2010 module exam Flashcards
1
Q
RT optic nerve lesion?
A
Blindness in RT eye
2
Q
What are the correct properties to be able to pass BBB?
A
C
3
Q
A patient with injury to the brain was asked to draw the left pic, but his drawing was the one on the right, where the lesion is located?
A
Right temporo-parietal junction
4
Q
Which of the following contains sympathetic & parasympathetic fibers?
A
Striaterminalis
5
Q
If you stretch a muscle you will evoke which of the following? (not sure)
A
- inhibitory interneurons stretch
reflex = knee jerk = excite! contraction = golgi tendon organ = inhibitory
6
Q
Which of the following nuclei will receive information about the sensation?
A
Ventrolateral nucleus
7
Q
A patient presented with developmental abnormality in the central canal.
What most likely would be the presentation?
A
Bilateral loss of sensation in the neck region ( Not sure)
8
Q
Which artery is blocked in wellenberg syndrome (lateral medullary syndrome)?
A
Vertebral artery (PICA wasn’t in the choices)
9
Q
A patient presented with muscle weakness, fasciculations (signs of LMN), where
do you suspect the lesion?
A
Lesion in the anterior horn of the spinal cord
10
Q
How does fast adapting receptors receive stimulus and generate the potential?
A
Getting the stimulus at the beginning and end
11
Q
Loss of sensation to the medial one half of the fingers with atrophy to the
interosseous muscles of the hand?
A
Ulnar nerve injury
12
Q
Dorsal horn of the spinal cord is developed from?
A
Alarplate
13
Q
A patient with polio will have?
A
Lower limb loss of deep tendon reflex (hyporeflexia), muscle wasting and weakness
14
Q
What receptor is responsible for keeping the upright posture (standing)?
- Muscle spindle
- Ruffini
A
Muscle spindle
15
Q
Activation of the Parasympathetic system will cause what?
A
Increase GI activity
16
Q
Which part of the face will lose function if there is an injury to the right facial nerve at the stylomastoid foramen?
A
Right Lower Face
17
Q
Patient presented with ptosis and pupil constriction?
- Descending sympathetic fibers
- 3rd Nerve Palsy
A
- Descending sympathetic fibers
18
Q
What most likely would be the signs seen in patient with segmental
demylination?
A
Hyporeflexia & muscle weakness (Explanation: NOT muscle wasting
because axon is not cut its just demylinated)
19
Q
Young female with MS presented with visual abnormality, in direct reflex the eye
more dilated than indirect reflex of the same eye?
- Optic neuritis
- Right afferent papillary defect is affected
A
- Optic neuritis
20
Q
A patient with a lung cancer presented with ptosis & miosia & anhidrosis?
A
Horner’s syndrome
(Explanation: The sympathetic tract passes next to the apex of the lung so any tumor in the apex can compress the sympathetic tract)
21
Q
Ptosis with dilated pupil?
A
Occulomotor nerve palsy
22
Q
Brain lipid metabolism is characterized by?
A
Synthesis of long chain fatty acid
23
Q
An old lady complains of hypertension, diabetes, horizontal diplopia, &
convergent squint?
A
Abducent nerve lesion
24
Q
Peroxisomal defect (learning topic biochemwk) lipotoxicity due to?
A
accumaltion of long chain fatty acid
Long chain fatty acids must be metabolized first in peroxisome
25
Sustained stimulation of pontine reticular fibers causes what?
Increase tone of antigravity muscles
26
Lesion in corticobulbar tract of the internal capsule?
Contra lateral paralysis in lower part of the face
27
A 57 year old man has lateral deviation of the eyeball, where is the lesion?
- Abducent nerve
- Occulomotor nerve
- Occulomotor nerve
28
The cause of Alzheimer's disease?
Increasedβ-secretase activity
29
Central pontine myelinolysis happens due to?
Hyponatremia
30
A Japanese patient presented with NMO. What is true about the disease?
