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CNS module - 4th year > 2013 module exam > Flashcards

2013 module exam Flashcards

1
Q

The following EEG was taken from a 20 year old subject during sleep. What does this waveform indicate?

  1. A typical interictal discharge
  2. A sharp wave that does not indicate any abnormality
  3. Typical ictal discharge
A
  1. A sharp wave that does not indicate any abnormality

Note: the picture in the exam had a drop below the baseline BEFORE the sharp wave which confused some students and made them choose A. Interictal sharp waves usually have a drop below the baseline by the descending limb of the sharp wave (not before the sharp wave itself).

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2
Q

An 18 year old male suffered from a car accident, resulting in a right hemi cord section. What would you see in clinical examination?

A. Loss of pain and sensation on right side
B. Loss of right proprioception and vibration
C. Loss of left proprioception and vibration D. Left Babinski sign

A

B. Loss of right proprioception and vibration

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3
Q

A 28 year old woman had right ulnar nerve palsy and left perineal nerve palsy then left facial paralysis. All of that within 10 days. What is the diagnosis?

A. Mononeuropathy
B. Polyneuropathy
C. Mononeuropathy Multiplex

A

C. Mononeuropathy Multiplex

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4
Q

What is the functional significance of having 5 diff types of Noradrenaline in sympathetic postganglionic system?

A. To potentiate each other
B. To prevent damage from drugs
C. To have organ specific sympathetic activity
D. Backup

A

C. To have organ specific

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5
Q

A diabetic patient presented with loss of sensation in his lower limb below the knee bilaterally. He also lost sensation below his wrist

A. Mononeuritis multiplex
B. Mononeuropathy
C. Polyneuropathy

A

C. Polyneuropathy

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6
Q

What is the origin of the medial lemniscus?

A

Gracile and cuneate nucleus

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7
Q

A patient presented with weakness and atrophy of his lower limb muscles, no sensory deficit, fasciculation, and absent reflexes. What is his condition?

A. Polio
B. Carpel tunnel syndrome
C. Mononeuropathy
D. Amyotrophic lateral sclerosis

A

A. Polio

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8
Q

A 19 year old came w bilateral ascending paralysis. His CSF is clear, with normal glucose and protein levels and a high lymphocyte level. What’s the diagnosis?

A. Guillain-Barre syndrome.
B. Acute disseminated encephalitis
C. Subacute sclerosing panencephalitis.

A

A. Guillain-Barre syndrome.

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9
Q

What happens in the reciprocal excitation of the Golgi tendon reflex?

A. Activation of 1b afferents and excitation of antagonist muscles
B. Activation of 1a afferents and excitation of antagonist muscles

A

A. Activation of 1b afferents and excitation of antagonist muscles

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10
Q

Paralysis of the lower limb caused by occlusion of?

A. Great anterior medullary artery
B. Anterior spinal artery
C. Segmental artery

A

A. Great anterior medullary artery

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11
Q

Which receptor detects different modalities of sensation?

A

Free nerve ending

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12
Q

Through what mechanism do mechanoreceptors send signals when there is stimulation by touch?

A. Voltage gated channels open B. Ligand channels open
C. Stretch channels open

A

C. Stretch channels open

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13
Q

Which receptor detects vibration?

A

Pacinian corpuscle

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14
Q

Which of the following is important in degeneration and regeneration when peripheral nerves are damaged?

A. Macrophages
B. Schwann cells
C. Microglia

A

A. Macrophages

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15
Q

What could be the presentation of a patient with amyotrophic lateral sclerosis?

A. Hoffman’s sign, fasciculation, extensor plantar reflex
B. Babinski sign, spasticity, clonus only
C. Fasciculations, atrophy, intention tremor

A

A. Hoffman’s sign, fasciculation, extensor plantar reflex

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16
Q

Histopathological examination showed patches of demyelination in the sub-cortex and viral antigens in oligodendrocytes?

A

Progressive multifocal encephalopathy

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17
Q

A patient presented with loss of sensation in right side of his face, loss of balance in right side of his body, paralysis of right face. What is the syndrome?

A. Right lateral pontine syndrome
B. Left lateral pontine syndrome
C. Right lateral medullary syndrome

A

A. Right lateral pontine syndrome

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18
Q

Which nucleus carries pain and temperature sensations from the face?

