Neurological & Gastrointestinal Disorders

Question 1

What is multiple sclerosis?

Answer 1

A chronic autoimmune demyelinating disorder of the CNS, leading to progressive neurological dysfunction.

Question 2

What causes MS?

Answer 2

Immune-mediated attack on oligodendrocytes, leading to demyelination and axonal damage.

Question 3

What are the four main types of MS progression?

Answer 3

1) Relapsing-remitting MS (RRMS) – Most common, periods of flare-ups and remission.

2) Secondary progressive MS (SPMS) – RRMS progresses to continuous worsening.

3) Primary progressive MS (PPMS) – Steady worsening from onset, no remission.

4) Progressive-relapsing MS (PRMS) – Progressive course with acute relapses.

Question 4

What are the hallmark symptoms of MS?

Answer 4

Optic neuritis (vision loss),
limb weakness,
sensory deficits,
ataxia, and
cognitive dysfunction.

Question 5

How is MS diagnosed?

Answer 5

MRI showing demyelinating plaques, CSF with oligoclonal bands

Question 6

What is a stroke?

Answer 6

A sudden neurological deficit due to impaired cerebral blood flow, leading to infarction or hemorrhage.

Question 7

What are the two main types of stroke?

Answer 7

1) Ischemic stroke (80%) – Due to thrombus or embolism.

2) Hemorrhagic stroke (20%) – Due to vessel rupture (e.g., aneurysm, hypertension).

Question 8

What is the FAST mnemonic for stroke recognition?

Answer 8

F – Face drooping
A – Arm weakness
S – Speech difficulty
T – Time to call emergency services

Question 9

What is the acute treatment for ischemic stroke?

Answer 9

IV thrombolysis (tPA) within 4.5 hours, mechanical thrombectomy for large clots.

Question 10

What is epilepsy?

Answer 10

A neurological disorder causing recurrent seizures due to abnormal electrical activity in the brain.

Question 11

What are the two main types of seizures?

Answer 11

1) Focal (partial) seizures – Localized to one brain area (e.g., temporal lobe epilepsy).

2) Generalized seizures – Affect both hemispheres (e.g., tonic-clonic, absence seizures).

Question 12

What is status epilepticus?

Answer 12

A seizure lasting >5 minutes or repeated seizures without recovery. It is a medical emergency.

Question 13

What is the first-line treatment for epilepsy?

Answer 13

Antiepileptic drugs (e.g., valproate, lamotrigine, levetiracetam).

Question 14

What is Parkinson’s disease?

Answer 14

A progressive neurodegenerative disorder caused by dopaminergic neuron loss in the substantia nigra.

Question 15

What are the classic symptoms of Parkinson’s?

Answer 15

Bradykinesia,
resting tremor,
rigidity,
postural instability.

Question 16

What is the main treatment for Parkinson’s?

Answer 16

Levodopa + carbidopa (dopamine precursor therapy).

Question 17

What is gastritis?

Answer 17

Inflammation of the gastric mucosa, which can be acute or chronic.

Question 18

What are the two most common causes of gastritis?

Answer 18

1) Helicobacter pylori infection

2) NSAID overuse (inhibiting prostaglandins, leading to mucosal damage)

Question 19

What are common symptoms of gastritis?

Answer 19

Epigastric pain,
nausea,
vomiting,
bloating.

Question 20

What is a peptic ulcer?

Answer 20

A mucosal defect in the stomach or duodenum due to acid-pepsin damage.

Question 21

What are the major risk factors for peptic ulcers?

Answer 21

H. pylori infection,
NSAIDs,
smoking,
alcohol,
stress.

Question 22

How do gastric and duodenal ulcers differ?

Answer 22

• Gastric ulcer – Worse with meals, pain 30–60 minutes after eating.
• Duodenal ulcer – Pain relieved by eating, occurs 2–3 hours after meals.

Question 23

What is the treatment for peptic ulcers?

Answer 23

Proton pump inhibitors (PPIs),
H. pylori eradication (triple therapy).

Question 24

What is Crohn’s disease?

Answer 24

A chronic, relapsing inflammatory disease affecting any part of the GI tract, with transmural inflammation.

Question 25

What are key features of Crohn’s disease?

Answer 25

Skip lesions, cobblestone mucosa, fistula formation, non-caseating granulomas.

Question 26

What is ulcerative colitis?

Answer 26

A chronic inflammatory disease limited to the colon and rectum, with superficial inflammation (mucosa only).

Question 27

What are the key features of ulcerative colitis?

Answer 27

Continuous colonic involvement, crypt abscesses, bloody diarrhea.

Question 28

What are complications of ulcerative colitis?

Answer 28

Toxic megacolon, colorectal cancer risk.

Question 29

What is the treatment for inflammatory Bowel Disease (IBD)?

Answer 29

Mild cases: 5-ASA (mesalamine). Moderate cases: Corticosteroids. Severe cases: Immunosuppressants, biologics (TNF inhibitors), surgery (colectomy in UC).

Question 30

What are the key differences between Crohn’s disease and ulcerative colitis?

Answer 30

Crohn’s disease: Can affect any part of the GI tract (mouth to anus), transmural inflammation, skip lesions. Ulcerative colitis: Limited to the colon & rectum, mucosal inflammation only, continuous lesions.

Question 31

How do Crohn’s and ulcerative colitis differ in location and depth of inflammation?

Answer 31

Crohn’s: Anywhere in the GI tract, affects entire wall thickness (transmural). UC: Only in the colon & rectum, mucosa-only inflammation.

Question 32

How does the pattern of inflammation differ between Crohn’s disease and ulcerative colitis?

Answer 32

Crohn’s: Patchy "skip lesions", meaning affected areas are interspersed with healthy tissue. UC: Continuous inflammation, spreading proximally from the rectum.

Question 33

What are the major complications of Crohn’s disease and ulcerative colitis?

Answer 33

Crohn’s: Fistulas, abscesses, strictures, malabsorption. UC: Toxic megacolon, increased risk of colorectal cancer.

Question 34

Which has a higher risk of colorectal cancer, Crohn’s or ulcerative colitis?

Answer 34

Ulcerative colitis has a higher risk of colorectal cancer, especially with long-standing disease (>10 years). Crohn’s has a moderate risk, but mainly in areas of chronic inflammation.

Question 35

How is treatment different for Crohn’s disease vs. ulcerative colitis?

Answer 35

Mild IBD (inflammatory Bowel Disease) (both types): 5-ASA (mesalamine). Moderate cases: Corticosteroids. Severe cases: Crohn’s → Biologics (TNF inhibitors), possible surgery. UC → Colectomy can be curative.