[MCQ] Parkinson’s Disease (PD) and Other Movement Disorders- Part 1

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Parkinson’s Disease (PD) and Other Movement Disorders- Part 1

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Question 1

Paralysis agitans was described in Ayureda (Charaka Samhita) centuries ago by the name of ?

A	Adhyashana
B	Kampavata
C	Jatharagni
D	Shalmali

Question 1 Explanation:

Paralysis agitans described by James Parkinson is an independent description of Kampavata (Kampa:tremor, Vata:metabolic derangement predisposing to neurologic and mental diseases) described in Ayureda (Charaka Samhita) centuries ago. Several preparations containing Mucuna pruriens (Kapikachu) were descrided for treatment of patients with Kampavata. The major active compound present in Mucuna pruriens is levodopa.

Question 2

The first name of Parkinson was ?

A	John
B	James
C	Jack
D	George

Question 2 Explanation:

Parkinson disease was first described by James Parkinson in 1817.

Question 3

Corpus Luysii is the name given to ?

A	Claustrum
B	Subthalamic nucleus
C	Globus pallidus
D	Substantia nigra

Question 3 Explanation:

Corpus Luysii is the name given to subthalamic nucleus (STN) which is the only glutamatergic nucleus in the “basal ganglia”.

Question 4

Which of the following is commonest neurodegenerative disease ?

A	Alzheimer’s disease (AD)
B	Parkinson’s disease (PD)
C	Wilson’s disease (WD)
D	SCA 3 (spinocerebellar ataxia)

Question 4 Explanation:

Parkinson’s disease (PD) is the second commonest neurodegenerative disease, exceeded only by Alzheimer’s disease (AD).

Question 5

Which of the following is not included in the cardinal features of PD ?

A	Rest tremor
B	Masked facies
C	Bradykinesia
D	Gait impairment

Question 5 Explanation:

Cardinal features of PD include rest tremor, rigidity, bradykinesia and gait impairment. Nondopaminergic features (as they do not fully respond to dopaminergic therapy) include freezing of gait, postural instability, speech difficulty, autonomic disturbances, sensory alterations, mood disorders, sleep dysfunction, cognitive impairment, and dementia.

Question 6

Non-motor features of PD include all except ?

A	Sleep disturbances
B	Cognitive impairment
C	Loss of taste
D	Loss of smell

Question 6 Explanation:

Non-motor aspects of PD include depression and anxiety, cognitive impairment, sleep disturbances, sensory abnormalities and pain, loss of smell (anosmia) and disturbances of autonomic function

Question 7

Pathological hallmark feature of PD is ?

A	Degeneration of dopaminergic neurons in SNc
B	Reduced striatal dopamine
C	Intracytoplasmic proteinaceous inclusions (Lewy bodies)
D	All of the above

Question 7 Explanation:

Pathologically, the hallmark features of PD are degeneration of dopaminergic neurons in the substantia nigra pars compacta (SNc), reduced striatal dopamine, and intracytoplasmic proteinaceous inclusions known as Lewy bodies.

Question 8

Cholinergic neurons are present in ?

A	Locus coeruleus (LC)
B	Nucleus basalis of Meynert (NBM)
C	Raphe nuclei of the brainstem
D	All of the above

Question 8 Explanation:

Cholinergic neurons are present in nucleus basalis of Meynert (NBM). Norepinephrine neurons are present in locus coeruleus (LC) and serotonin neurons in raphe nuclei of the brainstem, and neurons of the olfactory system, cerebral hemispheres, spinal cord, and peripheral autonomic nervous system.

Question 9

Pathological changes in PD begin in ?

A	Peripheral autonomic nervous system
B	Olfactory system
C	Dorsal motor nucleus of vagus nerve in lower brainstem
D	All of the above

Question 10

Which of the following is mostly responsible for signs of parkinsonism ?

A	Decreased traffic in indirect striato-pallidal pathway
B	Increased traffic in direct striato-nigral pathway
C	Decreased ability of thalamus to activate frontal cortex
D	All of the above

Question 10 Explanation:

Striatal dopamine denervation results in increased traffic in indirect striato-pallidal pathway and decreased traffic in direct pathway. Downstream consequence of this is increased activity in striatal outflow stemming from the increased activity of STN and ultimately GPi/SNr neurons. Because striatal outflow is inhibitory to the thalamus (GABA), there is a decrease in the ability of thalamus to activate frontal cortex leading to signs of parkinsonism.

Question 11

Which of the following is not a component of basal ganglia ?

A	Striatum (putamen & caudate nucleus)
B	Subthalamic nucleus (STN)
C	Globus pallidus pars externa (GPe)
D	Claustrum

Question 11 Explanation:

Basal ganglia are subcortical nuclei that include striatum (putamen & caudate nucleus), subthalamic nucleus (STN), globus pallidus pars externa (GPe), globus pallidus pars interna (GPi) & SNc. Symptom complex of Parkinsonism reflect damage to different components of basal ganglia.

Question 12

Which of the following is the revised criteria for the clinical diagnosis of PD ?

