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CNS module - 4th year > 2013 final > Flashcards

2013 final Flashcards

1
Q

A lesion in which of the following sites will result in this defect?

A. Optic chiasm
B. Optic nerve
C. Optic tract
D. Calcarine cortex

A

D. Calcarine cortex

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2
Q

Which of the following characterizes brain wave forms and frequencies?

A. The form of dendritic tree on the cortical neurons
B. Summation of the synchronized activity of cortical neurons
C. Unsynchronized activity of all cortical neurons

A

B. Summation of the synchronized activity of cortical neurons

Note: This is EXACTLY how the question and choices were phrased in the exam. The answer has been confirmed by Dr. Andreas Henkel.

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3
Q

The figure shows electroencephalography (EEG), electrooculography (EOG), and electromyography (EMG) that were obtained from a 20-year-old healthy female during her sleep. Which stage of sleep do these recordings represent?

A. REM
B. Stage 1
C. Stage 2
D. Stage 3

A

B. Stage1

Note: This is the exact figure that we got in the exam so I’ll attach the whole figure for you to compare the recordings betweem different stages of sleep.
When EMG doesn’t show muscular atony and EOG doesn’t show rapid eye movements, you can exclude “REM” and your answer depends on what EEG shows.

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4
Q

A 28-year-old woman presented with a 3-week history of progressive dull headache aggravated by movements. She also had transient visual field blackouts. Fundoscopy showed a swollen optic disc. MRI brain showed no hydrocephalus or mass lesions or venous sinus thrombosis. What is the most likely diagnosis?

A. Idiopathic intracranial hypertension
B. Migraine with aura
C. Cluster headache
D. Brain tumor

A

A. Idiopathic intracranial hypertension

Note: The doctor mentioned this disease during the lecture.

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5
Q

Where is the auditory cortex located?

A. Superior temporal lobe
B. Medial temporal lobe
C. Inferior temporal lobe

A

A. Superior temporal lobe

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6
Q

Through which part of the crus cerebri of the midbrain does the corticospinal tract pass?

A. Lateral 1/6
B. Middle 2/3
C. Medial 1/6

A

B. Middle 2/3

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7
Q

What is the target of most efferent fibers from the flocculonodular lobe of the cerebellum?

A. Festigial nucleus
B. Dentatenucleus
C. Emboliformnucleus
D. Vestibular nucleus

A

D. Vestibular nucleus

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8
Q

Which 2 cranial nerves are involved in the pupillary light reflex?

A

CN II & CN III

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9
Q

Which of the following opens into the round window?

A. Scala tympani
B. Scala vestibule

A

A. Scala tympani

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10
Q

Which of the following provides preganglionic parasympathetic fibers to the ciliary ganglion (Sphincter pupillae)?

A

Edinger-Westphal nucleus

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11
Q

The axons of which of the following cells form Schaffer collaterals?

A. Granular cells of the cerebral cortex
B. Golgi cells of the cerebral cortex
C. Pyramidal cells of the hippocampus
D. Granular cells of the hippocampus
E. Golgi cells of the hippocampus
A

C. Pyramidal cells of the hippocampus

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12
Q

A defect in which of the following muscles will cause ptosis?
A. Levator palpebrae superioris
B. Orbicularis oculi

A

A. Levator palpebrae superioris

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13
Q

Which structure is unaffected by blocking the migration of neural crest cells?

A. Facial ganglion
B. Trigeminal ganglion
C. Medulla of suprarenal gland
D. Facial skeleton
E. Choroidplexus
A

E. Choroidplexus

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14
Q

What is the main target of the efferent fibers from caudate nucleus?

A. VA of thalamus
B. Putamen
C. Globuspallidus
D. Premotor and motor areas

A

A. VA of thalamus

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15
Q

Where do the efferent fibers of putamen project to in the direct circuit of the basal ganglia?

A. Globus pallidus
B. Substania nigra reticulata
C. Subthalamicnucleus

A

A. Globus pallidus

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16
Q

Choose the most appropriate structure: Its damage will result in retrograde degeneration of the medial zone of the hypothalamus.

