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Neurology 1 > Case 17 - Overview > Flashcards

Case 17 - Overview Flashcards

1
Q

which of these conditions is a chronic immune mediated , inflammatory demyelinating disease of the CNS

a.MS
b.Guillian barre
c.brown squared
d.parkinsons
e.huntingtons

A

a.MS

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2
Q

what is the most common initial clinical syndrome in MS

a.optic neuritis
b.transverse myelitis
c.brainstem syndrome

A

a.optic neuritis

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3
Q

MS discovered on an MRI for another reason is known as

a.CIS
b.RIS

A

b.RIS

radiologically isolated syndrome

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4
Q

unilateral loss of vision , typically worsening over days, loss of colour vision and retrobulbar eye pain made worse by eye movement that improves over weeks or months indicates what

A

optic neuritis

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5
Q

the visual loss in optic neuritis is

a.unilateral
b.bilateral

A

a.unilateral

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6
Q

the retrobulbar pain experienced in optic neuritis is usually

a. relieved by movement
b.exacerbated by movement

A

b.exacerbated by movement

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7
Q

optic neuritis improves over…

a.weeks - months
b.months - years
c.hours - days
d.minutes - hours

A

a.weeks - months

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8
Q

an area of inflammation within the spinal cord is known as

a.optic neuritis
b.transverse myelitis
c.brainstem syndromes

A

b.transverse myelitis

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9
Q

Lhermittes phenomenon ( electric shock sensation down spine on neck flexion) is due to a lesion in which part of the spinal cord

a.cervical
b.thoracic
d.lumbar
e.sacral
d.coccygeal

A

a.cervical

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10
Q

weakness , sensory symptoms , bladder and bowel dysfunction and lhermittes phenomenon is seen in which condition that precedes MS

a.optic neuritis
b.transverse myelitis
c.brain stem syndromes

A

b.transverse myelitis

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11
Q

vertigo, dysarthria (slurred speech), dysphagia, diplopia, trigeminal neuralgia (one sided facial pain), double vision, ataxia and internuclear ophthalmoplegia indicate which initial clinical syndrome of MS

a.optic neuritis
b.transverse myelitis
c.brain stem syndromes

A

c.brain stem syndromes

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12
Q

in internuclear ophthalmoplegia (as seen in brainstem syndromes preceding MS) there is…

a.ipsilateral impaired adduction and contralateral nystagmus

b.contralateral impaired adduction and ipsilateral adducting nystagmus

c.ipsilateral abduction and contralateral abducting nystagmus

d.contralateral impaired abduction and ipsilateral abducting nystagmus

A

a.ipsilateral impaired adduction and contralateral nystagmus. (when abducting)

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13
Q

increased tone, clonus, weakness, hypereflexia and extensor plantar responses are examples of what seen in MS

a, upper motor neurone signs
b.lower motor neurone signs

A

a, upper motor neurone signs

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14
Q

how does the optic disc appear in MS

a.hard exudates present
b.decreased cup to disc ratio
c, white pale disc

A

c, white pale disc

optic nerve atrophy

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15
Q

at what age does MS usually onset

a.childhood
b.adolescensce
c.adulthood
d.elderly

A

c.adulthood

20-40 yrs

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16
Q

MS happens more commonly in ..

a.males
b. females

A

b. females

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17
Q

which virus is a risk factor for MS

a.epstein barr
b.covid
c.herpes zoster
d.cmv

A

a.epstein barr

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18
Q

living in which regions increases risk of MS

a.high latitude
b.low latitude

A

a.high latitude

less UV exposure and less vitamin D

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19
Q

which of these is a modifiable risk factor for MS

a.smoking
b. alcohol
c. obesity

A

a.smoking

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20
Q

what is the most common subtype of MS

a.relapse remitting
b.secondary progressive
c.primary progressive

A

a.relapse remitting

85%

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21
Q

how long after onset does relapse remitting become secondary progressive

a.2 yrs
b.5 yrs
c.10 yrs

A

c.10 yrs

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22
Q

a steady increase in disability without attacks describes which type of MS

a.primary progressive
b.secondary progressive
c.relapsing remitting

A

a.primary progressive

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23
Q

no new disability between attacks followed by a steady increase in disability describes which type of MS

