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Neuro states > Neuromuscular diseases > Flashcards

Neuromuscular diseases Flashcards

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1
Q

Which symptom is not characteristic for Myasthenia gravis?
A) diplopia
B) ptosis
C) dysarthria
D) aphasia
E) muscle weakness worsening with physical exercise

A

D) aphasia

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2
Q

First-choice treatment in Myasthenia gravis:
A) atropin
B) acetylcholinesterase inhibitors
C) steroid
D) plasma exchange therapy
E) vitamins

A

B) acetylcholinesterase inhibitors

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3
Q

Motor neurone disease:
A) Eaton–Lambert syndrome
B) Amyotrophic lateral sclerosis
C) Duchenne muscular dystrophy
D) Guillain–Barré syndrome

A

B) Amyotrophic lateral sclerosis

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4
Q

Which symptom is not characteristic for Amyotrophic lateral sclerosis?
A) Babinski-reflex (extensor plantar reflex)
B) atrophy of the small hand muscles
C) fasciculation
D) dysphagia
E) paraesthesia

A

E) paraesthesia

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5
Q

Which is not characteristic for Guillain–Barré syndrome?
A) albuminocytologic dissociation in the CSF
B) ascending paresis
C) cranial nerves are never affected
D) segmental demyelinisation
E) mortality is under 3%

A

C) cranial nerves are never affected

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6
Q

When to suspect polymyositis?
A) numbness with paresis
B) paresis starts in the proximal limb muscles
C) normal erythrocyte sedimentation rate
D) paresis in the proximal limb muscles along with fever and pain

A

D) paresis in the proximal limb muscles along with fever and pain

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7
Q

Which is not characteristic for polymyositis?
A) weakness of the proximal muscles
B) weakness of the external ocular muscles
C) weakness of the muscles of the neck
D) muscle pain

A

B) weakness of the external ocular muscles

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8
Q

Usual onset of facio-scapulo-humeral muscular dystrophy:
A) first years of life
B) 2nd–3rd decade
C) 4th–5th decade
D) 6th decade

A

B) 2nd–3rd decade

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9
Q

Which is not characteristic for myasthenia gravis?
A) damage of the synaptic folds
B) damage of the ACh-receptors
C) damage of the ACh-containing vesicles
D) disturbance of the neuromuscular transmission

A

C) damage of the ACh-containing vesicles

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10
Q

Which symptom is not characteristic for myasthenia gravis?
A) pathologic fatigue of muscles
B) ocular muscles are often affected
C) bulbar muscles are often affected
D) pathologic reflexes

A

D) pathologic reflexes

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11
Q

Which symptom is not provoked by muscarin?
A) nausea
B) salivation
C) fasciculation
D) bronchial secretion
E) vertigo

A

C) fasciculation

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12
Q

Which is not characteristic for Duchenne muscular dystrophy?
A) X-linked recessive inheritance
B) loss of ambulation at 25–30 years of age
C) selective damage of the muscles
D) markedly high CK levels at early phases
E) absence of dystrophin in skeletal muscles

A

B) loss of ambulation at 25–30 years of age

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13
Q

Frequent symptom in ALS:
A) dementia
B) agnosia
C) problems with urination
D) all of the above
E) none of the above

A

E) none of the above

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14
Q

Which disease is associated more frequently with polymyositis?
A) adrenoleukodystrophy
B) Lyme disease
C) SLE
D) viral hepatitis

A

C) SLE

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15
Q

Which is not true for lower motor neuron disease?
A) individual atrophy of the muscles
B) missing or decreased deep tendon reflexes
C) fasciculation
D) problems with urination

A

D) problems with urination

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16
Q

A 25-year old female complains about gait disturbance for two months. Walking on stairs is most problematic. Laboratory tests reveal increased ESR, CK and gamma-globulin levels. What is the most likely diagnosis?
A) poliomyelitis
B) polymyositis
C) Coxsackie-infection
D) autosomal recessive muscular dystrophy
E) myasthenia gravis

A

B) polymyositis

17
Q

Which autoimmune disease may be associated with polyneuropathy?
1) Systemic Lupus Erythematosus
2) rheumatoid arthritis
3) Wegener’s-granulomatosis
4) Sjögren-syndrome

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

E) all of the answers are correct

18
Q

Specific to the Becker’s muscular dystrophy:
1) X-linked recessive inheritance
2) the onset of symptoms is about between 5-15 years of age
3) high serum CK values
4) the dystrophin protein in the muscle is abnormal

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

E) all of the answers are correct

19
Q

In myasthenia gravis:
1) in the neuromuscular junction, the postsynaptic acetylcholine receptors are impaired
2) autoimmune disease
3) thymectomy can be an effective therapy
4) often a malignant tumor lies in the background

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

A) 1st, 2nd and 3rd answers are correct

20
Q

It contains acetylcholinesterase inhibitor:
1) pyridostigmin/Mestinon®
2) nimesulid/Mesulid®
3) neostigmin/Stigmosan®
4) urapidil/Ebrantil®

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

B) 1st and 3rd answers are correct

21
Q

Common symptoms of ALS and acute Guillain-Barré syndrome:
1) paresthesia
2) pathological reflexes (pyramidal signs or primitive reflexes)
3) hereditary disorder
4) muscle weakness

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

D) only 4th answer is correct

22
Q

The typical liquor of acute Guillain-Barré syndrome is characterised by:
1) increased protein value
2) decreased protein value
3) normal cell count
4) increased cell count

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

B) 1st and 3rd answers are correct

23
Q

Therapy for acute Guillain-Barré syndrome:
1) steroid
2) vitamins (B1 vitamin)
3) azathioprine
4) plasma exchange therapy

