2009 module exam Flashcards
Patient with loss of vibration and movement of a limb is due to damage to the lateral side of the left medial leminisci in the pons, what nucleus is affected?
Right hand
Which tract is responsible for coordination of eye movement?
MLF
A patient with left corticospinal tract lesion
Positive Babinski sign of the left foot
Which is a fast adapting receptor?
Meissner corpuscle
How do fast adapting receptors perceive the stimulus and generate the potential?
Get stimulus at beginning and end
What increases the sensitivity of the muscle to stretch?
Gamma motor neuron
What is the afferent pathway elicited in a clinically tested knee jerk?
I-a
What is an example of a bilateral reflex?
Withdrawal reflex
What initiates the movement in a muscle?
Multisynapse in the spinal circuit
What is a function of stretch reflex?
Compensates for the unexpected disturbances during maintenance of posture
A patient with muscle atrophy, weakness, flaccid paralysis, diminished reflexes, have a problem in
Anterior horn cells
Damage to last finger and ring weakness
Ulnar nerve injury
A patient with loss of vibration in left leg and loss of motor functions at the same leg with loss of pain and temperature of the right leg
Hemiplegia of the left part of the spinal cord at (T6-T12) (mo mohem mn wain lay wain elmohem elconcept)
Which nerve is related to the red nucleus?
Occulomotor
What is the function of the spinal nucleus of CN V?
Ipsilateral pain and temperature of the face
What is supplied by the trochlear nerve?
Superior oblique
What supplies the pharynx and larynx?
Nucleus ambiguous
What is the main cause of CN III palsy?
PCA aneurysm
Tubocurarine usually blocks (N1) ach receptors, why does it have no effect on the ANS?
Because N1 receptors are not found in ANS
What increases activity of NA receptors?
ATP
Demyelination of posterior and lateral spinal columns is caused by
Vitamin B deficiency
Patient with MS and INO due to lesion in
MLF
Alcoholic patient with MS is probably
Central pontine myelinolysis
What is the best way to diagnose MS?
IgG index
A patient with headaches, vision problems, and claudications, what is the best way to diagnose him?
ESR
Type of immune-mediated activity against MG?
Complement
Patient with loss of vision for 3 hours, then returned and after check up tests are normal
TIA
Which part of the internal capsule contains corticospinal tract?
Posterior limb
Which thalamic nuclei connect to cingulate gyrus?
Anterior thalamic nuclei
Which nucleus connect to ML and SL ?
VPL
Which cerebral cortex layers are well developed in motor cortex?
III and V
Which artery is seen in the circle of willis?
Anterior cerebral artery
A patient with shock due to MI
Watershed infarction
Which fibers affect the alertness of a person?
Reticular formation afferents
The main effector on cerebral blood flow
Partial pressure of CO2
Patient with hypotension and cerebral blood flow from 50 became 25. What is a way to increase?
Increase in systemic BP
Patient with hypotension and cerebral blood flow from 50 became 25 for half an hour, and then restored. What happened to the neurons at that time?
Transient loss of neuronal activity
What is the main way of fuel utilization in ischemia?
Induction of glycolytic pathway
What is the neurotransmitter responsible for neuronal death and apoptosis after ischemia?
L-glutamate
What is the mechanism of death of neurons in ischemia?
Opening of Ca++ channels and precipitation of metabolites
What is the radiopharmaceutical used to diagnose cerebral metabolism?
F-18 deoxy glucose
Nuclear imaging from Tc-99m HMPAO showed no blood flow in a patient with stroke and hemiplegia. Which area is affected?
Fronto-parietal lobe
What is the function of prefrontal cortex?
Creation of working memory
Stroke is the … leading cause of death in Kuwait?
4th
Why is the prevalence of stroke low in Kuwait?
Young population
What determines the output of globus pallidum?
Subthalamic nuclei
What sends dopaminergic fibers to striatum?
Substania Nigra
What is the reason for akinesia in Parkinson’s?
Overactivity of indirect circuit
What is caused by degeneration of striatal neurons?
Huntington’s
What is caused by selective subthalamic nucleus lesion?
Hemiballism
What is caused by neuroleptics?
Tardive dyskinesia
What is the main mechanism of damping effect of cerebellum?
Excitation of purkinji neuron by both fibers
Neurophysiologic mechanism of motor skill learning is based on
Long term depression
What is the main characteristic of essential tremor?
