Organic Disorders

 

1. The following are true of dementia:  
A. Incidence is 5 % in the under 65’s F
B. Incidence is about 30 % in the over 85’s T
C. Alzheimer’s disease is the most common cause T
D. Frontal lobe dementia is the second most common cause in the over 65’s F
E. Reversible dementias account for about 5 % of all dementias T
   
2. Regarding the aetiology of Alzheimer’s disease:  
A. Females are affected twice as commonly as males T
B. Familial forms are autosomal dominant T
C. The presenilin-2 gene is on chromosome 14 F
D. The gene for presenilin-1 is on chromosome 19 F
E. Trauma is a risk factor T
   
3. Regarding the aetiology of Alzheimer’s disease:  
A. The apolipoprotein e gene is on chomosome 19 T
B. The Beta-amyloid precursor protein is on chromosome 21 T
C. Trisomy 21 is a risk factor T
D. Presenilin-1 causes about 50 % of early onset dementias T
E. Late onset dementia is associated with alpha-1 macroglobulin F
   
4. Pathological findings in Alzheimer’s include:  
A. Loss of cortical neurones T
B. Amyloid plaques are the critical pathological feature of AD T
C. Relative sparing of the outer 3 layers of cortex F
D. Gliosis T
E. Granulovacuolar degeneration T
   
5. Neurochemical findings in Alzheimer’s include:  
A. Cholinergic loss in the locus coeruleus F
B. Serotinergic neuron loss correlates with depression F
C. Noradrenergic loss is most marked in early-onset dementia T
D. Increased GABA F
E. Decreased somatostatin and CK T
   
6. Clinical features of Alzheimer’s dementia may include:  
A. Long-term memory loss T
B. Disorders of Language and praxis T
C. Depression T
D. Loss of primitive reflexes F
E. Persecutory delusion T
   
7. Investigations in AD may show:  
A. Increase in the dominant alpha rhythm on EEG F
B. Shortening of the P300 potential F
C. Reduced metabolism in the temporal lobes on PET T
D. Reduction in the temporal lobe volume T
E. Loss of theta and delta activity on EEG F
   
8. Lewy body dementia:  
A. Unlike AD, does not result in loss of cholinergic function F
B. Is characterized by Lewy bodies in the cortex and substantia nigra T
C. Results in increased dopaminergic function F
D. May result in hallucinations and delusions T
E. Fluctuations in the presentation exclude this diagnosis F
   
9. Multi-infarct dementia:  
A. Is more common in men T
B. Has been linked to an autosomal recessive heritability F
C. Causes cerebral atrophy and ventriculomegaly T
D. Can be rated using the Hatchinski index T
E. Can result in seizures T
   
10. In multi-infarct dementia:  
A. Depression is rare F
B. Shows a slow, gradual deterioration F
C. PET shows asymmetric changes in the cortex T
D. SPECT shows increased blood flow F
E. MRI shows areas of multiple infarction T
   
11. Binswanger’s disease:  
A. Is more properly called subcortical arteriosclerotic encephalopathy T
B. Is characterized by abnormal pyramidal function T
C. Gait is normal F
D. Sphincter disturbance is common T
E. MRI shows high intensity lesions distributed evenly throughout the cortex F
   
12. Pick’s disease:  
A. Is more common in men F
B. Has been linked to an autosomal dominant gene T
C. Is characterized by changes in personality and behaviour T
D. CT shows enlargement of the frontal horns T
E. EEG shows abnormalities in a similar pattern to Alzheimer’s F
   
13. Pathological findings in Pick’s disease may include:  
A. Atrophy of the frontal and parietal lobes F
B. ‘Knife-blade’ atrophy T
C. Senile plaques F
D. Neurofibrillary tangles F
E. Neuronal loss in the outer cortex T
   
14. Frontal lobe dementia:  
A. Is a common cause of early-onset dementia T
B. Is more common in men T
C. There is rarely a family history F
D. Is easily seen on EEG F
E. Pathological findings include gliosis and spongiosis T
   
15. Huntington’s chorea:  
A. Is more common in men F
B. Is due to an autosomal dominant gene T
C. Shows incomplete penetrance F
D. The gene lies on chromosome 4 T
E. Usually presents in the 3rd or 4th decade T
   
16. Huntington’s chorea:  
A. Demonstrates ‘imprinting’ T
B. Demonstrates ‘anticipation’ T
C. The gene codes for GABA F
D. Results in reduced levels of GABA in the caudate nucleus T
E. Decreased levels of dopamine in the basal ganglia F
   
17. Clinical features of Huntington’s disease may include:  
A. Dysarthria T
B. Epilepsy T
C. Paranoia and schizophreniform illness T
D. Increased risk of suicide T
E. Depression T
   
