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Flashcards in chapter 43-44-45-46 Deck (39):
1

What is the change in stroke death rate for the US and western Europe?
A. Rates are continuously decreasing
B. Rates decreased until the mid 1990^, and are now increasing
C. Rates are continuously increasing
D. There has been no consistent change

a

2

Which is the most common malignant primary brain neoplasm?
A. Anaplastic astrocytoma
B. Glioblastoma (GBM)
C. Malignant meningioma
D. Primitive neuroectodermal tumor (PNET)

b

3

What effect does epilepsy have on mortality rates?
A. No change in mortality
B. Higher mortality mainly due to motor vehicle accidents
C. Higher mortality due to multiple causes
D. Lower mortality since they have ongoing medical care

c

4

Which is the most common cause of epilepsy in the world?
A. Trauma
B. Genetic inheritance
C. Benign tumor
D. Neurocysticercosis

d

5

A patient recently diagnosed with multiple sclerosis has a monozygotic twin plus three other
siblings. How do you advise her about the risk of her other family members developing MS?
A. The risk for the twin is 50%, but the risk to the others is about the same as the general
population
B. The risk for the twin is about 30%, and the risk for the other siblings is 3-4%
C. The risk for the twin is 2-3% and the risk for the other siblings is about the same as in the
general population

b

6

Migration studies have shown that there is an effect of location for the incidence of multiple
sclerosis. Which of the following statements about migration are generally accepted?
A. Migration before the age of 15 years results in adoption of the risk of the new environment
B. Migration after the age of 1 5 years results in maintenance of the risk of the initial
environment
C. Risk is greater in UK, US, Canada, Australia, and South Africa than in other areas
D. All are true

d

7

Which of the following are early complications of HIV infection?
A. Cryptococcal meningitis
B. Toxoplasmosis
C. Acute demyelinating neuropathy
D. Progressive multifocal leukoencephaiopathy
E. All of these

c

8

Which of the following statements are true regarding epidemiology of epilepsy?
1. Seizures are more likely at the extremes of age, in infancy and with advanced age
2. Myoclonic seizures are most common in infancy
3. Absence seizures do not begin alter young adult life
4. Simple partial seizures peak in middle age

e

9

The risk of stroke and stroke death rates have fallen in the US. Which of the following
statements are true regarding epidemiology of stroke?
1. Mortality from stroke has declined about 70% in the past 40 years
2. Age-adjusted stroke death rate is higher for blacks than other ethnic groups in the US
3. Stroke death rate for American Indians increased rather than decreased
4. Incidence of cerebral hemorrhage is greatest in Hispanics and blacks

e

10

A woman is diagnosed as having an autosomal dominant condition. Which advice is appropriate
regarding counseling?
A. Half of the children will have the condition
B. Each child has a 50% chance of having the gene
C. Transmission of the gene is from females to males
D. All are true

b

11

A boy is diagnosed as having a mitochondrial disorder. There are three younger siblings. Neither
parent appears to be affected. What is the most appropriate counseling for the patient and
family?
A. Each of the siblings has a 50% chance of carrying the gene
B. Transmission is only from females to males
C. Children of die patient will not carry the gene
D. The lack of symptoms in the parents indicates that this is a new mutation in the child, and
siblings are not at risk

c

12

A male child is diagnosed as having an X-Iinked disorder. What would be appropriate counseling
for the patient and family?
A. All daughters of the patient will cany the gene
B. None of the sons of the patient will have the gene
C. Females can be affected
D. All are true

d

13

What neurologic disorder is associated with detect of the Y-chromosome?
A. Progressive ataxia
B. Peripheral neuropathy
C. Developmental delay progressing to mental retardation
D. Muscular dystrophy
E. None of these

e

14

Which of the following statements are true regarding trinucleotide repeats in patients with
neurologic disease?
A. There can be earlier onset with increases in the repeat number
B. Huntington's disease ;s due to unstable triplet repeats
C. Some hereditary spinal cerebellar afaxias aie due to unstable triplet repeats
D. Polymerase chain reaction is used to determine the repeat size
E. All of these are true

e

15

Which of the following are autosomal recessive disorders?
1. Tay-Sachs disease
2. Friedreich's ataxia
3. Phenylketonuria
4. Wilson's disease

e

16

A 40-year-oid woman has a parent with Huntington's disease and has no clinical symptoms. She
wants testing for herself. She is status post hysterectomy for ovarian cancer, presumably cured
years before. She has no children. Which of the following pieces of information are accurate
and appropriate for counseling?
1. Early diagnosis carries no opportunity for early intervention in
the disease
2. Testing cannot determine the age of onset of anticipated seventy of the disease
3. There is estimated 90% penetrance by age 60 years
4. Patients homozygous for the gene have a much worse clinical presentation than
heterozygous patients

a

17

A patient is diagnosed with a disorder which is typically thought of as inherited in an autosomal
dominant fashion. Parents are no longer living, but apparently lived to advanced age without
similar clinical symptoms. Which are possible explanations for this?
1. The parents did not live long enough to express the defective gene and become
symptomatic.
2. Alternative parentage should be considered.
3. The patient may have a new mutation.
4. The patient has a recessive condition rather than a dominant condition

