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ROSH REVIEW-Neurology Exam Questions and Answers | 100% Pass
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ROSH REVIEW-Neurology Exam Questions and Answers | 100% Pass Which of the following is correct regarding multiple sclerosis? ABecomes more prevalent the farther you live from the equator BMore common in men CRetinal tear is a common presenting symptom DWorsens during the course of pregnancy -...

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  • September 15, 2024
  • 205
  • 2024/2025
  • Exam (elaborations)
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  • rosh review neurology exam questions and answers

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©SOPHIABENNETT
EXAM_SOLUTIONS GUARANTEED SUCCESS 2024/2025 ACADEMIC YEAR




©SOPHIABENNETT 9/3/24 2024/2025

, ©SOPHIABENNETT EXAM SOLUTIONS_2024/2025 Tuesday, September 3, 2024 10:30 AM



ROSH REVIEW-Neurology Exam
Questions and Answers | 100% Pass


Which of the following is correct regarding multiple sclerosis?




ABecomes more prevalent the farther you live from the equator



BMore common in men



CRetinal tear is a common presenting symptom



DWorsens during the course of pregnancy - Answer✔️✔️-Correct Answer ( A )

Explanation:

Multiple sclerosis (MS) is most common in people of Northern European descent.

Caucasians develop MS at nearly twice the rate of African Americans in the United

States. In many areas of the world, MS is more prevalent in temperate latitudes

(approaching 1 in 500 in some locations) and becomes less prevalent toward the

equator (1 in 20,000 or rare case reports only in some locations). Multiple sclerosis is a

disease characterized by multifocal areas of demyelination in the brain and spinal cord,

with associated inflammatory cell infiltrates, reactive gliosis, and axonal degeneration. It

typically presents in young adults with episodic neurologic dysfunction. Pathologically,

most cases are characterized by multifocal areas of demyelination and gross gliotic

Page | 1

, ©SOPHIABENNETT EXAM SOLUTIONS_2024/2025 Tuesday, September 3, 2024 10:30 AM


scarring in the brain and spinal cord. Classic locations of these lesions, called plaques,

are the optic nerves, periventricular white matter, deep white matter, juxtacortical white

matter, corpus callosum, cerebellar peduncles, and dorsolateral spinal cord. The

presentation of MS is quite variable. The classic presentation involves acute to

subacute onset of impaired vision or sensation. Patients may often describe fatigue,

depression, bladder urgency, weakness, impaired balance, and impaired coordination.



Multiple sclerosis occurs 2- to 2.5-fold more frequently in women than in men (B), a sex

predilection that is common in autoimmune diseases. Optic neuritis, not retinal tear (C)

is a classic presenting syndrome, typically with visual symptoms in one eye. Many

women with MS successfully have multiple children, and the symptoms of MS diminish

during pregnancy (D), especially by the third trimester, when the frequency of

exacerbations is reduced by approximately two thirds.

One Step Further

Question: Do patients with relapsing-remitting MS ever convert to other types of MS? -

Answer✔️✔️-Answer: Most patients presenting with relapsing-remitting MS convert to

secondary-progressive MS after 20 to 40 years

Which of the following is true about myasthenia gravis?



Limb weakness and dysarthria are the most common presenting symptoms

Muscle weakness tends to worsen after long periods of rest

Optic neuritis is commonly associated with the condition

Symptoms are decreased by cooling - Answer✔️✔️-Correct Answer ( D )


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, ©SOPHIABENNETT EXAM SOLUTIONS_2024/2025 Tuesday, September 3, 2024 10:30 AM


Explanation:

Myasthenia gravis (MG) is an autoimmune disease characterized by muscle weakness

and fatigue seen particularly with repetitive use of voluntary muscles. It is caused by

antibodies that attack and reduce the number of nicotinic acetylcholine receptors

leading to a decrease in response to acetylcholine. Cooling improves the symptoms of

myasthenia gravis. This is the basis of the "ice test." When ptosis is present, an ice

pack is placed over the affected eye for two minutes, and the ptosis resolves. It is

thought that local cooling results in a slowing of the kinetics of the acetylcholine

receptor, allowing for a prolonged effect of acetylcholine and improvement of symptoms.



The most frequent initial symptoms of myasthenia gravis are bulbar, typically with ptosis

and diplopia (A) due to ocular muscular weakness, or weakness of the levator

palpebrae superioris. Muscle weakness tends to improve (B) after long periods of rest.

Patients become weaker with repetitive activity. Optic neuritis (C) is associated with

multiple sclerosis, not myasthenia gravis.

One Step Further

Question: Myasthenia gravis is often misdiagnosed in the elderly population as what

condition? - Answer✔️✔️-Answer: Ischemic stroke, especially when there is new-onset

facial weakness.

A 56-year-old woman presents with burning pain and tingling on the palmar surfaces of

digits 1-3 of her right hand. The pain has been present for several months and awakens

her at night. There is no atrophy or weakness of her hand. However, volar wrist




Page | 3

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