A. Spinal nucleus of trigeminal
B. Main sensory nucleus of trigeminal

A

A. Spinal nucleus of trigeminal

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19
Q

Which part of the body will be affected if there is a lesion in the rostral pyramid of the medulla?

A. Contralateral side
B. Bilateral
C. Ipsilateral

A

A. Contralateral side

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20
Q

Patient with contralateral hemiplegia and his eye was dilated and displaced outward and downward. Where is lesion?

A

Midbrain

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21
Q

What is a characteristic of myelin in the brain?

A. Has specific basic protein
B. Has very low phosphatidylamino

A

A. Has specific basic protein

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22
Q

Which of the following controls breathing rhythm and heart rate?

A

Reticular formation in the medulla

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23
Q

Post mortem exam of the brain of a patient showed plaques in optic nerve and demyelination of the spinal cord. Antibodies against aquaporin 4 were negative for life?

A. Multiple sclerosis
B. Neuromyelitis optica
C. CPM

A

A. Multiple sclerosis

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24
Q

What is the mechanism of antibody- mediated damage in myasthenia gravis?

A. Opsonization by c3b
B. Ab mediated phagocytosis C. Complement mediated lysis

A

C. Complement mediated lysis

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25
Q

Vagus supplies which nucleus?

A

Nucleus tractus solitaires

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26
Q

What connects the cortex to the contralateral cerebellum?

A

Pons

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27
Q

.Marked electrolyte imbalance with pseudo-coma occurs in?

A

Central Pontine Syndrome

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28
Q

What is the importance of peroxisome in the brain?

A. Synthesize linoleic and linolenic fatty acids
B. Degrade very long chain fatty acids

A

B. Degrade very long chain fatty acids

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29
Q

Preganglionic parasympathetic fibers to the Otic Ganglion are projected from?

A

Inferior salivary nucleus

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30
Q

Preganglionic parasympathetic fibers to the ciliary ganglion projected from?

A. Oculomotor nucleus
B. Dorsal nucleus of Vagus
C. Edinger-Westphal nucleus

A

C. Edinger-Westphal nucleus

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31
Q

Upper part of the tympanic membrane was rupture and injured a nerve. Which function will be affected?

A. Submandibular gland
B. Lacrimal gland
C. Parotid gland

A

A. Submandibular gland

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32
Q

A normotensive 19 year old male presented with spontaneous sudden lobar hemorrhage. Which of the following could be the cause?

A

Cerebral amyloid angiopathy

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33
Q

What nuclear medicine method is used to evaluate cerebral perfusion in someone?

A. Tc-99m HMPAO and acetazolamide
B. Tc-99m HMPAO

A

B. Tc-99m HMPAO

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34
Q

What is used to evaluate the risk of stroke in cerebral ischemia?

A. Tc-99m HMPAO and acetazolamide
B. Tc-99m HMPAO

A

A. Tc-99m HMPAO and acetazolamide

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35
Q

Damage to the inferior frontal gyrus results in which of the following conditions?

A. Wernicke’s aphasia
B. Broca’s aphasia
C. Conductive aphasia

A

B. Broca’s aphasia

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36
Q

A young girl presented with a sudden severe headache. They found blood in her subarachnoid space. What is the most common cause of her condition?

A. Atherosclerosis
B. Congenital
C. Hypertension

A

B. Congenital

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37
Q

Transient loss of retinal field vision with recovery after 6 hours

A

TIA

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38
Q

Subarachnoid hemorrhage case. Cause?

A

Congenital anomaly

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39
Q

What is the correct sequence of sensory-motor hierarachy?

A

Sensory > posterior association > anterior association > premotor > primary motor

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40
Q

Patient presents with paralysis of the right leg below the knee and loss of sensation in the same area. He also had urinary incontinence. Which artery is blocked?

A

Blockage of left ACA

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41
Q

Right lower face weakness and same side limb paralysis which artery is occluded?

A. PICA
B. AICA
C. Rt MCA
D. Lt MCA

A

D. Lt MCA

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42
Q

What would worsen the condition of a patient with stroke?

A. Decreasing systolic BP below 140mmhg
B. Decreasing blood sugar

A

A. Decreasing systolic BP below 140mmhg

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43
Q

A lady does not recognise the left side of her body. Which part of her brain is affected?

A. Non dominant parietal lobe
B. Dominant parietal lobe

A

A. Non dominant parietal lobe

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44
Q

A patient presented with leg weakness and apathy. Which area of the brain is affected?

