Personalized Medicine in Neurology Learning Outcomes

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Questions and Answers

What is a key factor in the etiology of neurodegeneration?

  • Excessive vitamin C intake
  • Impaired mitochondrial dynamics (correct)
  • Overproduction of vitamin D
  • High levels of glucose in the blood

Which metal accumulation in the human brain is a causative factor in the induction of oxidative stress?

  • Carbon (C)
  • Gold (Au)
  • Sodium (Na)
  • Copper (Cu) (correct)

What does overproduction of reactive oxygen species during oxidative stress lead to?

  • Improved cognitive function
  • Decreased heart rate
  • Neuronal damage (correct)
  • Better muscle coordination

Which primary brain regions are affected in major neurodegenerative diseases?

<p>Spinal cord and Brain stem (B)</p> Signup and view all the answers

What plays a key role in the pathophysiology of Alzheimer's Disease (AD) and Parkinson's Disease (PD)?

<p>Sensitivity of glial cells and neurons to reactive oxygen species (D)</p> Signup and view all the answers

What is identified as a contributing factor to the pathogenesis of neurodegenerative diseases?

<p>Genetic factors (B)</p> Signup and view all the answers

Which of the following is NOT a characteristic of neurodegenerative diseases?

<p>They cause an increase in neuronal activity over time (B)</p> Signup and view all the answers

Which of the following statements about Alzheimer's disease (AD) and Parkinson's disease (PD) is NOT true?

<p>They respond identically to the same treatment for all patients (A)</p> Signup and view all the answers

What is the primary cause of the greatest burden of neurodegenerative diseases?

<p>Dementias (D)</p> Signup and view all the answers

Which of the following statements about the clinical symptoms of neurodegenerative diseases is true?

<p>They start some years before they become clinically apparent (A)</p> Signup and view all the answers

What percentage of dementia cases is represented by Alzheimer's disease?

<p>60-70% (B)</p> Signup and view all the answers

Which of the following is NOT a common symptom associated with neurodegenerative diseases?

<p>Increased appetite (A)</p> Signup and view all the answers

What is the primary function of neurons in the context of neurodegenerative diseases?

<p>To serve as the building blocks of the nervous system (B)</p> Signup and view all the answers

Which of the following statements about the clinical presentation of neurodegenerative diseases is true?

<p>They can present with variable clinical courses (A)</p> Signup and view all the answers

Which of the following regions of the brain and spinal cord are primarily affected in Amyotrophic Lateral Sclerosis (ALS)?

<p>Motor cortex, brain stem, and spinal cord (B)</p> Signup and view all the answers

Which of the following is an approved drug for the treatment of ALS?

<p>Riluzole (D)</p> Signup and view all the answers

Which of the following statements is true regarding the inheritance pattern of Huntington's Disease (HD)?

<p>HD is an autosomal dominant disorder. (A)</p> Signup and view all the answers

On which chromosome is the Huntington's Disease (HD) gene located?

<p>Chromosome 4 (B)</p> Signup and view all the answers

If one parent has Huntington's Disease, what is the probability that their child will inherit the disease?

<p>50% (B)</p> Signup and view all the answers

Which of the following statements accurately describes the concept of 'carriers' in relation to Huntington's Disease?

<p>There are no carriers for Huntington's Disease. (B)</p> Signup and view all the answers

What is the primary objective of the 'Personalized Neurology' approach in the context of neurodegenerative diseases?

<p>To identify biomarkers that allow for precise subtyping and targeted therapies. (A)</p> Signup and view all the answers

Which of the following is NOT listed as a potential cause of sporadic Amyotrophic Lateral Sclerosis (ALS)?

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

Which biomarker is considered a direct marker of Aβ pathology?

<p>Plasma P-tau concentrations (A)</p> Signup and view all the answers

What is the most direct biomarker for tangle pathology?

<p>Tau PET (A)</p> Signup and view all the answers

Which biomarker is rich in axons and leaks into CSF and blood during neuroaxonal degeneration?

<p>Neurofilament light (NFL) (B)</p> Signup and view all the answers

What is the best-established imaging biomarker for neurodegeneration?

<p>Volumetric MRI of the brain (A)</p> Signup and view all the answers

Which biomarker is considered a synaptic biomarker?

<p>Neurogranin in CSF (C)</p> Signup and view all the answers

What do CSF and plasma tau concentrations represent as markers?

