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Adams 10th > Chapter 46 - Peripheral nerves > Flashcards

Chapter 46 - Peripheral nerves Flashcards

1
Q 
The PNS includes the following structures EXCEPT
A. CN I
B. CN II
C. Dorsal root
D. Ventral root
E. A and B
F C and D
A

E. A and B (p. 1310)

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2
Q 
Toxic acts directly on the membranes of Schwann cells near the DRG and adjacent parts of motor and sensory nerves (the most vascular parts of the peripheral nerve)
A. Diphtheria
B. PAN
C. Tabes dorsalis
D. Doxorubicin toxicity
E. Arsenic
F. Vincristine toxicity
A

A. Diphtheria (p. 1312)

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3
Q 
Occlusion of vasa nervorum results in multifocal nerve infarctions
A. Diphtheria
B. PAN
C. Tabes dorsalis
D. Doxorubicin toxicity
E. Arsenic
F. Vincristine toxicity
A

B. PAN (p. 1312)

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4
Q 
Meningoradiculitis of the posterior roots, mainly lumbosacral segments
A. Diphtheria
B. PAN
C. Tabes dorsalis
D. Doxorubicin toxicity
E. Arsenic
F. Vincristine toxicity
A

C. Tabes dorsalis (p. 1312)

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5
Q 
Protein synthesis of DRG is blocked with subsequent neuronal destruction
A. Diphtheria
B. PAN
C. Tabes dorsalis
D. Doxorubicin toxicity
E. Arsenic
F. Vincristine toxicity
A

D. Doxorubicin toxicity (p. 1312)

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6
Q 
Combines with the axoplasm of the largest sensory and motor nerves via sulfhydryl bonds
A. Diphtheria
B. PAN
C. Tabes dorsalis
D. Doxorubicin toxicity
E. Arsenic
F. Vincristine toxicity
A

E. Arsenic (p. 1312)

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7
Q 
Damages the microtubular transport system
A. Diphtheria
B. PAN
C. Tabes dorsalis
D. Doxorubicin toxicity
E. Arsenic
F. Vincristine toxicity
A

F. Vincristine toxicity (p. 1312)

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8
Q 
Focal degeneration of the myelin sheath with sparing of the axon
A. Segmental demyelination
B. Wallerian degeneration
C. Axonal degeneration
D. All of the above
A

A. Segmental demyelination (p. 1312)

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9
Q 
Dying forward
A. Segmental demyelination
B. Wallerian degeneration
C. Axonal degeneration
D. All of the above
A

B. Wallerian degeneration (p. 1313)

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10
Q 
Dying back
A. Segmental demyelination
B. Wallerian degeneration
C. Axonal degeneration
D. All of the above
A

C. Axonal degeneration (p. 1313)

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11
Q 
Weakness of dorsiflexion, eversion, and inversion of the foot*
A. Plexopathy
B. Radiculopathy
C. Mononeuropathy
D. Neuronopathy
E. Mononeuropathy multiplex
A

B. Radiculopathy (p. 1319)

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12
Q 
Weakness of ankle dorsiflexion, foot eversion, and foot inversion is likely due to*
A. L5 radiculopathy
B. S1 radiculopathy
C. Lumbosacral plexopathy
D. Sciatic nerve pathology
E. Peroneal nerve injury
A

A. L5 radiculopathy (p. 1319)

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13
Q 
Inversion is spared in a foot drop
A. L5 radiculopathy
B. S1 radiculopathy
C. Lumbosacral plexopathy
D. Sciatic nerve pathology
E. Peroneal nerve injury
A

E. Peroneal nerve injury (p. 1319)

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14
Q 
Most common cause of acute or subacute generalized paralysis in practice
A. GBS
B. Polio
C. Syringomyelia
D. TB of the spine
A

A. GBS (p. 1322)

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15
Q 
Most frequent identifiable antecedent infection in GBS
A. Mycoplasma
B. HIV
C. Campylobacter jejuni
D. HSV
E. TB
A

