[MCQ] Peripheral Neuropathy - Part 5

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Peripheral Neuropathy - Part 5

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Question 1

Most common form of peripheral neuropathy associated with HIV infection is ?

A	Distal symmetric polyneuropathy (DSP)
B	Inflammatory demyelinating polyneuropathy
C	Autonomic neuropathy
D	Sensory ganglionitis

Question 1 Explanation:

DSP is the most common form of peripheral neuropathy associated with HIV infection and usually is seen in patients with AIDS.

Question 2

Lumbosacral polyradiculopathy in advanced HIV/AIDS is due to ?

A	Herpes
B	CMV infection
C	Tuberculosis
D	Lymphoma

Question 2 Explanation:

Lumbosacral polyradiculopathies are usually due to CMV infection in advanced HIV/AIDS.

Question 3

Anti-HIV drug not associated with neuropathy is ?

A	Zidovudine
B	Lamivudine
C	Abacavir
D	All of the above

Question 3 Explanation:

Zidovudine, lamivudine and abacavir are not associated with neuropathy. Dideoxycytidine, dideoxyinosine & stavudine are neurotoxic and can cause a painful sensory neuropathy.

Question 4

Most common malignancy causing neuropathies is ?

A	Lung cancer
B	Carcinoma breast
C	Carcinoma ovary
D	Carcinoma stomach

Question 4 Explanation:

Most common malignancy causing neuropathy is lung cancer. Neuropathies also complicate carcinoma of breast, ovaries, stomach, colon, rectum.

Question 5

Paraneoplastic encephalomyelitis/sensory neuronopathy (PEM/ SN) usually complicates which of the following malignancies ?

A	Small cell lung carcinoma
B	Carcinoma breast
C	Carcinoma ovary
D	Carcinoma stomach

Question 5 Explanation:

Paraneoplastic encephalomyelitis/sensory neuronopathy (PEM/SN) usually complicates small cell lung carcinoma.

Question 6

Autoantigen found in sera / CSF of patients with paraneoplastic PEM/SN is ?

A	Amphiphysin
B	Hu protein
C	Gephyrin
D	Cyclin B1

Question 6 Explanation:

Polyclonal antineuronal antibodies (IgG) directed against Hu antigen are found in sera or CSF in the majority of patients with paraneoplastic PEM/SN.

Question 7

Predominantly motor neuropathy is caused by ?

A	Lead neuropathy
B	Dapsone neuropathy
C	Vincristine neuropathy
D	All of the above

Question 8

Which of the following may cause optic neuropathy ?

A	Chloramphenicol
B	Ethambutol
C	Nitrous oxide
D	All of the above

Question 9

Which of the following is toxic to dorsal root ganglia neurons ?

A	Cisplatin
B	Paclitaxel
C	Vincristine
D	Thalidomide

Question 9 Explanation:

Cisplatin is toxic to dorsal root ganglia neurons, producing a dose-related large-fiber sensory neuropathy (neuronopathy).

Question 10

Which of the following is not a feature of cisplatin toxicity ?

A	Hearing loss
B	Lhermitte’s sign
C	Sensory ataxia
D	Dicrease in motor strength

Question 10 Explanation:

Small-fiber sensation (pain & temperature) and motor strength are spared in cisplatin toxicity.

Question 11

“Dying back” axonal neuropathy is a feature of ?

A	Cisplatin toxicity
B	Paclitaxel toxicity
C	Vincristine toxicity
D	Thalidomide toxicity

Question 11 Explanation:

Paclitaxel affects microtubule assembly, causing disruption of axonal transport and a “dying back” axonal neuropathy.

Question 12

Which of the following is a potentially neurotoxic drug ?

A	Isoniazid
B	Disulfiram
C	Pyridoxine
D	All of the above

Question 12 Explanation:

Nitrofurantoin, isoniazid, disulfiram and pyridoxine are potentially neurotoxic drugs. They cause a sensory greater than motor length-dependent axonal neuropathy or neuronopathy/ganglionopathy

Question 13

Which of the following is inhibited by isoniazid (INH) resulting in pyridoxine deficiency and neuropathy ?

A	Pyridoxal phosphate
B	Pyridoxal 5'-phosphate
C	Pyridoxal kinase
D	Pyridoxal phosphokinase

Question 13 Explanation:

INH inhibits pyridoxal phosphokinase, resulting in pyridoxine deficiency and consequent neuropathy. Prophylactic administration of pyridoxine 100 mg/day can prevent this neuropathy. Pyridoxine (Vitamin B6) refers to a family of compounds that include pyridoxine, pyridoxal, pyridoxamine, and their 5'-phosphate derivatives.