A. Stria terminalis
B. Fornix
C. Medial forebrain bundle
D. Dorsal longitudinal fasciculus
E. Fasciculus retroflexus
F. Mamillothalamic tract
G. Mamillotegmental tract
A

F. Mamillothalamic tract

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17
Q

Choose the most appropriate structure: It projects to the parahippocampal gyrus and septal area.

A. Stria terminalis
B. Fornix
C. Medial forebrain bundle
D. Dorsal longitudinal fasciculus
E. Fasciculus retroflexus
F. Mamillothalamic tract
G. Mamillotegmental tract
A

A. Stria terminalis

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18
Q

Choose the most appropriate structure: A lesion in this structure would damage the hypoglossal nerve.

A. Genu of corpus callosum
B. Genu of internal capsule
C. Rostrum of corpus callosum
D. Rostrum of internal capsule

A

B. Genu of internal capsule

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19
Q

Choose the most appropriate structure: It is related to the floor of the anterior horn of the lateral ventricle.

A. Genu of corpus callosum
B. Genu of internal capsule
C. Rostrum of corpus callosum
D. Rostrum of internal capsule

A

C. Rostrum of corpus callosum

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20
Q

Which structure allows infections to spread from the nasopharynx to middle ear?

A

Auditory tube

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21
Q

A defect in which nucleus will result in dilated pupil?

A

Oculomotor nucleus

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22
Q

What separates thalamus from globus pallidus?

A

Posterior limb of internal capsule

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23
Q

Which nucleus receives efferent fibers for taste sensation?

A

Nucleus tractus solitaris (NTS)

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24
Q

A patient was found to have parasagittal meningioma adherent to the falx cerebri. Which of the following manifestations will be found in this patient?

A

Leg paralysis

Note: Parasagittal meningioma can compress the paracentral lobule.

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25
Q

Which of the following thalamic nuclei projects to prefrontal cortex and is responsible for the emotional function of thalamus (personality and judgment)?

A

Medial nucleus

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26
Q

What is the mechanism of action of local anesthetics?

A

Block Na channel

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27
Q

What is the mechanism of action of carbamazepine?

A

Block Na channel

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28
Q

Which anti-psychotic drug causes severe bone marrow suppression and orthostasis?

A

Clozapine

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29
Q

Which anti-psychotic drug doesn’t have an antiemetic effect?

A

Aripirazole

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30
Q

Which drug is used in the treatment of Parkinson’s disease and crosses the BBB?

A. Dopamine
B. Selegiline
C. Domperidone

A

B. Selegiline

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31
Q

Which drug blocks 5HT1A-receptor?

A

Buspirone

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32
Q

Which drug inhibits the reuptake of GABA?

A

Tiagabine

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33
Q

What is the drug of choice for status epilepticus?

A

Phenytoin

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34
Q

Which drug is an NMDA-receptor antagonist?

A

Ketamine

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35
Q

Which anti-epileptic drug is relegated for refractory cases because of its side effects?

A

Vigabatrine

36
Q

What is the mechanism of action of vigabatrine?

A

Inhibits degradation of GABA by GABA transaminase

37
Q

Choose the drug that fits the mechanism of action: Inhibits the reuptake of noradrenaline, serotonin, and dopamine.

A. Caffeine
B. Nicotine
C. Cannabinoids
D. Coccaine

A

D. Coccaine

38
Q

Choose the drug that fits the mechanism of action: Inhibits Phosphodiesterase.

A. Caffeine
B. Nicotine
C. Cannabinoids
D. Coccaine

A

A. Caffeine

39
Q

Which drug is used limitedly due to its complicated dietary restrictions?

A

Phenelzine or tranylcypromine

40
Q

Choose from the list the most appropriate event that will result in this consequences: Inhibition of the granule cell in a feed forward manner.

A. Repetitive stimulation of parallel fibers
B. Repetitive stimulation of climbing fibers
C. Stimulation of golgi cells by mossy fibers
D. Stimulation of golgi cells by parallel fibers

A

C. Stimulation of golgi cells by mossy fibers

41
Q

Choose from the list the most appropriate event that will result in this consequences: Long-term depression of the synapses between parallel fibers and Purkinje cells.

