Neurology - An Introduction to lower motor neuron disorders

Question 1

increased tone, reflexes and plantar responses indicates what

a.upper motor neurone lesion
b.lower motor neurone lesion

Answer 1

a.upper motor neurone lesion

Question 2

wasting, decreased tone, reflexes and plantar decrease indicates what

a.upper motor neurone lesion
b.lower motor neurone lesion

Answer 2

b.lower motor neurone lesion

Question 3

possible sites of pathology of LMN weakness

Answer 3

anterior horn cell
nerve root - radiculopathy
peripheral nerve - neuropathy
neuromuscular junction
muscle fibres - myopathy

Question 4

painless and progressive weakness and wasting indicates a disorder of what

a. anterior horn cell
b. nerve root - radiculopathy
c. peripheral nerve - neuropathy
d. neuromuscular junction
e. muscle fibres - myopathy

Answer 4

a. anterior horn cell
motor horn

Question 5

which of these conditions is an example of anterior horn cell disorder

a.motor neurone disease
b.myasthenia gravis
c.eaton lambert
d.multiple sclerosis
e. stroke

Answer 5

a.motor neurone disease

Question 6

in motor neurone disease there are….

a.only upper motor neurone signs
b.only lower motor neurone signs
c.upper and lower motor neurone signs

Answer 6

c.upper and lower motor neurone signs

Question 7

patient with painless progressive weakness and wasting , increased tone and decreased reflexes , normal eye movements and normal sensation indicates what

a.motor neurone disease
b.myasthenia gravis
c.eaton lambert
d.multiple sclerosis
e. stroke

Answer 7

a.motor neurone disease

Question 8

spinal muscular atrophy is a disorder of what

a. anterior horn cell
b. nerve root - radiculopathy
c. peripheral nerve - neuropathy
d. neuromuscular junction
e. muscle fibres - myopathy

Answer 8

a. anterior horn cell

Question 9

mechanical compression of a nerve root leads to what

a. anterior horn cell disorders
b. radiculopathy
c. neuropathy
d. neuromuscular junction disorder
e. myopathy

Answer 9

b. radiculopathy

Question 10

patient with pain weakness and sensory loss . the weakness is confined to one myotone and the sensory loss is confined to one dermatome and reflex loss at the nerve root level indicates what

a. anterior horn cell disorders
b. radiculopathy
c. neuropathy
d. neuromuscular junction disorder
e. myopathy

Answer 10

b. radiculopathy

Question 11

loss of the bicep jerk reflex, accompanied by pain, sensory loss of one dermatome and weakness of one myotome indicates radiculopathy at which level

a.c3
b.c4
c.c5
d.c6
c.7

Answer 11

c.c5

Question 12

mainly radiculopathy occurs in which roots

a.cervical and thoracic
b.thoracic and lumbar
c.lumbar and sacral
d.cervical and lumbar

Answer 12

d.cervical and lumbar

Question 13

which nerve root is responsible for elbow flexion

a.c5
b.c6
c.c7
d.c8
e.t1

Answer 13

a.c5

Question 14

which nerve root is responsible for wrist extension

a.c5
b.c6
c.c7
d.c8
e.t1

Answer 14

b.c6

Question 15

which nerve root is responsible for wrist flexion and finger extension

a.c5
b.c6
c.c7
d.c8
e.t1

Answer 15

c.c7

Question 16

which nerve root is responsible for finger abduction
a.c5
b.c6
c.c7
d.c8
e.t1

Answer 16

e.t1

Question 17

what nerve root is responsible for knee flexion and big toe extension

a.t1
b.l2
c.l3
d.l4
e.l5

Answer 17

e.l5

Question 18

what nerve root is responsible for knee extension

a.t1
b.l2
c.l3
d.l4
e.l5

Answer 18

c.l3
d.l4

Question 19

what nerve root is responsible for big toe flexion

a.t1
b.l2
c.l3
d.l4
e.l5
f.s1

Answer 19

f.s1

Question 20

which nerve root is responsible for the biceps reflex

a.c5
b.c6
c.c7
d.l3.l4
e.l5,s1

Answer 20

a.c5

Question 21

which nerve root is responsible for the brachioradialis reflex

a.c5
b.c6
c.c7
d.l3.l4
e.l5,s1

Answer 21

b.c6

Question 22

which nerve root is responsible for the triceps reflex

a.c5
b.c6
c.c7
d.l3.l4
e.l5,s1

Answer 22

c.c7

Question 23

which nerve root is responsible for the quadriceps reflex

a.c5
b.c6
c.c7
d.l3.l4
e.l5,s1

Answer 23

d.l3.l4

Question 24

diffuse disorder of peripheral nerves

Answer 24

polyneuropathy

Question 25

single peripheral nerve disorder

Answer 25

mononeuropathy

Question 26

disorder of several individual nerves

Answer 26

mononeuropathy multiplex

Question 27

which nerves are affected first in polyneuropathies a.proximal b.distal

Answer 27

b.distal

Question 28

polyneuropathies have weakness +/- sensory loss starting distally in which pattern a.asymetrical b.one sided only c.symmetrical

