[MCQ] Ataxic Disorders- Part 1

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Ataxic Disorders- Part 1

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Question 1

Sensory information for postural control is primarily generated by ?

A	Visual system
B	Vestibular system
C	Proprioceptive receptors in muscle spindles & joints
D	All of the above

Question 1 Explanation:

Sensory information for postural control is primarily generated by visual system, vestibular system and by proprioceptive receptors in the muscle spindles and joints. Loss of two of the three pathways is compromises standing balance. Clinically, gait disorder must be viewed as the product of a neurologic deficit and a functional adaptation.

Question 2

“As if walking on a slippery surface” best relates to ?

A	Cautious Gait
B	Stiff-Legged Gait
C	Freezing Gait
D	Frontal Gait Disorder

Question 2 Explanation:

Cautious gait refers to describe a patient who walks with an abbreviated stride & lowered center of mass, as if walking on a slippery surface. This disorder is both common and nonspecific.

Question 3

Which of the following is the commonest etiology of gait disorders ?

A	Sensory deficits
B	Parkinsonism
C	Cerebellar degeneration
D	Psychogenic

Question 4

Stiff-legged gait category includes which of the following ?

A	Spastic gait
B	Dystonia
C	Stiff-person syndrome
D	All of the above

Question 5

Causes of freezing gait include ?

A	Parkinson’s disease
B	Progressive supranuclear palsy
C	Corticobasal degeneration
D	All of the above

Question 5 Explanation:

Difficulty with gait initiation leads to a freezing gait seen in PD, progressive supranuclear palsy, multiple system atrophy, corticobasal degeneration & primary pallidal degeneration.

Question 6

Pill-rolling tremor is specific for ?

A	Parkinson’s disease
B	Progressive supranuclear palsy
C	Corticobasal degeneration
D	All of the above

Question 6 Explanation:

Patients of PSP, MSA and CBD frequently present with axial stiffness, postural instability, and a shuffling gait but lack the characteristic pill-rolling tremor of Parkinson’s disease

Question 7

“Gait apraxia” is characteristic of ?

A	Sensory ataxia
B	Cerebellar gait ataxia
C	Frontal gait disorder
D	Psychogenic gait disorder

Question 7 Explanation:

Frontal gait disorder or “gait apraxia” features wide base of support, short stride, shuffling along floor and difficulty with starts & turns.

Question 8

Which of the following relate to frontal gait disorders ?

A	Gait apraxia
B	“Slipping clutch” syndrome
C	Lower body parkinsonism
D	All of the above

Question 8 Explanation:

Difficulty with gait initiation is referred to as “slipping clutch” syndrome & lower body parkinsonism

Question 9

Cerebellar gait ataxia is characterized by all except ?

A	Unable to walk tandem heel to toe
B	Difficulty in maintaining balance when turning
C	Narrow base of support
D	Falls is a late event

Question 9 Explanation:

Cerebellar gait ataxia is characterized by a wide base of support, erratic foot placement, difficulty in maintaining balance on turning (an early feature) and tandem gait. Falls in daily life is a late event.

Question 10

Sensory ataxia is characterized by ?

A	Stance destabilized by eye closure
B	Look down at their feet when walking
C	Joint position & vibration sense diminished in lower limbs
D	All of the above

Question 10 Explanation:

In sensory ataxia, stance is destabilized by eye closure. Patient looks down at their feet when walking and do poorly in dark. Joint position & vibration sense is diminished in lower limbs.

Question 11

Which of the following is a feature of vestibular disorder ?

A	Vertigo
B	Nystagmus
C	Poor balance
D	All of the above

Question 11 Explanation:

Feature of vestibular disorders are vertigo (subjective appreciation or illusion of movement), nystagmus (vestibulo-oculomotor sign) & poor balance (impairment of vestibulo-spinal function).

Question 12

Symptoms & signs of true cerebellar ataxia consist of all except ?

A	Gait impairment
B	Hand incoordination
C	Romberg sign
D	Tremor with movement

Question 12 Explanation:

Ataxia due to vestibular nerve or labyrinthine disease results in gait disorder associated with dizziness, light-headedness or perception of movement. Cerebellar ataxia presents as gait impairment, scanning speech, visual blurring due to nystagmus, hand incoordination and tremor with movement. True cerebellar ataxia is devoid of vertiginous complaints. In sensory ataxia, imbalance worsens when visual input is removed (Romberg sign).

Question 13

Symptoms & signs of true cerebellar ataxia consist of all except ?

A	Nystagmus
B	Scanning speech
C	Dizziness
D	Tremor with movement

Question 13 Explanation:

Patients with hereditary ataxia or alcoholic cerebellar degeneration do not complain of dizziness

Question 14

Acute and reversible ataxia can occur due to which of the following ?