Antibodies against aquaporine 4 water channels
31
(Scenario) Female presented with sudden onset of paralysis on left arm and leg, loss of pain, temperature from half of her face, her eyes deviated laterally toward the right, ptosis, & dilated pupil.
which of the following is responsible for the loss of pain and temperature from the face?
Spinal nucleus of CN V
32
(Scenario) Female presented with sudden onset of paralysis on left arm and leg, loss of pain, temperature from half of her face, her eyes deviated laterally toward the right, ptosis, & dilated pupil.
which part of the brain is affected?
Superior midbrain
33
(Scenario) Female presented with sudden onset of paralysis on left arm and leg, loss of pain, temperature from half of her face, her eyes deviated laterally toward the right, ptosis, & dilated pupil.
which artery is most likely to be affected?
Posterior cerebral artery
34
What is the method of choice to diagnose a patient with CVA?
- CT
- MRI
CT
35
What is the sensory-motor hierarchy upon cortical function?
somatosensory cortex -> parieto-occipital -> pre-frontal association -> premotor -> primary motor (Flip Flop Concept)
36
Working memory in which part?
Prefrontal (Anterior Association Area)
37
A person with severe hypotension (MAP<50mmHg) what will happen to the brain?
reduce cerebral blood flow (Explanation: because less than 50 out of auto
regulation range)
38
What types of cells are present in the 5th cerebral cortical layer?
Pyramidal cells
39
What type of herniation can occur in the temporal lobe?
- Tentoriem
- Cantral ....
- Tentoriem
40
A 76 years old man has confusion and deeping coma after a cardiogenic shock, a
week later, he died. Autopsy would reveal?
Global cerebral ischemia
41
When reading out laud, which of the following is bypassed?
Wenicke's area
42
What is the most common etiology of lacunar infarcts?
Systemic hypertension
43
What is a specific feature of supplementary motor association cortex?
- Doesn’t have a somatotopicpicture
- When stimulated, activates bilateral limb movement
- When stimulated, activates a specific group of muscles
- Independent of premotor and motor cortex
- Found in the anterior lateral side of the cortex
- Found in the anterior lateral side of the cortex
44
A patient who can not recognize an object in his hand, which type of
agnosia?
Astereognosia
45
A patient who can not recognize his left side of his body, which type of agnosia?
Personal neglect
46
An old man who had aneurysm in his MCA, what type of hemorrhage is most
likely to accur?
Subarachnoid
47
What's true about functional columns of the cerebral cortex?
Different columns can activate the same muscle for different synergic
movements
48
The blood supply to certain area of the brain increases due to what?
Glutamate release
49
Cerebellum develops from which embryological structure?
Rhombic lips
50
On MRI, structure present in midline of sagittal section of the brain?
Pineal body
51
Damage to the subthalamusprodues which disease?
Hemibalism
52
If a person imagines doing a sequence in his fingers, which part of the brain is
active?
Supplementary motor area
53
Which of the following physiological processes involves Motor Skill
Learning ?
Long-Term Depression (Cerebellum)
54
What is the mechanism behind coordination of movement in cerebellum?
Feed-forward mechansim
55
Cerebellum uses go-stop effect to coordinate movement. What causes this damping effect?
- collaterals of mossay& climbing fibers to deep nuclei before going to purkunje
- Complex spikes ( I think those are in LTD to learn new things, not for
normal go-stop)
- collaterals of mossay& climbing fibers to deep nuclei before going to purkunje
56
Characteristic features of idiopathic parkinson's disease?
- Not responding to lavedopa treatment
- Bradycardia, cogwheel rigidy, resting tremor
- Falling after 2 years of disease
- Bilateral weakness & rigidity, no tremor
- Bradycardia, cogwheel rigidy, resting tremor
57
What is a character of CAG repeats?
- There is always translation & transcription
- It causes polyA repetition
- There is always translation & transcription
58
Which of the following will be disinhibited when strial neurons are
activated in the basal ganglia?
Thalamocortical in the direct pathway
59
A Tri-nucleotide CAG repeats disease with a normal BP of 11-12 and
abnormal expansion of 68-69 BP?
- Hungtington's disease
- Spinocerebrallar ataxia??
