Multiple Sclerosis Pathology Quiz
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Questions and Answers

What is the primary pathological characteristic of Multiple Sclerosis?

  • Dysmyelination
  • Demyelination (correct)
  • Secondary axonal degeneration
  • Neuronal loss

    • What cells are responsible for myelinating axons in the CNS?

  • Schwann cells
  • Oligodendrocytes (correct)
  • Astrocytes
  • Microglia

    • Which of the following is true regarding the epidemiology of MS?

  • Male prevalence is higher than female.
  • The disease is more common closer to the equator.
  • Risk is increased 15-20 times in first-degree relatives. (correct)
  • Age of onset is typically after 50 years.

    • Which geographic region has the highest prevalence of MS?

    <p>Europe</p> Signup and view all the answers

    In Multiple Sclerosis, which of the following structures is typically preserved?

    <p>Axons</p> Signup and view all the answers

    Which of the following is the most common presenting symptom of MS?

    <p>Visual loss due to optic neuritis</p> Signup and view all the answers

    What is Lhermitte’s sign, commonly seen in MS?

    <p>Tingling or electric shock-like feeling down the spine with neck flexion.</p> Signup and view all the answers

    What is Uhtoff's phenomenon in the context of MS?

    <p>Worsening of symptoms with raised body temperature.</p> Signup and view all the answers

    Which of the following symptoms is associated with trigeminal neuralgia in MS?

    <p>Severe facial pain.</p> Signup and view all the answers

    A 30-year-old patient presents with gait imbalance, vertigo, and diplopia. Which condition should be suspected?

    <p>Multiple sclerosis</p> Signup and view all the answers

    Which symptom of MS is characterized by balance or gait disturbance?

    <p>Ataxia</p> Signup and view all the answers

    Which of the following symptoms indicates spinal cord involvement in MS?

    <p>Acute transverse myelitis</p> Signup and view all the answers

    Which of the following is the most common form of MS at onset?

    <p>Relapsing-remitting MS</p> Signup and view all the answers

    Which form of MS is characterized by continuous progression of symptoms from the start without remission?

    <p>Primary progressive MS</p> Signup and view all the answers

    Which of the following indicates an active MS plaque?

    <p>Perivascular and parenchymal inflammation with lymphocytes and macrophages.</p> Signup and view all the answers

    What imaging finding indicates an active MS plaque?

    <p>Gadolinium enhancement on MRI.</p> Signup and view all the answers

    What pathological features are seen in a chronic MS plaque?

    <p>Hypocellularity with reactive astrocytes and some axonal loss.</p> Signup and view all the answers

    In the pathogenesis of Multiple Sclerosis, what early process is seen in active plaques?

    <p>Attempted remyelination.</p> Signup and view all the answers

    What is the characteristic macroscopic finding in multiple sclerosis?

    <p>Well-demarcated white matter plaques</p> Signup and view all the answers

    What is the appearance of acute MS plaques on gross examination?

    <p>Yellowish plaques in white matter</p> Signup and view all the answers

    Which areas of the CNS can be affected by MS plaques?

    <p>Brainstem, cerebellum, spinal cord, and cerebral hemispheres</p> Signup and view all the answers

    What does the blue staining in MS pathology represent?

    <p>Demyelinated areas</p> Signup and view all the answers

    What inflammatory cells are present in an acute MS plaque on microscopy?

    <p>Macrophages and lymphocytes</p> Signup and view all the answers

    What is a feature of old MS plaques?

    <p>Cavitation in affected areas</p> Signup and view all the answers

    Which of the following is preserved in the microscopic examination of an acute MS plaque?

    <p>Axons</p> Signup and view all the answers

    What is the primary method for diagnosing MS?

    <p>Clinical diagnosis based on history and examination</p> Signup and view all the answers

    Which diagnostic criteria is used to confirm Multiple Sclerosis?

    <p>McDonald Criteria</p> Signup and view all the answers

    According to the McDonald Criteria, what must be demonstrated to diagnose MS?

    <p>Dissemination of CNS lesions in space and time</p> Signup and view all the answers

    What additional diagnostic tool can confirm oligoclonal bands supportive of MS?

    <p>CSF analysis through lumbar puncture</p> Signup and view all the answers

    What is the significance of delayed P100 potentials in MS diagnosis?

    <p>They support demyelination in the visual pathway.</p> Signup and view all the answers

    A patient has two or more attacks with objective clinical evidence of one lesion. What additional data is needed for MS diagnosis?

    <p>Dissemination in space demonstrated by MRI or another clinical attack implicating a different site.</p> Signup and view all the answers

    Which imaging modality is most commonly used to support the diagnosis of MS?

    <p>Brain MRI with contrast</p> Signup and view all the answers

    According to the McDonald Criteria, dissemination in time can be demonstrated by:

    <p>MRI findings or a second clinical attack</p> Signup and view all the answers

    What does 'dissemination in space' refer to in the context of MS diagnosis?

