[MCQ] Parkinson’s Disease (PD) and Other Movement Disorders- Part 6

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Parkinson’s Disease (PD) and Other Movement Disorders- Part 6

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Congratulations - you have completed Parkinson’s Disease (PD) and Other Movement Disorders- Part 6. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

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Question 1

Effective medication in the treatment of Tourette’s Syndrome is ?

A	Clonidine
B	Guanfacine
C	Olanzapine
D	All of the above

Question 1 Explanation:

Clonidine, Guanfacine, Atypical neuroleptics (risperidone, olanzapine, ziprasidone) and classical neuroleptics (haloperidol, fluphenazine, or pimozide) are useful in treatment of TS.

Question 2

Which of the following about myoclonus is false ?

A	Rapid, jerky movement of <100 msec. duration
B	Asterixis is a negative myoclonus
C	Interferes with normal movement
D	Suppressible

Question 2 Explanation:

Myoclonus is a rapid, jerky movement of <100 msec. duration due to single or repetitive muscle discharges. It occur spontaneously, in association with voluntary movement (action myoclonus) or in response to an external stimulus (reflex or startle myoclonus). Negative myoclonus consists of a twitch due to a brief loss of muscle activity (asterixis in hepatic failure). Myoclonic jerks differ from tics in that they interfere with normal movement and are not suppressible

Question 3

Myoclonus can be seen in association with pathology in ?

A	Cortical region
B	Subcortical region
C	Spinal cord region
D	All of the above

Question 3 Explanation:

Myoclonus can be seen in association with pathology in cortical, subcortical, or spinal cord regions and associated with hypoxemic damage, encephalopathy, and neurodegeneration

Question 4

Which of the following is useful in the treatment of myoclonus ?

A	Valproic acid
B	Piracetam
C	Levetiracetam
D	All of the above

Question 4 Explanation:

Treatment primarily consists of treating the underlying condition or removing offending agent. Valproic acid, piracetam, clonazepam, primidone and levetiracetam may be effective.

Question 5

Which of the following is an example of Dystonia ?

A	Blepharospasm
B	Torticollis
C	Oromandibular dystonia
D	All of the above

Question 5 Explanation:

Dystonia is the most common acute hyperkinetic drug reaction. It is typically generalized in children and focal in adults like blepharospasm, torticollis, or oromandibular dystonia.

Question 6

Which of the following about tardive dyskinesia (TD) is false ?

A	Choreiform movements
B	Mouth, lips, and tongue mostly involved
C	Tetrabenazine helpful in refractory cases
D	None of the above

Question 7

Use of metoclopramide for more than how many weeks increases the risk of tardive dyskinesia (TD) ?

A	2 weeks
B	4 weeks
C	6 weeks
D	12 weeks

Question 7 Explanation:

FDA has warned that use of metoclopramide for more than 12 weeks increases the risk of TD

Question 8

Levels of which of the following is markedly elevated in neuroleptic malignant syndrome (NMS) ?

A	Creatine kinase
B	Lactic dehydrogenase
C	Lactic acid
D	All of the above

Question 8 Explanation:

Neuroleptic malignant syndrome (NMS) is characterized by muscle rigidity, elevated temperature, altered mental status, hyperthermia, tachycardia, labile blood pressure, renal failure, and markedly elevated creatine kinase levels. Myoclonus is not a feature of NMS but of serotonin syndrome

Question 9

Myoclonus can result with the use of which of the following drugs ?

A	Phenytoin
B	Fluoxetine
C	Buspirone
D	All of the above

Question 9 Explanation:

Drugs can be associated with parkinsonism & hyperkinetic movement disorders like phenytoin (chorea, dystonia, tremor, myoclonus), carbamazepine (tics and dystonia), tricyclic antidepressants (dyskinesias, tremor, myoclonus), fluoxetine (myoclonus, chorea, dystonia), oral contraceptives (dyskinesia), adrenergics (tremor), buspirone (akathisia, dyskinesias, myoclonus), and digoxin, cimetidine, diazoxide, lithium, methadone, and fentanyl (dyskinesias

Question 10

Restless Legs Syndrome was first described by ?

A	Christopher Ross
B	Micheal Emre
C	Thomas Willis
D	James Hardy

Question 10 Explanation:

Restless legs syndrome (RLS) is a neurologic disorder and was first described in seventeenth century by English physician Thomas Willis.

