[MCQ] Diseases of the Spinal Cord- Part 3

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Diseases of the Spinal Cord- Part 3

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Question 1

Which of the following is false about ‘Neuromyotonia’ ?

A	Muscle stiffness at rest & during sleep
B	Distal limb muscles most severely affected
C	Myokymia
D	None of the above

Question 2

Central cord syndrome results from all except ?

A	Trauma
B	Infection
C	Syringomyelia
D	Anterior spinal artery ischemia

Question 2 Explanation:

Central cord syndrome is due to damage to gray matter nerve cells & crossing spinothalamic tracts near the central spinal canal. Trauma, syringomyelia, tumors & anterior spinal artery ischemia cause central cord syndrome

Question 3

Dissociated sensory loss in central cord syndrome means ?

A	Loss of JPS & vibration sense with preservation of pain & temperature sense
B	Loss of pain & temperature sense with preservation of JPS & vibration sense
C	Loss of pain sense with preservation of temperature sense
D	Loss of temperature sense with preservation of pain sense

Question 3 Explanation:

In cervical cord, central cord syndrome produces arm weakness out of proportion to leg weakness and “dissociated” sensory loss (loss of pain & temperature sense with preservation of light touch, joint position, and vibration sense over shoulders, lower neck & upper trunk

Question 4

Which of the following is false about anterior spinal artery syndrome ?

A	Due to occlusion of anterior spinal artery
B	Motor, sensory & autonomic functions are lost below the level of lesion
C	Retained vibration & position sensation
D	None of the above

Question 4 Explanation:

Anterior spinal artery syndrome is due to infarction of spinal cord due to its occlusion or diminished flow. Destruction spares posterior columns. Motor, sensory and autonomic functions are lost below the level of lesion, Vibration and position sensation are retained.

Question 5

“Around the clock” pattern of weakness is seen in ?

A	Central cord syndrome
B	Anterior spinal artery syndrome
C	Foramen magnum syndrome
D	All of the above

Question 5 Explanation:

Compressive lesions near foramen magnum produce weakness of ipsilateral shoulder & arm followed by weakness of ipsilateral leg, then contralateral leg, & finally contralateral arm, an “around the clock” pattern that may begin in any of 4 limbs. Typical suboccipital pain spreading to neck & shoulders is present..

Question 6

Which of the following features does not favour the diagnosis of extramedullary lesions ?

A	Radicular pain
B	Early sacral sensory loss
C	Sparing of sensation in perineal & sacral areas
D	Spastic weakness in legs

Question 6 Explanation:

Prominent radicular pain with early sacral sensory loss (lateral spinothalamic tract) & spastic weakness in legs (corticospinal tract) indicate extramedullary lesions.

Question 7

Which of the following features favours the diagnosis of intramedullary lesions ?

A	Radicular pain
B	Early corticospinal tract signs
C	Sparing of sensation in perineal & sacral areas
D	Spastic weakness in legs

Question 7 Explanation:

Intramedullary lesions produce poorly localized burning pain & spare sensation in perineal and sacral areas (“sacral sparing”), due to laminated configuration of spinothalamic tract with sacral fibers outermost. corticospinal tract signs appear later.

Question 8

Which of the following features favours noncompressive myelopathy ?

A	Neck or back pain
B	Bladder disturbances
C	Sensory symptoms preceding paralysis
D	Myelopathy without antecedent symptoms

Question 8 Explanation:

Epidural compression causes warning signs of neck or back pain, bladder disturbances and sensory symptoms that precede development of paralysis. Noncompressive etiologies produce myelopathy without antecedent symptoms.

Question 9

Which of the following features favours noncompressive myelopathy ?

A	Neck or back pain
B	Bladder disturbances
C	Sensory symptoms preceding paralysis
D	Myelopathy without antecedent symptoms

Question 9 Explanation:

Question 10

Which of the following malignant tumors usually do not metastasize to “thoracic” spinal cord ?

A	Breast
B	Kidney
C	Ovary
D	Lymphoma

Question 10 Explanation:

Almost any malignant tumor can metastasize to spinal column with breast, lung, prostate, kidney, lymphoma & plasma cell dyscrasia being frequent. Thoracic cord is most commonly involved. Metastases from prostate & ovarian cancer occur disproportionately in sacral & lumbar vertebrae

Question 11

Batson’s plexus is composed of ?

