[MCQ] Peripheral Neuropathy - Part 1

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Peripheral Neuropathy - Part 1

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Question 1

Peripheral nerves are composed of which of the following elements ?

A	Sensory
B	Motor
C	Autonomic
D	All of the above

Question 1 Explanation:

Peripheral nerves are composed of sensory, motor and autonomic elements.

Question 2

Which of the following is not a major class of nerves ?

A	Large myelinated
B	Large unmyelinated
C	Small myelinated
D	Small unmyelinated

Question 2 Explanation:

Nerves can be subdivided into three major classes: large myelinated, small myelinated, and small unmyelinated.

Question 3

Motor axons conduct impulses at the speed of about ?

A	25 m/sec
B	50 m/sec
C	75 m/sec
D	100 m/sec

Question 3 Explanation:

Motor axons are usually large myelinated fibers & conduct impulses at ~ 50 m/sec.

Question 4

Sensory fibers are of which type ?

A	Large myelinated
B	Small myelinated
C	Small unmyelinated
D	Any of the above

Question 4 Explanation:

Sensory fibers may be any of the three types namely, large myelinated, small myelinated or small unmyelinated.

Question 5

Which of the following is a possibility in symmetric proximal and distal weakness with sensory loss ?

A	Chronic inflammatory demyelinating polyneuropathy (CIDP)
B	Charcot-Marie-Tooth disease
C	Spinal muscular atrophy (SMA)
D	Diabetes mellitus

Question 5 Explanation:

In the scenario of symmetric proximal and distal weakness with sensory loss, inflammatory demyelinating polyneuropathy (GBS and CIDP) are a possibility.

Question 6

Which of the following is a possibility in symmetric distal sensory loss with or without distal weakness ?

A	Chronic inflammatory demyelinating polyneuropathy (CIDP)
B	Guillain-Barré syndrome
C	Spinal muscular atrophy (SMA)
D	Diabetes mellitus

Question 6 Explanation:

In the scenario of symmetric distal sensory loss with or without distal weakness, cryptogenic or idiopathic sensory polyneuropathy (CSPN), diabetes mellitus and other metabolic disorders, drugs, toxins, hereditary (Charcot-Marie-Tooth, amyloidosis, and others) are a possibility.

Question 7

Which of the following is a possibility in asymmetric distal weakness with sensory loss with involvement of multiple nerves ?

A	Multifocal CIDP
B	Sarcoidosis
C	Hereditary neuropathy with liability to pressure palsies
D	All of the above

Question 8

Which of the following is a possibility in asymmetric proximal and distal weakness with sensory loss ?

A	Diabetes mellitus
B	Meningeal carcinomatosis
C	Hereditary neuropathy with liability to pressure palsies
D	All of the above

Question 9

Which of the following is a possibility in asymmetric distal weakness (UMN) without sensory loss ?

A	Diabetes mellitus
B	Multifocal motor neuropathy
C	Motor neuron disease
D	Progressive muscular atrophy

Question 9 Explanation:

Asymmetric distal weakness without sensory loss with upper motor neuron findings is seen in motor neuron disease. Those without upper motor neuron findings is seen in progressive muscular atrophy, juvenile monomelic amyotrophy (Hirayama disease), multifocal motor neuropathy, multifocal acquired motor axonopathy.

Question 10

Which of the following is a possibility in asymmetric distal weakness (UMN) without sensory loss ?

A	Diabetes mellitus
B	Multifocal motor neuropathy
C	Motor neuron disease
D	Progressive muscular atrophy

Question 10 Explanation:

Question 11

Which of the following is a possibility in symmetric sensory loss and distal areflexia with upper motor neuron findings ?

A	Vitamin B12 deficiency
B	Vitamin E deficiency
C	Copper deficiency
D	All of the above

Question 11 Explanation:

Symmetric sensory loss and distal areflexia with upper motor neuron findings is seen in Vitamin B12, vitamin E, and copper deficiency with combined system degeneration with peripheral neuropathy, hereditary leukodystrophies (adrenomyeloneuropathy)

Question 12

Which of the following

A	Guillain-Barré syndrome
B	Spinal muscular atrophy
C	Diabetes mellitus
D	Chronic inflammatory demyelinating polyneuropathy (CIDP)

Question 12 Explanation:

Symmetric weakness without sensory loss with proximal and distal weakness is seen in spinal muscular atrophy and with distal weakness seen in hereditary motor neuropathy (“distal” SMA) or atypical CMT

Question 13

If the patient has only weakness without any evidence of sensory or autonomic dysfunction, the diagnosis can be ?

A	Motor neuropathy
B	Neuromuscular junction abnormality
C	Myopathy
D	Any of the above

Question 13 Explanation:

If the patient has only weakness without any evidence of sensory or autonomic dysfunction, a motor neuropathy, neuromuscular junction abnormality, or myopathy can be the cause.

Question 14

Heat intolerance is a symptom due to which of the following abnormalities ?

