[MCQ] Peripheral Neuropathy - Part 4

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Peripheral Neuropathy - Part 4

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Question 1

Presence of which of the following is a risk factors for diabetic neuropathy ?

A	Long-standing, poorly controlled DM
B	Presence of retinopathy
C	Presence of nephropathy
D	All of the above

Question 1 Explanation:

Risk factors for the development of diabetic neuropathy include long-standing, poorly controlled DM and presence of retinopathy & nephropathy.

Question 2

Which of the following is the most common form of diabetic neuropathy ?

A	Diabetic truncal radiculoneuropathy (DTRN)
B	Diabetic lumbosacral radiculoplexus neuropathy
C	Oculomotor (III or VI nerve) neuropathy
D	Diabetic sensorimotor polyneuropathy (DSPN)

Question 2 Explanation:

Diabetic Distal Symmetric Sensory and Sensorimotor Polyneuropathy (DSPN) is the most common form of diabetic neuropathy

Question 3

Sensory loss in DSPN begins in ?

A	Nose
B	Fingers
C	Toes
D	Buttocks

Question 3 Explanation:

DSPN manifests as sensory loss beginning in the toes that gradually progresses over time up the legs and into the fingers and arms.

Question 4

Which of the following nerves are involved in diabetic sensorimotor polyneuropathy (DSPN) ?

A	Small- and large-fiber sensory
B	Autonomic
C	Motor
D	All of the above

Question 4 Explanation:

DSPN is a mixed neuropathy with small- & large-fiber sensory, autonomic, & motor nerve involvement in various combinations. Sensory & autonomic symptoms are more prominent than motor

Question 5

Which of the following has relevance in the pathogenesis of diabetic sensorimotor polyneuropathy (DSPN) ?

A	Myo-inositol
B	Betaine
C	Glutamine
D	All of the above

Question 5 Explanation:

DSPN could be caused by an increased neuronal glucose conversion to sorbitol by aldose reductase using NADPH as a coenzyme. Sorbitol decreases levels of myo-inositol and phosphoinositides, leading to a decrease in diacylglycerol, protein kinase C, and Na+, K+, ATPase activity. This sequence of events leads to axonal loss & demyelination

Question 6

Diabetic autonomic neuropathy is typically seen in combination with ?

A	DSPN
B	Diabetic neuropathic cachexia
C	Polyradiculoneuropathies
D	Cranial neuropathies

Question 6 Explanation:

Autonomic neuropathy is typically seen in combination with DSPN.

Question 7

Initial presentation in diabetic amyotrophy or Bruns-Garland Syndrome is ?

A	Pain
B	Sensory loss
C	Muscle weakness
D	Diplopia

Question 7 Explanation:

Typically, patients of diabetic radiculoplexus neuropathy present with severe pain in low back, hip, and thigh in one leg. Atrophy & weakness of proximal & distal muscles in the affected leg become apparent within a few days or weeks. Neuropathy is often accompanied by severe weight loss.

Question 8

Asymmetric abrupt-onset diabetic neuropathy is ?

A	Diabetic truncal radiculoneuropathy (DTRN)
B	Diabetic lumbosacral radiculoplexus neuropathy
C	Cranial neuropathy
D	All of the above

Question 8 Explanation:

Asymmetric abrupt-onset diabetic neuropathies include diabetic truncal radiculoneuropathy (DTRN), diabetic lumbosacral radiculoplexus neuropathy (DLSRPN) & oculomotor (III or VI nerve) neuropathy

Question 9

Which is the most frequently involved cranial nerve in diabetes ?

A	III
B	IV
C	VI
D	VII

Question 9 Explanation:

Cranial neuropathy occurs in those over 50 years and who already have evidence of DSPN. Abducens (sixth) nerve is most often affected. Spontaneous recovery typically occurs within 3 - 5 months. Bell’s palsy is common in older diabetics.

Question 10

Which is the most frequently involved cranial nerve in diabetes ?

A	III
B	IV
C	VI
D	VII

Question 10 Explanation:

In regard to cranial mononeuropathies, a seventh nerve palsy is most common, followed by third nerve, sixth nerve, and, less frequently, fourth nerve palsies

Question 11

Which of the following is not a feature of diabetic third nerve palsy ?

