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Parkinson's Disease Flashcards

1
Q

Which of the following are parkinsonian features?

A. memory impairment, executive dysfunction, tremor
B. delirium, seizure, rigidity
C. tremor, rigidity, bradykinesia
D. Hallucinations, dysphagia, rest tremor

A

C. tremor, rigidity, bradykinesia

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2
Q

What is the second most common age-related neurodegenerative disease?

A. AD
B. PD
C. MS
D. ALS
E. Any of the options
A

B. PD

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3
Q

Which has higher lifetime risk for PD?

A. Men
B. Women
C. Equal
D. None of the options

A

A. Men (2%) > Women (1.3%)

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4
Q

Which of the following characterizes the hallmarks of PD?

A. reduced striatal dopamine
B. extra neuronal inclusions
C. degenerations of cholinergic neurons in SNc
D. Tau proteins
E. Any of the options
A

A. reduced striatal dopamine

Hallmark features of PD:

  1. Degeneration of dopaminergic neurons in the SNc
  2. Reduced striatal dopamine
  3. Intraneuronal inclusions known as Lewy bodies and Lewy neurites
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5
Q

Which of the following is correctly paired?

A. Acetylcholine - Locus coeruleus
B. Serotonin - Raphe nuclei
C. Norepinephrine - Nucleus of Meynert
D. Serotonin - Caudate nucleus
E. Acetylcholine - Subthalamic nucleus
A

B. Serotonin - Raphe nuclei

Acetylcholine - Nucleus of Meynert
Norepinephrine - Locus coeruleus
Serotonin - raphe nuclei

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6
Q

Rest tremor, rigidity, bradykinesia and gait dysfunction develop at what stage of PD?

A. Early
B. Middle
C. Late
D. End
E. Any of the options
A

B. Middle

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7
Q

All are motor features of PD EXCEPT:

A. Hypomimia
B. Hypophonia
C. RBD
D. Dysphagia
E. Micrographia
A

C. RBD (Rapid eye movement (REM) sleep behavior disorder)

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8
Q

All are nonmotor features of PD EXCEPT:

A. Mood disorders
B. Drooling
C. Dementia
D. Anosmia
E. Orthostatic hypotension
A

B. Drooling

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9
Q

It is a generic term used to define a syndrome manifest by bradykinesia with rigidity and/or tremor

A. Delirium
B. Syncope
C. Parkinsonism
D. Kinesia
E. None of the options
A

C. Parkinsonism

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10
Q

All of the following parts of the basal ganglia are affected by PD EXCEPT:

A. Caudate nucleus
B. Subthalamic nucleus
C. Globus pallidus pars externa 
D. Globus pallidus pars interna
E. None of the options
A

None of the options

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11
Q

Of all forms of parkinsonism, PD is comprised of what percentage?

A. 30%
B. 40%
C. 50%
D. 75%
E. 80%
A

D. 75%

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12
Q

Imaging of the brain dopamine system in PD patients can be performed using which of the following?

A. MRI
B. PET
C. SPECT
D. CT Scan
E. Any of the options
A

E. Any of the options

PET / SPECT

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13
Q

Which of the following is considered as secondary parkinsonism?

A. DLB
B. HD
C. FTD
D. NPH
E. AD
A

D. NPH

Table 427-2. Secondary Parkinsonism

Drug-induced
Tumor
Infection
Vascular
NPH
Trauma
Liver failure
Toxins
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14
Q

Which of the following was the first PD-linked and most intensely investigated PD gene?

A. SNCA
B. LRRK2
C. PINK1/Parkin
D. GBA
E. Any of the options
A

A. SNCA

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15
Q

Which of the following genes was considered the most important risk factor for PD development?

A. SNCA
B. LRRK2
C. PINK1/Parkin
D. GBA
E. Any of the options
A

D. GBA

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16
Q

Which of the following genes account for most familial PD cases?

A. SNCA
B. LRRK2
C. PINK1/Parkin
D. GBA
E. Any of the options
A

B. LRRK2

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17
Q

Which of the following genes is the major cause of autosomal recessive and early-onset PD?

A. SNCA
B. LRRK2
C. PINK1 
D. Parkin
E. GBA
A

D. Parkin

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18
Q

Which of the following is the major input and output of the basal ganglia in PD?

