- Opening pressure: elevated ?
- WBC: > 100 /mm3
- Cell type: neutrophils ?
- Lactate: > 3.5 mmol/L
- Protein: normal ?
- Glucose CSF/serum ratio: < 0.4 ?
40. Pseudobulbar palsy
- Is a result of a damage of motor fibers traveling from the cerebral cortex to the lower brain stem ?
- Is a result of a lower motor neuron lesion of the nerves in the lower brain stem?
- Normal emotions?
- Labile emotions?
- Spastic tongue?
- Wasted tongue, fasciculations?
39. Motor innervation of the upper limb (I)
- Biceps brachii: radial nerve?
- Triceps brachii: radial nerve?
- Brachioradialis: radial nerve?
- Flexor carpi radialis: radial nerve?
- Extensor pollicis longus: radial nerve?
- Extensor pollicis brevis: radial nerve?
38. Motor neuron diseases
Upper motor neurons (UMN)
Lower motor neurons (LMN)
- Amyotrophic lateral sclerosis (ALS): UMN degeneration + LMN degeneration?
- Progressive muscular atrophy (PMA): LMN degeneration?
- Primary lateral sclerosis (PLS): UMN degeneration?
- Progressive bulbar palsy (PBP): LMN degeneration?
- Hereditary spastic paraplegia (HSP): LMN degeneration?
- Pseudobulbar palsy: UMN degeneration?
37. Effects of various drugs on the neuromuscular junction
- Pyridostigmine is a reversible acetylcholinesterase inhibitor?
- Amifampridine blocks potassium channel efflux in nerve terminals which increases duration of the action potential?
- Aminoglycoside antibiotics can aggravate myasthenia gravis (MG) ?
- Patients with MG show decreased susceptibility to depolarizing neuromuscular blocking agents ?
- Patients with MG show increased susceptibility to non-depolarizing neuromuscular blocking agents?
- Patients with Lambert-Eaton myasthenic syndrome show decreased susceptibility to both depolarizing and non-depolarizing neuromuscular blockers?
36. Brodmann areas
- Area 4 – Primary somatosensory cortex?
- Area 44, 45 – Auditory cortex?
- Areas 3, 1, 2 – Primary motor cortex?
- Area 17 – Secondary visual cortex?
- Areas 41, 42 – Broca’s area?
- Area 18 – Primary visual cortex?
35. Neuromuscular junction
- When action potential arrives at the presynaptic neuron terminal, voltage-dependent calcium channels open and calcium ions flow from the extracellular fluid into the neuron?
- Influx of calcium into the neuron triggers the fusion of acetylcholine vesicles with the membrane and the release of ACh into the synaptic cleft?
- Nicotinic and muscarinic ACh receptors (AChRs) are ligand-gated ion channels?
- The binding of ACh to nicotinic AChR in the postsynaptic muscle membrane opens a calcium channel within the receptor allowing calcium influx and depolarization of the muscle membrane?
- Two ACh molecules must bind with each AChR to open its channel?
- Choline acetyltransferase in the synaptic cleft decomposes ACh into choline and acetic acid?
34. Diagnosis of myasthenia gravis
- The titer of anti-AChR antibodies in patients with myasthenia gravis (MG) closely matches the severity of symptoms?
- The sensitivity of anti-AChR antibodies with pure ocular MG is between 85 – 90% ?
- Repetitive nerve stimulation typically shows decremental response in MG?
- Repetitive nerve stimulation typically shows facilitation in Lambert-Eaton myasthenic syndrome?
- Single-fiber electromyography is the most sensitive test for MG?
- Subjective improvement in muscular weakness after intravenous edrophonium is considered as positive Tensilon test and confirmation of MG ?
33. Antibodies in myasthenia gravis
- Antibodies against the nicotinic acetylcholine receptor (AChR) are found in 50 – 60% of patients with generalized myasthenia gravis (MG)?
- A majority of antibodies against the AChR found in patients with MG are “blocking” antibodies which prevent binding of acetylcholine to the AChR?
- Anti-AChR “binding” antibodies, bind to the AChR and cause destruction of junctional folds by activating the complement system?
- Most of the seronegative MG patient (those that do not have anti-AChR antibodies but have MG) have antibodies against P/Q-type VGCC (voltage gated-calcium channels)?
- Antibodies against LRP4, Agrin and titin proteins are shown in some seronegative MG patients ?
- Patients that have anti-MuSK (Muscle-Specific Kinase) antibodies suffer from Lambert–Eaton myasthenic syndrome?
32. Brain tumors and grades (I)
According to “The 2016 World Health Organization Classification of Tumors of the Central Nervous System”:
- Pilocytic astrocytoma: WHO grade II ?
- Anaplastic astrocytoma: WHO grade IV ?
- Anaplastic oligodendroglioma: WHO grade III ?
- Ependymoma: WHO grade I ?
- Gangliocytoma: WHO grade I ?
- Pineoblastoma: WHO grade IV ?