2008 module exam Flashcards
a patient had an injury to one side (it was mentioned) of the posterior spinal cord. what symptom might he has?
- loss of vibration sense at the contralateral side
a patient with loss of vibration sense. which artery might be occluded? (not sure if antreior or posterior!)
- posterior spinal artery
a lesion in the beginning of medial side of internal arcuate fibers
a. gracillus nucleus
b. cuneate nucleus
a. gracillus nucleus
inferior colliculus projects to
- medial geniculate body
the nucleus responsible for pain & temperature sensation from the face
- spinal nucleus of the 5th cranial nerve
the nucleus that sends motor fibers to the face
- motor nucleus of the 5th cranial nerve
the artery blocked in lateral medullary syndrome
- PICA
the cells that can proliferate in case of nerve injury
- Schwann cells
- oligodendrocyte
- Schwann cells
which cortical layers are highly developed in sensory cortex?
-2&4
a patient with lower limb paralysis. which artery might be occluded
- anterior cerebral
- anterior choroidal
- anterior cerebral (not sure)
which of these might be affected in case of injury to the superior cerebellar peduncle?
Dentothalamic
the dorsal horn develops from
alar layer
medulla oblengata develops from?
myelencephalon
khalid khan’s Q: about fornix - before the commissure
-
if a patient developed decreased ability to hear low frequency sounds, which
structure might be affected?
- lateral geniculate
- medial geniculate
- superior temporal gyrus
- middle temporal gyrus
- inferior temporal gyrus
?
which of these is nourished by aqueoshumerus?
- cornea
damage to this may cause hyperacusis
- facial nerve
satiety centre in hypothalamus
- ventromedial nucleus
crossing of tectospinal tract
midbrain
structure where pineal body is found in:
epithalamus
a structure that forms lateral lemniscus
cochlear nucleus
lesion at inferior colliculus level affects
trochlear nerve
a mixed cranial nerve
CN7
Nerve supply to pterygoid muscle
5th CN
Medial side of pons is supplied by
Paramedian artery
Posterior side of midbrain is supplied by
Superior cerebellar
Weber’s syndrome involves
Midbrain
A lesion lateral in the brainstem affects which of the following tracts?
a. Descending sympathetic
b. Corticospinal
c. Medial lemniscus
a. Descending sympathetic
Injury to this vessel may lead to 3rd nerve palsy
Posterior communicating artery
Large defect of perfusion of right parietal, frontal, and temporal areas
Right MCA
Receives mamillothalamic tract
Anterior thalamic nuclei
Receives spinothalamic & dorsal lemniscus
VPL nucleus
A pathway entering the cerebellum through SCP?
Dentothalamic
Fibers from basal ganglia to the thalamus
Ansa reticularis
the most important function of the dynamic (deep muscle refelx?)
- correct for stumble
- (coordinates?) movement of one joint
?
which of these a bilateral somatic reflex?
- withdrwal refelx
- swallowing
withdrwal refelx (not sure)
someone with an injury to an association cortex. he cannot (recognize?? what is in the left feild)
hemineglect
During stance phase of walking cycle, which system is the most important?
- medullary reticulospinal
- lateral vestibulospinal
- corticospinal
- spinothalamic
- rubrospinal
- lateral vestibulospinal
a patient with resting tremor, rigidity, and (ataxia??). which pathway might be
affected?
thalamocortical
mechanism of learning in the cerebellum / motor skill learning is done by which
mechanism?
- long term potentiation
- long term deppression
?
