4 Written Questions

1. inflammatory process of the spinal cord as a result of viral infection, MS, radiation myelopathy; Usually occurs at SC levels T4-6 or T10-12
   Clinical Presentation: symmetrical severe muscle weakness of legs+arms, loss of reflexes, pain, non specific sensory loss, bowel/bladder dysfunction
2. Degeneration of fasciculus gracilis with a loss of vibratory sensation, two-point discrimination, and conscious proprioception; develops 10-20 years after syphilis infection. Also referred to as tertiary syphilis or neurosyphilis; Neurons in the DRG degenerate especially in the lower thoracic and lumbosacral segments
   Clinical Presentation: results in ataxia; stabbing pains in the trunk and legs; urinary incontinence and impotence; absence of knee and ankle reflexes
3. inflammation of the leptomeninges and underlying subarachnoid
4. Acute demyelinating, inflammatory polyradiculoneuropathy causing primarily flaccid motor paralysis;affects nerve roots and peripheral nerves; assumed autoimmune etiology
   Clinical Presentation: ascending, symmetrical pattern of paralysis/paresis starting in the legs and spreading to the arms; noted clumsiness, foot/hand pain and/or tingling in a stocking/glove pattern; may require assisted ventilation

4 Multiple Choice Questions

1. inflammation of the gray matter of the spinal cord; caused by an Enterovirus that attacks Anterior Horn Cells & sometimes motor nuclei of brainstem, often resulting in spinal and muscle deformity and paralysis (polio = gray); Systemic illness prior to neurologic symptoms
   
   Clinical Manifestation: Muscles become painful & stiff, LMN asymmetrical weakness with prominent atrophy over time; survivors often develop postpolio syndrome
   1. encephalitis
   2. Syringomyelia
   3. Poliomyelitis
   4. meningitis
2. degeneration of corticospinal tracts, posterior columns, spinocerebellar tract caused by the inability to absorb vitamin B12
   Clinical presentation: Loss of proprioception, vibratory sense, light touch, motor
   1. Tabes Dorsalis
   2. Caisson disease
   3. Transverse Myelitis
   4. subacute combined degeneration
3. 1- Syrinx (fluid-filled, slit-like cavity) develops in the spinal cord or brain stem (syringobulbia), causing damage to the crossing fibers of spinothalamic tract and resulting in neurological disability. Most secondary to trauma or congenital hydrocephalus (Arnold-Chiari Malformation).
   2- Clinical manifestations include wasting of intrinsic muscles of hand, spastic weakness in legsshawl like, bilateral loss of pain and temperature sensation in the upper extremities with preservation of touch and sensation.
   1. Syringomyelia
   2. Poliomyelitis
   3. Tabes Dorsalis
   4. meningitis
4. brain inflammation caused by a virus
   1. meningitis
   2. encephalitis
   3. Poliomyelitis
   4. Tabes Dorsalis

4 True/False Questions

1. Cervical spondylosis → degenerative condition of intervertebral discs in cervical region. Associated w/ degeneration of facet jts, hypertrophy of ligamentum flavum, and ossification of longitudinal ligament and bone spurring leading to spinal cord, nerve root and vertebral artery compression

   True        False

2. Amyotrophic Lateral Sclerosis → degenerative condition of intervertebral discs in cervical region. Associated w/ degeneration of facet jts, hypertrophy of ligamentum flavum, and ossification of longitudinal ligament and bone spurring leading to spinal cord, nerve root and vertebral artery compression

   True        False

3. Friedreich's Ataxia → progressive degeneration of spinocerebellar and corticospinal tracts and dorsal columns; genetic cause-autosomal recessive disorder

   True        False

4. Caisson disease → Decompression sickness; occlusion of epidural venous sinuses by nitrogen bubbles forced out of solution by rapid decompression; impaired venous return and hemorrhagic infarcts in spinal cord affecting the thoracic region first
   Clinical Presentation: joint pain, skin rash, edema, parasthesias and paralysis in LE more than UE

   True        False