[MCQ] Parkinson’s Disease (PD) and Other Movement Disorders- Part 2

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Parkinson’s Disease (PD) and Other Movement Disorders- Part 2

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Question 1

Environmental risk factors for PD include all except ?

A	Exposure to pesticides
B	Consumption of well water
C	Rural living
D	Urban living

Question 1 Explanation:

Risk factors include a positive family history, male gender, head injury, exposure to pesticides, consumption of well water, and rural living.

Question 2

Which of the following neurotoxin produces parkinsonism ?

A	Apamin
B	Botulinum
C	MPTP
D	Tetanospasmin

Question 2 Explanation:

MPTP (1-methyl-4-phenyl-1,2,5,6-tetrahydropyridine) is a byproduct of the illicit manufacture of a heroin-like drug, causes a PD-like syndrome in addicts. MPTP is transported to CNS, where it is metabolized to form MPP+, a mitochondrial toxin that is selectively taken up by, and damages, dopamine neurons. MPTP toxicity can be prevented by coadministration of a MAO-B inhibitor that blocks its conversion to the toxic pyridinium ion MPP+

Question 3

Toxins that can produce secondary Parkinsonism include all except ?

A	1-Methyl-1,2,4,6 tetrahydropyridine (MPTP)
B	Manganese
C	Cyanide
D	Carbon dioxide

Question 4

Toxins that can produce secondary PD include all except ?

A	Methanol
B	Ethanol
C	Carbon monoxide
D	Carbon disulfide

Question 4 Explanation:

1-Methyl-1,2,4,6 tetrahydropyridine (MPTP), Manganese, Cyanide, Methanol, Carbon monoxide, Carbon disulfide, Hexane produce parkinsonism

Question 5

Drug that can cause secondary parkinsonism is ?

A	Amiodarone
B	Lithium
C	Chlorperazine
D	All of the above

Question 5 Explanation:

Drugs that can cause secondary parkinsonism include metoclopramide, chlorperazine, tetrabenazine, amiodarone, and lithium.

Question 6

Drugs that can produce secondary PD include all except ?

A	Metoclopramide
B	Reserpine
C	Methyldopa
D	Clonidine

Question 7

Drugs that can produce secondary PD include all except ?

A	Lithium carbonate
B	Valproic acid
C	Phenytoin
D	Fluoxetine

Question 7 Explanation:

Drugs that can produce secondary PD include neuroleptics (typical antipsychotics), some atypical antipsychotics, antiemetics (compazine, metoclopramide), dopamine-depleting agents (reserpine, tetrabenazine), alpha methyldopa, lithium carbonate, valproic acid, fluoxetine

Question 8

Which of the following gene is a late-onset PD susceptibility gene ?

A	PARK 1
B	PARK 2
C	PARK 7
D	PARK 10

Question 8 Explanation:

PARK10 is a late-onset PD susceptibility gene.

Question 9

Which of the following gene leads to an autosomal dominant form of PD ?

A	PARK 1
B	PARK 4
C	PARK 5
D	PARK 5All of the above

Question 9 Explanation:

PARK1, PARK4 & PARK5 genes lead to an autosomal dominant form of PD with atypical features like early age of onset & rapid progression of symptoms.

Question 10

Which of the following gene leads to an autosomal recessive form of PD ?

A	PARK 1
B	PARK 2
C	PARK 5
D	All of the above

Question 10 Explanation:

PARK2 and PARK7 genes lead to autosomal recessive disorders with atypical features like juvenile forms of parkinsonism.

Question 11

Which of the following statements about familial forms of PD is false ?

A	PARK1 and PARK5 lead to autosomal dominant PD
B	PARK2 and PARK7 lead to autosomal recessive PD
C	PARK5 encodes synuclein
D	PARK2 encodes parkin

Question 11 Explanation:

PARK1 encodes alpha-synuclein, mutation leading to its abnormal aggregation. PARK2 encodes parkin, an E3 ubiquitin protein ligase

Question 12

Which of the following is false for Familial Parkinson’s disease ?

A	Mutations in -synuclein and ubiquitin carboxy-terminal hydroxylase L1 (UCH-L1)
B	Characteristic histopathologic feature is Lewy body
C	Lewy body is eosinophilic cytoplasmic inclusion that contains neurofilaments and -synuclein
D	None of the above

Question 13

Glutamate is the neurotransmitter for which of the following pathways ?