Sustained tremor
Loss of neurons in substania nigra will lead to
Parkinson’s
Patient with nystagmus, gaze paresis, bilateral hypotonia, gait ataxia
Pancerebellar ataxia
Alcoholic patient with gait ataxia
Damage to superior vermix
Boxer who used to take many blows in the past suffers from which type of tremor?
- Cerebellar
- Essential
- Parkinsonism
(we’re not sure which is the right answer)
Why is it urgent to diagnose cerebellar infarction?
Because surgical evacuation of the hematoma prevent death from brainstem compression
What is a cause of Hungtinton’s disease?
Expansion of CAG repeats
What is the mechanism of dopamine action on the striatum?
Inhibit D2 receptors by adenylyl cyclase
EBM – when is the lead time?
From time of screening until usual time of diagnosis
EBM – a pretest probability of 20% with sensitivity of 50% and specificity of 75%. What is the NPV?
87%
Low O2 and what will lead to ketone bodies formation?
Glucose
What is the brain wave?
Current of ions in dendrites
What leads to high amplitude and low frequency of the waves?
Synchronization of the waves
What causes the spike of the interictal charge?
Paroxysmal depolarization shift
Patient who is 14 years old develops a seizure and suddenly falls. His brother also has the same condition mainly in the morning with generalized tonic-clonic seizure. What syndrome is this?
Juvenile-myoclonic syndrome
Which nucleus is important for keeping consciousness?
Orexin
Patient with fracture to temporal lobe and he is fine but after 30 minutes fell into a coma
Extradural hematoma
Synchronization of circardian rhythms occur mostly due to
Morning light
Normal sleep is initiated by activation of
VLPO
Ventral horn is developed by
Basal plate
What is the structure affected in kluver-bucy syndrome?
Amyglada
Short term memory to long term memory is by
Long term potentiation
Noxious receptors
Increase Ca influx
AD is characterized by
Amyloid plaques, tangles, and neuronal loss
What may be best regulated?
Energy expenditure
What causes tangles formation?
Hyperphosphorylation of tau
What forms amyloid plaques?
aB
What is the mechanism of oxidant formation in AD?
aB peptides
patient with neurodegenerative disorder that shows vacuoles in cerebral cortex w/o pathological findings?
Prions disease
What is bypassed during visual information (reading)?
Wernicke’s area
What characterizes Alzheimers?
Loss of cerebral cortex
What is the normal ICP in supine position?
8-18
What type of aura is least associated with migraines?
Auditory
Which type of headache occurs for 15-180 and associated with severe pain?
Cluster
How do we diagnose a patient with headaches?
CT scan
7-year-old child with a tumor in the cerebellum and the presence of Homer Wright Rosettes
Medulloblastoma
Mother with Toxoplasma Gandi and she is pregnant in the first trimester. What will be soon?
Ring enhancing lesion
Pathogenesis of cerebral malaria
Microvascular pathology
Patient with thick exudate at cerebellum and pons
Tuberculous meningitis
Which infection usually causes meningitis in sickle cell patients?
Hemophilis influenza
Which virus causes subacute sclerosing panencephalitis?
Measles
Which virus causes fatal encephalitis and can be vaccinated by an inactivated vaccine?
Rabies
Which virus can cause acute post exposure syndromes ADEM?
Measles
What is the prophylaxis for pregnant women for meningococcal meningitis?
Ceftriaxone
Patient with meningitis and lactate CSF is 2.5
Viral meningitis
What is the main cuase of variant prion disease in young people?
Eat food with BSE
Which nerve is responsible for tightening the tympanic
membrane?
Mandibular
What causes hyperacusis?
Facial nerve injury
What causes damage to LL?
Cochlear nerve damage
Vestibular, visual, and somatosensory system function together in
Vestibular nuclei
While walking to go sit in class, during swinging of your left leg, which tract is active?
Left lateral corticospinal
Why does sound amplify in children 3 months?
Areolar changes resorption in middle ear
Patient with blue eyes, eczema, blondie hair, mental retardation
Phenylketonuria
Which cell cause AP in eyes?
Ganglion cells
Between which does retinal detachment occur?
Photoreceptors and retinal pigmentation epithelium
Patient with tunnel vision
Peripheral retina
Object agnosia
Temporal lobe
Patient presents with pie in the sky
Temporal lobe affected
Someone eats a salty substance. What happens?
Membrane depolarization by Na+ through gradient change
Which structure lies in the middle of a sagittal section of the brain
Pineal gland