A	Alcohol
B	Phenytoin
C	Lithium
D	All of the above

Question 14 Explanation:

Acute & reversible ataxia can result from intoxication with alcohol, phenytoin, lithium & barbiturates. Hypothyroidism must always be considered as a readily treatable and reversible form of chronic symmetric gait ataxia

Question 15

Which of the following may lead to development of ataxia of gait ?

A	B1 deficiency
B	B12 deficiency
C	Hyponatremia
D	All of the above

Question 15 Explanation:

Subacute development of ataxia of gait may be due to vitamin B1 and B12 deficiency and hyponatremia.

Question 16

Anti-Tr autoantibody is related to which of the following ?

A	Breast cancer
B	Ovarian cancer
C	Small-cell lung cancer
D	Hodgkin’s disease

Question 16 Explanation:

Paraneoplastic cerebellar ataxia may present with various tumor states. Autoantibodies related to breast and ovarian cancers is anti-Yo, with small-cell lung cancer is anti-PQ type voltage-gated calcium channel, and with Hodgkin’s disease is anti-Tr.

Question 17

True cerebellar ataxia result from the involvement of ?

A	Cerebellum
B	Spinocerebellar pathway
C	Frontopontocerebellar pathway
D	All of the above

Question 17 Explanation:

True cerebellar ataxia result from involvement of cerebellum, spinocerebellar pathways and frontopontocerebellar pathway from rostral frontal lobe.

Question 18

Patients with which of the following disorder fall over backwards ?

A	Progressive supranuclear palsy
B	Cerebellar pathology
C	Lesions of the vestibular system
D	Patients with somatosensory deficits

Question 18 Explanation:

Patients with cerebellar pathology may lean & topple toward side of lesion. Patients with lesions of vestibular system have lateral pulsion & toppling falls. Patients with progressive supranuclear palsy fall over backwards. Gait freezing in Parkinson’s disease results in a forward fall.

Question 19

Which of the following is not a cause of symmetric ataxia ?

A	Inherited ataxia
B	Hypothyroidism
C	Multiple sclerosis
D	Meningovascular syphilis

Question 19 Explanation:

Demyelinating disease multiple sclerosis presents with focal and ipsilateral cerebellar signs of subacute duration (days to weeks).

Question 20

Which of the following drugs can cause symmetric ataxia ?

A	Phenytoin
B	Lithium
C	Barbiturates
D	All of the above

Question 21

Paraneoplastic cerebellar ataxia is associated with ?

A	Breast cancer
B	Small-cell lung cancer
C	Hodgkin’s disease
D	All of the above

Question 21 Explanation:

Paraneoplastic cerebellar ataxia is associated with breast and ovarian cancers (anti-Yo), smallcell lung cancer (anti-PQ type voltage-gated calcium channel), and Hodgkin’s disease (anti-Tr).

Question 22

Paraneoplastic syndrome associated with myoclonus and opsoclonus occurs with ?

A	Breast cancer
B	Lung cancer
C	Neuroblastoma
D	All of the above

Question 22 Explanation:

Paraneoplastic syndrome associated with myoclonus and opsoclonus occurs with breast cancer (anti-Ri), lung cancer and neuroblastoma.

Question 23

Which of the following is caused by an untranslated pentanucleotide repeat ?

A	SCA6
B	SCA7
C	SCA10
D	SCA17

Question 23 Explanation:

Autosomal spinocerebellar ataxias (SCAs) include SCA types 1 through SCA28, dentatorubropallidoluysian atrophy (DRPLA) & episodic ataxia (EA) types 1 and 2. SCA1, SCA2, SCA3 [Machado-Joseph disease (MJD)], SCA6, SCA7, and SCA17 are caused by CAG triplet repeat expansions in different genes. SCA8 is due to an untranslated CTG repeat expansion, SCA12 is linked to an untranslated CAG repeat, and SCA10 is caused by an untranslated pentanucleotide repeat.

Question 24

Ataxins are ?

A	Expanded polyserine proteins
B	Expanded polyglutamine proteins
C	Expanded polyarginine proteins
D	Expanded polyleucine proteins

Question 24 Explanation:

CAG encodes glutamine & expanded CAG triplet repeat expansions in SCA’s result in expanded polyglutamine proteins, termed ataxins, that produce a toxic gain of function with autosomal dominant inheritance.

Question 25

About what number of glutamines due to expanded polyglutamine ataxins are potentially toxic to neurons ?

A	10
B	20
C	30
D	40

Question 25 Explanation:

Expanded polyglutamine ataxins with more than ~40 glutamines are potentially toxic to neurons. They impair neuronal functions, alter efficiency of ubiquitin-proteosome system of protein turnover and induce neuronal apoptosis.