18. Findings in Huntington’s disease include:  
A. Caudate atrophy T
B. Increased blood flow in the neostriatum F
C. EEG shows spike-wave activity F
D. Reduced striatal metabolism T
E. Atrophy of the basal ganglia T
   
19. Prion diseases:  
A. Are more common in women F
B. Are encoded on chromosome 10 F
C. Individuals with the E4 apolipoprotein allele are at reduced risk F
D. The familial form is autosomal recessive F
E. Usually have a normal EEG F
   
20. Normal pressure hydrocephalus:  
A. Is more common in the pre-senium F
B. May be preceded by a history of head injury T
C. Is characterized by impairment of memory, pyramidal function, and attention F
D. CT shows periventricular lucencies and abnormal sulci F
E. Is due to blockage of the ventricular system F
   
21. The following are true of head injury:  
A. The duration of post-traumatic amnesia correlates with the extent of brain injury T
B. The duration of retrograde amnesia correlates with psychiatric disability F
C. Frontal lobe syndrome is due to brain damage T
D. Depression is due to brain damage F
E. Aggressive tendencies are not due to brain damage F
   
22. Regarding psychiatric illness following head injury:  
A. Schizophrenia is more common in mild injuries T
B. Affective illness is more common T
C. There is a higher incidence of hypomania than depressive psychosis F
D. Suicide is more common T
E. Suicide is associated with frontal and temporal lobe damage T
   
23. In ‘Punch drunk’ syndrome:  
A. Morbid jealousy is more common T
B. Pyramidal signs are characteristic T
C. CT scan shows cerebellar atrophy and normal ventricles F
D. Pathological changes are similar to normal ageing F
E. Commonly occurs in boxers T
   
24. The following symptoms are commonly seen in frontal lobe lesions:  
A. Magnetism T
B. Contralateral optic atrophy F
C. Ipsilateral spastic paresis F
D. ‘Witzelsucht’ T
E. Dyspraxia F
   
25. The following are seen in lesions of the non-dominant parietal lobe:  
A. Dysphasia F
B. Prosopagnosia T
C. Alexia F
D. Constructional dyspraxia T
E. Body image disorders F
   
26. Features of Gerstmann’s syndrome may include:  
A. Bilateral parietal lobe lesion F
B. Right-left disorientation T
C. Dysgraphaesthesia F
D. Finger agnosia T
E. Dysgraphia T
   
27. Dominant temporal lobe lesions may cause:  
A. Impaired visual memory F
B. Homonymous hemianopia T
C. Impaired verbal memory T
D. Impaired visual memory F
E. Dysprosody F
   
28. Bilateral temporal lobe lesions may cause:  
A. Amnesic syndrome T
B. Cortical blindness F
C. Hyperorality T
D. Hypersexuality T
E. Social-emotional agnosia T
   
29. Features of occipital lobe lesions may include:  
A. Complex visual hallucinations T
B. Visual field defects T
C. Anton’s syndrome T
D. Sensory neglect F
E. Anomia F
   
30. Regarding Multiple Sclerosis :  
A. It is more common in women T
B. Survival is less in women F
C. Survival is greater if onset is at a younger age T
D. Lhermitte phenemenon is almost pathognomonic in a young person T
E. Visual evoked potentials are abnormal in 10 - 20 % F
   
31. In Multiple sclerosis :  
A. Depression is about as common as in the general population F
B. Dementia can occur T
C. IgG ratios are lower than normal F
D. Oligoclonal bands are seen in the IgM region on electrophoresis F
E. Epilepsy is more common than normal T
   
32. The following are characteristics of Parkinson’s disease :  
A. Bradykinesia T
B. Intention tremor F
C. Cogwheel rigidity T
D. Impaired postural reflexes T
E. Cognitive impairment F
   
33. In Parkinson’s disease :  
A. The risk decreases with age F
B. It is more common in females F
C. Smoking has a negative association T
D. Pesticide exposure is a risk factor T
E. There is a loss of axons in the substantia nigra F
   
34. In Parkinson’s disease :  
A. Rigidity is due to enhancement of long-latency stretch reflexes T
B. Tremor is associated with alpha-gamma co-activation T
C. Tremor is present in only 25 % of patients F
D. Dementia is seen in 15-20 % T
E. Depressive illness is seen in 85 % of patients F
   
35. Regarding Wilson’s disease :  
A. It is autosomal recessive T
B. Onset is always in childhood F
C. Kayser-Fleischer rings are due to copper deposition in the iris F
D. Psychiatric symptoms are related to the severity of the hepatic involvement F
E. Around half of all patients will have psychiatric symptoms T
   
