Neurologists Exam Neurologists Exam Neurodegenerative & Movement Disorders 1 — Questions and Answers
Question 1: The triad of resting tremor, rigidity, and bradykinesia is classic for which neurodegenerative disorder?
- Parkinson's disease (Correct answer)
- Huntington's disease
- Multiple sclerosis
- Amyotrophic lateral sclerosis
Correct answer: Parkinson's disease
Parkinson's disease is characterized by the cardinal motor triad of resting tremor, cogwheel rigidity, and bradykinesia due to dopaminergic neuron loss.
Question 2: Which protein aggregate is the pathological hallmark found in Lewy body dementia and Parkinson's disease?
- Alpha-synuclein (Lewy bodies) (Correct answer)
- Tau neurofibrillary tangles
- TDP-43 inclusions
- Amyloid-beta plaques
Correct answer: Alpha-synuclein (Lewy bodies)
Lewy bodies are intraneuronal aggregates of misfolded alpha-synuclein protein, defining the neuropathology of Parkinson's disease and LBD.
Question 3: Huntington's disease is caused by a CAG trinucleotide repeat expansion in which gene?
- HTT (huntingtin) (Correct answer)
- ATXN1 (ataxin-1)
- FMR1 (fragile X)
- C9orf72
Correct answer: HTT (huntingtin)
Huntington's disease results from a CAG repeat expansion (>36 repeats) in the HTT gene encoding the huntingtin protein on chromosome 4.
Question 4: Which finding on neuroimaging is most characteristic of multiple system atrophy (MSA-P subtype)?
- Putaminal atrophy with T2 hypointensity and rim sign (Correct answer)
- Hippocampal atrophy on MRI
- White matter hyperintensities on FLAIR
- Caudate atrophy on MRI
Correct answer: Putaminal atrophy with T2 hypointensity and rim sign
MSA-P shows putaminal atrophy with T2 hypointensity and a hyperintense lateral rim (hot cross bun sign in MSA-C) on MRI.
Question 5: The DaTscan (dopamine transporter scan) is used to differentiate Parkinson's disease from which condition?
- Essential tremor (Correct answer)
- Huntington's disease
- Wilson's disease
- Tourette syndrome
Correct answer: Essential tremor
DaTscan shows reduced dopamine transporter uptake in PD but is normal in essential tremor, helping distinguish these two tremor disorders.
Question 6: Which medication is considered the gold standard for symptomatic treatment of Parkinson's disease motor symptoms?
- Levodopa/carbidopa (Correct answer)
- Bromocriptine alone
- Amantadine alone
- Pramipexole alone
Correct answer: Levodopa/carbidopa
Levodopa combined with carbidopa (a peripheral decarboxylase inhibitor) remains the most effective symptomatic treatment for Parkinson's motor features.
Neurologists Exam Neurologists Exam Neurodegenerative & Movement Disorders 1
The triad of resting tremor, rigidity, and bradykinesia is classic for which neurodegenerative disorder?