e

18

A rare inheritance pattern is uniparental disomy. What are the implications of this?
A. A single parent donates two adjacent chromosomes which make up a novel
chromosome pair
B. Patients have a single chromosome which would be recessive but is dominant because die
single chromosome is unopposed
C. Two of the same chromosomes are inherited from a single parent
D. Genetic material for the chromosome is inherited through the mitochondria, rather than
nuclei

c

19

Which is the mode of inheritance of familial Alzheimer's disease?
A. Autosomal dominant
B. Autosomal recessive
C. X-linked dominant
D. Mitochondrial

a

20

Multiple sclerosis is clearly due to inappropriate immune attack. Which of the following
statements are true regarding immune response in MS?
A. There is not identified autoantigen
B. MS is immune mediated but not necessarily autoimmune
C. T-helper cells are thought to mediate the disease
D. There is believed to be activation of myelin-specific T cells
E. All are true

e

21

Which of the following have been shown to be beneficial for patients with MS?
1. Giatiramer acetate
2. Interferon
3. Interferon p-lb
4. Interferon y

a

22

Which type of immune response characterizes myasthenia gravis?
A. B-cell mediated
B. T-cell mediated
C. Both
D. Neither

c

23

Which of the following statements are true regarding the immunology and pathology of AIDP
and CIDP?
A. AIDP and CIDP are both immune mediated
B. There is endoneurial lymphocytic infiltrate
C. Axonal damage can occur
D. Specific autoantibodies have been found for AIDP but not CIDP
E. All are true

e

24

High-dose corticosteroids are used for which of the following?
A. AIDP
B. CIDP
C. Both
D. Neither

b

25

I Vlg is used for treatment of which of the following?
A. AIDP
B. CIDP
C. Both
D. Neither

c

26

Which of the following statements are true regarding thymectomy for parents with myasthenia
gravis?
1. Thymectomy is best performed prior to puberty
2. Thymectomy is most indicated for elderly patients
3. Thymectomy has short-term benefits which have to be followed by long-term immunosupressants
4. Thymectomy has a remission mte of at least 80%

d

27

A patient with proximal weakness had a muscle biopsy which shows peri fascicular atrophy with
degenerating tibcrs at the periphery of the fascicles, and capillary damage with microinfarcts.
Immunofluorescence shows immune complex deposition within the endothelium. Which is the
most likely diagnosis?
A. Polymyositis
B. Dermaiomyositis
C. Inclusion body myositis
D. None of these

b

28

A patient with symptoms of encephalitis is found to have anti-Hu antibodies. Which is the most
likely underlying cause?
A. Breast cancer
B. Ovarian cancer
C. Small cell lung cancer
D. Non-small cell lung cancer

c

29

A patient presents with cerebellar ataxia and is found to have anti-Yo antibodies. Which is the
most likely diagnosis?
A. Breast cancer
B. Melanoma
C. Small ceil lung cancer
D. Non-small cell iung cancer

a

30

A 46-year-old man presents with fever, headache, confusion, and mild left-sided weakness.
Which is the most likely diagnosis?
A. Bacterial meningitis
B. Bacterial brain abscess
C. Viral meningitis
D. Viral encephalitis

d

31

Which of the following clinical findings help to differentiate meningitis from encephalitis?
A. Nausea and vomiting
B. Headache
C. Focal neurologic findings
D. Lymphocytic pleocytosis of the CSF

c

32

All of the following statements are true regarding poliomyelitis EXCEPT which?
A. Poliomyelitis due to wild type poliovirus does not occur in the US
B. Patients with immunodeficiency can develop polio after vaccination
C. Vaccine-related polio does not occur in immunocompetent individuals
D. During polio epidemics, 90% of infected patients were asymptomatic

c

33

A patient with known AIDS presents with fever, malaise, weakness, which is multifocal and is
associated with pain in multiple regions. There are regions of sensory loss which are patchy.
Which is the most likely diagnosis?
A. Polyradiculitis
B. Toxoplasmosis
C. Cryptococcal meningitis
D. Toxic neuropathy due to medications for HIV infection

a

34

Which of the following is the most common cause of viral meningitis?
A. Arbovirus
B. Enterovirus
C.Herpesvirus
D. CMV

b

35

Which of the following is appropriate treatment for HSV meningitis?
A. Acyclovir
B. Famciclovir
C. Valacyclovir
D. Any of these

d

36

West Nile virus (WNV) produces which of the following9
A. Encephalitis
B. Meningitis
C. Both
D. Neither

c

37

A patient presents with recurrent episodes of aseptic meningitis, separated by months and
years. Which is the most likely pathogen?
A. HSV-1
B. HSV-2
C. CMV
D. HIV

b

38

Which of the following cause myelitis?
1. ECHO
2. HIV
3. West Nile
4. Polio

e

39

Antiviral treatment is available for which of the following causes of encephalitis and meningitis?
1. HIV
2. CMV
3. HSV
4. WNV

a