36. After Cerebrovascular Incidents:  
A. Residual deficits occur in 90 % T
B. Personality change is rare F
C. Depression is common with left hemisphere lesions T
D. Anxiety is common T
E. Emotional lability is more common in those with right temporal lesions F
   
37. Multiple sclerosis:  
A. Is more common in men F
B. Is more common in the northern hemisphere T
C. Progressive conditions are more common than relapsing-remitting ones F
D. Depression is common T
E. Dementia is not a feature F
   
38. Regarding the features of MS:  
A. Epilepsy is less common than in the general population F
B. Erectile dysfunction can occur T
C. CSF examination shows oligoclonal bands in the IgA region F
D. Optic neuritis results in painless visual disturbance F
E. Symptoms can be improved by a hot bath F
   
39. Parkinson’s disease:  
A. Is less common in women T
B. Is associated with pesticide exposure T
C. Is less common in non-smokers F
D. There is loss of dopaminergic cell bodies in the substantia nigra T
E. Lewy bodies are often seen T
   
40. Clinical features of Parkinson’s disease include:  
A. Increased rate of blinking F
B. Tremor inhibited by purposeful movement T
C. Dementia T
D. Higher incidence of depressive illness T
E. Dementia is less common in men F
   
41. In Klinefelter’s syndrome :  
A. The usual karyotype is XYY F
B. Urinary gonadotrophin levels are reduced F
C. Intelligence is normal F
D. Criminal behaviour is an established association F
E. EEG shows slowed alpha waves T
   
42. In Turner’s syndrome :  
A. There is secondary amenorrhoea F
B. Congenital rectal abnormalities are common T
C. Verbal intelligence is normal T
D. Visuospatial abilities are also normal F
E. The incidence of psychotic illness is increased F
   
43. In Wilson’s disease :  
A. Most cases present in the first two decades T
B. It is an autosomal dominant condition F
C. Hepatocytes are forced to store copper due to increased levels of caeruloplasmin F
D. Diagnosis is by raised plasma caeruloplasmin levels F
E. Urinary copper excretion is usually elevated T
   
44. Symptoms of Wilson’s disease include :  
A. Changes in personality and behaviour T
B. Epilepsy T
C. Rigidity and dystonia T
D. Visual symptoms F
E. Cognitive impairment T
   
45. The following are true in Wilson’s disease :  
A. The ventricles are normal F
B. The basal ganglia show lesions on CT T
C. Treatment is with penicillamine T
D. It is important to avoid vitamin B6 during treatment F
E. Neurological disturbance responds better than hepatic disturbance T
   
46. The following are true for porphyria :  
A. Haem precursors are readily oxidized to porphyrins T
B. All cases are autosomal recessive F
C. Abdominal pain and neuropathy are rarely seen F
D. Episodes can be precipitated by tricyclic antidepressants T
E. EEG is always abnormal F
   
47. Regarding mitochondrial myopathy :  
A. Transmission is usually maternal T
B. Most cases present after the age of 20 F
C. Smooth muscle biopsy (such as from the rectum) is diagnostic F
D. Limb weakness can occur on its own T
E. It may present as a chronic fatigue syndrome T
   
48. In Neuroacanthocytosis :  
A. Red blood cells are abnormal T
B. Tics are seen T
C. Frontal lobe pictures can be seen T
D. Intellectual impairment rules out the diagnosis F
E. Shrinkage of the caudate head on CT can differentiate this condition from Huntington’s chorea F
F. May present with OCD T
G. Anxiety and depression are frequent T
   
   
   
   
   
49. The following are true for Cerebral Ceroid Lipofuscinosis :  
A. It is also called Leigh disease F
B. It can occur in infancy T
C. Only autosomal dominant forms have been recognized F
D. It commonly presents as dementia with motor symptoms T
E. Death is within 6-12 months F
   
50. In Subacute Necrotizing Encephalomyopathy :  
A. It is inherited as an autosomal recessive condition T
B. It is due to a disturbance of thiamine metabolism T
C. The condition usually presents in adolescence F
D. Death is prolonged F
E. It can also occur in adults, when it presents as impaired intellect and motor symptoms T
   
51. Hallorvorden-Spatz syndrome :  
A. Is a rare pyramidal disorder F
B. Typically presents at a young age T
C. Changes in personality also occur T
D. EEG is normal F
E. CT scan resembles Huntington’s chorea, with prominent atrophy of the basal ganglia T
   
52. The following are true of the Sphingolipidoses :  
A. They are autosomal recessive conditions T
B. Patients with Gaucher’s disease have a greatly reduced life-span F
C. Most cases of Niemann-Pick disease present in early life T
D. Jewish people have a reduced incidence of Niemann-Pick disease F
E. Tay Sachs disease usually results in death before the age of 2 T
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