A	Nerves
B	Arteries
C	Veins
D	Capillaries

Question 11 Explanation:

Batson’s plexus is a network of veins along the anterior epidural space.

Question 12

Pain in neoplastic epidural compressive myelopathy worsens with ?

A	Movement
B	Coughing
C	Sneezing
D	All of the above

Question 12 Explanation:

Pain in neoplastic epidural compressive myelopathy typically worsens with movement, coughing or sneezing & awakens patients at night.

Question 13

Which of the following is false about intradural mass lesions ?

A	Slow-growing & benign
B	Initial symptom is radicular pain
C	Asymmetric, progressive spinal cord syndrome
D	None of the above

Question 13 Explanation:

Most intradural mass lesions are slow-growing & benign. Symptoms usually begin with radicular sensory symptoms followed by an asymmetric, progressive spinal cord syndrome

Question 14

Intradural neurofibromas typically arise near ?

A	Anterior root
B	Posterior root
C	Radicle
D	Any of the above

Question 14 Explanation:

Intradural neurofibromas typically arise near the posterior root.

Question 15

Which of the following is a primary intramedullary tumor ?

A	Ependymomas
B	Hemangioblastomas
C	Low-grade astrocytoma
D	All of the above

Question 15 Explanation:

Primary intramedullary tumors of spinal cord include ependymomas, hemangioblastomas, or low-grade astrocytomas in adults. They present as central cord or hemicord syndromes, often in cervical region.

Question 16

Clinical triad of spinal epidural abscess consists of all except ?

A	Midline dorsal pain
B	Fever
C	Progressive limb weakness
D	Sensory loss

Question 16 Explanation:

Clinical triad of spinal epidural abscess consists of midline dorsal pain, fever & progressive limb weakness.

Question 17

Which of the following about spinal epidural abscess is false ?

A	Infections of skin is a risk factor
B	Commonly due to hematogenous spread
C	Streptococcus most common bacteria
D	Lumbar puncture is not recommended

Question 17 Explanation:

Most cases of spinal epidural abscess are due to Staphylococcus aureus. Gram-negative bacilli, streptococcus, anaerobes, fungi and tuberculosis are other important causes

Question 18

The spinal cord is supplied by how many arteries ?

A	1
B	2
C	3
D	4

Question 18 Explanation:

Spinal cord is supplied by 3 arteries - single anterior spinal artery & paired posterior spinal arteries.

Question 19

Anterior spinal artery feeder - Artery of Adamkiewicz arises at ?

A	C6
B	T4 - T5
C	T11 - L2
D	L4 - L5

Question 19 Explanation:

Anterior spinal artery is fed by radicular vessels that arise at C6, at an upper thoracic level, and most consistently, at T11 - L2 (artery of Adamkiewicz).

Question 20

Posterior spinal arteries become less distinct below ?

A	Midcervical level
B	Midthoracic level
C	Midlumbar level
D	Midsacral level

Question 20 Explanation:

Posterior spinal arteries supply posterior columns & become less distinct below midthoracic level.

Question 21

With systemic hypotension, greatest ischemic risk of cord infarction is at the level of ?

A	C6
B	T3 - T4
C	T11 - L2
D	L5 - S1

Question 21 Explanation:

With systemic hypotension, greatest ischemic risk is at T3 - T4 and also at boundary zones between anterior & posterior spinal artery territories.

Question 22

Which of the following is not a feature of anterior cord syndrome ?

A	Paraplegia or quadriplegia
B	Loss of pain & temperature sense
C	Sparing of vibration & position sense
D	Preservation of sphincter control

Question 22 Explanation:

Anterior cord syndrome is due to acute infarction in the territory of anterior spinal artery that presents as paraplegia or quadriplegia, dissociated sensory loss affecting pain & temperature sense but sparing vibration & position sense, and loss of sphincter control. Sharp midline or radiating back pain localized to the area of ischemia is frequent.

Question 23

Spinal cord infarction is associated with ?

