CME Credit--March 2001

By answering the following questions, you can earn 2 category 1 CME credits.  These questions will be based on the discussion found on Neurolist during the month of March 2001.  In order to receive the credits you must score at least a 70% on this test and submit payment to the Medical College of Georgia for $ 25.00 for the two credits.  If you do not score high enough to obtain the credits then you will not be charged.  After submission of the questions you will be taken to a secure web site where you can enter your credit card information.  If you prefer, you may also send this information by fax or phone; the information needed to do this will appear on the secure web site.   You may take this test more than once if you do not receive a satisfactory score.  You must be a member of Neurolist to receive CME credit; membership in Neurolist is free.

The goal of Neurolist is to meet the learning needs of a worldwide group of neurologists. The most important need is to have a group of colleagues with a diverse experience with whom problem cases in neurology can be discussed with. In addition we will discuss new studies and findings of interest to neurologists. Finally we will discuss other issues of interest to neurologists. All areas of neurology will be discussed during the course of the year.

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For Each question there is one best answer.  Please select the best answer:

1)All of the following are true Except:
A) Statin drugs reduce circulating endothelin-1 and C-reactive protein.
B) Statins reduce blood pressure and may stabilize atherosclerotic plaques.
C) Dietary therapy for lowering LDL and raising HDL is preferable to statins because of the high incidence of liver toxicity and rhabdomyolysis attributable to this class of drugs.
D) If you are a mouse whose diet consists solely of cheese and grapefruit juice, it would be advisable to avoid eating atorvastatin pills you find lying on the ground.
E) Patients with acute myocardial or brain infarcts may benefit from the early administation of aspirin, Plavix and a statin drug.
2)The following statements are true concerning botulinum toxins Except:
A) The toxin is formed from the spores of clostridium botulinum an obligate anaerobe.
B) 1 mouse unit of botulinum toxin type A (allergan-Botox) is equivalent to 50 mouse units of botulinum toxin type B (Elan-Myobloc).
C) A test injection of botulinum toxin into the forehead is the best method for determining a secondary non-responder to botulinum toxin.
D) Hemifacial spasms, blepharospasm, strabismus and cervical dystonia are approved indications for botulinum toxin.
E) Generally accepted but not approved indications for botulinum toxin include excessive sweating, focal limb dystonia (writer's cramp), spasticitiy, and spasmodic dysphonia

3)The CURE study reported at the meeting of the American College of Cardiology found all of the following Except:

A) Patients having a mild heart attack had a 20% less likely chance of developing either another heart attack or stroke if they took clopidogrel (Plavix) in addition to standard therapy.
B) Clopidogrel (Plavix) reduces the risk of stroke by 30% in all patients.
C) Besides clopidogrel (Plavix) patients in this study took ASA (asprin).
D) Patient taking clopidogrel (Plavix) had a 30% chance of a serious bleed.
E) Benefits of using clopidogrel were seen as early as 3 hours after administration.
4) Signs of neurosyphilis include all of the following Except:
A) Elevated WBC in the CSF.
B) Positive RPR in the CSF.
C) Positive FTA-ABS in the CSF.
D) Argyll Robertson pupil.
E) Positive India Ink Prep.
5)Bechets Disease includes the following findings:
A) Elevated CSF protein, elevated CSF RBCs and elevated CSF glucose.
B) Elevated CSF WBCs, Elevated CSF RBCs and elevated CSF glucose.
C) Urogenital ulcers and normal CSF.
D) Urogenital ulcers, uveitis and elevated CSF WBCs.
E) Urogenital ulcers, parotitis and hilar adenopathy.
6)Chronic therapy for the prevention of strokes may include all of the following Except:
A) ASA (aspirin) at a dose of 325 mg a day.
B) Warfarin (coumadin) to maintain an INR of greater than 2.0.
C) Heparin drip to maintain a PTT of 38-45.
D) Clopidogrel (Plavix).
E) ASA/dipyridamol combination therapy (Aggrenox).
7)Which of the following statements are true:
A) There is a relationship between prostate cancer and AIDP (Guillian-Barre syndrome).
B) AIDP is best diagnosed by the presence of a profound axonal neuropathy on lower extremity nerve conduction studies.
C) Proteins found on viruses or bacteria may cause the formation of autoantibodies that attack the myelin sheath causing the symptoms of AIDP (Guillian-Barre).
D) Elevated CSF protein is necessary to make the diagnosis of AIDP (Guillian-Barre).
E) Low amplitude motor responses is often a favorable prognostic indicator in AIDP.
8)The following are found in Devic's disease:
A) Acute vertigo and hearing loss.
B) Optic neuritis and an acute intramedullary cervical cord lesion.
C) Optic neuritis and a sensory neuropathy.
D) Hilar adenopathy and an acute cervical cord lesion.
E) Optic neuritis, uveitis, and parotitis.
9)The following statements about Myasthenia Gravis are true Except:
A) The ice-pack test is a simple clinical test for myasthenia gravis that produces few side effects.
B) The symptoms of myasthenia gravis will fluctuate throughout the day.
C) About 20-25% of patients with generalized myasthenia gravis will not have acetylcholine receptor antibodies.
D) If the edrophonium (tensilon) test is negative the patient does not have myasthenia gravis.
E) Acute worsening of myasthenia gravis may be treated with IVIG or plasma exchange.
10)The following are true concerning the use of anti-edema agents in a cerebral hemmorhage.
A) Steroids must be given to prevent acute deterioration.
B) Acetazolamide (Diamox) has been given acutely in patients with signs of increased intracranial pressure.
C) Mannitol 50 mg is of use in an intracranial hemmorhage.
D) Dopamine should be used as it tends to promote vascular regeneration.
E) Nitroglycerin should be immediately taken as soon as the diagnosis is made.

                                                                                                              

Revised April 10, 2001

(c) 2001 Medical College of Georgia