A. Striatum - GPi & SNr
B. Caudate - GPe & SNc
C. Globus pallidus - GPi & SNc
D. Subthalamic nucleus - GPi & SNr

A

A. Striatum - GPi & SNr

The striatum is the major input region of the basal ganglia, while GPi and SNr are the major output regions.

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19
Q

Which of the following drugs is the mainstay therapy for PD?

A. Amantadine
B. Bromocriptine
C. Carbidopa
D. Levodopa

A

D. Levodopa

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20
Q

Which of the following is true about Dopamine?

A. Brain neurotransmitter
B. Does not cross BBB
C. Precursor of levodopa
D. All of the options

A

D. All of the options

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21
Q

Which of the following drugs remains the most effective symptomatic treatment for PD?

A. Amantadine
B. Bromocriptine
C. Carbidopa
D. Levodopa
E. Benserazide
A

D. Levodopa

22
Q

All of the following are second generation of nonergot dopamine agonists EXCEPT:

A. Pramipexole
B. Ropinirole
C. Rotigotine
D. Bromocriptine

A

D. Bromocriptine

2ND GEN of nonergot dopamine agonists:

Pramipexole
Ropinirole
Rotigotine

23
Q

All of the following are irreversible MAO-B inhibitors EXCEPT:

A. Selegiline
B. Rasagiline
C. Benztropine
D. Safinamide
E. None of the options
A

D. Safinamide

Irreversible MAO-B Inhibitors
Selegiline
Rasagiline

24
Q

MAO-B inhibitors can prevent which of the following?

A. Atypical parkinsonism
B. Wilson’s disease
C. Dementia with Lewy bodies
D. MPTP - induced Parkinsonism

A

D. MPTP - induced Parkinsonism

25
Q

Which of the following is the most effective COMT inhibitor?

A. Tolcapone
B. Entacapone
C. Opicapone
D. Clocapone
E. Any of the options
A

A. Tolcapone

26
Q

What is the most severe adverse effect of Tolcapone?

A. Vomiting
B. Urine discoloration
C. Kidney failure
D. Hepatotoxicity
E. Respiratory depression
A

D. Hepatotoxicity

27
Q

Which of the following are anticholinergic drugs used to treat severe tremors of elderly patients?

A. Amantadine
B. Benztropine
C. Carbidopa
D. Levodopa
E. Ethosuximide
A

B. Benztropine

Anticholinergic drugs - Benztropine and Trihexyphenidyl

Amantadine - antiviral agent / NMDA receptor antagonist

28
Q

Which of the following is the only oral agent used to reduced dyskinesia without worsening parkinsonian features?

A. Amantadine
B. Benztropine
C. Carbidopa
D. Levodopa
E. Ethosuximide
A

A. Amantadine

29
Q

Anti-PD drugs are usually discontinued in what sequence?

A. Anticholinergics -> Amantadine -> Dopamine agonists -> COMT inhibitors -> MAO-B inhibitors
B. Amantadine -> Anticholinergics -> Dopamine agonists -> MAO-B inhibitors -> COMT inhibitors
C. B. Amantadine -> Dopamine agonists -> Anticholinergics -> MAO-B inhibitors -> COMT inhibitors
D. None of the options

A

A. Anticholinergics -> Amantadine -> Dopamine agonists -> COMT inhibitors -> MAO-B inhibitors

30
Q

Which of the following drugs should a physician consider first in managing the Parkinson’s Disease?

A. Rasagiline
B. Levodopa
C. Tolcapone
D. Amantadine
E. Any of the options
A

A. Rasagiline

  1. Neuroprotective therapy (Rasagiline, Coenzyme Q10, Ropinorole, Pramipexole)
31
Q

Which of the following is/are neuropathological feature of LBD?

A. Lewy bodies
B. Lewy neurites
C. NFTs
D. Neuritic plaques
E. Any of the options
A

E. Any of the options

Lewy bodies & Lewy neurites

32
Q

Lewy body and lewy neurite pathology often begins in …

A. Enteric and ANS
B. Brainstem
C. Substantia nigra
D. Cerebral cortex

A

A. Enteric and ANS

Enteric and ANS -> Brainstem -> substantia nigra -> limbic system -> cerebral cortex

33
Q

Which of the following characterizes DLB?

