Set out below is a series of multiple choice questions designed to test your understanding of three articles in our series on neurology (Parkinson's disease [February 26, p333, and March 25, p476] and multiple sclerosis [May 6, p694]). All pharmacists are invited to complete the questions and send their answers, together with a stamped and addressed A5 (230 x 160mm) envelope, to: The College of Pharmacy Practice, Barclays Venture Centre, University of Warwick Science Park, Coventry CV4 7EZ, by June 5. Results will be returned along with a certificate of completion which, for college members, will count towards continuing education requirements. The correct answers will be published in The Journal. A provisional time of four hours is given for the articles relating to this Credit for Learning exercise.
Genus Pharmaceuticals will provide a £500 prize to the pharmacist who achieves the highest marks overall in the four Credit for Learning exercises published in 2000. There will be a runner up prize of £200.
Completion of Credit for Learning questions entitles pharmacy undergraduates to one point towards the professional development certificate, a joint initiative between the BPSA and the College of Pharmacy Practice.
The Journal does not have the resources to enter into correspondence about answers to questions.
This web page is for information only. Answers should be submitted on the printed form.
Answers (PJ, August 19, p280)
Draw a ring around either T or F (T=true, F=false). There may be more than one true answer to each question.
| 1. Regarding Parkinson's disease (PD): | |
| (a) It is the most common neurodegenerative disorder in the UK | T/F |
| (b) It has a prevalence of 2 per cent in people over 80 years old | T/F |
| (c) It is more prevalent in males than females | T/F |
| (d) Black people are less commonly affected than white people | T/F |
| (e) China is thought to have a relatively low incidence | T/F |
| 2. In the differential diagnosis of PD: | |
| (a) The condition can be misdiagnosed as a stroke | T/F |
| (b) Drug-induced PD tends to be more common in women than men | T/F |
| (c) In drug-induced PD, withdrawal of the causative drug will normally resolve symptoms within eight weeks | T/F |
| (d) Unlike parkinsonian tremor, essential tremor tends to be exacerbated by alcohol | T/F |
| (e) Other neurodegenerative diseases with similar signs/symptoms tend to have better prognoses than PD | T/F |
| 3. In relation to the use of levodopa in the management of PD: | |
| (a) It should be taken after food in the later stages of the disease | T/F |
| (b) Domperidone is useful in PD primarily to prevent nausea associated with dopamine agonists | T/F |
| (c) Its absorption may be reduced by concomitant iron therapy | T/F |
| (d) Breaking a Sinemet CR tablet prior to administration is not generally recommended | T/F |
| (e) The bioavailability of Sinemet CR tablets is reduced in the presence of food | T/F |
| 4. Regarding the use of dopamine agonists in the management of PD: | |
| (a) All agents are longer-acting than levodopa | T/F |
| (b) All agents may cause pleuropulmonary fibrosis | T/F |
| (c) Toxicity tends to be more likely if agents are co-prescribed with erythromycin | T/F |
| (d) Apomorphine when used as an alternative to levodopa may cause a Coomb's positive haemolytic anaemia | T/F |
| (e) Ropinirole may cause sudden-onset drowsiness | T/F |
| 5. Relating to the implications and prognosis of PD: | |
| (a) Tremor-dominant PD has a more favourable prognosis than other variants of the disease | T/F |
| (b) It is estimated that up to half of PD sufferers also have depression | T/F |
| (c) Clozapine is the only agent licensed for treating the neuropsychiatric complications of PD | T/F |
| (d) Atypical antipsychotics are safe with respect to exacerbation of motor symptoms of PD | T/F |
| (e) There is good evidence that levodopa therapy improves life-expectancy of patients with PD | T/F |
| 6. In multiple sclerosis (MS): | |
| (a) It has a prevalence of 0.2 per cent in the UK | T/F |
| (b) Male sufferers outnumber females | T/F |
| (c) Acute exacerbations are thought to result from an inflammatory demyelination | T/F |
| (d) Progression of the disease is thought to be associated with axonal loss | T/F |
| (e) The disease is characterised by deposition of myelin basic protein around neuronal axons | T/F |
| 7. Regarding the role of beta-interferon in MS: | |
| (a) Interferon beta-1b has an amino acid sequence identical to natural interferon beta | T/F |
| (b) Interferon beta treatment is considered to reduce relapse rate by 50 per cent | T/F |
| (c) There is no evidence that interferon beta-1b has activity in secondary progressive MS | T/F |
| (d) Improvements with treatment do not seem to be associated with changes in lesion load observed by magnetic resonance imaging (MRI) | T/F |
| (e) It may provoke an antibody response in up to 50 per cent of patients within two years of treatment | T/F |
| 8. When considering the use of immunosuppressant drugs in MS: | |
| (a) With mitozantrone, the maximum cumulative dose should not exceed 160mg | T/F |
| (b) Mitozantrone in combination with methylprednisolone has resulted in a significant reduction in relapse frequency | T/F |
| (c) Mitozantrone has caused significant cardiotoxicity in MS trials | T/F |
| (d) There is at present insufficient evidence that intravenous (IV) immunoglobulin therapy is effective against secondary progressive MS | T/F |
| (e) Lenercept is thought to act by binding irreversibly to tumour necrosis factor receptors | T/F |
| 9. In acute exacerbations of MS: | |
| (a) Relapses are typically slow and insidious in onset in most patients | T/F |
| (b) IV steroid therapy is thought to be more effective than oral steroids in the treatment of relapses | T/F |
| (c) Osteoporosis may occur in patients treated with high-dose IV methylprednisolone | T/F |
| (d) There is no good evidence that any particular steroid is superior to another in management of acute relapses of MS | T/F |
| (e) Plasma exchange has not been shown to be effective | T/F |
| 10. In managing spasticity associated with MS: | |
| (a) Tolerance often occurs with long-term use of baclofen | T/F |
| (b) Baclofen is prone to cause postural hypotension as a dose-related side effect | T/F |
| (c) Tizanidine tends to produce less muscle weakness than baclofen | T/F |
| (d) The use of benzodiazepines is limited by their tendency to produce dependency | T/F |
| (e) Patients receiving dantrolene should have regular checks of their renal function | T/F |
The College of Pharmacy Practice
Credit for Learning: 1