<p>Response to Aβ pathology (C)</p> Signup and view all the answers

Which marker shows an increase in concentration in tau PET-positive individuals well before detectable tau pathology on PET?

<p>Plasma P-tau concentrations (A)</p> Signup and view all the answers

'SV2A-' and 'Fluorodeoxyglucose (FDG)' are associated with which type of imaging?

<p>'SV2A-' with amyloid positron emission tomography (PET) and 'FDG' with volumetric MRI of the brain (A)</p> Signup and view all the answers

What type of data can NGS technologies collect in relation to neurodegenerative diseases?

<p>Digital genetic data (C)</p> Signup and view all the answers

What is one of the main purposes of conducting differential transcriptome analyses on brain tissue?

<p>Examine protein-coding genes (D)</p> Signup and view all the answers

What is a major focus of personalized or precision medicine?

<p>Customizing medical practice based on genetic tests (A)</p> Signup and view all the answers

How can combining genetic data help in understanding neurological disease mechanisms?

<p>Provide an 'omic' profile of the patients (A)</p> Signup and view all the answers

What type of studies can help identify preclinical disease stages according to the text?

<p>Genome-wide association studies (GWAS) (A)</p> Signup and view all the answers

Which factors are mentioned as non-genetic influences on neurodegenerative evolution?

<p>Nutrition and smoking habits (B)</p> Signup and view all the answers

What technique allows for the examination of non-coding RNAs or splicing events in brain tissue?

<p>Transcriptome analysis (B)</p> Signup and view all the answers

What is the primary goal of using NGS technologies in the context of neurodegenerative diseases?

<p>Generate digital genetic data for molecular signatures (C)</p> Signup and view all the answers

What is the primary consequence when both RB1 genes in a retinal cell are mutated or missing?

<p>The cell will grow unchecked and potentially become cancerous (A)</p> Signup and view all the answers

What is the primary purpose of genetic testing for RB1 mutations in individuals with newly diagnosed retinoblastoma?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary cause of the rapid central vision loss seen in Stargardt disease (STGD1)?

<p>Both a and b (A)</p> Signup and view all the answers

Which of the following is a key characteristic of monogenic macular dystrophies, such as Stargardt disease (STGD1)?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary benefit of intensive monitoring and early diagnosis of high-risk infants with retinoblastoma?

<p>It improves the prognosis for the affected individuals (B)</p> Signup and view all the answers

Which of the following statements about the inheritance pattern of Stargardt disease (STGD1) is correct?

<p>It has an autosomal recessive inheritance pattern (B)</p> Signup and view all the answers

What is the primary mechanism by which the defective ABCA4 protein leads to the development of Stargardt disease (STGD1)?

<p>It causes the accumulation of A2E lipofuscin in retinal pigment epithelium cells (C)</p> Signup and view all the answers

Which of the following is a key characteristic of monogenic macular dystrophies that complicates diagnosis?

<p>Incomplete penetrance and variability in disease expression (C)</p> Signup and view all the answers

What is the main reason for considering genetic testing valuable in the context of genetic eye diseases?

<p>To dictate a treatment and counseling plan based on disease-causing mutations (A)</p> Signup and view all the answers

Which two genetic variants are highlighted as major contributors to age-related macular degeneration (AMD) risk and pathogenesis?

<p>CFH (Y402H) and ARMS2/HTRA1 (C)</p> Signup and view all the answers

What provides the greatest genetic contribution to the development risk of age-related macular degeneration (AMD)?

<p>Short nucleotide polymorphism (SNP) associations on chromosomes 1q31 and 10q26 (B)</p> Signup and view all the answers

Which technology should ideally not be used as a stand-alone for advancing genomic medicine in the context of genetic eye diseases?

<p>NGS (Next-Generation Sequencing) (C)</p> Signup and view all the answers

What accounts for approximately 70% of the total risk associated with age-related macular degeneration (AMD)?

<p>Genetic variants in AMD (C)</p> Signup and view all the answers

In the context of personalized approaches to diagnosis, what is the primary factor that has provided opportunities for improved clinical diagnosis and personalized interventions?

<p>Increased access to NGS technologies (D)</p> Signup and view all the answers

What is believed to be attributable to 50% of the genetic risk associated with age-related macular degeneration (AMD)?