C. Campylobacter jejuni (p. 1322)

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16
Q 
Essential lesion in GBS
A. Increase in CSF protein
B. Edema of the nerve roots
C. Perivascular mononuclear inflammatory infiltration of the roots and nerves
D. Absence of inflammatory infiltrates
A

C. Perivascular mononuclear inflammatory infiltration of the roots and nerves (p. 1322)

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17
Q

Earliest immunologic event in GBS
A. Complement deposition on the myelin surface
B. Production of antibodies against myelin
C. Antigen-antibody reaction
D. None of the above

A

A. Complement deposition on the myelin surface (p. 1322)

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18
Q 
Earliest symptoms of GBS
A. Paresthesias in the toes and fingers
B. Symmetric weakness
C. Cranial nerve involvement
D. Pain in the muscles
A

A. Paresthesias in the toes and fingers (p. 1333)

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19
Q 
Variant of GBS associated with anti-GM1*
A. Pure sensory
B. Pure motor
C. Pandysautonomia
D. Axonal (AMAN)
A

D. Axonal (AMAN) (p. 1323)

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20
Q 
Variant of GBS associated with anti-GQ1b*
A. Ophthalmoplegia
B. Oculopharyngeal weakness
C. Cervico-brachial-pharyngeal weakness
D. Bilateral facial or abducens weakness
A

A. Ophthalmoplegia (p. 1324)

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21
Q 
Variant of GBS associated with anti-GT1a
A. Ophthalmoplegia
B. Oculopharyngeal weakness
C. Cervico-brachial-pharyngeal weakness
D. Bilateral facial or abducens weakness
A

C. Cervico-brachial-pharyngeal weakness (p. 1325)

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22
Q 
Poor prognosis in GBS*
A. Sudden severe weakness
B. Old age
C. Loss of sensation immediately after weakness
D. All of the above
A

B. Old age (p. 1330)

23
Q 
Acute replapsing predominantly motor polyneuropathy with an early bibrachial distribution of weakness and with truncal sensory loss, accompanied by abdominal pain, psychotic symptoms, and tachycardia
A. Porphyric polyneuropathy
B. Organophosphate polyneuropathy
C. TOCP polyneuropathy
D. Thallium polyneuropathy
E. Arsenic polyneuropathy
A

A. Porphyric polyneuropathy (p. 1332)

24
Q 
Early onset of painful paresthesias, sensory loss, and pain localized to joints, back, and chest, as well as rapid loss of hair
A. Porphyric polyneuropathy
B. Organophosphate polyneuropathy
C. TOCP polyneuropathy
D. Thallium polyneuropathy
E. Arsenic polyneuropathy
A

D. Thallium polyneuropathy (p. 1333)

25
Q 
Its most characteristic presentation is a motor mononeuropathy in the distribution of the radial nerves (wrist and finger drop) accompanied by anemia, basophilic stippling of RBC precursors in the bone marry, colicky abdominal pain, and constipation
A. Organophosphate neuropathy
B. Thallium polyneuropathy
C. Arsenical polyneuropathy
D. Lead neuropathy
A

D. Lead neuropathy (p. 1335)

26
Q 
Most common cause of polyneuropathy in general clinical practice
A. Infection
B. Paraneoplastic
C. Drug-induced
D. Diabetes mellitus
A

D. Diabetes mellitus (p. 1337)

27
Q 
Most important factor in the development of DM neuropathy
A. Being a Type 1 diabetic
B. Being a Type 2 diabetic
C. Level of HBA1c
D. Duration of diabetes
A

D. Duration of diabetes (p. 1338)

28
Q

Most common clinical syndrome of diabetic neuropathy
A. Distal, symmetrical, primarily sensory polyneuropathy affecting the lower extremities
B. Acute ophthalmoplegia
C. Acute mononeuropathy
D. Diabetic amyotrophy
E. Autonomic neuropathy