A. Olfactory hallucinations
B. Parkinsonism
C. Excessive daytime sleepiness
D. Two of the options
E. All of the options
A

D. Two of the options

Visual hallucinations
Parkinsonism
Fluctuating alertness
Neuroleptic sensitivity
REM RBD
Hyposmia
Excessive daytime sleepiness
34
Q

Which of the following stains are used to identify Lewy bodies?

A. Silver nitrate 
B. PAS
C. Trichome 
D. H & E
E. Lacquer
A

B. PAS (Periodic Acid-Schiff)

35
Q

This is called when the dementia and a neuropsychiatric syndrome precede or co-emerge with parkinsonism

A. PDD
B. DLB
C. AD
D. PD
E. MSA
A

B. DLB

36
Q

Which of the following is involved in parkinsonism?

A. Olivocerebellar circuit
B. Striatonigral circuit
C. Olivopontocerebellar circuit
D. Autonomic nervous system

A

B. Striatonigral circuit

Olivopontocerebellar circuit - ataxia
ANS - Autonomic dysfunction; orthostatic hypotension

37
Q

Which of the following is the major protein component in PD?

A. a-synuclein
B. Lewy bodies
C. Lewy neurites
D. All of the options

A

A. a-synuclein

38
Q

Which of the following shows pathology of glial cell inclusions in white matter?

A. MSA
B. PSP
C. CBS
D. PDD
E. DLB
A

A. MSA

PSP - tau-containing inclusions in neurons and glia
CBS - tau-containing inclusions in cerebral cortex

39
Q

Which of the following has Lewy bodies in neurons of cortex and brainstem?

A. MSA
B. PSP
C. CBS
D. PDD
E. DLB
A

E. DLB

40
Q

Which of the following characterizes HD?

A. Autosomal dominant disease
B. Degeneration of striatal neurons
C. Progressive movement disorder
D. Dementia
E. Two of the options
F. All of the options
A

F. All of the options

41
Q

Which of the following gene is responsible for HD?

A. HDD
B. HTD
C. HTT
D. HTN
E. HNN
A

C. HTT - encodes for huntingtin

Pathologic hallmark of HD - Intranuclear inclusions containing huntingtin

42
Q

What is the most common cause of death in HD?

A. Arrhythmia
B. Brain injury
C. Pneumonia
D. Respiratory failure
E. Cardiac arrest
A

C. Pneumonia

43
Q

Which of the following can be given to reverse the symptoms of Wernicke encephalopathy?

A. Thiamine
B. Riboflavin
C. Ascorbic Acid
D. Iron sulfate
E. Cobalamin
A

A. Thiamine (B1)

44
Q

Subacute combined degeneration of the spinal cord is caused by deficiency of which of the following?

A. Thiamine
B. Riboflavin
C. Ascorbic Acid
D. Iron sulfate
E. Cobalamin
A

E. Cobalamin (B12)

45
Q

Which of the following characterizes a rapidly progressive dementia?

A. Prion diseases
B. AD
C. FTLD
D. PD
E. PSP
F. CBS
G. MSA
H. HD
A

A. Prion diseases

46
Q

Which of the following most characterizes dementia?

A. Prion diseases
B. AD
C. FTLD
D. PD
E. PSP
F. CBS
G. MSA
H. HD
A

B. AD

47
Q

Which of the following characterizes hypokinetic movement disorder with or without dementia?

A. Prion diseases
B. AD
C. FTLD
D. PD
E. PSP
F. CBS
G. MSA
H. HD
A

D. PD

48
Q

Which of the following characterizes behavioral changes and language disturbance?

A. Prion diseases
B. AD
C. FTLD
D. PD
E. PSP
F. CBS
G. MSA
H. HD
A

C. FTLD

49
Q

Which of the following characterizes hyperkinetic movement disorder?

A. Prion diseases
B. AD
C. FTLD
D. PD
E. PSP
F. CBS
G. MSA
H. HD
A

H. HD

50
Q

All of the following have tau proteins as inclusions EXCEPT:

A. AD
B. FTLD
C. PSP
D. HD

A

D. HD

NVS (3 decks)

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