    <p>Damage occurring in multiple areas of the CNS</p> Signup and view all the answers

    What does 'dissemination in time' signify in MS diagnosis?

    <p>Evidence of damage occurring at different points in time</p> Signup and view all the answers

    What is the role of oligoclonal bands (OCBs) in MS diagnosis?

    <p>They indicate inflammation in the central nervous system.</p> Signup and view all the answers

    What is required to confirm MS in a patient with two or more attacks and clinical evidence of two or more lesions?

    <p>No additional data is required</p> Signup and view all the answers

    A patient presents with two attacks and clinical evidence of one lesion. What additional evidence is needed for an MS diagnosis?

    <p>Dissemination in space using MRI or further clinical attacks</p> Signup and view all the answers

    What does one attack with clinical evidence of two or more lesions indicate in MS diagnosis?

    <p>Dissemination in time must be confirmed.</p> Signup and view all the answers

    How can 'dissemination in time' be demonstrated in MS diagnosis?

    <p>MRI evidence of new lesions forming over time or a second clinical attack</p> Signup and view all the answers

    What imaging technique is most useful in demonstrating both dissemination in space and time for MS diagnosis?

    <p>MRI with gadolinium enhancement</p> Signup and view all the answers

    Which of the following is the first-line treatment for acute management of a severe MS relapse?

    <p>IV Methylprednisolone</p> Signup and view all the answers

    What is the primary aim of using glucocorticoids in the acute management of MS?

    <p>To reduce the duration of the relapse</p> Signup and view all the answers

    Plasma exchange is recommended in MS management for which of the following reasons? (Select one)

    <p>For patients with severe relapse not responding to glucocorticoids</p> Signup and view all the answers

    Which of the following statements about Disease Modifying Therapy (DMT) in MS is correct? A) It is effective in both relapsing-remitting and primary progressive MS. B) It slows disability progression and reduces relapse rates in relapsing-remitting MS. C) It is primarily used in secondary progressive MS. D) It has no role in long-term management.

    <p>It slows disability progression and reduces relapse rates in relapsing-remitting MS.</p> Signup and view all the answers

    What is the standard dose and duration for IV Methylprednisolone in the acute management of MS relapse?

    <p>1 g daily for 3–5 days</p> Signup and view all the answers

    In long-term management of multiple sclerosis (MS), which type of MS is disease-modifying therapy (DMT) recommended for?

    <p>Relapsing-remitting MS (RRMS)</p> Signup and view all the answers

    When might oral Prednisolone be considered in the acute management of MS?

    <p>As an alternative to IV Methylprednisolone</p> Signup and view all the answers

    Which of the following is NOT included in neurodegenerative diseases?

    <p>Vascular dementia</p> Signup and view all the answers

    What is a hallmark characteristic of neurodegenerative diseases?

    <p>Neuronal loss and gliosis</p> Signup and view all the answers

    Which protein is associated with neurodegenerative diseases?

    <p>Tau</p> Signup and view all the answers

    What is the pathological sequence in neurodegeneration?

    <p>Abnormal protein folding → Failure to eliminate proteins → Protein accumulation</p> Signup and view all the answers

    Which mechanism is NOT implicated in neurodegeneration? A. Oxidative stress B. Excitotoxicity C. Programmed cell death D. Autoimmune myelin destruction

    <p>Autoimmune myelin destruction</p> Signup and view all the answers

    Ubiquitin is primarily involved in what process in neurodegeneration?

    <p>Protein elimination</p> Signup and view all the answers

    Which protein is primarily found in extracellular deposits in neurodegenerative diseases?

    <p>Amyloid</p> Signup and view all the answers

    What is the role of Tau protein in neurons?

    <p>Stabilizing microtubules</p> Signup and view all the answers

    Alpha-synuclein is thought to: A. Act as a neurotransmitter B. Maintain synaptic vesicle supply in axon terminals C. Stabilize the neuronal cytoskeleton D. Promote protein degradation

    <p>Maintain synaptic vesicle supply in axon terminals</p> Signup and view all the answers

    The term 'tauopathy' refers to diseases associated with which protein?

    <p>Tau</p> Signup and view all the answers

    The selective neuronal vulnerability concept means:

    <p>Specific groups of neurons are targeted by the disease.</p> Signup and view all the answers

    Which protein is associated with synucleinopathy?

    <p>Alpha-synuclein</p> Signup and view all the answers

    What is the role of amyloid precursor protein?

    <p>Hypothetical, with no definitive function known.</p> Signup and view all the answers

    Which of the following is associated with akinetic/rigid movement disorders? (Select one)

    <p>Parkinson’s disease</p> Signup and view all the answers

    Which neurodegenerative disease is primarily linked to hyperkinetic movement disorders?

