2011 final Flashcards
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
• Left auditory nerve
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
• The right lower side
Note: this is equivalent to injury of the upper motor neurons supplying the motor nucleus of the facial nucleus
Which nucleus receives fibers from the cortex of the flocculonodular lobe?
- The vestibular nucleus
- The fastigial nucleus
• The vestibular nucleus
Where does the corticospinal tract run in the crus cerebri of the midbrain?
- Middle two third
- Medial one sixth
- Lateral one third
• Middle two third
Note: the order of fibers running in the crus cerebri from medial to lateral is: frontopontine, croticospinal, corticonuclear, temporopontine
Which nucleus receives signals regarding touch and pressure from the face?
Main sensory nucleus of trigeminal
Which of the following is likely to be injured due to fracture of the floor of the orbit?
Inferior oblique muscle
Which of the following cranial nerves carries the efferent fibers for the pupillary light reflex?
- III
- II
• III
Which of the following innervates the inner surface of the tympanic membrane?
Glossopharyngeal nerve
Which wall separates the middle ear from the dura?
Tegmental wall
Which wall of the middle ear has the round and oval windows?
Labyrinthine wall
Damage to which of the following structures causes unilateral deafness?
- Cochlear nucleus
- Inferior colliculus
- Lateral lemniscus
• Cochlear nucleus
Where is the primary auditory area located?
Superior temporal gyrus
Which of the following represents a correct sequence of structures involved in the primary circuit of the basal ganglia?
Globus pallidus to thalamus
Injury to which of the following structures can cause retrograde neurodegeneration of the amygdala?
Stria terminalis
Stimulation of which of the following structures can result in excitation of the mammillary bodies?
Fornix
Which nucleus receives fibers carried by the glossopharyngeal nerve
regarding taste sensations?
Nucleus tractus solitaries
Which of the following functional areas is present in the wall of the calcarine sulcus?
- Primary visual area
- Secondary visual area
• Primary visual area
Which of the following tracts are most likely to be injured due to damage to the most anterior part of the internal capsule?
Corticospinal tract
Damage to which of the following nuclei results in pupil dilation?
Edinger-westphal nucleus
Which of the following can cause hydrocephalus?
Aqueduct stenosis
Which of the following is responsible for feedback regulation of body weight?
Leptin
Which of the following is released in response to thirst?
Vasopressin
Which of the following is responsible for stopping the feeding drive?
Amylin
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
• EPSPs and IPSPs of the dendrites of cortical neurons
Which of the following correctly represents the sensorymotor hierarchy in the higher cortical centers?
Posterior association area -> anterior association area -> premotor area -> primary motor area
Which of the following only fires if a motor action is required?
Anterior association area
What maintains the tone of smooth muscles of the arterioles in the brain?
The partial pressure of CO2 in tissues
Which of the following modulates the effect of norepinephrine by increasing its activity?
Co-release of ATP
Which of the following is correct regarding the receptor potential?
- It is proportional to the strength of the stimulus
- Frequency coded
• 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
What is the difference between rods and cones?
Type and distribution of the pigments
How does dopamine exert its effect in the basal ganglia?
It activates the direct circuit
Together with the basal ganglia, which of the following is involved in the selection of movements due to external cues?
Lateral premotor area
Epilepsy can result from damage of the medial temporal lobe. What can
mediate that damage?
Excitotoxicity
Stepping on a sharp object causes flexion of the leg on that side. What
happens to the leg on the other side?
An excitatory interneuron synapses with the motor neuron innervating the extensor muscle of the leg on the other side
Which of the following is involved in walking in a constant speed?
Polysynaptic reflex
Which of the following is involved in preventing someone from falling when being suddenly pushed from the back?
- Feedback mechanism
- Monosynaptic reflex
• Feedback mechanism
Which of the following is involved in learning how to play piano?
Cerebellar synaptic plasticity
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
• Inhibits inappropriate programs of movemets
Which deficiency is associated with subacute combined degeneration of the spinal cord?
Vitamin B12 deficiency
Genetic defect of which of the following underlies hereditary spastic
paraplegia?
- Anterograde retrograde transport
- Rho signaling system
• Anterograde retrograde transport
Which of the following brain tumors commonly occurs in children in the posterior cranial fossa?
Pilocytic astrocytoma
What can present with gelatinous or fibrinous exudate usually at the base
of the brain?
Tuberculous meningitis
In which condition are round or oval eosinophilic cytoplasmic inclusions
found in the brain stem and cerebellum?
Rabies
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?
Alzheimer’s disease
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?
Parkinsons disease
Multiple sclerosis is an autoimmune disease that is associated with
demyelinating plaques. Where are those plaques most commonly located?
Periventricular region
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?
Ruptured berry aneurysm
Rupture of which of the following structures is associated with subdural hematoma?
Communicating veins
What can be a consequence of a mutation affecting the potassium channels in the presynaptic membrane?
Increase in the flux of calcium
Which disease is characterized by abnormally expanded CTG repeats
from 50 to 2000 repeats (normal from 5 to 30)?
Myotonic dystrophy
Which condition result from a mutation in an ion channel protein?
Epilepsy
Release of which of the following mediators results in neuronal apoptosis in ischemia-reperfusion injury?
Cytochrome c
What is the function of peroxisomes in brain cells?
Alpha oxidation of fatty acids
How is Alzheimer’s disease different from prion disease?
There is no infectious form of Alzheimer’s disease
How does the presence of VV alleles in prion gene reduce the probability of acquiring prion disease?
It reduces the binding between the normal and abnormal forms of prion protein
Which of the following elements is associated with the amyloid plaques in Alzheimer’s disease?
Aluminum
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?
Doperidol and fentanyl
What is the mechanism of action of lidocaine at normal doses?
It blocks voltage-gated sodium channels
Which drug acts by inhibiting GABA transaminase and increasing the activity of glutamate decarboxylase?
Valproic acid
Which drug has a narrow spectrum of activity and blocks T calcium
channels?
Ethosuxemide
Tolerance to which of the following effects doesn’t develop with the
repeated use of benzodiazepines?
Anxiolytic effect
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?
Zolpidem
Note: zolpidem is used for sleep-onset insomnia
Which drug has an on-off effect?
Levodopa
Which drug is a muscarinic antagonist?
Benzotropine
Which of the following accurately describes the action of morphine on different sites?
Inhibits adenyl cyclase, closes calcium channels, opens potassium channels
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
• Rifampicin for 2 days
Which of the following is a risk factor for acquiring streptococcus pneumoniae meningitis?
Sickle cell disease
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?
Pancerebellar disease
A heavy alcohol drinker develops ataxia. Which of the following structures is most likely to be affected?
Superior vermis
Note: alcohol selectively damages superior part of the cerebellar vermis
Occlusion of which of the following arteries typically brings about lateral medullary (Wallenberg) syndrome?
Vertebral artery
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?
Horners syndrome
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?
Left oculomotor nerve palsy
A patient presented with horizontal diplopia on looking to the right. He
couldn’t abduct his right eye. What is the likely diagnosis?
Right abducent nerve palsy
Which of the following is associated with segmental demyelination?
Muscle weakness and decreased deep tendon reflexes
Which of the following is true regarding poliomyelitis?
Associated with muscle paralysis, muscle atrophy, and absent deep tendon reflexes
What is the most sensitive imaging technique used to detect cerebrovascular accident?
CT scan
Which of the following nuclear imaging techniques is used to diagnose patients with cerebral ischemia?
HMPAO Tec99 with acetazolamide infusion
What can the improvement of diagnostic imaging in stroke cause an apparent increase in?
In incidence and prevalence of stroke