A	U.K. brain bank criteria
B	U.K. brain store criteria
C	U.K. brain support criteria
D	U.K. brain diagnosis criteria

Question 12 Explanation:

U.K. brain bank criteria is the revised criteria for the clinical diagnosis of PD.

Question 13

In PD, metabolic imaging (PET/SPECT) shows which of the following ?

A	Reduced uptake in posterior putamen
B	Increased activity in GPi
C	Decreased activity in thalamus
D	All of the above

Question 13 Explanation:

Imaging of brain dopamine system in PD with positron emission tomography (PET) or singlephoton emission computed tomography (SPECT) shows reduced uptake of striatal dopaminergic markers, particularly in posterior putamen, increased activity in the GPi with decreased activity in thalamus.

Question 14

Commonest cause of familial PD is due to mutations of ?

A	LRRK1 gene
B	LRRK2 gene
C	LRRK3 gene
D	LRRK4 gene

Question 14 Explanation:

Mutations of LRRK2 gene are the commonest cause of familial PD and are responsible for ~1% of typical sporadic cases of the disease.

Question 15

As a cause of PD, which LRRK2 mutation is the commonest ?

A	Gly2017Ser
B	Gly2018Ser
C	Gly2019Ser
D	Gly2020Ser

Question 15 Explanation:

Six different LRRK2 mutations have been linked to PD, with Gly2019Ser being the commonest.

Question 16

Diagnosis of atypical Parkinsonism is favoured by all except ?

A	Early speech impairment
B	Early gait impairment
C	Absence of rest tremor
D	Asymmetry

Question 16 Explanation:

Atypical Parkinsonism is characterized by early speech and gait impairment, absence of rest tremor, no asymmetry, poor or no response to levodopa, and an aggressive clinical course. Pathologically, neurodegeneration occurs without Lewy bodies. Metabolic imaging of basal ganglia/ thalamus network shows decreased activity in GPi with increased activity in thalamus, reverse of what is seen in PD.

Question 17

Manifestations of Multiple-system atrophy (MSA) include all except ?

A	Parkinsonian features
B	Cerebellar features
C	Sensory features
D	Autonomic features

Question 17 Explanation:

Multiple-system atrophy (MSA) manifests as a combination of parkinsonian, cerebellar, and autonomic features. When parkinsonian features are predominant, term MSA-p is used and when cerebellar features are predominant, term MSA-c is used.

Question 18

Degeneration of which of the following is found in MSA ?

A	SNc
B	Striatum
C	Inferior olivary nuclei
D	All of the above

Question 19

Glial cytoplasmic inclusions (GCIs) characteristic of MSA stain for ?

A	Tau
B	Alpha-synuclein
C	UCHL-1
D	Parkin

Question 19 Explanation:

Pathologically, MSA is characterized by degeneration of SNc, striatum, cerebellum & inferior olivary nuclei coupled with characteristic glial cytoplasmic inclusions (GCIs) that stain for alphasynuclein.

Question 20

“Hot cross buns” sign relates to which of the following ?

A	MSA
B	PSP
C	Corticobasal ganglionic degeneration
D	All of the above

Question 20 Explanation:

The pontine “hot cross buns” sign is a MRI feature of MSA-c.

Question 21

“Hummingbird sign” relates to which of the following ?

A	MSA
B	PSP
C	Corticobasal ganglionic degeneration
D	All of the above

Question 21 Explanation:

The “hummingbird sign” on midsagittal MRI images is a feature of progressive supranuclear palsy (PSP) and is due to atrophy of midbrain with relative preservation of pons.

Question 22

Parkinsonism is a feature of ?

A	Wilson’s disease
B	Huntington’s disease
C	Hallervorden-Spatz disease
D	All of the above

Question 22 Explanation:

Parkinsonism is a feature of Wilson’s disease, Huntington’s disease (Westphal variant), doparesponsive dystonia and pantothenate kinase (PANK)–associated neurodegeneration (formerly known as Hallervorden-Spatz disease).

Question 23

Which of the following is the cause of PD in majority ?

A	Sporadic
B	Genetic
C	Cerebrovascular disease
D	Drugs

Question 23 Explanation:

Most PD cases occur sporadically (85–90%) and are of unknown cause

Question 24

Peak age of onset of Sporodic Parkinson’s disease (PD) is in which decade of life ?

A	50s
B	60s
C	70s
D	80s

Question 24 Explanation:

Peak age of onset of PD is in the 60s (range is 35 to 85 years), and the course of the illness ranges between 10 and 25 years.

Question 25

Factors linked to a reduced incidence of PD include all except ?

A	Coffee drinking
B	Smoking
C	Use of NSAIDs
D	Alcohol use

Question 25 Explanation:

Factors linked to a reduced incidence of PD include coffee drinking, smoking, use of nonsteroidal anti-inflammatory drugs, and estrogen replacement in postmenopausal women.

