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CNS module - 4th year > 2011 final > Flashcards

2011 final Flashcards

1
Q

The following audiogram represents the air and bone conduction of both ears in a female with hearing problem. Which structure is likely to be affected?

O : air conduction in right ear
< : bone conduction in right ear
] : air conduction of left ear
square : bone conduction of left ear

  • Left auditory nerve
  • Right auditory nerve
  • Left middle ear
  • Right middle ear
A

• Left auditory nerve

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2
Q

If the left corticobulbar fibers were injured, which side of the face will be affected?

  • The right lower side
  • The left lower side
  • The entire left side
A

• The right lower side

Note: this is equivalent to injury of the upper motor neurons supplying the motor nucleus of the facial nucleus

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3
Q

Which nucleus receives fibers from the cortex of the flocculonodular lobe?

  • The vestibular nucleus
  • The fastigial nucleus
A

• The vestibular nucleus

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4
Q

Where does the corticospinal tract run in the crus cerebri of the midbrain?

  • Middle two third
  • Medial one sixth
  • Lateral one third
A

• Middle two third

Note: the order of fibers running in the crus cerebri from medial to lateral is: frontopontine, croticospinal, corticonuclear, temporopontine

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5
Q

Which nucleus receives signals regarding touch and pressure from the face?

A

Main sensory nucleus of trigeminal

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6
Q

Which of the following is likely to be injured due to fracture of the floor of the orbit?

A

Inferior oblique muscle

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7
Q

Which of the following cranial nerves carries the efferent fibers for the pupillary light reflex?

  • III
  • II
A

• III

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8
Q

Which of the following innervates the inner surface of the tympanic membrane?

A

Glossopharyngeal nerve

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9
Q

Which wall separates the middle ear from the dura?

A

Tegmental wall

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10
Q

Which wall of the middle ear has the round and oval windows?

A

Labyrinthine wall

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11
Q

Damage to which of the following structures causes unilateral deafness?

  • Cochlear nucleus
  • Inferior colliculus
  • Lateral lemniscus
A

• Cochlear nucleus

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12
Q

Where is the primary auditory area located?

A

Superior temporal gyrus

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13
Q

Which of the following represents a correct sequence of structures involved in the primary circuit of the basal ganglia?

A

Globus pallidus to thalamus

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14
Q

Injury to which of the following structures can cause retrograde neurodegeneration of the amygdala?

A

Stria terminalis

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15
Q

Stimulation of which of the following structures can result in excitation of the mammillary bodies?

A

Fornix

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16
Q

Which nucleus receives fibers carried by the glossopharyngeal nerve
regarding taste sensations?

A

Nucleus tractus solitaries

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17
Q

Which of the following functional areas is present in the wall of the calcarine sulcus?

  • Primary visual area
  • Secondary visual area
A

• Primary visual area

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18
Q

Which of the following tracts are most likely to be injured due to damage to the most anterior part of the internal capsule?

A

Corticospinal tract

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19
Q

Damage to which of the following nuclei results in pupil dilation?

A

Edinger-westphal nucleus

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20
Q

Which of the following can cause hydrocephalus?

A

Aqueduct stenosis

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21
Q

Which of the following is responsible for feedback regulation of body weight?

A

Leptin

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22
Q

Which of the following is released in response to thirst?

A

Vasopressin

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23
Q

Which of the following is responsible for stopping the feeding drive?

A

Amylin

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24
Q

What do the waves on EEG represent?

  • EPSPs and IPSPs of the dendrites of cortical neurons
  • EPSPs and IPSPs of the dendrites of thalamic neurons
  • Action potentials of the cortical neurons
A

• EPSPs and IPSPs of the dendrites of cortical neurons

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25
Q

Which of the following correctly represents the sensorymotor hierarchy in the higher cortical centers?

A

Posterior association area -> anterior association area -> premotor area -> primary motor area

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26
Q

Which of the following only fires if a motor action is required?