A

A. Distal, symmetrical, primarily sensory polyneuropathy affecting the lower extremities (p. 1338)

29
Q

Which best describes diabetic ophthalmoplegia?
A. Isolated, painless, complete third nerve palsy
B. Isolated, painless, third nerve palsy with sparing of pupillary function
C. Isolated painful, third nerve palsy with sparing of pupillary function
D. Isolated painful palsy of CNs III and IV

A

C. Isolated painful, third nerve palsy with sparing of pupillary function (p. 1338)

30
Q 
A patient with asthma develops multiple strokes and has elevated ESR and eosinophilia. What is the most likely cause?*
A. PAN
B. Churg-Strauss
C. Wegener
D. SLE
E. Temporal arteritis
A

B. Churg-Strauss (p. 1341)

31
Q

Most common cause of mononeuropathy multiplex
A. Vasculitic
B. Diabetes
C. Hereditary liability to pressure palsies
D. Paraneuroplastic
E. HIV

A

A. Vasculitic (p. 1341)

32
Q 
A patient with mononeuropathy multiplex also presents with abdominal pain, hematuria, fever, eosinophilia, hypertension, vague limb pains, asthma and is positive for p-ANCA. What is the most likely diagnosis?
A. PAN
B. Churg-Strauss
C. Wegener
D. Essential mixed cryoglobulinemia
A

A. PAN (pp. 1341-1342)

33
Q 
A patient with mononeuropathy multiplex has a history of taking zafirlukast and is positive for c-ANCA. What is the most likely diagnosis?
A. PAN
B. Churg-Strauss
C. Wegener
D. Essential mixed cryoglobulinemia
A

B. Churg-Strauss (p. 1342)

34
Q 
A patient with mononeuropathy multiplex secondary to vasculitis affecting vessels of smaller caliber. tested positive for c-ANCA. What is the most likely diagnosis?
A. PAN
B. Churg-Strauss
C. Wegener
D. Essential mixed cryoglobulinemia
A

C. Wegener (p. 1342)

35
Q 
A patient with mononeuropathy multiplex has a history of hepatitis C. What disease would you most likely consider?
A. PAN
B. Churg-Strauss
C. Wegener
D. Essential mixed cryoglobulinemia
A

D. Essential mixed cryoglobulinemia (p. 1343)

36
Q 
Triad of cranial nerve palsies, radiculitis, and aseptic meningitis is most characteristic of
A. Sarcoid neuropathy
B. Lyme neuropathy
C. Sjorgen disease-associated neuropathy
D. Migratory sensory neuritis
A

B. Lyme disease (p. 1345)

37
Q 
Most common cause of acute and subacute meningeal radiculopathies
A. Neoplastic
B. Infectious
C. Sarcoidosis
D. Arachnoiditis
A

A. Neoplastic (p. 1349)

38
Q 
Most frequent paraprotein in adults
A. IgG
B. IgM
C. IgG
D. IgA
A

A. IgG (p. 1350)

39
Q 
Polyneuropathy is associated most often with this paraprotein
A. IgG
B. IgM
C. IgG
D. IgA
A

B. IgM (p. 1350)

40
Q

The following are seen in both GBS and CIDP EXCEPT*
A.Both are widespread polyradiculoneuropathies
B. Both show CSF cytoalbuminologic dissociation
C. Both exhibit NCV abnormalities characteristic of a demyelinating neuropathy
D. Both show similar multifocal perivenous inflammatory infiltrates
E. Both are equally responsive to corticosteroids

A

E. Both are equally responsive to corticosteroids (p. 1354)

41
Q 
Which of the following medications is least likely to cause a neuropathy?*
A. Amiodarone
B. Isoniazid
C. Phenytoin
D. Vincristine
E. Pyridoxine
F. Allopurinol
A

F. Allopurinol (p. 1320, Table 46-2)

42
Q 
Weakness of elbow extension, wrist extension, and thumb abduction*
A. C6 radiculopathy
B. C7 radiculopathy
C. Cervical plexopathy
D. Radial nerve pathology
E. Posterior interosseous injury
A

