Neuromuscular Questions

1. A lesion in which nerve would not allow the patient to make the OK sign with
the thumb and index inger!
". #n a $ells %als& &ou would expect to ind weakness in all the ollowing muscles
except!
a' Orbicularis oculi
b' Orbicularis oris
c' %lat&smus
d' (asseter
). *he genetic deect in +ereditar& Neuropath& with ,iabilit& to %ressure %alsies is!
a' -eletion on %(% ""
b' -uplication on %(% ""
c' -eletion on % .ero
d' -uplication on % /ero
0. #n 1ti person s&ndrome &ou would expect to ind the ollowing except!
a' 23ual incidence in men and women
b' %roximal distribution o stiness
c' -evelopment o lordosis
d' -iabetes
e' 1ei/ures are not seen
4. Ater an episode o Optic Neurits the best predictor o (1 is!
a' 516 studies
b' Age o the patient
c' $rain (7
d' 6amil& histor&
8. *he ollowing are consistent with the diagnosis o ,2(1 except!
a' +istor& o cancer
b' -r& mouth and constipation
c' %roximal weakness
d' -ecrement on rapid stimulation
e' All o the above
9. #n cervical stenosis &ou could ind the ollowing signs or s&mptoms except!
a' Absence o pain
b' (ixture o upper and lower motor neuron signs
c' ,oss o distal relexes
d' 6asiculations and wasting in the lower extremit&
:. #n congenital m&otonic d&stroph& &ou can ind all the ollowing except!
a' 5ardiac arrh&thmias
b' +&potonia
c' 5ontractures
d' m&otonia
e' %oor suck
;. On a $rain (7# lesions in the gra&<white matter are more characteristic with !
a' (1
b' (etachromic leukod&stroph&
c' =asculitis
d' %(,
1>. *he ollowing are true o adrenoleukod&stroph& except
a' ?<linked disorder
b' -eect o beta oxidation
c' Onl& exist as a childhood orm
d' Accumulation o ver&<long chain att& acids
11. A child with acute or subacute descending paral&sis and sluggish pupils most
likel& is suering rom@
a. $otulism
b. 1pinal muscular atroph&
c. Nonketotic h&pergl&cemia
d. (&otonic d&stroph&
1". %eriascicular atroph& on muscle biops& is most consistent with the diagnosis o@
a. %ol&m&ositis
b. -ermatom&ositis
c. #nclusion $od& (&ositis
d. 1tatin (&opath&
1). =asculitis has been associated with all the ollowing except@
a. Amphetamine use
b. %ol&arteritis nodosa
c. 7heumatoid
d. Aegeners granulomatosis
e. %ol&m&algia rheumatica
10. *he ollowing are true in B$1 electroph&siological studies except
a. 1lowing o peripheral conduction velocit&
b. #ncreased central conduction time
c. %rolonged 6<waves and distal motor latencies
d. 1paring o the sural nerve 1NA%
e. All are true
14. #n 6acioscapulohumeral d&stroph& patients have all the ollowing except@
a. 6acialC shoulder and upper arm weakness
b. 7elative sparing o the deltoids
c. 6oot dorsilexion weakness
d. 1&mptoms are as&mmetrical
e. Benetic detection is not commerciall& available
18. *he ollowing can be seen in #nclusion $od& (&ositis except@
a. -istal upper extremeti& weakness
b. Occurs more re3uentl& in &ounger patients
c. (uscle biops& shows inlammator& changes and deposition o am&loid
d. 2(B shows diuse irritabilit& and ibrillation potentials.
19. #n +N%% the genetic deect is ound on which chromosome!