A. Parietal Lobe
B. Frontal Lobe
C. Occipital Lobe

A

B. Frontal Lobe

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45
Q

Which part of the lateral ventricle is related to calcar avis?

A. Posterior horn
B. Inferior horn
C. Anterior horn

A

A. Posterior horn

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46
Q

Which part of the lateral ventricle is related to the hippocampus?

A

Inferior horn

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47
Q

A 33 year old male with traumatic spinal injury. What is characteristic of corticospinal tract lesion?

A. Fasciculation
B. Spastic muscle tone

A

B. Spastic muscle tone

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48
Q

Which of the following causes vasoconstriction of cerebral arterioles?

A

Metabolism of arachidonic acid into 20-HETE in smooth muscles

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49
Q

What is the function of the main neurons of the principal sulcus of the frontal cortex?

A. Scan objects in the visual field
B. Select appropriate movements
C. Correct unwanted motor movements
D. Stores knowledge to guide motor behavior

A

D. Stores knowledge to guide motor behavior

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50
Q

A patient is comprehensive and can’t pronounce words, but he is having normal swallowing. Which area is affected?

A. Motor Speech
B. Wernicke’s
C. Global
D. Conduction

A

A. Motor Speech

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51
Q

A childe presented with enlargement of Lateral ventricle with normal 3rd and 4th ventricles. Where is the blockage in the ventricular system?

A. Interventricular foramen
B. Cerebral aqueduct
C. Medial aperture
D. Lateral aperture

A

A. Interventricular foramen

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52
Q

A right-handed man presented with aphasia. What is another sign he could present with?

A. Left hemiparasis
B. Right homonomus hemianopia
C. Left lower quadrant hemianopia

A

B. Right homonomus hemianopia

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53
Q

Right handed man with aphasia. What other symptom?

A

Right homonymous hemianopia

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54
Q

A patient suffered of cardiac arrest. On post mortem examination brain section showed diffuse watershed infarcts and cortical laminar necrosis. What is the most probable etiology?

A

Global cerebral ischemia

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55
Q

Which of the following has the major cause of vasodilation in case of hypoperfusion?

A. NO
B. Glutamate from neurons
C. High Partial pressure of CO2

A

C. High Partial pressure of CO2

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56
Q

After restoring reperfusion in a patient suffering from stroke, cerebral blood flow is not restored immediately. What is the reason for this delay?

A

Contraction of pericytes

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57
Q

What is the main source of fibers going to cerebellum through MCP?

A. Pontine nuclei
B. Medulla

A

A. Pontine nuclei

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58
Q

What is the main output of cerebellum?

A. Red nucleus
B. Axons of deep cerebellar nuclei
C. Vestibular nuclei axons

A

B. Axons of deep cerebellar nuclei

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59
Q

Patient presented with limb ataxia and spasticity. On inspection she had muscle wasting, on examination she has a positive Babinski sign. Echo showed cardiomegaly. What is the diagnosis?

A

Fredrick Ataxia

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60
Q

What happens when the direct pathway is excited under low cortex activity?

A. Increase K+ in striatum by acting on D1 receptors
B. Increases calcium by acting on D1
C. Decrease K+ by acting on D2 receptors
D. Increase K+ by acting on D2 receptors

A

A. Increase K+ in striatum by acting on D1 receptors

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61
Q

What forms the axons of granular cells?

A. Parallel fibers
B. Purkinje

A

A. Parallel fibers

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62
Q

Putamen receives most of its input from?

A

Motor and premotor area

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63
Q

A 60 year old male seen in causality complaining of waddling to the left. On finger-to- nose test he had dysdiadokokinesia, intention tremor, and dysmetria only on the left side. What is the pathology?

A. Infarction of the left cerebellar hemisphere
B. Paraneoplastic syndrome
C. Tumor in the right cerebellar hemisphere
D. Spinocerebellar infarction

A

A. Infarction of the left cerebellar hemisphere

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64
Q

Which of the following movement disorder can be classified as both hyperkinetic and hypokinetic?

A. Huntington’s Chorea
B. Parkinson’s disease
C. Hemiballism

A

A. Huntington’s Chorea

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65
Q

What happens with excessive stimulation of the indirect pathway?