Question 11

Secondary RLS may be associated with ?

A	Pregnancy
B	Peripheral neuropathy
C	Renal failure
D	All of the above

Question 11 Explanation:

Secondary RLS may be associated with pregnancy, anemia, ferritin deficiency, renal failure, and peripheral neuropathy

Question 12

Which of the following in Wilson’s disease can manifest alone ?

A	Neurologic disorders
B	Psychiatric disorders
C	Liver disorders
D	Any of the above

Question 12 Explanation:

Wilson’s disease (WD) is an autosomal recessive inherited disorder of copper metabolism that may manifest with neurologic, psychiatric, and liver disorders, alone or in combination. About half of WD patients (esp. younger patients) manifest with liver abnormalities.

Question 13

Kayser-Fleischer (KF) rings are seen in nearly what proportion of WD patients with hepatic presentations ?

A	20 %
B	40 %
C	80 %
D	100 %

Question 13 Explanation:

Kayser-Fleischer (KF) rings are seen in 80% of WD patients with hepatic presentations.

Question 14

Kayser-Fleischer (KF) rings are seen in nearly what proportion of WD patients with neurologic features ?

A	20 %
B	40 %
C	80 %
D	100 %

Question 14 Explanation:

Kayser-Fleischer (KF) rings are seen in nearly all WD patients with neurologic features. It is very rare for WD patients with neurologic features not to have KF rings.

Question 15

Which of the following statements about Kayser-Fleischer (KF) rings is false ?

A	Represent deposition of copper in Descemet’s membrane
B	Brownish discoloration of the peripheral cornea
C	Best detected by slit-lamp examination
D	None of the above

Question 15 Explanation:

Kayser-Fleischer rings (KF rings) represent the deposition of copper in Descemet’s membrane producing brownish discoloration of peripheral cornea. They are best detected by slit-lamp examination.

Question 16

Which of the following marks the onset of neurologic manifestations in WD ?

A	Bradykinesia
B	Tremor
C	Dystonia
D	Dysarthria

Question 16 Explanation:

Neurologic onset usually manifests in the second decade with tremor and rigidity. Tremor is usually in upper limbs, bilateral, and asymmetric.

Question 17

In WD, which of the following is false ?

A	Low levels of blood copper
B	Low levels of blood ceruloplasmin
C	High levels of urinary copper
D	None of the above

Question 17 Explanation:

In WD, low levels of blood copper and ceruloplasmin and high levels of urinary copper are found but normal levels do not exclude the diagnosis

Question 18

In WD, which of the following is false ?

A	Low levels of blood copper
B	Low levels of blood ceruloplasmin
C	High levels of urinary copper
D	None of the above

Question 18 Explanation:

In WD, low levels of blood copper and ceruloplasmin and high levels of urinary copper are found but normal levels do not exclude the diagnosis

Question 19

In WD, MRI shows symmetric hyperintensity on T2-weighted images in ?

A	Putamen
B	Caudate
C	Pallidum
D	All of the above

Question 19 Explanation:

In WD, MRI shows symmetric hyperintensity on T2-weighted images in putamen, caudate & pallidum.

Question 20

Which of the following is the gold standard for the diagnosis of WD ?

A	Kayser-Fleischer (KF) rings
B	Generalized atrophy on CT brain scan
C	Hyperintensity of putamen on T2-weighted MRI images
D	High copper levels in liver biopsy

Question 20 Explanation:

Liver biopsy with demonstration of high copper levels is the gold standard for diagnosis of WD.

Question 21

Which of the following blocks the absorption of copper ?

A	Penicillamine
B	Tetrathiomolybdate
C	Trientine
D	Zinc

Question 21 Explanation:

Tetrathiomolybdate blocks absorption of copper. Penicillamine increases copper excretion. Trientine & zinc are useful drugs for maintenance therapy.

Question 22

Which of the following statements about Penicillamine is false ?

A	Worsens symptoms in initial stages of therapy
B	Increases copper excretion
C	Should be coadministered with pyridoxine
D	None of the above

Question 23

Astasia-abasia is best related to ?