(…………………………………………)- about what happens in cerebellar nuclei
-change activation into inhibition (not sure)
fastest brain wave
- gamma
the brain wave that prevails in slow wave sleep
- delta
- theta
-delta (not sure)
which of the following characterizes slow wave sleep?
activation of VLPO
mechanism of neuron death in epilepsy
- excitotoxicity of neurons
- over activity of neurons
- over activity of dendrite
?
arousal is a result of?
inhibition of the reticular nucleus ((not sure it was written like this))
receives reticular formation
intralaminar nucleus
a question about the neurotransmitter that stabilizes wakefulness
-
feeding is controled by
- leptin
- activation of NYP
- leptin
in conduction hearing loss, there is a problem in
sound amplification
the neurotransmitter most repidly degraded
- glutamate
- acetycholine
?
where in visual pathway do the 2 images fuse?
primary visual cortex
function of dynamic fibers in stretch reflex
a. makes movements more accurate
b. compensates for unexpected obstacles during movement
b. compensates for unexpected obstacles during movement
a person first looked at something he liked then he tried to memorize that by
rehearsal- which of these is active?
a. Occipital cortex
b. Supplementary motor area
?
The principle energy consuming process in the brain
Maintaining ionic gradient
The main excitotoxic neurotransmitter in the brain
Glutamate
Effect of hyperventilation on the brain
Decrease CBF
Concept of penumbra
-
Conductive aphasia results from
Ischemia to inferior parietal lobe
Dopamine effect on movement
Inhibits indirect pathway + disinhibit direct pathway
Selective destruction of subthalamic nucleus
Hemi ballismus (not sure- maybe there were better options)
A structure concerned with posture & eye movement?
Flocculonoddular lobe of cerebellum
Effect of Mossy & climbing fibers
Excitatory
A pathway affected in Parkinson’s disease
a. Nigro-striatal
b. Striato-nigral
a. Nigro-striatal
The role of cerebellum in coordinating movement is done through which
mechanism?
a. Feed forward
b. Damping
a. Feed forward
Signals leaving cerebellum
a. Are of increasing activity & then decreasing effect on DCN
b. Are of decreasing activity & then increasing effect on DCN
a. Are of increasing activity & then decreasing effect on DCN
fuel of neurons in case of ischemia
ketone body
oxidative stress in ischemia results from
failure of the antioxidant system
a disease related to trinucleotide repeat that results in polyglutamine tract
spinobulbar ataxia (not sure it was written this way)
a question about amyloid and Alzheimer’s
-
question about prion disease
-
one of the most common cause of mental retardation due to CGG trinucleotide
repeats causing loss of function
fragile X syndrome
which of these is recommended to prevent early neonatal bacterial meningitis
?
the prophylactic given to non pregnant contact for a patient w/ meningococcal meningitis
rifampicin
given to eradication of nasopharyngeal carriage of meningococcal meningitis
sulfadiazine
what drug will you give to an elderly with meningococcal meningitis who is about to
(………..) to the ward
?
AIDS patient with JC virus
PML
which disease results in demyelination of dorsal & lateral columns?
V B 12 deficiency
a patient with vitamin deficincy that results in nerve hypomethylation.
subacute combined………(, it’s in the learning topic elly m7ad dresah week 8.)
an elderly patient with hemiplegia duo to thrombus. small infarctions in his brains.
what might be the cause?
elderly w/right parietal infarct, thrombo-embolism in peripheral cerebral n.?
a. mural thrombus in the heart
b. HTN w/chronic liver failure
c. Rheumatic CVD w/left atrial mural thrombus
?
a lady with sudden onset of loss of consciosness. CNS analysis showed blood in CSF
subarachnoid hemorrhage
a lady who fall on her left side of head –> loss of consciousness. had left parietal bleeding. then she became unconscious again and died. what is the pathology?
extradural hematoma
vaculation
prion disease
plasma cells around arterioles indicate
syphilis
alcoholic man suffered from spinal cord (??) demyelination?
Central pontine syndrome
.premature neonate with calcification, periventricular edema ,easonophilicintranuclear cytoplasmic inclusions
CMV infection
increased CSF to plasma glycine?
cytochrome c deficiency b.pyruvate DH defi c. Glycine encephalopathy
the most presumptive CSF finding for meningitis
increased pus cells
CSF lactate = 7. This indicates
bacterial meningitis
The most important risk factor for ICH?