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See all quizzes of Parkinson’s Disease (PD) and Other Movement Disorders at here:

Parkinson’s Disease (PD) and Other Movement Disorders- Part 1| Parkinson’s Disease (PD) and Other Movement Disorders- Part 2| Parkinson’s Disease (PD) and Other Movement Disorders- Part 3| Parkinson’s Disease (PD) and Other Movement Disorders- Part 4|Parkinson’s Disease (PD) and Other Movement Disorders- Part 5|Parkinson’s Disease (PD) and Other Movement Disorders- Part 6

1 Paralysis agitans was described in Ayureda (Charaka Samhita)
centuries ago by the name of ?
A. Adhyashana
B. Kampavata
C. Jatharagni
D. Shalmali

2 The first name of Parkinson was ?
A. John
B. James
C. Jack
D. George

3 Corpus Luysii is the name given to ?
A. Claustrum
B. Subthalamic nucleus
C. Globus pallidus
D. Substantia nigra

4 Which of the following is commonest neurodegenerative disease ?
A. Alzheimer’s disease (AD)
B. Parkinson’s disease (PD)
C. Wilson’s disease (WD)
D. SCA 3 (spinocerebellar ataxia)

5 Which of the following is not included in the cardinal features of
PD ?
A. Rest tremor
B. Masked facies
C. Bradykinesia
D. Gait impairment

6 Non-motor features of PD include all except ?
A. Sleep disturbances
B. Cognitive impairment
C. Loss of taste
D. Loss of smell

7 Pathological hallmark feature of PD is ?
A. Degeneration of dopaminergic neurons in SNc
B. Reduced striatal dopamine
C. Intracytoplasmic proteinaceous inclusions (Lewy bodies)
D. All of the above

8 Cholinergic neurons are present in ?
A. Locus coeruleus (LC)
B. Nucleus basalis of Meynert (NBM)
C. Raphe nuclei of the brainstem
D. All of the above

9 Pathological changes in PD begin in ?
A. Peripheral autonomic nervous system
B. Olfactory system
C. Dorsal motor nucleus of vagus nerve in lower brainstem
D. All of the above

10 Which of the following is mostly responsible for signs of
parkinsonism ?
A. Decreased traffic in indirect striato-pallidal pathway
B. Increased traffic in direct striato-nigral pathway
C. Decreased ability of thalamus to activate frontal cortex
D. All of the above

11 Which of the following is not a component of basal ganglia ?
A. Striatum (putamen & caudate nucleus)
B. Subthalamic nucleus (STN)
C. Globus pallidus pars externa (GPe)
D. Claustrum

12 Which of the following is the revised criteria for the clinical
diagnosis of PD ?
A. U.K. brain bank criteria
B. U.K. brain store criteria
C. U.K. brain support criteria
D. U.K. brain diagnosis criteria

13 In PD, metabolic imaging (PET/SPECT) shows which of the
following ?
A. Reduced uptake in posterior putamen
B. Increased activity in GPi
C. Decreased activity in thalamus
D. All of the above

14 Commonest cause of familial PD is due to mutations of ?
A. LRRK1 gene
B. LRRK2 gene
C. LRRK3 gene
D. LRRK4 gene

15 As a cause of PD, which LRRK2 mutation is the commonest ?
A. Gly2017Ser
B. Gly2018Ser
C. Gly2019Ser
D. Gly2020Ser

16 Diagnosis of atypical Parkinsonism is favoured by all except ?
A. Early speech impairment
B. Early gait impairment
C. Absence of rest tremor
D. Asymmetry

17 Manifestations of Multiple-system atrophy (MSA) include all except ?
A. Parkinsonian features
B. Cerebellar features
C. Sensory features
D. Autonomic features

18 Degeneration of which of the following is found in MSA ?
A. SNc
B. Striatum
C. Inferior olivary nuclei
D. All of the above
19 Glial cytoplasmic inclusions (GCIs) characteristic of MSA stain
for ?
A. Tau
B. Alpha-synuclein
C. UCHL-1
D. Parkin

20 “Hot cross buns” sign relates to which of the following ?
A. MSA
B. PSP
C. Corticobasal ganglionic degeneration
D. All of the above

21 “Hummingbird sign” relates to which of the following ?
A. MSA
B. PSP
C. Corticobasal ganglionic degeneration
D. All of the above

22 Parkinsonism is a feature of ?
A. Wilson’s disease
B. Huntington’s disease
C. Hallervorden-Spatz disease
D. All of the above

23 Which of the following is the cause of PD in majority ?
A. Sporadic
B. Genetic
C. Cerebrovascular disease
D. Drugs

24 Peak age of onset of Sporodic Parkinson’s disease (PD) is in
which decade of life ?
A. 50s
B. 60s
C. 70s
D. 80s

25 Factors linked to a reduced incidence of PD include all except ?
A. Coffee drinking
B. Smoking
C. Use of NSAIDs
D. Alcohol use

Parkinson’s Disease (PD) and Other Movement Disorders

[MCQ] Parkinson’s Disease (PD) and Other Movement Disorders- Part 1

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Parkinson’s Disease (PD) and Other Movement Disorders- Part 1

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