A	Parkinsonism
B	Cerebellar degeneration
C	Psychogenic movement disorder
D	Nystagmus

Question 23 Explanation:

Astasia-abasia refers to odd gyrations of posture with wastage of muscular energy, extreme slow motion, and dramatic fluctuations over time observed in patients with somatoform disorders and conversion reaction.

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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 Effective medication in the treatment of Tourette’s Syndrome is ?
A. Clonidine
B. Guanfacine
C. Olanzapine
D. All of the above

2 Which of the following about myoclonus is false ?
A. Rapid, jerky movement of <100 msec. duration
B. Asterixis is a negative myoclonus
C. Interferes with normal movement
D. Suppressible

3 Myoclonus can be seen in association with pathology in ?
A. Cortical region
B. Subcortical region
C. Spinal cord region
D. All of the above

4 Which of the following is useful in the treatment of myoclonus ?
A. Valproic acid
B. Piracetam
C. Levetiracetam
D. All of the above

5 Which of the following is an example of Dystonia ?
A. Blepharospasm
B. Torticollis
C. Oromandibular dystonia
D. All of the above

6 Which of the following about tardive dyskinesia (TD) is false ?
A. Choreiform movements
B. Mouth, lips, and tongue mostly involved
C. Tetrabenazine helpful in refractory cases
D. None of the above
7 Use of metoclopramide for more than how many weeks increases
the risk of tardive dyskinesia (TD) ?
A. 2 weeks
B. 4 weeks
C. 6 weeks
D. 12 weeks

8 Levels of which of the following is markedly elevated in neuroleptic
malignant syndrome (NMS) ?
A. Creatine kinase
B. Lactic dehydrogenase
C. Lactic acid
D. All of the above

9Myoclonus can result with the use of which of the following
drugs ?
A. Phenytoin
B. Fluoxetine
C. Buspirone
D. All of the above

10 Restless Legs Syndrome was first described by ?
A. Christopher Ross
B. Micheal Emre
C. Thomas Willis
D. James Hardy

11 Secondary RLS may be associated with ?
A. Pregnancy
B. Peripheral neuropathy
C. Renal failure
D. All of the above

12 Which of the following in Wilson’s disease can manifest alone ?
A. Neurologic disorders
B. Psychiatric disorders
C. Liver disorders
D. Any of the above

13 Kayser-Fleischer (KF) rings are seen in nearly what proportion of
WD patients with hepatic presentations ?
A. 20 %
B. 40 %
C. 80 %
D. 100 %

14 Kayser-Fleischer (KF) rings are seen in nearly what proportion of
WD patients with neurologic features ?
A. 20 %
B. 40 %
C. 80 %
D. 100 %

15 Which of the following statements about Kayser-Fleischer (KF)
rings is false ?
A. Represent deposition of copper in Descemet’s membrane
B. Brownish discoloration of the peripheral cornea
C. Best detected by slit-lamp examination
D. None of the above

16 Which of the following marks the onset of neurologic
manifestations in WD ?
A. Bradykinesia
B. Tremor
C. Dystonia
D. Dysarthria

17 In WD, which of the following is false ?
A. Low levels of blood copper
B. Low levels of blood ceruloplasmin
C. High levels of urinary copper
D. None of the above

18 In WD, MRI shows symmetric hyperintensity on T2-weighted
images in ?
A. Putamen
B. Caudate
C. Pallidum
D. All of the above

19 Which of the following is the gold standard for the diagnosis of
WD ?
A. Kayser-Fleischer (KF) rings
B. Generalized atrophy on CT brain scan
C. Hyperintensity of putamen on T2-weighted MRI images
D. High copper levels in liver biopsy

20 Which of the following blocks the absorption of copper ?
A. Penicillamine
B. Tetrathiomolybdate
C. Trientine
D. Zinc

21 Which of the following statements about Penicillamine is false ?
A. Worsens symptoms in initial stages of therapy
B. Increases copper excretion
C. Should be coadministered with pyridoxine
D. None of the above
22 Astasia-abasia is best related to ?
Harrison’s 18th Ed. 3334
A. Parkinsonism
B. Cerebellar degeneration
C. Psychogenic movement disorder
D. Nystagmus

Parkinson’s Disease (PD) and Other Movement Disorders

[MCQ] Parkinson’s Disease (PD) and Other Movement Disorders- Part 6

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Parkinson’s Disease (PD) and Other Movement Disorders- Part 6

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