Question 1

What is the most common type of dementia?

Accepted Answer

Alzheimer's disease is the most common cause of dementia overall. It is one of the principal causes of disability and decreased quality of life among older adults.

Question 2

Which medication used in the treatment of Alzheimer's disease acts on nicotine receptors?

Accepted Answer

Galantamine not only protects the cholinergic system but also acts on nicotine receptors, which are depleted in Alzheimer's disease.

Question 3

A patient with dystonia presents to the physician for a Botox injection.Where will the physician most likely inject the Botox?

Accepted Answer

Injection directly into the actively contracting muscles blocks the neuromuscular junction by acting presynaptically to reduce the release of acetylcholine, producing a chemical denervation.

Question 4

The physical therapist assistant (PTA)begins treatment on a patient diagnosed with PD.The patient informs the therapist that he has a thalamic stimulator to help control his PD.What symptom of PD will best be controlled with the thalamic stimulator?

Accepted Answer

Deep brain stimulation uses a pacemaker-like device surgically implanted with the electrodes in the nuclei of choice and a pulse generator implanted in the chest. When a tremor begins, the client activates the low voltage high frequency generator by passing a magnet over a generator implanted in the chest. Stimulation through the electrodes can be applied to the internal globus pallidus and the subthalamic nucleus or thalamus. Thalamic stimulation is most effective for tremor with less effect on dyskinesia and rigidity.

Question 5

What is the most common initial manifestation of Parkinson's disease (PD)?

Accepted Answer

Tremor of PD often appears unilaterally and may be confined to one upper limb for months to even years. It is the most common initial manifestation of PD. It is first seen as a rhythmic back and forth motion of the thumb and finger referred to as the pill-rolling tremor.

Question 6

Which of the following is associated with an improved prognosis of MS?

Accepted Answer

Choices A, B, and C are indicative of a possible severe course of MS. Sensory symptoms, infrequent attacks, full neurologic recovery after a relapse and a low level of disability after 5 to 7 years may be associated with an improved prognosis.

Question 7

Huntington's disease (HD)is characterized by an atrophy of what part of the brain?

Accepted Answer

The ventricles are enlarged as a result of atrophy of the adjacent basal ganglia, specifically the caudate nucleus and putamen.

Question 8

What cranial nerve is involved with tic douloureux?

Accepted Answer

Although it is an uncommon finding, tic douloureux is highly characteristic of MS in a young person. Tic douloureux (also called trigeminal neuralgia) is a shock-like pain in the face.

Question 9

Which of the following symptoms of ALS are considered signs of lower motor neuron involvement?

Accepted Answer

The other choices listed are indicative of upper motor neuron lesions associated with ALS.

Question 10

A physician suspects Alzheimer's disease in a patient.He decides to use magnetic resonance imaging (MRI)and computed tomography (CT)scans to help confirm this diagnosis.What part of the brain will be measured to aid in this diagnosis?

Accepted Answer

Both MRI and CT can identify changes in the brain that are associated with Alzheimer's disease. Diagnostic criteria are based on the measurement of the medial temporal lobe atrophy or volumetric measurement of the entorhinal cortex and hippocampus.

Question 11

Which of the following symptoms is indicative of late stage HD?

Accepted Answer

Sleep disorders become a progressive problem throughout the course of HD. Sleep reversal is seen in severely affected persons and is probably related to dementia.

Question 12

What is the most physically devastating of neurodegenerative diseases?

Accepted Answer

ALS is a disorder that is generally recognized as an adult onset progressive motor neuron disease, but it is also a complex disease process underlying a multisystem illness. It is the most physically devastating of the neurodegenerative diseases.

Question 13

What type of multiple sclerosis (MS)describes an initial pattern of relapse and remission and changes into a steadily progressive pattern over time?

Accepted Answer

Secondary progressive MS describes an initial pattern of relapse and remission that changes into a steadily progressive pattern over time in more than 50% of the relapsing individuals. There sometimes are continued relapses during this phase. This conversion generally occurs 5 to 10 years after the initial onset of relapsing symptoms.

Question 14

Which of the following would be an effective intervention strategy for patients diagnosed with Alzheimer's disease?

Accepted Answer

Exercises should be short and simple and be done in the same order each time. Alzheimer's patients respond to treatment sessions with decreased sensory input and increased repetition of exercises.

Question 15

Which of the following functions will remain normal throughout the course of ALS?

Accepted Answer

Throughout the course of the disease, eye movements and sensory, bowel, and bladder functions are preserved.

Question 16

Which of the following is a false statement regarding diagnostic criteria for ALS?

Accepted Answer

All the other changes are normal with progressive ALS. Cerebrospinal fluid will be normal, and there will be no changes on a myelogram.

Question 17

What is the single most common and disabling symptom of MS?

Accepted Answer

Fatigue is typically present in the midafternoon and may take the form of increased motor weakness with effort, mental fatigue, and sleepiness. MS-related fatigue presents as an overwhelming feeling of tiredness in those who have done little and are not depressed.

Question 18

At what stage of ALS would a patient begin to use adaptive equipment to facilitate activities of daily living (ADLs)?

Accepted Answer

There is moderate selective weakness characterized in stage II. The patient will have slight decreased independence in ADLs such as difficulty climbing stairs, raising arms, and buttoning clothing. ALS is generally graded from stage I to stage VI, with stage VI being bedridden and completely dependent in all ADLs.

Question 19

Loss of which neurotransmitter activity in the brain correlates to the severity of Alzheimer's disease?

Accepted Answer

Acetylcholine is an important neurotransmitter in areas of the brain involved in memory formation, and loss of acetylcholine activity correlates with the severity of Alzheimer's disease.

Question 20

Which of the following is considered a sign of dementia rather than a normal sign of aging?

Accepted Answer

Choice A, C, and D are considered normal signs of aging. There is an impaired sense of smell with dementia.

Quiz 20: Degenerative Diseases of the Central Nervous System