Answer 28

c.symmetrical

Question 29

in polyneuropathies reflexes are abscent ....... a.late b.early

Answer 29

b.early

Question 30

pes cavus is seen in what a.mononeuropathies b.mononeuropathies multiplex c.polyneuropathies

Answer 30

c.polyneuropathies

Question 31

mononeuropathies are often... a.idiopathic b.idiosyncratic c.compressive/ traumatic

Answer 31

c.compressive/ traumatic

Question 32

foot drop is caused by palsy of which nerve a.median nerve b.radial nerve c.ulnar d.common peroneal nerve

Answer 32

d.common peroneal nerve

Question 33

fatiguability is the hallmark of which disorder a. anterior horn cell disorders b. radiculopathy c. neuropathy d. neuromuscular junction disorder e. myopathy

Answer 33

d. neuromuscular junction disorder

Question 34

which muscles are commonly involved in neuromuscular junction disorders a.intraocular b.extraoccular c. facial d.cardiac

Answer 34

b.extraoccular opthalmoplegia, ptosis, diplopia

Question 35

opthalmoplegia, ptosis and diplopia followed by problems with chewing , swallowing and nasal sounding speech are seen in which conditions a. anterior horn cell disorders b. radiculopathy c. neuropathy d. neuromuscular junction disorder e. myopathy

Answer 35

d. neuromuscular junction disorder

Question 36

what is the most common neuromuscular junction disorder a.eaton lambert b.myasthenia gravis c. motor neurone disease d.multiple sclerosis e.parkinsons

Answer 36

b.myasthenia gravis

Question 37

proximal, symmetrical weakness with sparing of reflexes until late indicates what a. anterior horn cell disorders b. radiculopathy c. neuropathy d. neuromuscular junction disorder e. myopathy

Answer 37

e. myopathy

Question 38

weakness distribution - asymetric reflexes- lost or increased wasting - early other- mixed upper and lower mn signs a.anterior horn cell disorder b.nerve root disorder c.peripheral nerve disorder d.neuromuscular junction disorder e.myopathy

Answer 38

a.anterior horn cell disorder

Question 39

weakness in one myotome reflexes- lost at lesion wasting- no other - dermatomal sensory loss a.anterior horn cell disorder b.nerve root disorder c.peripheral nerve disorder d.neuromuscular junction disorder e.myopathy

Answer 39

b.nerve root disorder

Question 40

weakness distal and symmetrical reflexes- lost early wasting- early other - distal sensory loss a.anterior horn cell disorder b.nerve root disorder c.peripheral nerve disorder d.neuromuscular junction disorder e.myopathy

Answer 40

c.peripheral nerve disorder

Question 41

weakness proximal, fatiguable reflexes- normal wasting- no other - extraocular and bulbar muscle involvement a.anterior horn cell disorder b.nerve root disorder c.peripheral nerve disorder d.neuromuscular junction disorder e.myopathy

Answer 41

d.neuromuscular junction disorder

Question 42

weakness - proximal and symmetrical reflexes- normal wasting- late other - a.anterior horn cell disorder b.nerve root disorder c.peripheral nerve disorder d.neuromuscular junction disorder e.myopathy

Answer 42

e.myopathy

Question 43

stairs/ hair brushing difficulties indicates weakness where a.proximal b.distal

Answer 43

a.proximal

Question 44

tripping/ difficulty opening jars difficulties indicates weakness where a.proximal b.distal

Answer 44

b.distal

Question 45

weakness coming on over years indicates what cause a.genetic b.inflammatory

Answer 45

a.genetic

Question 46

there is no pain in which conditions a.nmj/ mnd b.radiculopathies

Answer 46

a.nmj/ mnd PAIN ESP. IN RADICULOPATHIES

Question 47

symptoms of respiratory muscle weakness

Answer 47

lethargy nausea early morning headache

Question 48

scapular winging is seen in a.anterior horn cell disorder b.nerve root disorder c.peripheral nerve disorder d.neuromuscular junction disorder e.myopathy

Answer 48

e.myopathy

Question 49

spontaneous firing of a single motor unit (motor nerve and group of muscles it innervates)

Answer 49

fasciculations indicates active denervation and reinnervation

Question 50

what should be tested in all patients with neuromuscular weakness a.crp b. ccp d.anti transglutaminase e.creatine kinase

Answer 50

e.creatine kinase

Question 51

which enzyme is primarily found in skeletal /cardiac muscle and increases after high intensity excercise a.crp b. ccp d.anti transglutaminase e.creatine kinase

Answer 51

e.creatine kinase

Question 52

increase of creatine kinase >10,000 indicates what

Answer 52

rhabdomyolysis muscular dystrophy

Question 53

which test gives info about how the nerve conducts the motor response a.nerve conduction b.electromyography

Answer 53

a.nerve conduction

Question 54

which test gives info about damage to muscle as a result of myopathy or denervation a.nerve conduction b.electromyography

Answer 54

b.electromyography

Question 55

what type of muscle is best for a muscle biopsy a.weak b.strong c.atrophied

Answer 55

a.weak