Question 14

What dose of Pyridoxine (Vitamin B6) can cause toxicity ?

A	100 mg / day
B	106 mg / day
C	110 mg / day
D	116 mg / day

Question 14 Explanation:

At high doses of Pyridoxine (116 mg/day), patients can develop a severe sensory neuropathy with dysesthesias and sensory ataxia

Question 15

Most common presentation of lead poisoning is ?

A	Sensory neuropathy
B	Motor neuropathy
C	Autonomic neuropathy
D	Encephalopathy

Question 15 Explanation:

Most common presentation of lead poisoning is an encephalopathy. Motor neuropathy can also occur. Sensation is generally preserved. Autonomic nervous system can be affected

Question 16

In lead poisoning, serum levels of which of the following is elevated ?

A	Alpha fetoprotein
B	Ceruloplasmin
C	Coproporphyrin
D	Prolactin

Question 16 Explanation:

Serum coproporphyrin level is elevated in lead poisoning

Question 17

Mee’s lines are related to which of the following ?

A	Mercury
B	Arsenic
C	Lead
D	All of the above

Question 17 Explanation:

Mee’s lines are transverse lines at the base of fingernails & toenails. Mee’s lines are seen in arsenic toxicity and following thallium poisoning.

Question 18

Diagnosis of vitamin B12 deficiency is made by ?

A	Low serum cobalamin levels
B	Raised levels of methylmalonic acid
C	Raised levels of homocysteine
D	All of the above

Question 18 Explanation:

Serum methylmalonic acid and homocysteine, the metabolites that accumulate when cobalamindependent reactions are blocked, are elevated.

Question 19

Erythrocyte transketolase activity is reduced in the blood of which nutritional neuropathy ?

A	Thiamine (Vitamin B1)
B	Pyridoxine (Vitamin B6)
C	Cobalamin (Vitamin B12)
D	Riboflavin

Question 19 Explanation:

Blood & urine assays for thiamine are not reliable for diagnosis of deficiency. Erythrocyte transketolase activity and the percentage increase in activity (in vitro) following the addition of thiamine pyrophosphate (TPP) may be more accurate & reliable.

Question 20

Drug that acts as pyridoxine (Vitamin B6) antagonist is ?

A	Isoniazid
B	Cycloserine
C	Penicillamine
D	All of the above

Question 20 Explanation:

Isoniazid, cycloserine and penicillamine act as pyridoxine antagonists by combining to aldehyde moiety of vitamin B6. Vitamin B6 deficiency is most commonly seen in patients treated with isoniazid or hydralazine.

Question 21

Measurement of xanthurenic acid after tryptophan loading helps in the diagnosis of ?

A	Thiamine (Vitamin B1) deficiency
B	Pyridoxine (Vitamin B6) deficiency
C	Cobalamin (Vitamin B12) deficiency
D	Riboflavin deficiency

Question 21 Explanation:

Measurement of xanthurenic acid after tryptophan loading can help confirm the diagnosis of pyridoxine (Vitamin B6) deficiency.

Question 22

Strachan’s syndrome is characterized by ?

A	Painful sensory neuropathy
B	Orogenital dermatitis
C	Amblyopia and deafness
D	All of the above

Question 22 Explanation:

Strachan’s syndrome is characterized by a painful sensory neuropathy associated with orogenital dermatitis, amblyopia and deafness

Question 23

Clinical features of vitamin E deficiency resemble those of ?

A	Subacute combined degeneration of spinal cord
B	Friedreich’s ataxia
C	Pellagra
D	Tabes dorsalis

Question 23 Explanation:

Presentation of vitamin E deficiency resemble those of Friedreich’s ataxia.

Question 24

Which of the following damage neurons in dorsal root ganglion ?

A	Cisplatin
B	Varicella zoster virus (VZV)
C	Vitamin E deficiency
D	All of the above

Question 25

The number of tendons in carpal tunnel is ?

A	7
B	8
C	9
D	10

Question 26

In carpal tunnel syndrome (CTS), nocturnal paresthesia is common in ?

