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Adams 10th > Chapter 36 - MS > Flashcards

Chapter 36 - MS Flashcards

1
Q

Which of the following is true of the pathology in MS?*
A. The optic nerves, chiasm, and more commonly the optic tracts may be affected
B. Inflammatory lesions are made up of neutrophils
C. Complement does not play a role in MS
D. Oligodendrocyte dystrophy is present

A

D. Oligodendrocyte dystrophy is present (p. 917)

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2
Q 
This is a typical feature of MS wherein there is temporary induction, by heat or exercise, of unilateral visual blurring*
A. Uhthoff phenomenon
B. Lhermitte sign
C. Pulfrich effect
D. Charcot triad
A

A. Uhthoff phenomenon (p. 920)

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3
Q 
Flexion of the neck induces a tingling, electric-like feeling down the shoulders and back, and less commonly, down the anterior thighs
A. Uhthoff phenomenon
B. Lhermitte sign
C. Pulfrich effect
D. Charcot triad
A

B. Lhermitte sign (p. 921)

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4
Q 
The phenomenon in which an object such as a pendulum that is swinging perpendicular to the patient’s line of sight, appears to be moving in a 3D circular motion
A. Uhthoff phenomenon
B. Lhermitte sign
C. Pulfrich effect
D. Charcot triad
A

C. Pulfrich effect (p. 921)

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5
Q

Which of the following signs and symptoms comprise the Charcot triad of MS?*
A. Nystagmus, scanning speech, intention tremor
B. Nystagmus, optic neuritis, dysarthria
C. Ataxia, intention tremor, nystagmus
D. Ataxia, intention tremor, scanning speech

A

A. Nystagmus, scanning speech, intention tremor (p. 923)

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6
Q 
Drug that is effective in controlling paroxysmal attacks of neurologic deficits in MS
A. Carbamazepine
B. Acetazolamide
C. ACTH
D. Isoniazid
A

A. Carbamazepine (p. 925)

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7
Q 
Drug that blocks the painful tonic spasms that are elicited by hyperventilation in MS
A. Carbamazepine
B. Acetazolamide
C. ACTH
D. Isoniazid
A

B. Acetazolamide (p. 925)

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8
Q

True of concentric sclerosis of Balo:*
A. Alternating bands of destruction and preservation of myelin
B. There is a centripetal diffusion of some factor that is damaging to myelin
C. Low incidence in the Philippines
D. Not seen in chronic relapsing MS

A

A. Alternating bands of destruction and preservation of myelin (p. 927)

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9
Q 
The only measure of disease activity in MS:
A. CSF pleocytosis
B. CSF oligoclonal bands
C. CSF protein
D. CSF IgG
A

A. CSF pleocytosis (p. 927)

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10
Q

MRI contrast findings characteristic of acute MS lesions:
A. Non contrast enhancing
B. Open ring of enhancement, with the open segment being medially situated
C. Open ring of enhancement, with the open segment being laterally situated
D. Thick regular ring enhancement

A

B. Open ring of enhancement, with the open segment being medially situated (p. 928)

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11
Q

True of MS and pregnancy except
A. Pregnancy is typically associated with clinical stability
B. The average relapse rate declines in each trimester
C. Relapse rate reaches a level less than 1/3 of the expected rate by the 3rd trimester
D. There continues to be a decreased risk of exacerbations in the first few months postpartum

A

D. There continues to be a decreased risk of exacerbations in the first few months postpartum (p. 930)

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12
Q

True of natalizumab in MS except
A. The AFFIRM study showed a twofold improvement in efficacy in MS compared to interferon
B. There is a virtual lack of acute side effects
C. There is a risk of developing PML is greater with increased duration of use
D. Prior or concurrent use of immunosuppressive drugs decrease the risk of developing PML

A

D. Prior or concurrent use of immunosuppressive drugs decrease the risk of developing PML (p. 935)

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13
Q 
Alemtuzumab is known to produce which adverse effects?
A. PML
B. Idiopathic thrombocytopenic purpura
C. Autoimmune thyroiditis
D. B & C only
E. All of the above
A