A	Globus pallidus externa - subthalamic nucleus
B	Substantia nigra compacta - striatum
C	Subthalamic nucleus - Substantia nigra reticulata
D	Globus pallidus interna - thalamus

Question 14

Gamma aminobutyric acid (GABA) is the neurotransmitter for which of the following pathways ?

A	Globus pallidus externa - subthalamic nucleus
B	Striatum - Globus pallidus interna
C	Globus pallidus interna - thalamus
D	All of the above

Question 15

Which of the following pathways is excitatory ?

A	Globus pallidus externa - subthalamic nucleus
B	Striatum - Globus pallidus externa
C	Globus pallidus interna - thalamus
D	Subthalamic nucleus - Globus pallidus interna

Question 16

Which of the following pathways is inhibitory ?

A	Globus pallidus externa - subthalamic nucleus
B	Striatum - Globus pallidus externa
C	Globus pallidus interna - thalamus
D	All of the above

Question 17

Which of the following is false in PD ?

A	Increased firing of neurons in STN
B	Increased firing of neurons in GPi
C	Excessive inhibition of thalamus
D	None of the above

Question 17 Explanation:

In PD, dopamine denervation causes increased firing of neurons in STN & GPi, resulting in excessive inhibition of thalamus, consequent reduced activation of cortical motor systems & development of parkinsonian features

Question 18

Which of the following is most frequently present in patients with true PD ?

A	Rest tremor
B	Rigidity
C	Bradykinesia
D	Masked facies

Question 18 Explanation:

Three cardinal signs of PD are rest tremor, rigidity & bradykinesia. Tremor is present in 85% of patients with true PD and diagnosis of PD is difficult if tremor is absent.

Question 19

Most disabling motor feature of PD is ?

A	Rest tremor
B	Rigidity
C	Bradykinesia
D	Stooped posture

Question 19 Explanation:

The most disabling motor feature of PD is bradykinesia

Question 20

Which of the following is false about ‘rest tremor’ in PD ?

A	Frequency of 4 to 6 Hz
B	Appear bilaterally, first distally
C	May appear in lips, tongue and jaw
D	Spares head and neck

Question 20 Explanation:

Rest tremor, at a frequency of 4 to 6 Hz, typically appears unilaterally, first distally, involving the digits and wrist with a “pill-rolling” character. Tremor usually spreads proximally, ipsilaterally, and occasionally to the leg before crossing to the other side. It may appear later in lips, tongue and jaw but spares the head and neck.

Question 21

Testing for postural instability in PD is done by ?

A	Swing test
B	Push test
C	Pull test
D	Lift test

Question 21 Explanation:

In advanced PD, postural instability is one of the most disabling feature. It can be tested in office with the “pull test”.

Question 22

Term used to describe gait in PD is ?

A	Pigeon gait
B	Antalgic gait
C	Scissor gait
D	Festinating gait

Question 22 Explanation:

Festinating gait is a classic sign of parkinsonism due to a combination of flexed posture and loss of postural reflexes. The patient accelerates to “catch up” with body’s center of gravity.

Question 23

In Latin "festino" means ?

A	"to fall"
B	"to freeze"
C	"to hurry"
D	"to swing"

Question 23 Explanation:

In Latin "festino" means "to hurry".

Question 24

Which of the following strongly suggests a diagnosis other than PD ?

A	Dystonia involving distal arm or leg
B	Significant postural instability & falls in first years of illness
C	Proximal and ipsilateral tremors
D	Freezing of gait

Question 24 Explanation:

Significant postural instability and falls in the first years of the illness strongly suggest a diagnosis other than PD like Progressive Supranuclear Palsy, DLB.

Question 25

Manifestation that may be present long before the onset of motor signs in PD include ?

A	Anosmia
B	Depression
C	Sleep disorders
D	All of the above

Question 25 Explanation:

Anosmia, depression and sleep disorders may be present long before the onset of motor signs.