A	Aortic atherosclerosis
B	Dissecting aortic aneurysm
C	Hypotension from any cause
D	All of the above

Question 23 Explanation:

Spinal cord infarction results from aortic atherosclerosis, dissecting aortic aneurysm, vertebral artery occlusion or dissection in neck, profound hypotension from any cause, cardiogenic emboli, vasculitis related to collagen vascular disease, and surgical interruption of aortic aneurysms

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See all quizzes of Diseases of the Spinal Cord- Part 3 here:

1.Which of the following is false about ‘Neuromyotonia’ ?
A. Muscle stiffness at rest & during sleep
B. Distal limb muscles most severely affected
C. Myokymia
D. None of the above
2. Central cord syndrome results from all except ?
A. Trauma
B. Infection
C. Syringomyelia
D. Anterior spinal artery ischemia

3. Dissociated sensory loss in central cord syndrome means ?
Harrison’s 18th Ed. 3367
A. Loss of JPS & vibration sense with preservation of pain &
temperature sense
B. Loss of pain & temperature sense with preservation of JPS &
vibration sense
C. Loss of pain sense with preservation of temperature sense
D. Loss of temperature sense with preservation of pain sense

4. Which of the following is false about anterior spinal artery
syndrome ?
A. Due to occlusion of anterior spinal artery
B. Motor, sensory & autonomic functions are lost below the level
of lesion
C. Retained vibration & position sensation
D. None of the above

5. “Around the clock” pattern of weakness is seen in ?
A. Central cord syndrome
B. Anterior spinal artery syndrome
C. Foramen magnum syndrome
D. All of the above

6. Which of the following features does not favour the diagnosis of
extramedullary lesions ?
A. Radicular pain
B. Early sacral sensory loss
C. Sparing of sensation in perineal & sacral areas
D. Spastic weakness in legs

7. Which of the following features favours the diagnosis of
intramedullary lesions ?
A. Radicular pain
B. Early corticospinal tract signs
C. Sparing of sensation in perineal & sacral areas
D. Spastic weakness in legs

8. Which of the following features favours noncompressive
myelopathy ?
A. Neck or back pain
B. Bladder disturbances
C. Sensory symptoms preceding paralysis
D. Myelopathy without antecedent symptoms

9. Which of the following malignant tumors usually do not
metastasize to “thoracic” spinal cord ?
A. Breast
B. Kidney
C. Ovary
D. Lymphoma

10. Batson’s plexus is composed of ?
A. Nerves
B. Arteries
C. Veins
D. Capillaries
11. Pain in neoplastic epidural compressive myelopathy worsens
with ?
A. Movement
B. Coughing
C. Sneezing
D. All of the above

12. Which of the following is false about intradural mass lesions ?
A. Slow-growing & benign
B. Initial symptom is radicular pain
C. Asymmetric, progressive spinal cord syndrome
D. None of the above

13. Intradural neurofibromas typically arise near ?
A. Anterior root
B. Posterior root
C. Radicle
D. Any of the above

14. Which of the following is a primary intramedullary tumor ?
A. Ependymomas
B. Hemangioblastomas
C. Low-grade astrocytoma
D. All of the above

15. Clinical triad of spinal epidural abscess consists of all except ?
A. Midline dorsal pain
B. Fever
C. Progressive limb weakness
D. Sensory loss

16. Which of the following about spinal epidural abscess is false ?
A. Infections of skin is a risk factor
B. Commonly due to hematogenous spread
C. Streptococcus most common bacteria
D. Lumbar puncture is not recommended

17. The spinal cord is supplied by how many arteries ?
A. 1
B. 2
C. 3
D. 4

18. Anterior spinal artery feeder – Artery of Adamkiewicz arises at ?
A. C6
B. T4 – T5
C. T11 – L2
D. L4 – L5

19. Posterior spinal arteries become less distinct below ?
A. Midcervical level
B. Midthoracic level
C. Midlumbar level
D. Midsacral level

20. With systemic hypotension, greatest ischemic risk of cord infarction
is at the level of ?
A. C6
B. T3 – T4
C. T11 – L2
D. L5 – S1

21. Which of the following is not a feature of anterior cord syndrome ?
A. Paraplegia or quadriplegia
B. Loss of pain & temperature sense
C. Sparing of vibration & position sense
D. Preservation of sphincter control

22. Spinal cord infarction is associated with ?
A. Aortic atherosclerosis
B. Dissecting aortic aneurysm
C. Hypotension from any cause
D. All of the above

Diseases of the Spinal Cord

[MCQ] Diseases of the Spinal Cord- Part 3

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Diseases of the Spinal Cord- Part 3

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