Neurology: Case of the Month

Test Yourself — Patient 56

Progressive Multifocal Leukoencephalopathy

  1. What is the recognized cause of progressive multifocal leukoencephalopathy?
    • [ A ] Herpes simplex virus
    • [ B ] Slow virus infections
    • [ C ] JC virus
    • [ D ] Cytomegalovirus
  2. In recent years, what is the most common illness associated with PML?
    • [ A ] Cryptococcal meningitis
    • [ B ] AIDS (acquired immune deficiency syndrome)
    • [ C ] Lymphoma
    • [ D ] Neurosarcoidosis
  3. Which of the following regions of the brain is most commonly affected in patients with PML?
    • [ A ] Optic nerve and retina
    • [ B ] Temporal pole
    • [ C ] Basal ganglia
    • [ D ] Occipital-parietal region
  4. All of the following are recognized histologic characteristics of PML, EXCEPT:
    • [ A ] Bizarre appearing astrocytes
    • [ B ] Alzheimer type II astrocytes
    • [ C ] Ground-glass inclusion bodies
    • [ D ] Enlarged oligodendrocyte nuclei
  5. To date, the most widely accepted therapeutic strategy in cases of PML is aimed at:
    • [ A ] Inhibition of viral DNA topoisomerase
    • [ B ] Inhibition of host DNA topoisomerase
    • [ C ] Reversal of the predisposing immunodeficiency state
    • [ D ] Inhibition of JC viral replication by nucleoside analogs
    • [ E ] Passive transfer of anti-JC viral antibodies

 

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