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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 Environmental risk factors for PD include all except ?
A. Exposure to pesticides
B. Consumption of well water
C. Rural living
D. Urban living

2 Which of the following neurotoxin produces parkinsonism ?
A. Apamin
B. Botulinum
C. MPTP
D. Tetanospasmin

3 Toxins that can produce secondary Parkinsonism include all except ?
A. 1-Methyl-1,2,4,6 tetrahydropyridine (MPTP)
B. Manganese
C. Cyanide
D. Carbon dioxide

4 Toxins that can produce secondary PD include all except ?
A. Methanol
B. Ethanol
C. Carbon monoxide
D. Carbon disulfide

5 Drug that can cause secondary parkinsonism is ?
A. Amiodarone
B. Lithium
C. Chlorperazine
D. All of the above

6 Drugs that can produce secondary PD include all except ?
A. Metoclopramide
B. Reserpine
C. Methyldopa
D. Clonidine
7 Drugs that can produce secondary PD include all except ?
A. Lithium carbonate
B. Valproic acid
C. Phenytoin
D. Fluoxetine

8 Which of the following gene is a late-onset PD susceptibility gene ?
A. PARK 1
B. PARK 2
C. PARK 7
D. PARK 10

9 Which of the following gene leads to an autosomal dominant
form of PD ?
A. PARK 1
B. PARK 4
C. PARK 5
D. All of the above

10 Which of the following gene leads to an autosomal recessive
form of PD ?
A. PARK 1
B. PARK 2
C. PARK 5
D. All of the above

11 Which of the following statements about familial forms of PD is
false ?
A. PARK1 and PARK5 lead to autosomal dominant PD
B. PARK2 and PARK7 lead to autosomal recessive PD
C. PARK5 encodes synuclein
D. PARK2 encodes parkin

12 Which of the following is false for Familial Parkinson’s disease ?
A. Mutations in -synuclein and ubiquitin carboxy-terminal
hydroxylase L1 (UCH-L1)
B. Characteristic histopathologic feature is Lewy body
C. Lewy body is eosinophilic cytoplasmic inclusion that contains
neurofilaments and -synuclein
D. None of the above
13 Glutamate is the neurotransmitter for which of the following
pathways ?
A. Globus pallidus externa – subthalamic nucleus
B. Substantia nigra compacta – striatum
C. Subthalamic nucleus – Substantia nigra reticulata
D. Globus pallidus interna – thalamus
14 Gamma aminobutyric acid (GABA) is the neurotransmitter for
which of the following pathways ?
A. Globus pallidus externa – subthalamic nucleus
B. Striatum – Globus pallidus interna
C. Globus pallidus interna – thalamus
D. All of the above
15 Which of the following pathways is excitatory ?
A. Globus pallidus externa – subthalamic nucleus
B. Striatum – Globus pallidus externa
C. Globus pallidus interna – thalamus
D. Subthalamic nucleus – Globus pallidus interna
16 Which of the following pathways is inhibitory ?
A. Globus pallidus externa – subthalamic nucleus
B. Striatum – Globus pallidus externa
C. Globus pallidus interna – thalamus
D. All of the above

17 Which of the following is false in PD ?
A. Increased firing of neurons in STN
B. Increased firing of neurons in GPi
C. Excessive inhibition of thalamus
D. None of the above

18 Which of the following is most frequently present in patients with
true PD ?
A. Rest tremor
B. Rigidity
C. Bradykinesia
D. Masked facies

19 Most disabling motor feature of PD is ?
A. Rest tremor
B. Rigidity
C. Bradykinesia
D. Stooped posture

20 Which of the following is false about ‘rest tremor’ in PD ?
A. Frequency of 4 to 6 Hz
B. Appear bilaterally, first distally
C. May appear in lips, tongue and jaw
D. Spares head and neck

21 Testing for postural instability in PD is done by ?
A. Swing test
B. Push test
C. Pull test
D. Lift test

22 Term used to describe gait in PD is ?
A. Pigeon gait
B. Antalgic gait
C. Scissor gait
D. Festinating gait

23 In Latin “festino” means ?
A. “to fall”
B. “to freeze”
C. “to hurry”
D. “to swing”

24 Which of the following strongly suggests a diagnosis other than
PD ?
A. Dystonia involving distal arm or leg
B. Significant postural instability & falls in first years of illness
C. Proximal and ipsilateral tremors
D. Freezing of gait

25 Manifestation that may be present long before the onset of motor
signs in PD include ?
A. Anosmia
B. Depression
C. Sleep disorders
D. All of the above

Parkinson’s Disease (PD) and Other Movement Disorders

[MCQ] Parkinson’s Disease (PD) and Other Movement Disorders- Part 2

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Parkinson’s Disease (PD) and Other Movement Disorders- Part 2

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