A. Repetitive stimulation of parallel fibers
B. Repetitive stimulation of climbing fibers
C. Stimulation of golgi cells by mossy fibers
D. Stimulation of golgi cells by parallel fibers

A

B. Repetitive stimulation of climbing fibers

Note: Choice “D” results in inhibition of the granule cells in a feedback manner.

42
Q

Which of the following corresponds to paroxysmal depolarization shift?

A. Sharp wave
B. Spike slow wave complex
C. Polyspikes

A

A. Sharp wave

43
Q

How does the UMN modulate the spinal reflexes?

A. Increase the proprioceptive fibers
B. Alters the depolarization state of the LMNs
C. Influence the gamma motor neurons

A

B. Alters the depolarization state of the LMNs

44
Q

What relays the signals from the cerebellum to the lower motor neurons?

A. Red nucleus neurons
B. Vestibular nucleus neurons

A

A. Red nucleus neurons

45
Q

What is the effect of administering tubocurarine on autonomic neurotransmission (ganglia)?

A. Blocks nicotinic receptors on postganglionic neurons
B. Blocks nicotinic receptors on preganglionic neurons
C. Blocks nicotinic receptors on both preganglionic and postganglionic neurons
D. No effect on autonomic neurotransmission

A

D. No effect on autonomic neurotransmission

Note: Tubocuracrine blocks ONLY N2 receptors on the skeletal muscles.

46
Q

What is the result of diffuse damage to the occipital lobe?

A. Associative agnosia
B. Appreciative agnosia

A

B. Appreciative agnosia

47
Q

What affects the cerebral blood flow when neuronal activity increases under normal conditions?

A

Glutamate

48
Q

Which of the following filters the ascending sensory information from sensory organs to the cortex?

A. Ventrolateral thalamus
B. Reticular nucleus

A

B. Reticular nucleus

Note: VL nucleus of thalamus is just a “relay station” in the ascending sensory pathway to integrate the information while the reticular nucleus acts as a filtering system that modulates the sensory signals that come to thalamus.

49
Q

What happens to a person who suffers RAS (reticular activating system) damage?

A. Extend limbs away from the body
B. Death
C. Stops breathing
D. Develops spastic paralysis of the lower limbs
E. Falls into deep coma
A

E. Falls into deep coma

50
Q

Choose the most appropriate brain area: A lesion in this area affects working memory.

A. Anterior association cortex
B. Parietal association area
C. Temporal association area
D. Prefrontal cortex

A

D. Prefrontal cortex

51
Q

Choose the most appropriate brain area: It is responsible for spatial cognition and motor functions (movement in space).

A. Anterior association cortex
B. Parietal association area
C. Temporal association area
D. Prefrontal cortex

A

B. Parietal association area

52
Q

Which of the following results in chorea without Akinesia?

A. Lesion in subthalamic nucleus
B. Damage to D1 striatal neurons and hyperactive GPi
C. Damage to D2 striatal neurons and hyperactive GPe
D. Damage to D1 striatal neurons and hyperactive GPe

A

C. Damage to D2 striatal neurons and hyperactive GPe

53
Q

choose the most appropriate structure: It sends signals to hypothalamus to control emotions and motivations.

A. Vagal nuclei
B. Nucleus tractus solitaris
C. Reticularformation
D. Limbic system
E. Infundibulum
A

D. Limbic system

54
Q

choose the most appropriate structure: It receives neural signals from hypothalamus under stress.

A. Vagal nuclei
B. Nucleus tractus solitaris
C. Reticularformation
D. Limbic system
E. Infundibulum
A

C. Reticularformation
or E. Infundibulum?

I asked Dr. Hameed about the q and he said that he forgot the answer. I was between choices “C” and “E” but most students chose “C”.

55
Q

Which of the following is involved in spontaneous purposeful adjustment of movement and posture?

A. Vestibulospinal
B. Spinothalamic
C. Pyramidal
D. Anterolateral system

A

A. Vestibulospinal

56
Q

Which of the following spontaneously stimulates extensors of the body?

