrease in clinical symptoms, confirming the diagnosis of Myasthenia Gravis.

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9.

In Duchenne Muscular Dystrophy (Select 2)

There is an absence of dystrophin
The defective gene is the PIG-A gene on the X chromosome
There is a decreased production of dystrophin
It is caused by an increase in acetylcholine receptor destruction at the NMJ

Correct Answer(s)

A. There is an absence of dystrophin
A. The defective gene is the PIG-A gene on the X chromosome

Explanation

The correct answer is that there is an absence of dystrophin and the defective gene is the PIG-A gene on the X chromosome. Duchenne Muscular Dystrophy is a genetic disorder characterized by the absence of dystrophin, a protein that helps maintain the structure and function of muscle fibers. The PIG-A gene on the X chromosome is responsible for producing a protein involved in the production of dystrophin. Mutations in this gene can lead to a defective or absent dystrophin protein, resulting in the symptoms seen in Duchenne Muscular Dystrophy.

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Nervous System Pathology 2

Alzheimer's disease is irreversible.

Quiz Preview

A patient presents with paralysis in her feet and is beginning to notice weakness in her hands. She has diminished reflexes in her lower limbs as well. You do a thorough case history and find she was ill 3 weeks ago with a viral infection. What should you rule out first?

Which of the following is NOT true regarding Parkinson's disease?

Which of the following statements about Multiple sclerosis are true? (Select 2)

The most common primary brain tumor of adults is

Chloroquine use is associated with which type of disease?

Alzheimer's disease (Select 2)

A Tensilon test is used to help in the diagnosis of which disease and why? (Select 2)

In Duchenne Muscular Dystrophy (Select 2)