a.primary progressive
b.secondary progressive
c.relapsing remitting

A

b.secondary progressive

24
Q

no new disability between attacks describes which type of MS

a.primary progressive
b.secondary progressive
c.relapsing remitting

A

c.relapsing remitting

25
how do MS lesions appear on MRI a.dark b.white
b.white csf is bright white pathological white fluid shows duller white
26
in. a FLAIR MRI which signal is nullified a.fat b.csf
b.csf normally bright white
27
in a T1 MRI which tissue is bright a.fat b.csf c.csf and fat
a.fat T1- 1 tissue bright
28
in a T2 which tissue is bright a.fat b.csf c.csf and fat
c.csf and fat. t2-- 2 tissues are bright ww2 - water is white
29
what signal is suppressed in. STIR MRI a.fat b. csf
a.fat
30
in a gadolinium enhanced MRI what is enhanced a.fat b.csf d.vasculature
d.vasculature
31
vascular mimics of MS
small vessels disease CNS vasculitis CADASIL
32
autoimmune MS mimics
acute disseminated encephalomyelitis neuromyleitis optica SLE neurosarcoidosis
33
infectious mimics of MS
neurosyphilis HIV Lyme disease
34
neuroplastic mimics of MS
primary brain tumour glioblastis cerebri CNS lymphoma
35
genetic mimics of MI
mitochondrial disease adrenoleucodystrophy hereditary spastic parapesis
36
tests to exclude alternative diagnoses before referring to a neurologist
fbc crp lft rat calcium glucose thyroid glucose b12 HIV
37
why is a lumbar puncture done for suspected MS a. look for evidence of infection b.determine if viral or bacterial c. look for evidence of inflammation
c. look for evidence of inflammation
38
presence of what in csf may indicated ms
a.oligoclonal bands also look t wbc and proteins
39
wha test demonstrates a delay in signal transmission along the optic nerve a. MRI b. eeg c.emg d. VER
d. VER visual evoked response
40
the risk of ms after CIS (clinically isolated syndrome) is calculated based on what..
MRI lesion load presence of CSF oligoclonal bands
41
a focal deficit lasting more than 24 hrs preceded by at least 30 days of clinical stability is known as a.ms b.cis c.ris d.relapse
d.relapse confirmed with new or worsened neurological dysfunction
42
what is important to exclude in relapse management as pseudo relapses can occur as a result of this ... a.infection b.hormonal changes c.stress
a.infection
43
what drugs can be used to speed up recovery in some relapses a. steroids b.beta blockers c.DMARDs d.SSRIs
a. steroids
44
which part of the nerve is attacked in MS a.myelin sheath b.dendrites c.external lamina d.schwann cells
a.myelin sheath
45
over time the pathophysiology of ms changes from ............... to ................ a.inflammation, demyelination, remyelination to less inflammation , more axonal loss b.less inflammation , more axonal loss to inflammation, demyelination and remyelination
a.inflammation, demyelination, remyelination to less inflammation , more axonal loss
46
what is the purpose of treatment in MS a. curative b.disease modifying
b.disease modifying act on immune system to reduce inflam and demyelination reduce relapse rate may improve long term disability
47
in clinically isolated syndromes what is the purpose of DMT
can delay time until 2nd relapse decreased brain atrophy rate
48
what drugs are used in patients with active disease and more than 2 clinical relapses in prev 2 years a.moderate efficacy - interferon beta, glatiramer acetate, teriflunomide b.high efficacy - natilizumab, alemtuzumab
a.moderate efficacy - interferon beta, glatiramer acetate, teriflunomide
49
what drugs are used in patients with more active disease and frequent relapses a.moderate efficacy - interferon beta, glatiramer acetate, teriflunomide b.high efficacy - natilizumab, alemtuzumab
b.high efficacy - natilizumab, alemtuzumab
50
what drug is given in active secondary progressive MS a. interferon beta b.ocrelizumab c. siponimod d. natilizumab
c. siponimod
51
what drug is used to treat active primary progressive MS a. interferon beta b.ocrelizumab c. siponimod d. natilizumab
b.ocrelizumab
52
which drug is used for neuropathic pain (sharp stabbing burning sensation) in ms a.gabapentin b.ocrelizumab c.siponimod d.baclofen e.anti cholinergic d.anxiolytics
a.gabapentin
53
which drug is used for spacisitiy in ms a.gabapentin b.ocrelizumab c.siponimod d.baclofen e.anti cholinergic d.anxiolytics
d.baclofen
54
which drug is used for bladder overactivity in ms a.gabapentin b.ocrelizumab c.siponimod d.baclofen e.anti cholinergic d.anxiolytics
e.anti cholinergic
55
which drug is used for mood disorder in ms a.gabapentin b.ocrelizumab c.siponimod d.baclofen e.anti cholinergic d.anxiolytics
d.anxiolytics

Neurology 1 (44 decks)

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