<p>'Common variants' highlighted in CFH (Y402H) and ARMS2/HTRA1 (D)</p> Signup and view all the answers

Which is considered particularly valuable in the context of genetic eye diseases when a treatment plan is determined by the presence of a disease-causing mutation?

<p>'Genetic testing' (C)</p> Signup and view all the answers

What is the primary goal of stratifying inherited eye diseases (IEDs) based on phenotypic and genotypic characteristics?

<p>To identify gene-specific phenotypes in genetically heterogeneous monogenic diseases like retinitis pigmentosa (RP) (A)</p> Signup and view all the answers

What is the primary objective of personalized ophthalmology in the context of age-related macular degeneration (AMD)?

<p>To identify endophenotypes within the complex disease of AMD, enabling targeted interventions (C)</p> Signup and view all the answers

Which of the following statements accurately describes the characteristics of inherited retinal diseases (IRDs)?

<p>IRDs are a genetically and phenotypically heterogeneous group of conditions characterized by rod and cone photoreceptor degeneration (C)</p> Signup and view all the answers

Which of the following statements regarding the molecular basis of inherited eye diseases (IEDs) is correct?

<p>Dissecting the molecular basis of IEDs stratifies them into different disease subtypes (C)</p> Signup and view all the answers

Which of the following treatments is mentioned in the text as a potential option for diabetic eye disease?

<p>Laser surgery (B)</p> Signup and view all the answers

What is the approximate number of disease-causing genes that have been identified and mapped for inherited retinal diseases (IRDs)?

<p>Around 250 genes (D)</p> Signup and view all the answers

Which of the following statements regarding the symptoms of diabetic eye disease is correct, based on the information provided in the text?

<p>Individuals with diabetic eye disease may experience blurry vision, double vision, floaters, or dark spots (D)</p> Signup and view all the answers

What is a recommended treatment approach for wet age-related macular degeneration (AMD)?

<p>Treatments aimed at stopping abnormal blood vessel growth and antioxidant supplements (B)</p> Signup and view all the answers

What is the main reason for the need for testing guidelines and counseling infrastructure in eye disease management?

<p>To provide mechanism-specific treatments (B)</p> Signup and view all the answers

Why is accurate phenotyping considered crucial for disease stratification?

<p>To enable diagnostic context-specific data interpretation (A)</p> Signup and view all the answers

What is a key driver for the adoption of personalized approaches in medical research?

<p>The need for translational outputs (C)</p> Signup and view all the answers

Why are many RP patients diagnosed only in mid to late-stage disease despite peripheral vision loss?

<p>Photoreceptor degeneration (A)</p> Signup and view all the answers

Why is it crucial to identify RP patients early for clinical trials?

<p>To maximize the efficacy of treatment (A)</p> Signup and view all the answers

What is the primary challenge posed by the development of targeted therapies for RP patients?

<p>Ethical considerations in patient selection (D)</p> Signup and view all the answers

What impacts the success of clinical trials for RP treatment according to the text?

<p>Early identification of patients for maximal treatment efficacy (D)</p> Signup and view all the answers

Why may changes in diagnostic processes be needed for RP patient management?

<p>To enable early identification and treatment efficacy maximization (B)</p> Signup and view all the answers

What is the primary cause of Best vitelliform macular dystrophy (BVMD)?

<p>Mutations in BEST1 (A)</p> Signup and view all the answers

Which gene mutations result in Sorsby fundus dystrophy that resembles neovascular age-related macular degeneration (AMD) with early adulthood onset?

<p>TIMP3 (D)</p> Signup and view all the answers

What is the primary characteristic feature seen in Doyne honeycomb retinal degeneration?

<p>Drusen in the macula (A)</p> Signup and view all the answers

Which macular dystrophy is associated with accumulation of lipofuscin as yellowish white flecks?

<p>Doyne honeycomb retinal degeneration (A)</p> Signup and view all the answers

Which gene mutations are known to cause overlapping phenotypes associated with congenital or juvenile glaucoma?

<p>PAX6 and CYP1B1 (A)</p> Signup and view all the answers

What is the impact of detecting mutations in glaucoma-related genes on clinical care and genetic counseling?

<p>Allows for appropriate surveillance and timely treatment (A)</p> Signup and view all the answers

What is the presumed mechanism for photoreceptor and RPE dysfunction in Best vitelliform macular dystrophy (BVMD)?

<p>Subretinal fluid accumulation (B)</p> Signup and view all the answers

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