A

Anterior association area

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27
Q

What maintains the tone of smooth muscles of the arterioles in the brain?

A

The partial pressure of CO2 in tissues

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28
Q

Which of the following modulates the effect of norepinephrine by increasing its activity?

A

Co-release of ATP

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29
Q

Which of the following is correct regarding the receptor potential?

  • It is proportional to the strength of the stimulus
  • Frequency coded
A

• It is proportional to the strength of the stimulus

Note: receptor potential is also called generator potential; action potential, on the other hand, is frequency coded

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30
Q

What is the difference between rods and cones?

A

Type and distribution of the pigments

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31
Q

How does dopamine exert its effect in the basal ganglia?

A

It activates the direct circuit

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32
Q

Together with the basal ganglia, which of the following is involved in the selection of movements due to external cues?

A

Lateral premotor area

33
Q

Epilepsy can result from damage of the medial temporal lobe. What can
mediate that damage?

A

Excitotoxicity

34
Q

Stepping on a sharp object causes flexion of the leg on that side. What
happens to the leg on the other side?

A

An excitatory interneuron synapses with the motor neuron innervating the extensor muscle of the leg on the other side

35
Q

Which of the following is involved in walking in a constant speed?

A

Polysynaptic reflex

36
Q

Which of the following is involved in preventing someone from falling when being suddenly pushed from the back?

  • Feedback mechanism
  • Monosynaptic reflex
A

• Feedback mechanism

37
Q

Which of the following is involved in learning how to play piano?

A

Cerebellar synaptic plasticity

38
Q

Which of the following truly describes the function of the basal ganglia?

  • Inhibits inappropriate programs of movemets
  • Initiates movements through a connection with the prefrontal cortex
A

• Inhibits inappropriate programs of movemets

39
Q

Which deficiency is associated with subacute combined degeneration of the spinal cord?

A

Vitamin B12 deficiency

40
Q

Genetic defect of which of the following underlies hereditary spastic
paraplegia?

  • Anterograde retrograde transport
  • Rho signaling system
A

• Anterograde retrograde transport

41
Q

Which of the following brain tumors commonly occurs in children in the posterior cranial fossa?

A

Pilocytic astrocytoma

42
Q

What can present with gelatinous or fibrinous exudate usually at the base
of the brain?

A

Tuberculous meningitis

43
Q

In which condition are round or oval eosinophilic cytoplasmic inclusions
found in the brain stem and cerebellum?

A

Rabies

44
Q

A 77 year old male with dementia and cognitive disability died. On autopsy, his brain was atrophied and showed extracellular amyloid plaques and intracellular tangles of tau protein histologically. What is the likely pathology?

A

Alzheimer’s disease

45
Q

A 68 year old male with a history of rigidity and tremors passed away, and his brain showed hypopigmentation and loss of melanin in the substantia nigra. What is the likely pathology?

A

Parkinsons disease

46
Q

Multiple sclerosis is an autoimmune disease that is associated with
demyelinating plaques. Where are those plaques most commonly located?

A

Periventricular region

47
Q

A 35 year old female developed a sudden headache associated with hemorrhage in the subarachnoid space. A lumbar puncture revealed numerous red blood cells. What is the likely cause?

A

Ruptured berry aneurysm

48
Q

Rupture of which of the following structures is associated with subdural hematoma?

A

Communicating veins

49
Q

What can be a consequence of a mutation affecting the potassium channels in the presynaptic membrane?

A

Increase in the flux of calcium

50
Q

Which disease is characterized by abnormally expanded CTG repeats
from 50 to 2000 repeats (normal from 5 to 30)?

A

Myotonic dystrophy

51
Q

Which condition result from a mutation in an ion channel protein?

A

Epilepsy

52
Q

Release of which of the following mediators results in neuronal apoptosis in ischemia-reperfusion injury?

A

Cytochrome c

53
Q

What is the function of peroxisomes in brain cells?