A	Motor
B	Sensory
C	Autonomic
D	All of the above

Question 14 Explanation:

Symptoms of autonomic neuropathy are fainting spells or orthostatic lightheadedness (orthostatic fall in blood pressure without an appropriate increase in heart rate), heat intolerance or any bowel, bladder, or sexual dysfunction.

Question 15

Majority of neuropathies are predominantly ?

A	Motor
B	Sensory
C	Autonomic
D	Combined

Question 15 Explanation:

Majority of neuropathies are predominantly sensory in nature.

Question 16

Symmetric proximal and distal weakness is the hallmark of ?

A	Charcot-Marie-Tooth disease
B	Guillain-Barré syndrome (GBS)
C	Motor neuron disease
D	Diabetes mellitus

Question 16 Explanation:

Symmetric proximal & distal weakness is the hallmark of acquired immune demyelinating polyneuropathies, both acute form (AIDP) also known as Guillain-Barré syndrome (GBS) and the chronic inflammatory demyelinating polyneuropathy (CIDP).

Question 17

Which of the following is the cause of combined system degeneration with neuropathy ?

A	Vitamin B12 deficiency
B	Copper deficiency
C	HIV infection
D	All of the above

Question 17 Explanation:

Symmetric distal sensory neuropathy, with symmetric upper motor neuron involvement, suggests combined system degeneration with neuropathy as seen in vitamin B12 deficiency, copper deficiency, HIV infection, severe hepatic disease & adrenomyeloneuropathy

Question 18

Which of the following neuropathies does not present acutely or subacutely ?

A	GBS
B	Diabetes
C	Lyme disease
D	Porphyria

Question 18 Explanation:

Neuropathies with acute and subacute presentations include GBS, vasculitis, and radiculopathies related to diabetes or Lyme disease. A relapsing course is seen in CIDP and porphyria.

Question 19

Fixatives containing which element can lead to copper deficiency ?

A	Aluminium
B	Lead
C	Zinc
D	Nickel

Question 19 Explanation:

Fixatives that contain zinc that can lead to copper deficiency

Question 20

Which of the following is not a EDx finding in axonal neuropathy ?

A	Low-amplitude potentials
B	Absence of fibrillations
C	Relatively preserved distal latencies
D	Relatively preserved conduction velocities

Question 20 Explanation:

Nerve conduction studies (NCS) are helpful in differentiating between axonal degeneration or segmental demyelination. Low-amplitude potentials with relatively preserved distal latencies, conduction velocities, and late potentials, along with fibrillations suggest an axonal neuropathy. Relatively preserved amplitudes, slow conduction velocities, prolonged distal latencies and late potentials, and absence of fibrillations imply a primary demyelinating neuropathy.

Question 21

Most common cause of sensory ganglionopathies is ?

A	Porphyria
B	Diabetes mellitus
C	Vitamin B12 deficiency
D	Sjögren syndrome

Question 21 Explanation:

Most common causes of sensory ganglionopathies presenting as severe sensory ataxia are Sjögren syndrome and paraneoplastic neuropathy.

Question 22

Most commonly biopsied nerve is ?

A	Superficial peroneal nerve
B	Common peroneal nerve
C	Sural nerve
D	Superficial lateral cuteneous nerve

Question 22 Explanation:

Nerve biopsies should be done only if NCS studies are abnormal. Sural nerve is most commonly biopsied because it is a pure sensory nerve and biopsy will not result in loss of motor function.

Question 23

Which of the following physical finding favours diagnosis of CMT ?

A	Inverted champagne bottle appearanceof legs
B	Hammer toes
C	High arched feet (pes cavus)
D	All of the above

Question 23 Explanation:

Wasting & weakness of distal muscles of legs lead to inverted champagne bottle like appearance. Hammer toes & pes cavus are common & indicate onset of CMT in early life.

Question 24

Diagnosis of CMT is favoured by which of the following observation ?

A	Early age of onset
B	Positive family history
C	Long standing symptoms
D	All of the above

Question 24 Explanation:

Diagnosis of CMT is favoured by an early age of onset, positive family history, and long standing symptoms. If EDx findings indicate a demyelinating process, diagnosis of CMT can be made with confidence.

Question 25

Mutations in myelin protein zero (MPZ, or P0) gene can produce which of the following ?

A	DéJerine-Sottas Syndrome (DSS)
B	Congenital Hypomyelinating Neuropathy (CHN)
C	Charcot-Marie-Tooth 2 (CMT2) axonal neuropathy
D	All of the above

Question 25 Explanation:

Mutations in myelin protein zero (MPZ, or P0) gene can produce DSS, CHN, or CMT2.

Question 26

Infantile-onset or severe childhood forms of CMT include ?

A	Déjerine-Sottas syndrome (DSS)
B	Congenital hypomyelinating neuropathies (CHN)
C	Roussy-Lévy syndrome
D	All of the above

Question 26 Explanation:

Infantile-onset or severe childhood forms of CMT include Déjerine-Sottas syndrome (DSS), congenital hypomyelinating neuropathies (CHN) and Roussy-Lévy syndrome.