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See all quizzes of Ataxic Disorders at here:

1 Sensory information for postural control is primarily generated
by ?
A. Visual system
B. Vestibular system
C. Proprioceptive receptors in muscle spindles & joints
D. All of the above

2 “As if walking on a slippery surface” best relates to ?
A. Cautious Gait
B. Stiff-Legged Gait
C. Freezing Gait
D. Frontal Gait Disorder

3 Which of the following is the commonest etiology of gait disorders ?
A. Sensory deficits
B. Parkinsonism
C. Cerebellar degeneration
D. Psychogenic
4 Stiff-legged gait category includes which of the following ?
A. Spastic gait
B. Dystonia
C. Stiff-person syndrome
D. All of the above
5 Causes of freezing gait include ?
A. Parkinson’s disease
B. Progressive supranuclear palsy
C. Corticobasal degeneration
D. All of the above

6 Pill-rolling tremor is specific for ?
A. Parkinson’s disease
B. Progressive supranuclear palsy
C. Corticobasal degeneration
D. All of the above

7 “Gait apraxia” is characteristic of ?
A. Sensory ataxia
B. Cerebellar gait ataxia
C. Frontal gait disorder
D. Psychogenic gait disorder

8 Which of the following relate to frontal gait disorders ?
A. Gait apraxia
B. “Slipping clutch” syndrome
C. Lower body parkinsonism
D. All of the above

9 Cerebellar gait ataxia is characterized by all except ?
A. Unable to walk tandem heel to toe
B. Difficulty in maintaining balance when turning
C. Narrow base of support
D. Falls is a late event

10 Sensory ataxia is characterized by ?
A. Stance destabilized by eye closure
B. Look down at their feet when walking
C. Joint position & vibration sense diminished in lower limbs
D. All of the above

11Which of the following is a feature of vestibular disorder ?
A. Vertigo
B. Nystagmus
C. Poor balance
D. All of the above

12 Symptoms & signs of true cerebellar ataxia consist of all except ?
A. Gait impairment
B. Hand incoordination
C. Romberg sign
D. Tremor with movement

13 Symptoms & signs of true cerebellar ataxia consist of all except ?
A. Nystagmus
B. Scanning speech
C. Dizziness
D. Tremor with movement

14 Acute and reversible ataxia can occur due to which of the following ?
A. Alcohol
B. Phenytoin
C. Lithium
D. All of the above

15 Which of the following may lead to development of ataxia of gait ?
A. B1 deficiency
B. B12 deficiency
C. Hyponatremia
D. All of the above

16 Anti-Tr autoantibody is related to which of the following ?
A. Breast cancer
B. Ovarian cancer
C. Small-cell lung cancer
D. Hodgkin’s disease

17 Paraneoplastic Opsoclonus-Myoclonus Syndrome is related to
which of the following ?
A. Breast cancer
B. Lung cancer
C. Neuroblastoma
D. All of the above

18 True cerebellar ataxia result from the involvement of ?
A. Cerebellum
B. Spinocerebellar pathway
C. Frontopontocerebellar pathway
D. All of the above

19 Patients with which of the following disorder fall over backwards ?
A. Progressive supranuclear palsy
B. Cerebellar pathology
C. Lesions of the vestibular system
D. Patients with somatosensory deficits

20 Which of the following is not a cause of symmetric ataxia ?
A. Inherited ataxia
B. Hypothyroidism
C. Multiple sclerosis
D. Meningovascular syphilis

21Which of the following drugs can cause symmetric ataxia ?
A. Phenytoin
B. Lithium
C. Barbiturates
D. All of the above
22 Paraneoplastic cerebellar ataxia is associated with ?
A. Breast cancer
B. Small-cell lung cancer
C. Hodgkin’s disease
D. All of the above

23 Paraneoplastic syndrome associated with myoclonus and
opsoclonus occurs with ?
A. Breast cancer
B. Lung cancer
C. Neuroblastoma
D. All of the above

24 Which of the following is caused by an untranslated
pentanucleotide repeat ?
A. SCA6
B. SCA7
C. SCA10
D. SCA17

25 Ataxins are ?
A. Expanded polyserine proteins
B. Expanded polyglutamine proteins
C. Expanded polyarginine proteins
D. Expanded polyleucine proteins

26 About what number of glutamines due to expanded polyglutamine
ataxins are potentially toxic to neurons ?
A. 10
B. 20
C. 30
D. 40

Ataxic Disorders

[MCQ] Ataxic Disorders- Part 1

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Ataxic Disorders- Part 1

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