Myasthenia gravis is an inherited disorder passed directly from parent to child.
Correct Answer
False
False. Myasthenia gravis is an autoimmune disorder, and no inheritance pattern has been linked to it. The immune trigger is not fully understood.
Category: Myasthenia Gravis Basics
Question 2
In ocular myasthenia gravis, weakness is limited to the eyelid muscles and the muscles that move the eyes.
Correct Answer
True
True. The ocular form affects only the eyelids and extraocular muscles. The generalized form also weakens the limbs and the muscles of swallowing and breathing.
Category: Myasthenia Gravis Basics
Question 3
Myasthenic crisis is a medical emergency because weakness of the respiratory muscles can compromise ventilation.
Correct Answer
True
True. A sudden worsening of myasthenia gravis can weaken the diaphragm and other breathing muscles, and the patient may need mechanical ventilation.
Category: Crisis and Antidotes
Question 4
Extended-release pyridostigmine tablets can be crushed to make them easier to swallow.
Correct Answer
False
False. Extended-release forms must be swallowed whole; crushing them releases the full dose at once. A patient who cannot swallow them should ask the prescriber about another form.
Category: Cholinesterase Inhibitors
Question 5
A patient whose myasthenia gravis symptoms improve on pyridostigmine can safely stop the drug abruptly.
Correct Answer
False
False. Myasthenia gravis is lifelong, and symptoms return quickly if pyridostigmine is stopped suddenly. Any change should be made by the prescriber.
Category: Cholinesterase Inhibitors
Question 6
Patients taking pyridostigmine for myasthenia gravis should wear a medical alert bracelet.
Correct Answer
True
True. These patients are at risk of myasthenic or cholinergic crisis, and a bracelet tells responders about the disease and the drug in an emergency.
Category: Cholinesterase Inhibitors
Question 7
Direct-acting cholinergic agonists such as bethanechol are used to treat myasthenia gravis because they strongly stimulate nicotinic receptors.
Correct Answer
False
False. Direct-acting cholinergic agonists act mainly on muscarinic receptors and have little nicotinic effect at the neuromuscular junction, so they are not used for myasthenia gravis. Cholinesterase inhibitors are used instead.
Category: Cholinesterase Inhibitors
Question 8
The effects of an irreversible cholinesterase inhibitor last until the body synthesizes new cholinesterase.
Correct Answer
True
True. Irreversible inhibitors bind the enzyme permanently, so effects persist until new enzyme is made. These agents are highly toxic and readily cross the blood-brain barrier.
Category: Crisis and Antidotes
Question 9
Rozanolixizumab should not be started in a patient who has an active infection.
Correct Answer
True
True. This monoclonal antibody for generalized myasthenia gravis raises infection risk, so treatment is delayed until an active infection resolves.
Category: Myasthenia Gravis Immunotherapy
Question 10
Alzheimer's disease is reversible if it is treated in the early stage.
Correct Answer
False
False. Alzheimer's disease is progressive and irreversible. Current drugs may slow decline for a time but do not reverse it.
Category: Alzheimer's Pathology
Question 11
Carrying one or two copies of the APOE-e4 gene variant increases a person's risk of Alzheimer's disease.
Correct Answer
True
True. Apolipoprotein E transports cholesterol, and its e4 form is associated with higher Alzheimer's risk. Carrying it raises risk but does not guarantee the disease.
Category: Alzheimer's Pathology
Question 12
The brain changes of Alzheimer's disease begin a decade or more before symptoms appear.
Correct Answer
True
True. Beta-amyloid begins to build up and other changes start long before memory loss is noticed, which is one reason treatment aims at early disease.
Category: Alzheimer's Pathology
Question 13
Levels of acetylcholine in the cortex and hippocampus rise as Alzheimer's disease progresses.
Correct Answer
False
False. Acetylcholine falls as cholinergic neurons in the cortex and hippocampus degenerate. Cholinesterase inhibitors aim to preserve the acetylcholine that remains.
Category: Alzheimer's Pathology
Question 14
Cholinesterase inhibitors such as donepezil can worsen peptic ulcer disease because they increase gastric acid secretion.
Correct Answer
True
True. Increased acid can worsen an ulcer and lead to bleeding or perforation, so patients are watched for signs of GI bleeding. Regular NSAID or glucocorticoid use adds to this risk.
Category: Alzheimer's Drugs
Question 15
Galantamine is an NMDA receptor antagonist.
Correct Answer
False
False. Galantamine is a reversible cholinesterase inhibitor. Memantine is the NMDA receptor antagonist used in Alzheimer's disease.
Category: Alzheimer's Drugs
Question 16
Rivastigmine is extensively metabolized by the liver, so it has many drug interactions.
Correct Answer
False
False. Rivastigmine is not metabolized by the liver's drug-metabolizing enzymes and has no significant drug-drug interactions. Its main problem is GI effects such as nausea and vomiting.
Category: Alzheimer's Drugs
Question 17
The upper or lower back is a recommended site for a rivastigmine patch because the patient is less likely to remove it there by accident.
Correct Answer
True
True. Placing the patch on the back keeps it out of easy reach, which helps confused patients avoid pulling it off; the upper arm or chest can be used if the back is not accessible. Sites are rotated so the same spot is not reused right away.
Category: Alzheimer's Drugs
Question 18
Memantine is eliminated mainly unchanged in the urine.
Correct Answer
True
True. Because the kidneys clear memantine largely unchanged, renal impairment and alkaline urine can lead to accumulation. Renal function is monitored during therapy.
Category: Alzheimer's Drugs
Question 19
Memantine is approved only for mild Alzheimer's disease.
Correct Answer
False
False. Memantine is approved for moderate to severe dementia of the Alzheimer type. It is also combined with donepezil in one product for moderate to severe disease.
Category: Alzheimer's Drugs
Question 20
Lecanemab is taken by mouth once daily at home.
Correct Answer
False
False. Lecanemab is a monoclonal antibody given by IV infusion (a subcutaneous injection form is also available for maintenance); it is never taken by mouth. Patients are watched for infusion or injection reactions and have MRI monitoring during treatment.
Category: Alzheimer's Drugs