?
60
Degeneration of strial neurons causes which disease?
Hungtington's disease
61
Characteristic of polyglutamate tracts?
Abnormal tri-nucleotide repeats
62
A woman fell on the Rt side of her head. CT showed a fissure fracture in the Rt temporal bone. She was kept under observation and 4 hrs later she suffered from headache and went into coma. What is expected to be found on CT?
- Right extradural hematoma
- Left contre-coup cerebral hemorrhage
- Right extradural hematoma
63
The CBF is reduced to 30 due to systemic hypotension after 2 hrs the mean arterial
pressure was normalized and CBF retained to normal, consequences on electrical activity will be?
- No effect on electrical activity
- Permanent loss of electrical activity
- Transient but short loss of electrical activity
- Transient but prolonged loss of electrical activity
- Transient but short loss of electrical activity
64
A 25 years old student suddenly starts staring at the wall for 60 sec, his friend noticed him picking at his buttons and making some chewing movement, and he's not responding to his friend's request, what he's experiencing?
Complex partial seizure
65
Which wave will be recorded on EEG in occipital lobe, when the patient is in dark room then we open the lights?
Beta waves
66
Origin of fornix?
Molecular of hippocampus (Pyramidal) (NOT sure)
67
Which hormone regulates circadian rhythm?
Melatonin
68
A patient with multi-infarcts dementia, What would you see in autopsy?
Cystic spaces
69
If bilateral hippocumpus were removed. How the patient will present?
Can't form new long term memory
70
5- Which of the following is hyperphosphorelated in Alzheimer's disease?
Tau
71
What causes spike of the interictal discharge?
Paroxysmal depolarization shift
72
Retrograde injury to the hippocampus is caused by what?
Fornix
73
A brain CT of an old man showed multiple infarcts, which type of dementia he's
most likely to develop?
Vasculardementia
74
Dopaminergic reward system
Nucleus accumbance
75
Which area is responsible for hunger?
Lateral hypothalamus
76
Which of the following is characteristic of findings of a women that had an infection
during the 1st trimester of pregnancy?
Ring enhancing lesion
77
Infection from goat milk?
BrucellaMelitensis
78
What is the causative organism of cerebral abscess in bone transplant
patient?
- Candida
- Aspergillus Fumigatus
- Cryptococcus
- Candida
79
An old patient with history of bronchectesis presented with a lesion in the brain. what most likely would it be?
Cerebral Abscess
80
In which stage malaria will adhere to endothelial linings ?
ring stage (not sure)
81
A patient presented with esonophilic intracytoplasmic inclusions in the
purkinjie cells of cerebellum &brainstem ?
Rabies encephalitis
82
A patient presented with lesions filled with plasma cells & spiral micro
organism?
Neurosyphilis
83
Enlarged cells with cytoplasmic and nuclear inclusion?
CMV
84
Pathogenesis of cerebral malaria?
Microvascular pathology
85
Which of the following is associated with CJ disease?
PrP
86
The most common cause of meningitis in neonate?
E.coli
87
Supperative necrosis, gliosis, & granulation tissue are characteristics of?
Abscess
88
What is true about essential tremor?
- Sustained posture
- Autosomal recessive
- Sustained posture
89
Tumor with eosinophlic and stout processes?
Gemistocytic astrocytoma
90
What controls the amount of light passing in the eye?
Iris
91
A person doesn't see the left side of each visual field with normal pupillary
reflex in both eyes, what most likely would be injured?
Right Lateral geniculate body
92
Fracture of floor of orbit, which of the following structures will be affected?
- Inferior rectus
- opthalmic Artery
- inferior oblique
Inferior rectus
93
What can be presented as an early sign of INO?
Diplopia (not sure)
94
What artery supplies the visual cortex?
Posterior cerebral artery
95
A lesion in the optic radiation in the temporal lobe produce which of the following?
Pie in the sky
96
What is the most cost effective prevention for blindness caused by cataract will be?
