B biphasic illness with several days of fever then

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b) Biphasic illness with several days of fever, then meningeal symptoms and asymmetric flaccid paralysis 5 to 10 days later c) Descending motor paralysis with preservation of tendon reflexes and sensation d) Failure to isolate a virus from the cerebrospinal fluid in the presence of marked meningismus C 448
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Neuronophagia is seen in - (AI 94) a) Amoebic encephalitis b) Poliomyelitis c) Tuberculer meningoencephalitis d) Cerebral malaria 449
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“Neuronophagia is phagocytosis of nerve cells.” • In polio the nerve cells are destroyed and phagocytosed by microgliocytes. • The earliest histopathological change in polio are central chromatolysis of the nerve cells. Areas of the C.N.S involved in poliovirus infection - Hypothalamus - Thalamus Anterior horn and intermediate gray matter of the spinal cord 450
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Polio virus infection can result in all, except a) Anterior horn cell damage (AIIMS Dec 94) b) Autonomic involvement c) Respiratory involvement d) Paralysis in > 70% of cases 451
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452
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Polio virus infection can result in all, except a) Anterior horn cell damage (AIIMS Dec 94) b) Autonomic involvement c) Respiratory involvement d) Paralysis in > 70% of cases D 453
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A 45-year-old female presents to the outpatient clinic with symptoms of pain, fatigue and weakness in both lower limbs. She gives history of paralysis affecting both lower limbs in childhood from which she made good functional recovery. Which of the following is the most likely suspected diagnosis - (AI 12) a) Post Polio Syndrome b) Polymyositis c) Muscular Dystrophy d) Neuropathy 454
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Post-polio syndromes (PPS) is characterized by new or progressive muscle weakness and disability, usually occuring decades after the onset of acute poliomyelitis. The cause of progressive neurologic deterioration in PPS is unknown. The main theories of pathogenesis involve:- - Progressive degeneration of reinnervated motor units. - Persistence of poliovirus in neural tissue. - Induction of autoimmunity with consequent destruction of neural structures. 455
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There are no pathognomonic finding that distinguish PPS from remote polio. - The diagnosis of PPS is made on clinical grounds - Diagnostic criteria are as follows:- 1. • A prior episode of poliomyelitis with evidence of residual motor neuron loss. 2. A period of at least 15 years with neurologic and functional stability after the acute onset of polio. 3. A gradual (or rarely abrupt) onset of new weakness and abnormal muscle fatigability that persists for at least one year. 4. Exclusion of other medical conditions that cause similar symptoms. • 456
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A 45-year-old female presents to the outpatient clinic with symptoms of pain, fatigue and weakness in both lower limbs.
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  • Winter '16
  • jean grey

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