    <p>Huntington's disease</p> Signup and view all the answers

    Ataxia in neurodegenerative diseases primarily affects which part of the brain?

    <p>Cerebellum and its connecting tracts</p> Signup and view all the answers

    Which disease is associated with motor neuron dysfunction, including both upper motor neurons (UMN) and lower motor neurons (LMN)?

    <p>Amyotrophic lateral sclerosis (ALS)</p> Signup and view all the answers

    In Alzheimer's disease, which part of the brain is primarily affected?

    <p>Hippocampus and cortical neurons</p> Signup and view all the answers

    Which protein pathology is most commonly associated with Frontotemporal dementia (FTLD)?

    <p>Tau</p> Signup and view all the answers

    Which neurodegenerative disease is associated with corticobasal degeneration?

    <p>Corticobasal degeneration (TAU)</p> Signup and view all the answers

    Which of the following diseases is associated with alpha-synuclein pathology?

    <p>Parkinson's disease</p> Signup and view all the answers

    Damage to the frontal lobe can lead to impairments in which of the following behavioral domains? A. Visuospatial skills and sensory integration B. Judgment, abstract reasoning, and emotional control C. Memory and hallucinations D. Receptive language and automatisms

    <p>Judgment, abstract reasoning, and emotional control</p> Signup and view all the answers

    Impairments in visuospatial skills and sensory integration are primarily associated with damage to which part of the brain?

    <p>Parietal lobe</p> Signup and view all the answers

    Which area of the brain, when damaged, is most likely to result in memory disorders and hallucinations?

    <p>Temporal lobe (including the hippocampus, amygdala, and limbic system)</p> Signup and view all the answers

    Damage to the temporal neocortex is most commonly associated with which of the following? A. Sensory agnosias B. Receptive dysphasia and automatisms C. Impaired judgment and abstract reasoning D. Visual sensory system failure

    <p>Receptive dysphasia and automatisms</p> Signup and view all the answers

    Which lobe of the brain is responsible for processing visual sensory information?

    <p>Occipital lobe</p> Signup and view all the answers

    What is the unique feature of prion diseases?

    <p>They are characterized by a transmissible protein, not DNA or RNA.</p> Signup and view all the answers

    Which of the following diseases is associated with spongiform encephalopathy and rapidly progressive dementia with symptoms like hallucinations and myoclonus?

    <p>Creutzfeldt-Jakob disease</p> Signup and view all the answers

    What is the difference between dementia and delirium?

    <p>Delirium is an acute disorder of attention and cognition, and is reversible with treatment, whereas dementia is a progressive and irreversible decline in cognition.</p> Signup and view all the answers

    Which brain region is primarily affected in Alzheimer's disease and is noted during macroscopic examination?

    <p>Temporal lobe (hippocampus)</p> Signup and view all the answers

    Which of the following features is NOT a cardinal sign of Parkinson’s disease?

    <p>Cognitive decline (early feature)</p> Signup and view all the answers

    What is the characteristic microscopic finding in Parkinson's disease?

    <p>Lewy bodies (alpha-synuclein)</p> Signup and view all the answers

    In motor neuron disease (ALS), which protein is often implicated?

    <p>TDP43</p> Signup and view all the answers

    Which of the following is NOT typically a feature of ALS (Motor Neuron Disease)?

    <p>Progressive cognitive impairment (early feature)</p> Signup and view all the answers

    Which of the following is the first step in the investigation of cognitive decline in suspected neurodegenerative diseases?

    <p>Detailed history and cognitive assessment</p> Signup and view all the answers

    Which of the following is typically excluded during the investigation of neurodegenerative diseases to rule out reversible causes of cognitive decline?

    <p>Genetic mutations</p> Signup and view all the answers

    What does brain imaging (CT, MRI, or PET) help assess in patients with neurodegenerative diseases?

    <p>Exclude other causes of cognitive decline such as stroke</p> Signup and view all the answers

    What protein is commonly associated with amyotrophic lateral sclerosis (ALS) at the microscopic level?

    <p>TDP43</p> Signup and view all the answers

    Which of the following symptoms is characteristic of ALS?

    <p>Spasticity, hyperreflexia, and fasciculations</p> Signup and view all the answers

    What is the typical age of onset for amyotrophic lateral sclerosis (ALS)?

    <p>40-60 years</p> Signup and view all the answers

    Which of the following pathologic findings would you expect in the spinal cord of a patient with ALS?

    <p>Corticospinal tract degeneration</p> Signup and view all the answers

    What is the cause of death in most patients with ALS?

    <p>Respiratory failure</p> Signup and view all the answers

    Which of the following investigations is rarely used in the diagnosis of neurodegenerative diseases but may be performed to identify treatable causes?

    <p>Brain biopsy</p> Signup and view all the answers

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