A	Abrupt in onset
B	Intense retroorbital pain
C	Bilateral ptosis
D	Restriction of medial gaze & upgaze

Question 11 Explanation:

Diabetic III nerve palsy is abrupt in onset, heralded by intense retroorbital pain, double vision, unilateral ptosis & restriction of medial gaze & upgaze.

Question 12

Which of the following is not a feature of diabetic third nerve palsy ?

A	Abrupt in onset
B	Intense retroorbital pain
C	Dilated pupil
D	Improve spontaneously in 3 - 6 months

Question 12 Explanation:

Pupil is nearly always spared in diabetic III nerve palsy as pupillomotor fibers are present on the outer layers of III nerve fascicle, and an ischemic lesion tends to involve the center of the fascicle. Thus, diabetic third nerve palsies are characteristically pupil-sparing.

Question 13

Trigeminal neuropathy occurs in which of the following illnesses ?

A	Systemic sclerosis (Scleroderma)
B	Sjögren syndrome
C	Leprosy
D	All of the above

Question 14

Which of the following is related to insulin treatment for diabetes ?

A	Diabetic truncal radiculoneuropathy
B	Diabetic amyotrophy
C	Insulin neuritis
D	All of the above

Question 14 Explanation:

Insulin neuritis is a painful neuropathy seen with initiation of insulin treatment for diabetes.

Question 15

Carpal tunnel syndrome can be a presentation of which of the following illnesses ?

A	Familial amyloid polyneuropathy (FAP)
B	Hypothyroidism
C	Uremic neuropathy
D	All of the above

Question 16

Clinical presentation can mimic Guillain-Barré syndrome in ?

A	Porphyria
B	Sarcoidosis
C	Arsenic neuropathy
D	All of the above

Question 17

Acute, severe sensorimotor polyneuropathy can resemble Guillain- Barré syndrome in ?

A	Nitrofurantoin
B	Inflammatory Bowel Disease
C	Uremic Neuropathy
D	All of the above

Question 18

Mycobacterium leprae causes ?

A	Mononeuropathy
B	Mononeuropathy multiplex
C	Polyneuropathy
D	Plexopathy

Question 19

In leprosy, sensory loss does not occur in all except ?

A	Groin
B	Axilla
C	Pinnae of ears
D	Scalp

Question 19 Explanation:

In leprosy, sensory loss spares midline of trunk anteriorly, groin, axilla & scalp - the warmer regions of the body

Question 20

Which of the following cranial nerves is involved in leprosy ?

A	III
B	V
C	VI
D	XI

Question 20 Explanation:

V & VII cranial nerves, greater auricular nerve in neck, median & ulnar nerves, and peroneal nerves are involved in leprosy.

Question 21

Lyme disease is caused by ?

A	Borrelia recurrentis
B	Borrelia burgdorferi
C	Borrelia hermsii
D	Borrelia turicatae

Question 21 Explanation:

Lyme disease is caused by infection with Borrelia burgdorferi, a spirochete

Question 22

Diphtheritic neuropathy develops after how many months after the initial infection ?

A	1 or 2 months
B	2 or 3 months
C	3 or 4 months
D	4 or 5 months

Question 22 Explanation:

A generalized polyneuropathy may manifest 2 or 3 months following the initial diphtheritic infection

Question 23

Which of the following is the presentation of nerve involvement in HIV infection ?

A	Polyradiculopathy
B	Distal symmetric polyneuropathy (DSP)
C	Inflammatory demyelinating polyneuropathy
D	Any of the above

Question 23 Explanation:

Major presentations of peripheral neuropathy associated with HIV infection include distal symmetric polyneuropathy (DSP), inflammatory demyelinating polyneuropathy (GBS & CIDP), multiple mononeuropathies (vasculitis, CMV-related), polyradiculopathy (CMV-related), autonomic neuropathy, and sensory ganglionitis.