A. Reticular facilitating area (Pontine – Medial)
B. Reticular excitatory area (Medullary – Lateral)
C. Lower motor neurons

A

A. Reticular facilitating area (Pontine – Medial)

57
Q

How can we induce sleep using brainwave entrainment?

A

4 Hz sound waves are used to induce 4 Hz theta waves in the brain

Note: You need to know the frequency (4 Hz) and the type of stimulus used (sound waves) and what type of waves is generated in the brain (4 Hz theta waves).

58
Q

Which brainwaves are seen during deep sleep?

A. Theta waves

A

B. Delta waves

59
Q

Choose the mediator responsible for the following: Cerebral vasodilation during hypo-perfusion or ischemia (feedback regulation).

A. Glutamate
B. GABA
C. PGE2
D. Release of 20-HETE from arachidonic acid
E. NO
F. CO2
A

F. CO2

60
Q

Choose the mediator responsible for the following: Constriction of smooth muscles in cerebral arterioles.

A. Glutamate
B. GABA
C. PGE2
D. Release of 20-HETE from arachidonic acid
E. NO
F. CO2
A

D. Release of 20-HETE from arachidonic acid

61
Q

Which hypothalamic nucleus is responsible for heat loss?

A

Anterior nucleus

62
Q

Which method is used to rapidly diagnose TB meningitis?

A

CSF-PCR

63
Q

Choose the pathological effect of the following infections: The effect of cerebral malaria.

A. Cerebral edema
B. Microvascular infarction/hemorrhage
C. Ring enhancement lesions
D. Meningo-encephalitis

A

B. Microvascular infarction/hemorrhage

64
Q

Choose the pathological effect of the following infections: An infection transmitted from mother to fetus in the first trimester of pregnancy.

A. Cerebral edema
B. Microvascular infarction/hemorrhage
C. Ring enhancement lesions
D. Meningo-encephalitis

A

C. Ring enhancement lesions

65
Q

A 3-year-old child had an upper respiratory tract infection with fever few days ago. The
mother said that she has given him aspirin. What is the diagnosis?

A

Reye syndrome

66
Q

What type of vaccine is Hib?

A. Conjugate
B. Polysaccharide

A

A. Conjugate

67
Q

Which fungal pathogen is predominantly associated with meningitis in AIDS patients?

A. C. neoformans
B. Aspergillus fumigatus
C. Mucor
D. P. jiroveci

A

A. C. neoformans

68
Q

Choose the most appropriate diagnosis in the following scenarios: A disease caused by CAG repeat expansion in a gene located on chromosome 4p16.3.

A. Spinocerebellar ataxia
B. Amyotrophic lateral sclerosis
C. Huntington’s disease
D. Friedriech ataxia

A

C. Huntington’s disease

69
Q

Choose the most appropriate diagnosis in the following scenarios: A disease affecting 1:50,000 of the European population and is caused by GAA repeat
expansion.

A. Spinocerebellar ataxia
B. Amyotrophic lateral sclerosis
C. Huntington’s disease
D. Friedriech ataxia

A

D. Friedriech ataxia

70
Q

Choose the most appropriate pathological method that underlies the following: A hypertensive patient with lacunar infarcts in the basal ganglia.

A. Rupture of saccular aneurysm
B. Rupture of charcot bouchard microaneurysm
C. Hypoperfusion reperfusion
D. Occlusion of middle meningeal artery
E. Occlusion of deep penetrating branches of MCA

A

E. Occlusion of deep penetrating branches of MCA

71
Q

Choose the most appropriate pathological method that underlies the following: A patient developed subarachnoid hemorrhage after lifting heavy objects.

A. Rupture of saccular aneurysm
B. Rupture of charcot bouchard microaneurysm
C. Hypoperfusion reperfusion
D. Occlusion of middle meningeal artery
E. Occlusion of deep penetrating branches of MCA

A

A. Rupture of saccular aneurysm

72
Q

Which gene is mutated in Krabbe disease?

A

GALC

73
Q

A patient fell on the left side of his head and developed epidural hematoma. Fundoscopy showed papilledema on the right side. What is the cause of death?