A	Thumb
B	Index finger
C	Middle finger
D	All of the above

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See all quizzes of Peripheral Neuropathy here:

1 Most common form of peripheral neuropathy associated with HIV
infection is ?

A. Distal symmetric polyneuropathy (DSP)
B. Inflammatory demyelinating polyneuropathy
C. Autonomic neuropathy
D. Sensory ganglionitis

2 Lumbosacral polyradiculopathy in advanced HIV/AIDS is due to ?
A. Herpes
B. CMV infection
C. Tuberculosis
D. Lymphoma

3 Anti-HIV drug not associated with neuropathy is ?
A. Zidovudine
B. Lamivudine
C. Abacavir
D. All of the above

4 Most common malignancy causing neuropathies is ?
A. Lung cancer
B. Carcinoma breast
C. Carcinoma ovary
D. Carcinoma stomach

5 Paraneoplastic encephalomyelitis/sensory neuronopathy (PEM/
SN) usually complicates which of the following malignancies ?
A. Small cell lung carcinoma
B. Carcinoma breast
C. Carcinoma ovary
D. Carcinoma stomach

6 Autoantigen found in sera / CSF of patients with paraneoplastic
PEM/SN is ?
A. Amphiphysin
B. Hu protein
C. Gephyrin
D. Cyclin B1

7 Predominantly motor neuropathy is caused by ?
A. Lead neuropathy
B. Dapsone neuropathy
C. Vincristine neuropathy
D. All of the above
8 Which of the following may cause optic neuropathy ?
A. Chloramphenicol
B. Ethambutol
C. Nitrous oxide
D. All of the above
9 Which of the following is toxic to dorsal root ganglia neurons ?
A. Cisplatin
B. Paclitaxel
C. Vincristine
D. Thalidomide

10 Which of the following is not a feature of cisplatin toxicity ?
A. Hearing loss
B. Lhermitte’s sign
C. Sensory ataxia
D. Dicrease in motor strength

11 “Dying back” axonal neuropathy is a feature of ?
Harrison’s 17th Ed. 2659
A. Cisplatin toxicity
B. Paclitaxel toxicity
C. Vincristine toxicity
D. Thalidomide toxicity

12 Which of the following is a potentially neurotoxic drug ?
A. Isoniazid
B. Disulfiram
C. Pyridoxine
D. All of the above

13 Which of the following is inhibited by isoniazid (INH) resulting in
pyridoxine deficiency and neuropathy ?
A. Pyridoxal phosphate
B. Pyridoxal 5′-phosphate
C. Pyridoxal kinase
D. Pyridoxal phosphokinase

14 What dose of Pyridoxine (Vitamin B6) can cause toxicity ?
A. 100 mg / day
B. 106 mg / day
C. 110 mg / day
D. 116 mg / day

15 Most common presentation of lead poisoning is ?
A. Sensory neuropathy
B. Motor neuropathy
C. Autonomic neuropathy
D. Encephalopathy

16 In lead poisoning, serum levels of which of the following is
elevated ?
A. Alpha fetoprotein
B. Ceruloplasmin
C. Coproporphyrin
D. Prolactin

17 Mee’s lines are related to which of the following ?
A. Mercury
B. Arsenic
C. Lead
D. All of the above

18 Diagnosis of vitamin B12 deficiency is made by ?
A. Low serum cobalamin levels
B. Raised levels of methylmalonic acid
C. Raised levels of homocysteine
D. All of the above

19 Erythrocyte transketolase activity is reduced in the blood of which
nutritional neuropathy ?
A. Thiamine (Vitamin B1)
B. Pyridoxine (Vitamin B6)
C. Cobalamin (Vitamin B12)
D. Riboflavin

20 Drug that acts as pyridoxine (Vitamin B6) antagonist is ?
A. Isoniazid
B. Cycloserine
C. Penicillamine
D. All of the above

21 Measurement of xanthurenic acid after tryptophan loading helps
in the diagnosis of ?
A. Thiamine (Vitamin B1) deficiency
B. Pyridoxine (Vitamin B6) deficiency
C. Cobalamin (Vitamin B12) deficiency
D. Riboflavin deficiency

22 Strachan’s syndrome is characterized by ?
A. Painful sensory neuropathy
B. Orogenital dermatitis
C. Amblyopia and deafness
D. All of the above

23 Clinical features of vitamin E deficiency resemble those of ?
A. Subacute combined degeneration of spinal cord
B. Friedreich’s ataxia
C. Pellagra
D. Tabes dorsalis

24 Which of the following damage neurons in dorsal root ganglion ?
A. Cisplatin
B. Varicella zoster virus (VZV)
C. Vitamin E deficiency
D. All of the above
25 The number of tendons in carpal tunnel is ?
A. 7
B. 8
C. 9
D. 10
26 In carpal tunnel syndrome (CTS), nocturnal paresthesia is common
in ?
A. Thumb
B. Index finger
C. Middle finger
D. All of the above

Peripheral Neuropathy

[MCQ] Peripheral Neuropathy – Part 5

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Peripheral Neuropathy - Part 5

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