a. 0
b. 11
c. 19
d. ">
e. ""
1:. *he main distinguishing eature between B$1 and 5#-% is@
a. -em&elinating neuropathies
b. 516 indings
c. 1&mptoms
d. #nterval between s&mptoms and disease plateau
1;. (&otonic -&stroph& has the ollowing characteristics except@
a. 5ardiac conduction deects
b. 2arl& cataracts
c. +&pogammaglobulinemia
d. %roximal weakness
">. *he best wa& to assess the acial nerve proximal to the st&lomastoid orearm is b&
perorming@
a. 7outine acial nerve studies
b. 112%s
c. $link relexes
d. 5an not be assessed
"1. Ahich are true in a (artin<Bruber anastomosis@
a. #t occurs in 14<)> D o the population
b. #t consist o a communicating branch between the anterior interosseous to
the ulnar nerve in the orearm
c. *he nerve ibers are destined usuall& to the 1st-#O
d. All are true
"". Ahich are the ollowing drugs would not be used in (B
a. %rednisone
b. p&ridostigmine
c. a/athiaprine
d. (&cophenolate
e. )C0<diaminop&ridine
"). Ahich o the ollowing conditions have not been associated as possible risk
actors in brachial neuritis
a. =accinations
b. 1tress
c. 1urger&
d. 1trenuous ph&sical exertion
e. Epper respirator& tract inections
. All have been associated
"0. A patient with predominant proximal weaknessC cataracts and baldness is more
likel& to have@
a. (&otonic d&stroph& F-(1'
b. %roximal m&otonic d&stroph& F-("'
c. %aram&tonia congenital
d. (&otonia congenital
"4. *he drug o choice or the treatment o neurogenic orthostatic h&potension is@
a. 6luorocortisone
b. 1pirolactone
c. 2phedrine
d. (idodrine
"8. Ahich o the ollowing muscular d&strophies is most consistent with weakness in
the posterior calves
a. ,imb girdle d&stroph&< calpain deicienc&
b. (&otonic d&stroph&
c. (i&oshi m&opath&
d. 5entral core
"9. #n lepros& neuropath& which is not correct
a. Esuall& a large iber neuropath&
b. 5aused b& (&cobactrerium leprae
c. Esuall& involves the nose and ears
d. -em&elination can be seen on nerve conductions
":. Gou should consider what deicienc& in a patient with subacute p&ramidal tract
and dorsal column impairment@
a. .inc
b. 5opper
c. ,ead
d. =itamin 2
";. *he ollowing are true or ,2(1 except@
a. Autoimmune disorder
b. Associated with posts&naptic antibodies
c. %roximal weakness
d. #ncrement o 5(A% with 4>h/ stimulation
)>. *he ollowing are true o Nemaline m&opath& except@
a. 5ongenital h&potonia
b. %rogressive weakness
c. Normal intelligence
d. Normal extra<ocular muscles
)1. * or 6 #n -uchene (- treatment with prednisone has prolonged ambulation
b& "<) &ears.
)". Ahen suspecting m&otonic d&stroph& in a new born the most reliable wa& to test
is@
a. (uscle biops&
b. 2(B
c. 5%K
d. 2xam mother
)). *he ollowing are all trinucleotide repeats except@
a. +untingtons
b. 6ragile ? mental retardation
c. (&otnic d&stroph&
d. 15A 8
e. All are
)0. #n patients with a r&anodine receptor F7G71 gene' mutation &ou would expect@
a. 1ensitivit& to halothane and succin&lcholine
b. (alignant h&perthermia
c. 5entral core m&opath&
d. None o the above
e. All o the above
)4. *he ollowing are true or A.* aassociated muscle disease except@
a. A.* causes inhibition o reverse transcriptase and mitochondrial -NA
pol&merase
b. Occurs at low doses o less than 0>> mgHda&
c. -iagnosed b& muscle biops&
d. 7esolves ater stopping the drug
)8. Ahich o the ollowing drugs ma& exacerbate (B
a. Niedipine
b. $romocriptine
c. 5hloraphenicol
d. Babapentin
)9. 5ooper -eicienc& has been associated with all the ollowing except@
a. #ron supplementation
b. .inc overdose
c. Bastric b&pass
d. Over use o denture creams
):. (alignant h&perthermia is associated with except@
a. Autosomal recessive inheritance
b. +&permetabolic state induced b& inhalational and depolari/ing muscle
relaxants
c. #ncreased carbon dioxide production
d. (uscle breakdown
);. Ahich o the ollowing is speciic or h&perkalemic periodic paral&sis
a. 1odium channel abnormalit&
b. #nduced b& exercise
c. ,ast a ew hours
d. 2&elid m&otonia
40.Which are the following proteins/structures are found on the presynaptic
membrane?