Question 27

Which of the following is the role of PMP22 ?

A	Initiation of myelin spirals
B	Regulation & growth of Schwann cells
C	Maintenance of myelin sheaths
D	All of the above

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See all quizzes of Peripheral Neuropathy here:

1 Peripheral nerves are composed of which of the following elements ?
A. Sensory
B. Motor
C. Autonomic
D. All of the above

2 Which of the following is not a major class of nerves ?
A. Large myelinated
B. Large unmyelinated
C. Small myelinated
D. Small unmyelinated

3 Motor axons conduct impulses at the speed of about ?
A. 25 m/sec
B. 50 m/sec
C. 75 m/sec
D. 100 m/sec

4 Sensory fibers are of which type ?
A. Large myelinated
B. Small myelinated
C. Small unmyelinated
D. Any of the above

5 Proprioception & vibratory sensation are conducted to the brain
by ?
A. Large-diameter sensory fibers
B. Smaller-diameter myelinated fibers
C. Smaller-diameter unmyelinated fibers
D. All of the above

6 Which of the following is a possibility in symmetric proximal and
distal weakness with sensory loss ?
A. Chronic inflammatory demyelinating polyneuropathy (CIDP)
B. Charcot-Marie-Tooth disease
C. Spinal muscular atrophy (SMA)
D. Diabetes mellitus

7 Which of the following is a possibility in symmetric distal sensory
loss with or without distal weakness ?
A. Chronic inflammatory demyelinating polyneuropathy (CIDP)
B. Guillain-Barré syndrome
C. Spinal muscular atrophy (SMA)
D. Diabetes mellitus

8 Which of the following is a possibility in asymmetric distal weakness
with sensory loss with involvement of multiple nerves ?
A. Multifocal CIDP
B. Sarcoidosis
C. Hereditary neuropathy with liability to pressure palsies
D. All of the above

9 Which of the following is a possibility in asymmetric proximal
and distal weakness with sensory loss ?
A. Diabetes mellitus
B. Meningeal carcinomatosis
C. Hereditary neuropathy with liability to pressure palsies
D. All of the above

10 Which of the following is a possibility in asymmetric distal
weakness (UMN) without sensory loss ?
A. Diabetes mellitus
B. Multifocal motor neuropathy
C. Motor neuron disease
D. Progressive muscular atrophy

11 Which of the following is a possibility in symmetric sensory loss
and distal areflexia with upper motor neuron findings ?
A. Vitamin B12 deficiency
B. Vitamin E deficiency
C. Copper deficiency
D. All of the above

12 Which of the following is a possibility in symmetric weakness
without sensory loss ?
A. Guillain-Barré syndrome
B. Spinal muscular atrophy
C. Diabetes mellitus
D. Chronic inflammatory demyelinating polyneuropathy (CIDP)

13 If the patient has only weakness without any evidence of sensory
or autonomic dysfunction, the diagnosis can be ?
A. Motor neuropathy
B. Neuromuscular junction abnormality
C. Myopathy
D. Any of the above

14 Heat intolerance is a symptom due to which of the following
abnormalities ?
A. Motor
B. Sensory
C. Autonomic
D. All of the above

15 Majority of neuropathies are predominantly ?
A. Motor
B. Sensory
C. Autonomic
D. Combined

16 Symmetric proximal and distal weakness is the hallmark of ?
A. Charcot-Marie-Tooth disease
B. Guillain-Barré syndrome (GBS)
C. Motor neuron disease
D. Diabetes mellitus

17 Which of the following is the cause of combined system
degeneration with neuropathy ?
A. Vitamin B12 deficiency
B. Copper deficiency
C. HIV infection
D. All of the above

18 Which of the following neuropathies does not present acutely or
subacutely ?
A. GBS
B. Diabetes
C. Lyme disease
D. Porphyria

19 Fixatives containing which element can lead to copper deficiency ?
A. Aluminium
B. Lead
C. Zinc
D. Nickel

20 Which of the following is not a EDx finding in axonal neuropathy ?
A. Low-amplitude potentials
B. Absence of fibrillations
C. Relatively preserved distal latencies
D. Relatively preserved conduction velocities

21 Most common cause of sensory ganglionopathies is ?
A. Porphyria
B. Diabetes mellitus
C. Vitamin B12 deficiency
D. Sjögren syndrome

22 Most commonly biopsied nerve is ?
A. Superficial peroneal nerve
B. Common peroneal nerve
C. Sural nerve
D. Superficial lateral cuteneous nerve

23 Which of the following physical finding favours diagnosis of CMT ?
A. Inverted champagne bottle appearanceof legs
B. Hammer toes
C. High arched feet (pes cavus)
D. All of the above

Peripheral Neuropathy

[MCQ] Peripheral Neuropathy – Part 1

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Peripheral Neuropathy - Part 1

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