B. C7 radiculopathy (p. 1318, Table 46-1)

43
Q 
Predominantly sensory ganglionopathy*
A. INH
B. Pyridoxine
C. Allopurinol
D. None of the above
A

B. Pyridoxine (p. 1337)

44
Q 
Not true of MMN*
A. Normal CMAP
B. Symmetrical muscle weakness
C. Unresponsive to IVIg
D. Clonus and Babinski signs are characteristic
E. All of the above
A

E. All of the above (pp. 1356-1357)

45
Q 
The nerve most vulnerable to impaired motor function in lepromatous polyneuritis
A. Ulnar
B. Median
C. Peroneal
D. Posterior auricular
E. Facial
A

A. Ulnar (p. 1358)

46
Q 
Most common type of inherited peripheral neuropathy
A. CMT1A
B. CMT1X
C. HNPP
D. CMT1B
E. CMT2A
A

A. CMT1A (p. 1362)

47
Q 
Part of the brachial plexus that ilies in close relation to the subclavian artery and apex of the lung and is most susceptible to traction injuries and to compression by tumors that invade the costoclavicular space
A. Upper trunk
B. Middle trunk
C. Lower trunk
D. Lateral cord
E. Posterior cord
F. Medial cord
A

F. Medial cord (p. 1374)

48
Q 
The entire arm is paralyzed; the sensory loss is complete below a line extending from the shoulder diagnoally downward and medially to the middle third of the upper arm; the usual cause is vehicular trauma
A. Lesions of the entire brachial plexus
B. Upper brachial plexus paralysis
C. Lower brachial plexus paralysis
D. Middle brachial plexus paralysis
A

A. Lesions of the entire brachial plexus (p. 1374)

49
Q 
The most common causes are birth injuries, pressure on the supraclavicular region during anesthesia, and immune reactions to injections of foreign serum or vaccines; the arm hangs at the side, internally rotated and extended at the elbo; movements of the hand and forearm are unaffected
A. Lesions of the entire brachial plexus
B. Upper brachial plexus paralysis
C. Lower brachial plexus paralysis
D. Middle brachial plexus paralysis
A

B. Upper brachial plexus paralysis (p. 1374)

50
Q 
Commonly the result of traction on the abducted arm in a fall or during an operation on the axilla, Pancoast syndrome, compression by cervical ribs, and injuries during breech deliveries; characteristic clawhand deformity
A. Lesions of the entire brachial plexus
B. Upper brachial plexus paralysis
C. Lower brachial plexus paralysis
D. Middle brachial plexus paralysis
A

C. Lower brachial plexus paralysis (pp. 1374-1375)

51
Q 
Manifests mainly as weakness of flexion and pronation of the forearm; the intrinsic muscles of the hand innervated by the medial root of the median nerve are spared
A. Lower brachial plexus paralysis
B. Lateral cord lesion
C. Medial cord lesion
D. Posterior cord lesion
A

A. Lateral cord lesion (p. 1375)

52
Q 
Causes weakness of muscles supplied by the medial root of the median nerve and ulnar nerve
A. Lower brachial plexus paralysis
B. Lateral cord lesion
C. Medial cord lesion
D. Posterior cord lesion
A

C. Medial cord lesion (p. 1375)

53
Q 
Results in weakness of the deltoid, extensors of the elbow, wrist, and fingers, and sensory loss on the outer surface of the upper arm
A. Lower brachial plexus paralysis
B. Lateral cord lesion
C. Medial cord lesion
D. Posterior cord lesion
A

D. Posterior cord lesion (p. 1375)

54
Q 
The most common highly restricted form of brachial neuritis involves which nerve?
A. Long thoracic nerve
B. Suprascapular
C. Axillary
D. Posterior interosseous
E. Phrenic
A

A. Long thoracic nerve (p. 1376)

Adams 10th (27 decks)

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