a. Agrin
b. Muscle-specifc inase
c. !ihydropyridine receptors
d. "oltage-gated calcium channels
4#.$n the %e&ed and pronated forearm which muscle is the most powerful
supinator?
a. 'upinator
b. (le& )arpi *adialis
c. +iceps
d. ,riceps
4-..esions of the ffth lumbar ner/e root would be e&pected to cause
abnormalities in the following e&cept0
a. 12.
b. ,ibialis Anterior
c. ,ibialis 3osterior
d. 3araspinal Muscles
e. gracilis
44.$nner/ation to the diaphragm is through all the following roots e&cept?
a. )4
b. )4
c. )5
d. )6
44.,he subscapular ner/e inner/ates?
a. ,eres ma7or
b. ,eres minor
c. .e/ator 'capulae
d. *homboids
45.$n a patient with sero negati/e ocular myasthenia which other antibody
should be tested?
a. Agrin
b. "oltage-gated calcium antibodies
c. Muscle-specifc inase
d. 8aba antibodies
46.*adiculopathy in/ol/ing the )5 root would cause weaness in all the
following e&cept0
a. +iceps
b. +rachialis
c. 'upraspinatus
d. *homboid
e. 3ronator
49.'ingle-fber 1M8 is most sensiti/e for detecting M8 in which muscle?
a. ,rape:ius
b. (rontalis
c. 'ternocleidomastoid
d. 2and intrinsic
4;.Which of the following does not in%uence ner/e conduction results?
a. gender
b. .ower +ody temperature
c. 3lace on the body
d. ,hicness of the ner/e
e. Age o/er 60
4<.What is a distinguishing clinical feature between 8+' and )$3!
a. )'( results
b. 3attern of weaness
c. .oss of re%e&es
d. $nter/al between onset of symptoms and disease plateau
50.Which fndings is not consistent with $nclusion +ody Myositis?
a. Weaness of forearms and =uadriceps
b. (ibrillations and positi/e wa/es on 1M8
c. .arge motor unit potential on 1M8
d. >ccurs in older patients
5#.Which is the only muscle pro&imal to the nee is inner/ated by the
peroneal ner/e?
a. "astus lateralis
b. +icep femoris-long head
c. +iceps femoris-short head
d. 8racilis
5-.,he .5 root is the ma7or contributor to which muscle?
a. ,ibialis anterior
b. gastrocnemius
c. =uadriceps
d. gluteus medius
54.,he 2-re%e& is the electrophysiological e=ui/alent of0
54.,he pronator =uadratus is?
a. *esponsible for pronation of the forearm when the elbow %e&ed
b. 'upplied by the posterior interosseous ner/e
c. 'upplied by a branch of the median ner/e
d. *esponsible for pronation of the arm with the arm e&tended
e. A and ) are correct
f. + and ! are correct
55.$n compression of the cauda e=uina you would be e&pected to fnd0
a. 'addle anesthesia
b. 'phincter loss
c. .oss of anle re%e&es
d. All the abo/e
56.What do you e&pect to see in polymyositis?
a. 1M8 may demonstrate fbrillations and small polyphasic potentials
b. 3ro&imal weaness
c. 1le/ated creatineinase le/els
d. All are seen
59.Which of the following muscle is inner/ated by the glossopharyngeal
ner/e?
a. 'tapedius
b. +uccinators
c. 3osterior belly of the digastric
d. 'tylopharygeus
5;.,he trigeminal ner/e inner/ates all the following e&cept?
a. Masseter
b. ,emporalis
c. Medial and lateral pterygoids
d. ,ensor /elipalati
e. Anterior belly of digastric
f. Mylohyoid
5<.,he radial ner/e inner/ates all the following e&cept0
a. Abductor pollicis bre/is
b. 1&tensor pollicis longus
c. 1&tensor pollicus bre/is
d. 1&tensor digitorium longus
e. All the abo/e are inner/ated by the radial
60.Matching
a. >nion bulb or hypertrophy neuropathy #. Werdnig-
2o?man
b. 3erifascicular atrophy -. )M,
c. 8roup atrophy 4.!ermatomyositis
d. *agged red fber 4.$nclusion +ody
Myositis
e. *immed "acuole 5.Mitochondrial
myopathy