A. Coup contusion
B. Brain herniation

A

B. Brain herniation

74
Q

A 4-year-old child presented with ataxia. Brain imaging showed a tumor in the midline of the cerebellum. HPE showed undifferentiated small round blue cells. What is the diagnosis?

A

Medulloblastoma

75
Q

Which stain is the most effective for the diagnosis of metachromatic leukodystrophy?

A. H&E
B. Toluidineblue
C. Luxol fast blue
D. PAS

A

B. Toluidineblue

76
Q

Subacute combined degeneration of lateral and posterior columns of the spinal cord is caused by which of the following?

A. Vitamin B12 deficiency
B. Wernickeencephalopathy

A

A. Vitamin B12 deficiency

77
Q

A 30-year-old woman presented with a 3-day history of right orbital pain associated with eye movements and loss of vision in the right eye. On examination, visual acuity was 20/50 in the right eye and 20/20 in the left eye. Fundus examination was normal. There is red desaturation in the right eye, right-sided central scotoma, and relative afferent pupillary defect of the right eye. What is the most likely diagnosis?

A. Retrobulbar neuritis
B. Papillitis
C. Giant cell arteritis
D. Migraine aura
E. Cluster headache
A

A. Retrobulbar neuritis

78
Q

An old male presented with aphasia. Which of the following findings will most likely be noted during examination?

A. Babinski sign
B. Right homonymous hemianopia
C. Loss of sensation on the right side
D. Loss of motor function of the whole right half of the face
E. Left hemiplagia
A

B. Right homonymous hemianopia

79
Q

What is the mechanism of damage in myasthenia gravis?

A. Antibody-mediated phagocytosis
B. Opsonization by C3b
C. Complement-mediated lysis

A

C. Complement-mediated lysis

80
Q

What is the first structure to be compressed in transtentorial hernia?

A. ACA
B. PCA
C. Oculomotor nerve

A

Oculomotor nerve

81
Q

What are the epidemiological trends in trachoma, glaucoma, diabetic retinopathy?

  1. Trachoma: Decrease
    Glaucoma: Increase
    Diabetic retinopathy: Increase

2.
Trachoma: Decrease
Glaucoma: Decrease
Diabetic retinopathy: Decrease

3.
Trachoma: Decrease
Glaucoma: Decrease
Diabetic retinopathy: Increase

4.
Trachoma: Increase
Glaucoma: Increase
Diabetic retinopathy: Increase

A
  1. Trachoma: Decrease
    Glaucoma: Increase
    Diabetic retinopathy: Increase
82
Q

EBM: The strongest feature that increases the validity of an RCT and makes treatment arms equal
on all factors except for the treatment.

A. No drop-outs
B. Blinding
C. Intention to treat
D. Stratification
E. Randomization
A

E. Randomization

83
Q

EBM: This feature prevents systemic error (bias) in outcome assessment in an RCT.

A. No drop-outs
B. Blinding
C. Intention to treat
D. Stratification
E. Randomization
A

B. Blinding

84
Q

EBM: A screening test for iron deficiency anemia has a pretest probability pf 90%. What is the effect of decreasing pretest probability from 90% to 10%?

1. 
Sensitivity: Increase
Specificity: Decrease
PPV: Decrease
NPV: Increase
2.
Sensitivity: Decrease
Specificity: Increase
PPV: Increase
NPV: Decrease
3.
Sensitivity: Same
Specificity: Same
PPV: Decrease
NPV: Increase
4.
Sensitivity: Same
Specificity: Same
PPV: Increase
NPV: Decrease
A 
3.
Sensitivity: Same
Specificity: Same
PPV: Decrease
NPV: Increase
85
Q

EBM: An RCT usually has a description of the baseline characteristics (age, sex, race … etc.) based on the treatment status (treatment group and placebo group). What is the main purpose of providing this table?

A. To show that confounding effect was minimized
B. To show that random error was controlled
C. To show the efficacy of the treatment
D. To show the statistical difference in different groups

A

A. To show that confounding effect was minimized

CNS module - 4th year (17 decks)

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