- Cataract vision repair surgery
- Screeing pregnant mothers to prevent from childhood blindness due to cataract
Cataract vision repair surgery
97
Which of the following statement is correct in th case of blindness?
- Will not affect family life
- Increase the risk of depression
Increase the risk of depression
98
What structure is probably involved in Hyperacuses ?
Stapedius muscle
99
Patient with bilateral decrease in hearing?
- Lateral lemnsci lesion
- Tensor tympani
Lateral lemnsci lesion
100
What structures lie in the lateral part of middle ear?
Handle of malleus & chorda tympani
101
which of the following is located in the Sublenticular area?
Auditory radiation
102
what causes Unilateral hearing loss?
Organ of corti
103
Which receptors are activated in central sensitization seen in pain?
NK-1 & NMDA
104
Stimulation of external acoustic meatus -> coughing?
Vegus nerve
105
M.O.A of Lidocaine?
Na channels blockers
106
Which drug will increase the plasma concentration of drugs taken with it?
Valporic acid (it inhibits metabolism so the drug will be active longer)
107
What is the M.O.A for Benserazide?
Peripheral dopa decarboxylase inhibitor
108
Patient receiving anti-psychotic drugs & she's diagnosed with parkinson's disease, what is the best drug to treat her?
Benzotropine
109
M.O.A. of Benzodiazepines?
- GABA-A receptor, enhancing GABA- receptor mediated inhibition
- GABA-A modulators, enhancing GABA- Mediated synaptic
inhibition
GABA-A modulators, enhancing GABA- Mediated synaptic
| inhibition
110
Dopezepil M.O.A?
Acetylcholinestrase inhibitor
111
Memantine M.O.A?
NMDA antagonist
112
A patient will undergo surgery, but the Dr. wants him to be responsive to simple commands, what is the drug used for anesthesia?
Innovarpreparation (droperidol + fantanyl)
113
Cocaine M.O.A?
Blockage of presynaptic reuptake of monoamines
114
Which drug block levodopa effect in periphery by binding to the receptors?
Domperidone
115
Which drug can be used as an anxielitic and reduce muscle tone?
Diazepam
116
which of the following drugs causes nephrotoxicity, neuromuscular
paralysis?
Gentamicin
117
Drug of choice to treat herpes virus?
Acyclovir
118
How do morphine act?
Inhibiting adenylatecyclase, open K, close Ca
119
MOA-B inhibitor?
Selegiline
120
M.O.A of cannabis
Inhibits AC
121
12 year old boy, with fibrillar and microcystic fibers, bipolar, thin hair like projections?
Pilocytic astrocytoma
122
A patient presented with myxoid stroma & microcystic appearance & verocay bodies ?
Shwannoma
123
What is a character of homocystinuria?
Mental retardation
124
Which nerve supplies secretomotor to sub-lingual gland ?
chorda tympani (branch of facial nerve)
125
Ethics: A 70 year old woman with history of cataracts presents with severe loss of visual field, what is the reason that she didn’t go to the doctor earlier?
- this wouldn’t be a problem in Kuwait as it’s only in developing countries
- Existence of a male in the family with help any female to get access to health care
- Anxiety and fear of being a burden on her family doesn’t contribute her pres entation
- Women are less educated so they don’t know the symptoms that require health care
?
126
Deflection of steriocilia determines what?
Hyperpolarization or depolarization of the cell
127
Injury to what causes the no movement to the vocal fold?
Nucleus ambiguous
128
Tangles of arteries and veins and bleeding due to?
Arteriovenous malformation
129
(A scenario with 2qs, not sure about the ptosis & dilated pupil) A 50 yr old man came to the ER with hot painful sensation, ptosis, and dilated pupil, no movement of right vocal fold ..
-
130
EBM: Prevalence of a disease is 50%, if pre-test probability is 5%, what will happen to the test characteristics?
Sensitivity increases, increase NPV & decrease PPV specificity decrease
131
EBM: Two researchers argue a cut off for a diagnostic test of either 50 or 80 knowing that the higher the value the more aggressive is the disease?
The cut-off value of 50 has higher sensitivity than 80