HTN
Atrial fibrillation in relation to stroke?
Embolic stroke
Subdural hematoma
Rupture of bridging veins
Degeneration of dopamine producing neurons in SN (substantia nigra)
Parkinson’s
demyelinating neuropathies?
a. Ms. Weaknes n’ hyporeflexia
b. Increased ms. Tone due to spasticity
c. Clonus
?
- character of essential tremor?
a. Autosomal recessive
b. asymmetric
c. happens when maintaining posture
c. happens when maintaining posture (not sure)
myasthenia gravis
muscle fatigability after repetitive exercise
a patients w/ poliomyelitis. What would be a sign of this?
(sign of LMNL)
a disease characterized by resting tremor
Parkinson’s
a girl with sudden coordinated contractions (not sure about both the Q and choices :D)
- Tics
- juvenile epilepsy
?
a patients who cannot stand with his feet together
cerebellar ataxia
alcoholic cerebellar degeneration mostly affects
vermis
a patient presented with seizure. has a history of childhood seizures caused
by fever. (they gave a picture). Which lobe is affected?
temporal
in the pt in the previous Q, what is most likely the type of seizure he is
suffering from?
complex partial
a girl with …….Flickering………….. what is the type of
seizure?
absence (not sure)
CSF pressure normally is
8-18
A headache that lasts 15-180 min
cluster
A feature of LMN injuries
Flaccidity
Horizontal diplopia
6th CN palsy
Right MLF lesion
Failure to adduct right eye
Injury to right 12th CN
Tongue deviation to the right
A young female with relapsing (some neurologic deficits)- MRI shows some circular enhancing lesions
Multiple sclerosis
The main differentiating factor between TIA & stroke
Duration of neurological deficit
Immediate sign of UMNL
Clonus
Feature of UMNL
Absent abdominal reflexes
A patient with wernicke’s aphasia, what else might be noticed?
- babinski sign
- contralateral hemianopsia
?
drug used for partial seizures & induces liver enzymes
carbamazepine
the drug used to treat Lennox Gastant syndrome
Felbamate
a drug that is used to treat sleep onset insomnia (there were more details)
Zolpidim
MoA of BZDs|
potentiation of GABA chloride pore
a drug that acts as 5-HT A agonist
buspirone
an inhaled general anesthetic that decreases ICP and eliminated by
redistribution
- katamine
- thiopental
?
the antidote for midazol
flumazenil
what is the mechanism by which revastigine treats dementia?
antocholinesterase
which type of nerve fibers is first blocked by local anesthesia?
A delta
opoid analgesic that causes tachcardia due to inherent vagolytic effect
that Q got me confused bs chenna he mentioned it during the lecture, it wasn’t
written but he said it
(a Q from pain-I lecture) - it was EMQ with -something about secondary
sensory neurons
-
the receptor that once activated can also produce PG-I & PG E
bradykinin B2 receptor
(it was a long scenario- what i remember is: CT showed area of hypointensity (dark)
infarction
CT hyperdensity in cellar cystern
subarachnoid hemorrhage
which of the followings characterizes an “abnormal behavior”
deviates from social norms, deviates from statistical normsk maladaptive, results in distress
which of these has the (worst impact on a country)
- blindness of 10 year old healthy child
- blindness of (25?) year old (nonhealthy - i dont remember the disease exactly)
?
some people die bcz of stroke before being diagnosed. this will result in apparent
a. Mortality Decrease
b. Prevalence incease
c. Incidence dec. But prevalence inc.C.prevalence n’ mortality inc
less mortality
EBM: calculation of (1-NPV). (specificity- sensitivity- pretest propability were given)
-
EBM: to increase (senstitvity/ specificity) you have to decrease false negatives/ false positives
-
EBM: to rule in a disease, you need a higher:
PPV
