Neuroimmunology
QUESTIONS
1. Which of the following statements is true regarding acute disseminated encephalomyelitis (ADEM)?
A. It is indistinguishable from multiple sclerosis.
B. It is a nonvasculitic demyelinating process.
C. Genetics probably play no role in this disease.
D. Multiple sclerosis (MS) is usually a monophasic illness.
E. None of the above
View Answer
1. Answer: B. ADEM is a nonvasculitic inflammatory demyelinating condition that is very similar to MS but can be differentiated by clinical features and laboratory tests.
2. What percentage of patients that develop ADEM occurs in children under the age of 10?
A. 1%
B. 25%
C. 80%
D. 99%
E. None of the above
View Answer
2. Answer: C. Around 80% of childhood cases of ADEM occur under the age of 10. Less than 20% of cases occur in the second decade of life.
3. Which of the following is helpful in distinguishing ADEM from MS?
A. Age younger than 12
B. Fever
C. Seizures
D. Recent immunization
E. All of the above
View Answer
3. Answer: E. All of the above help distinguish ADEM from MS. Also, there are often less posterior column abnormalities, which is more common in MS patients.
4. A 17-year-old patient presents with ankylosing spondylitis. Which of the following statements is true?
A. More females than males are affected.
B. Uveitis is a possible associated condition.
C. Approximately 25% of the US population is affected.
D. The pain associated with this condition is worse in the afternoon and improves in the morning.
E. None of the above
View Answer
4. Answer: B. Uveitis, iritis, aortitis, pulmonary fibrosis, amyloidosis, and inflammatory bowel disease are all associated conditions. More men are affected than women, and only approximately 1% of the population is affected with this condition.
5. What percentage of patients with ankylosing spondylitis have HLA-B27 antigen?
A. 1%
B. 10%
C. 50%
D. 75%
E. 95%
View Answer
5. Answer: E. Ninety percent to 95% of patients have this antigen. This test is most helpful when the diagnosis is not clear.
6. What percentage of patients with Bell’s palsy have recurrence?
A. 15%
B. 30%
C. 70%
D. 90%
E. None of the above
View Answer
6. Answer: A. Approximately 10% to 15% of patients can have recurrence of Bell’s palsy on the ipsilateral side or the contralateral side of the initial palsy. Recurrence typically occurs in patients with a family history of recurrent Bell’s palsy. Some patients with recurrence were found to have tumors of the seventh nerve or inflammatory or demyelinating disease. Patients with diabetes are more likely to have recurrence as well.
7. Which of the following statements regarding Bell’s palsy is true?
A. Men are more likely to be affected than women.
B. The lowest incidence is in persons older than age 60.
C. Pregnant women are three times more likely to be affected than nonpregnant women.
D. Overall, patients have a poor prognosis with Bell’s palsy.
E. None of the above
View Answer
7. Answer: C. Pregnant women are more likely to be affected. The sexes are equally affected, and the highest incidence is in persons older than age 60.
8. What percentage of patients with Behçet’s disease have an associated oral ulcer?
A. 1%
B. 10%
C. 50%
D. 75%
E. 100%
View Answer
8. Answer: E. All patients with Behçet’s disease will have an associated oral aphthous ulceration. Approximately three fourths of patients will have genital aphthous ulceration.
9. Which of the following are hallmark features of MS?
A. Neurologic deficits usually once in time
B. Recurrent neurologic deficits that are disseminated by space and time
C. Seizure disorder
D. Bilateral optic neuritis and transverse myelitis
E. None of the above
View Answer
9. Answer: B. The clinical hallmark of the disease is the recurrent neurologic deficits that are disseminated in space and time.
10. Which of the following is not part of the four standard categories used to describe the clinical course of MS?
A. Relapsing remitting
B. Secondary progressive
C. Progressive relapsing
D. Primary progressive

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