A. Akinesia
B. Bradykinesia
C. Chorea
D. Tremor at rest
E. Intentional tremor
A

A. Akinesia

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66
Q

Ahmed was having a conversation with his friend who he thought suddenly stares in to space. What could he be experiencing?

A

Complex partial seizure

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67
Q

Which of the following is a sign of cerebellar disorder?

A. Akinesia
B. Bradykinesia 
C. Chorea
D. Myoclonus
E. Ballismus
F. Tremor at rest
G. Intentional tremor
A

G. Intentional tremor

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68
Q

A patient suffers from sudden vigorous forceful movements of his hand. What is this
movement disorder called?

A. Akinesia
B. Bradykinesia 
C. Chorea
D. Myoclonus
E. Ballismus
F. Tremor at rest
G. Intentional tremor
A

E. Ballismus

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69
Q

A 5 year old girls presented with enlarged tonsils. Later she had fidgety random seemingly semi purposive movements. What is the diagnosis?

A. Tonsillitis
B. Sydenham’s Chorea

A

B. Sydenham’s Chorea

70
Q

Origin of climbing fibers

A

Inferior olivary nucleus

71
Q

What are the main fibers of SCP?

A

Dento-thalamic fibers

72
Q

A 35 year old male presented to the clinic with complaints of sudden electric like jerky movements of his right arm which he wasn’t able to suppress. What is the disorder?

A. Tic disorder
B. Myoclonus
C. Tremor
D. Dystonia

A

B. Myoclonus

73
Q

What is true about the basal ganglia?

A

Head of caudate joins with putamen

74
Q

What is responsible for long term motor learning in the cerebellum?

A

Long term depression of synapsis of Parallel to Purkinji fibers.

75
Q

Neuron signals in the brain are affected by thalamo-cortical circuits? What could lead to epilepsy?

A. Decreased excitatory signals to GABA interneurons
B. Increased glutamate in neurons

A

A. Decreased excitatory signals to GABA interneurons

76
Q

How is movement inhibited in REM sleep?

A. Reticular inhibitory signals to lower motor neuron
B. Reticular lateral area inhibits UMN
C. Inhibition of UMN and LMN by reticular formation

A

A. Reticular inhibitory signals to lower motor neuron

77
Q

What arises from the alar plate?

A. Dorsal vagus
B. Gracile

A

B. Gracile

78
Q

What neurotransmitter after epilepsy causes neurotoxicity?

A. Glutamate
B. Aspartate
C. Leucine
D. Lysine

A

A. Glutamate

79
Q

What causes the electrical current detected on the surface by EEG?

A

EPSP of Dendrites

80
Q

What will happen if the connection between the cortex and red nucleus is cut?

A. Shaking/Tremors
B. Limbs will be flexed and held near the body
C. Atonic and flaccid limbs
D. Limbs extended away from the body

A

B. Limbs will be flexed and held near the body

Note: A cut above the red nucleus in the location specified in the question targets corticospinal tract not rubrospinal tract, so limbs will be flexed (b) not extended (d)

81
Q

What is seen with an anxious intellectually active adult?

A. alpha wave 
B. Beta wave 
C. Theta wave 
D. Sharp wave 
E. Spike
F. Polyspikes
G. Spike-slow wave complex 
H. Polyphasic spike pattern
A

B. Beta wave

82
Q

What is seen with generalized absence seizure?

A. alpha wave 
B. Beta wave 
C. Theta wave 
D. Sharp wave 
E. Spike
F. Polyspikes
G. Spike-slow wave complex 
H. Polyphasic spike pattern
A

G. Spike-slow wave complex

83
Q

What is seen with Grand mal tonic phase?

A. alpha wave 
B. Beta wave 
C. Theta wave 
D. Sharp wave 
E. Spike
F. Polyspikes
G. Spike-slow wave complex 
H. Polyphasic spike pattern
A

F. Polyspikes
and
H. Polyphasic spike pattern

Note: H was the correct answer as it is more sustained but because the Dr. used the term polyspikes (transient) in the lecture he asked for it to be counted correct too- Dr. Zoran.

84
Q

Bleeding of bridging veins

A

Subdural hematoma

85
Q

Which condition is associated with mutations in SCN1A gene?

A. GEFS
B. Dravet syndrome

A

A. GEFS
B. Dravet syndrome
*both choices were in the exam, both counted correct

86
Q

What results from mutation in KCNQ2?