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See all quizzes of Peripheral Neuropathy here:

1 Presence of which of the following is a risk factors for diabetic
neuropathy ?
A. Long-standing, poorly controlled DM
B. Presence of retinopathy
C. Presence of nephropathy
D. All of the above

2 Which of the following is the most common form of diabetic
neuropathy ?
A. Diabetic truncal radiculoneuropathy (DTRN)
B. Diabetic lumbosacral radiculoplexus neuropathy
C. Oculomotor (III or VI nerve) neuropathy
D. Diabetic sensorimotor polyneuropathy (DSPN)

3 Sensory loss in DSPN begins in ?
A. Nose
B. Fingers
C. Toes
D. Buttocks

4 Which of the following nerves are involved in diabetic
sensorimotor polyneuropathy (DSPN) ?
A. Small- and large-fiber sensory
B. Autonomic
C. Motor
D. All of the above

5 Which of the following has relevance in the pathogenesis of
diabetic sensorimotor polyneuropathy (DSPN) ?
A. Myo-inositol
B. Betaine
C. Glutamine
D. All of the above

6 Diabetic autonomic neuropathy is typically seen in combination
with ?
A. DSPN
B. Diabetic neuropathic cachexia
C. Polyradiculoneuropathies
D. Cranial neuropathies

7 Initial presentation in diabetic amyotrophy or Bruns-Garland
Syndrome is ?
A. Pain
B. Sensory loss
C. Muscle weakness
D. Diplopia

8 Asymmetric abrupt-onset diabetic neuropathy is ?
A. Diabetic truncal radiculoneuropathy (DTRN)
B. Diabetic lumbosacral radiculoplexus neuropathy
C. Cranial neuropathy
D. All of the above

9 Which is the most frequently involved cranial nerve in diabetes ?
A. III
B. IV
C. VI
D. VII

10 Which is the most frequently involved cranial nerve in diabetes ?
A. III
B. IV
C. VI
D. VII

11 Which of the following is not a feature of diabetic third nerve
palsy ?
A. Abrupt in onset
B. Intense retroorbital pain
C. Bilateral ptosis
D. Restriction of medial gaze & upgaze

12 Which of the following is not a feature of diabetic third nerve
palsy ?
A. Abrupt in onset
B. Intense retroorbital pain
C. Dilated pupil
D. Improve spontaneously in 3 – 6 months
13 Trigeminal neuropathy occurs in which of the following illnesses ?
A. Systemic sclerosis (Scleroderma)
B. Sjögren syndrome
C. Leprosy
D. All of the above
14 Which of the following is related to insulin treatment for diabetes ?
A. Diabetic truncal radiculoneuropathy
B. Diabetic amyotrophy
tahir99 – UnitedVRG
C. Insulin neuritis
D. All of the above

15 Carpal tunnel syndrome can be a presentation of which of the
following illnesses ?
A. Familial amyloid polyneuropathy (FAP)
B. Hypothyroidism
C. Uremic neuropathy
D. All of the above
16 Clinical presentation can mimic Guillain-Barré syndrome in ?
A. Porphyria
B. Sarcoidosis
C. Arsenic neuropathy
D. All of the above
17 Acute, severe sensorimotor polyneuropathy can resemble Guillain-
Barré syndrome in ?
A. Nitrofurantoin
B. Inflammatory Bowel Disease
C. Uremic Neuropathy
D. All of the above
18 Mycobacterium leprae causes ?
A. Mononeuropathy
B. Mononeuropathy multiplex
C. Polyneuropathy
D. Plexopathy

19 Peripheral nerves are affected in which type of leprosy ?
A. Tuberculoid
B. Lepromatous
C. Borderline
D. All of the above

20 In leprosy, sensory loss does not occur in all except ?
A. Groin
B. Axilla
C. Pinnae of ears
D. Scalp

21 Which of the following cranial nerves is involved in leprosy ?
A. III
B. V
C. VI
D. XI

22 Lyme disease is caused by ?
A. Borrelia recurrentis
B. Borrelia burgdorferi
C. Borrelia hermsii
D. Borrelia turicatae

23 Diphtheritic neuropathy develops after how many months after
the initial infection ?
A. 1 or 2 months
B. 2 or 3 months
C. 3 or 4 months
D. 4 or 5 months

24 Which of the following is the presentation of nerve involvement
in HIV infection ?
A. Polyradiculopathy
B. Distal symmetric polyneuropathy (DSP)
C. Inflammatory demyelinating polyneuropathy
D. Any of the above

Peripheral Neuropathy

[MCQ] Peripheral Neuropathy – Part 4

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Peripheral Neuropathy - Part 4

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