D. B and C only (p. 935)

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14
Q 
Agents that can be used for fatigue in MS patients except:
A. Amantadine
B. Modafinil
C. Methylphenidate
D. Dextroamphetamine
E. Corticosteroids
A

E. Corticosteroids (p. 935)

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15
Q 
Therapeutic options for tremors in MS except
A. Ventrolateral thalamotomy
B. Isoniazid
C. Clonazepam
D. None of the above
A

D. None of the above (p. 936)

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16
Q 
Antibody associated with NMO*
A. Aquaporin 4
B. IgA
C. IgM
D. Ig E
A

A. Aquaporin 4 (p. 936)

17
Q

Features that differentiate Devic’s disease from MS, except*
A. Cerebral demyelinating lesions
B. Absence of oligoclonal bands in CSF
C. Necrotizing and cavitary spinal cord lesions
D. Involves several contiguous longitudinal segments of the spinal cord

A

A. Cerebral demyelinating lesions (p. 936)

18
Q

True of ADEM except
A. It is distinguished pathologically by numerous foci of demyelination scattered throughout the brain and spinal cord
B. It is more common in adults
C. It is a humoral disease
D. The encephalitic form is expressed more fully in children than in adults
E. None of the above

A

B. It is more common in adults (p. 938)

19
Q 
The following features of Hurst disease distinguish it from ADEM except
A. Size of MRI lesions
B. Hemorrhagic character
C. Extent of perilesional edema
D. None of the above
A

D. None of the above (p. 941)

20
Q

Histologic appearance of chronic plaques in MS*
A. Partial or complete destruction or loss of myelin
B. Perivascular infiltration with mononuclear cells and lymphocytes
C. Macrophage infiltration
D. Acellular glial tissue

A

D. Acellular glial tissue (p. 917)

21
Q 
NOT seen in acute MS plaques*
A. Partial or complete destruction and loss of myelin
B. Axonal swelling
C. Astrocytic reaction
D. Perivascular infiltration
A

B. Axonal swelling (p. 917)

22
Q 
Which organism's genomic material has NOT been seen in MS?*
A. Mycoplasma
B. Borrelia burgdorferi
C. HHV 6
D. Chlamydia pneumoniae
A

A. Mycoplasma (p. 919)

23
Q 
An acute attack of MS with symptoms of intention tremor, nystagmus, and scanning speech has been called*
A. Uhthoff phenomenon
B. Lhermitte sign
C. Pulfrich effect
D. Charcot triad
A

D. Charcot triad (p. 923)

24
Q 
CSF oligoclonal bands are seen in
A. MS
B. Syphilic
C. Lyme disease
D. SSPE
E. All of the above
A

E. All of the above (p. 928)

25
Q 
Typical location of MS plaques EXCEPT*
A. Basal ganglia
B. Infratentorial
C. Juxtacortical
D. Periventricular
E. Optic nerve
F. Spinal cord
A

A. Basal ganglia (p. 930, Table 36-2)

26
Q

Factor most predictive of long-term disability in MS
A. Number of attacks
B. Length of interattack interval
C. Time reached to a state of moderate disability
D. Degree of disability at 5 years from the 1st symptom

A

D. Degree of disability at 5 years from the 1st symptom (p. 930)

27
Q 
mAb to alpha integrin; risk of PML
A. Natalizumab
B. Alemtuzumab
C. Rituximab
D. Ocrelizumab
A

A. Natalizumab (p. 934-935)

28
Q 
mAb to CD-52; risk of ITP and autoimmune thyroiditis
A. Natalizumab
B. Alemtuzumab
C. Rituximab
D. Ocrelizumab
A

B. Alemtuzumab (p. 935)

29
Q

What primarily differentiates NMO as a distinct entity from MS?*
A. Presence of specific antineural antibody
B. Its monophasic character
C. CSF oligoclonal bands
D. Amount of inflammatory infiltrates

A

A. Presence of specific antineural antibody (p. 936)

30
Q

Most fulminant form of demyelinating disease*
A. Concentric sclerosis of Balo
B. Schilder disease
C. ADEM
D. Acute necrotizing hemorrhagic encephalomyelitis

A

D. Acute necrotizing hemorrhagic encephalomyelitis (p. 941)

Adams 10th (27 decks)

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