A

Alpha oxidation of fatty acids

54
Q

How is Alzheimer’s disease different from prion disease?

A

There is no infectious form of Alzheimer’s disease

55
Q

How does the presence of VV alleles in prion gene reduce the probability of acquiring prion disease?

A

It reduces the binding between the normal and abnormal forms of prion protein

56
Q

Which of the following elements is associated with the amyloid plaques in Alzheimer’s disease?

A

Aluminum

57
Q

A doctor is willing to generally anesthetize a patient, but he wanted him to respond to simple commands and questions and to be in a state of sedation and analgesia at the same time. Which combination of drugs would be given?

A

Doperidol and fentanyl

58
Q

What is the mechanism of action of lidocaine at normal doses?

A

It blocks voltage-gated sodium channels

59
Q

Which drug acts by inhibiting GABA transaminase and increasing the activity of glutamate decarboxylase?

A

Valproic acid

60
Q

Which drug has a narrow spectrum of activity and blocks T calcium
channels?

A

Ethosuxemide

61
Q

Tolerance to which of the following effects doesn’t develop with the
repeated use of benzodiazepines?

A

Anxiolytic effect

62
Q

A patient complained to his doctor that he suffers from insomnia. However, once he falls asleep, he can sleep for 6 hours. Which drug can be given to this patient?

A

Zolpidem

Note: zolpidem is used for sleep-onset insomnia

63
Q

Which drug has an on-off effect?

A

Levodopa

64
Q

Which drug is a muscarinic antagonist?

A

Benzotropine

65
Q

Which of the following accurately describes the action of morphine on different sites?

A

Inhibits adenyl cyclase, closes calcium channels, opens potassium channels

66
Q

What chemoprophylaxis would you give a non-pregnant woman who has been in contact with a case of meningococcal meningitis?

  • Rifampicin for 2 days
  • Ceftriaxone for two days
A

• Rifampicin for 2 days

67
Q

Which of the following is a risk factor for acquiring streptococcus pneumoniae meningitis?

A

Sickle cell disease

68
Q

A 43 year old female with multiple sclerosis was found to have bilateral gaze paresis, intention tremor, bilateral dysmetria, abnormal heel to chin test, in addition to ataxic gait. Which of the following best describes her condition?

A

Pancerebellar disease

69
Q

A heavy alcohol drinker develops ataxia. Which of the following structures is most likely to be affected?

A

Superior vermis

Note: alcohol selectively damages superior part of the cerebellar vermis

70
Q

Occlusion of which of the following arteries typically brings about lateral medullary (Wallenberg) syndrome?

A

Vertebral artery

71
Q

A patient was found to have partial ptosis, and his left pupil was smaller
than the right one. Which of the following best describes his condition?

A

Horners syndrome

72
Q

A patient presented with horizontal diplopia. His right eye was pushed outward and downward. He couldn’t elevate or adduct his eye, and his eyelid was droopy while the pupil was normal. What is the likely diagnosis?

A

Left oculomotor nerve palsy

73
Q

A patient presented with horizontal diplopia on looking to the right. He
couldn’t abduct his right eye. What is the likely diagnosis?

A

Right abducent nerve palsy

74
Q

Which of the following is associated with segmental demyelination?

A

Muscle weakness and decreased deep tendon reflexes

75
Q

Which of the following is true regarding poliomyelitis?

A

Associated with muscle paralysis, muscle atrophy, and absent deep tendon reflexes

76
Q

What is the most sensitive imaging technique used to detect cerebrovascular accident?

A

CT scan

77
Q

Which of the following nuclear imaging techniques is used to diagnose patients with cerebral ischemia?

A

HMPAO Tec99 with acetazolamide infusion

78
Q

What can the improvement of diagnostic imaging in stroke cause an apparent increase in?

A

In incidence and prevalence of stroke

CNS module - 4th year (17 decks)

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