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

C) 2nd and 4th answers are correct

24
Q

The neurological status of the Guillain-Barré syndrome may include:
1) paraparesis
2) hypo- or areflexia
3) hypaesthesia
4) diplegia facialis

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

E) all of the answers are correct

25
Q

Which of the following diseases/states may cause myoglobinuria:
1) ischemic muscle destruction
2) status epilepticus
3) excessive muscle work
4) burning illness

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

E) all of the answers are correct

26
Q

Factors in the etiology of lateral amyotrophic sclerosis (ALS):
1) glutamate-excitotoxicity
2) anomalies of the cerebral vascular system
3) free radical-toxicity
4) immunological factors
5) disturbance of the protein homeostasis

A) 1st, 2nd and 3rd answers are correct
B) 1st, 3rd and 4th answers are correct
C) 2nd, 3rd and 4th answers are correct
D) 2nd, 3rd and 5th answers are correct
E) 2nd, and 4th answers are correct
F) 3rd, 4th and 5th answers are correct

A

B) 1st, 3rd and 4th answers are correct

27
Q

The differential diagnosis of amyotrophic lateralsclerosis (ALS) includes the following disease(s):
1) multiple sclerosis
2) multifocal motoric neuropathy
3) compression of the cervical spinal cord
4) cervical spondylosis
5) funicular myelosis

A) 1st, 2nd and 3rd answers are correct
B) 1st, 3rd and 4th answers are correct
C) 2nd, 3rd and 4th answers are correct
D) 2nd, 3rd and 5th answers are correct
E) 2nd, and 4th answers are correct
F) 3rd, 4th and 5th answers are correct

A

C) 2nd, 3rd and 4th answers are correct

28
Q

Plasma exchange can be used with good effect in:
1) inclusion body myositis
2) myasthenia gravis
3) spinal muscle atrophy
4) Guillain–Barré-syndrome
5) amyotrophic lateralsclerosis (ALS)

A) 1st, 2nd and 3rd answers are correct
B) 1st, 3rd and 4th answers are correct
C) 2nd, 3rd and 4th answers are correct
D) 2nd, 3rd and 5th answers are correct
E) 2nd and 4th answers are correct
F) 3rd, 4th and 5th answers are correct

A

E) 2nd and 4th answers are correct

29
Q

It can be helpful in the diagnosis of myasthenia gravis:
1) clinical symptoms
2) somatosensory evoked potential
3) repetitive stimulation
4) chest CT
5) muscle biopsy

A) 1st, 2nd and 3rd answers are correct
B) 1st, 3rd and 4th answers are correct
C) 2nd, 3rd and 4th answers are correct
D) 2nd, 3rd and 5th answers are correct
E) 2nd and 4th answers are correct
F) 3rd, 4th and 5th answers are correct

A

B) 1st, 3rd and 4th answers are correct

30
Q

In the Eaton-Lambert syndrome, plasmapheresis may be effective because the basis of the disease is the formation of antibodies against the acetylcholine receptor.
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

C) the statement is true, but the explanation is false;

31
Q

The Tensilon (edrophonium) test is used to differentiate myasthenic and cholinergic crises because administration of edrophonium improves the symptoms dramatically in myasthenic crisis
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

A) both the statement and the explanation are true and a causal relationship exists between them;

32
Q

In Guillain–Barré-syndrome preceding viral infection can always be proved, because immunological processes play a role in the pathogenesis of the disease.
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

D) the statement is false, but the explanation itself is true

33
Q

In the diagnosis of Guillain-Barré syndrome the primary diagnostic tool is sural nerve biopsy, because the pathological basis of the disease is the segmental demyelination of the peripheral nerves.
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

D) the statement is false, but the explanation itself is true

34
Q

Acute Guillain-Barré syndrome has fatal outcome in 50% of the cases, because respiratory paralysis, diaphragm paralysis may occur as a complication.
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

D) the statement is false, but the explanation itself is true

35
Q

The first diagnostic step is:
A 28-year-old man presented with progressing lower extremity weakness and ascending numbness that started about a week ago. He reported that he had a strong diarrhea three weeks ago.
A) cranial CT
B) repetitive nerve stimulation
C) thoracolumbar spine MRI
D) detailed neurological physical examination

A

D) detailed neurological physical examination

36
Q

Which disease is the most likely?A 28-year-old man presented with progressing lower extremity weakness and ascending numbness that started about a week ago. He reported that he had a strong diarrhea three weeks ago.
A) Guillain–Barré syndrome
B) diabetic polyneuropathy
C) amyotrophic lateral sclerosis
D) myasthenia gravis

A

A) Guillain–Barré syndrome

37
Q

The most likely cerebrospinal fluid finding is:A 28-year-old man presented with progressing lower extremity weakness and ascending numbness that started about a week ago. He reported that he had a strong diarrhea three weeks ago.
A) decreased protein level
B) normal protein protein concentration
C) cell-protein dissociation
D) elevated cell count

A

C) cell-protein dissociation

38
Q

Possible complications:
A 28-year-old man presented with progressing lower extremity weakness and ascending numbness that started about a week ago. He reported that he had a strong diarrhea three weeks ago.
1) paralysis of respiratory muscles
2) cranial nerve lesion
3) deep vein thrombosis
4) vegetative disturbances

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

E) all of the answers are correct

39
Q

In sural nerve biopsy we would find the following:
A 28-year-old man presented with progressing lower extremity weakness and ascending numbness that started about a week ago. He reported that he had a strong diarrhea three weeks ago.
1) neutrophil granulocyte infiltration
2) segmental demyelination
3) intact nerve
4) axonopathy may occur

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

C) 2nd and 4th answers are correct

Neuro states (6 decks)

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