A. epileptic encephalopathy
B. benign familial neonatal seizures

A

A. epileptic encephalopathy
B. benign familial neonatal seizures
*both counted correct

87
Q

Which of the following best applies to Alzheimer’s dementia?

A. APOE 4 increases the risk
B. Affects males more than females

A

A. APOE 4 increases the risk

88
Q

A patient lost 1 L of blood in a car accident but he was still conscious and felt thirsty. What is the most likely signaling mechanism?

A. Hypothalamic osmoreceptors
B. Carotid baroreceptors
C. Aortic chemoreceptors
D. Glucocorticoid receptors

A

B. Carotid baroreceptors

89
Q

Which part of the brain is responsible of procedural memory?

A. Thalamus
B. Hypothalamus
C. Hippocampus
D. Sub thalamic nuclei 
E. Basal Ganglia
A

E. Basal Ganglia

90
Q

What are the main efferent fibers of amygdala?

A. Fornix
B. Striae terminalis
C. Dorsal forebrain bundle

A

B. Striae terminalis

91
Q

Which of the following controls thermoregulation?

A

Anterior nucleus of hypothalamus

92
Q

What is responsible of shivering and release of thyroxine from the thyroid gland?

A

Posterior nucleus of hypothalamus

93
Q

The oxidizing effect on which protein could contribute to nerve damage in Alzheimer disease?

A. Tau
B. APP
C. Aβ42

94
Q

.Which of the following results from a non-coding trinucleotide repeat disorder?

A

Fredrick ataxia

95
Q

Patient with a neurologic disorder caused by CGG repeats

A

Fragile X Syndrome

96
Q

Which of the following is an autosomal dominant neurodegenerative disease?

A

Huntington

97
Q

Defective processing of this protein forms (or causes accumulation of) Aβ42 in Alzheimer’s?

98
Q

What hypothalamic nucleus mediates heat loss?

A

Anterior hypothalamic nucleus

99
Q

Unresponsive, unaraousable, EEG silence?

A. Coma
B. Brain death

A

B. Brain death

100
Q

Which one of the following is a taupathy with coiled bodies and inclusions in oligodendrocytes?

A

Progressive supranuclear paralysis

101
Q

A 70 year old patient has Alzheimer’s disease fell on her head and had subdural bleeding. What could contribute to her condition?

A

Brain atrophy

102
Q

What changes, when occur, mediate long term memory?

A. Increase presynaptic neurotransmitters
B. Increase NMDA receptors on post synaptic receptors
C. AMPA internalization

A

A. Increase presynaptic neurotransmitters

103
Q

Superoxide dismutase mutation (SOD1) ?

104
Q

Which structure has diffuse uniform decrease with aging?

A. White matter
B. Frontal
C. Temporal
D. Occipital

A

A. White matter

105
Q

Which region when lesioned will cause excessive eating, rage, and aggressive behavior?

A

Ventromedial

106
Q

Which area of the hypothalamus is responsible for heat loss?

107
Q

Which of the following thalamic nuclei plays part in recent memory?

A

Anterior nucleus

108
Q

Which of the following serotypes on Neisseria Meningitides cause outbreaks in Africa?

A. Type A
B. Type B
C. Type W135
D. Type C

A

A. Type A

Note: A for Africa, B for outBreaks/Britain, C for loCal outbreaks (College students), W135 for Haj.

109
Q

What is the immediate control measure that you would take for a suspected case of meningitis caused by Neisseria Meningitides admitted to your hospital?

A. Contact precaution
B. Ampicillin
C. Isolation in positive pressure room
D. Isolation in negative pressure room

A

D. Isolation in negative pressure room

110
Q

A post mortem examination of a patient revealed necrosis in temporal lobe. Which histological finding supports the diagnosis?

A. Inclusion bodies
B. Gitter cells

A

A. Inclusion bodies

111
Q

A cerebellar tumor in a 3 year old boy with undifferentiated round to oval cells forming rosettes. What is the most likely diagnosis?

A. Medulloblastoma
B. Oligodenroglioma
C. Ependymoma
D. Glioblastoma

A

A. Medulloblastoma

112
Q

Tumor in a 45 year old male shows pleomorphic cells with palisading around necrosis and endothelial cell proliferation?

A. Ependymoma
B. Glioblastoma
C. Medullablastoma

A

B. Glioblastoma

113
Q

CSF of AIDS patient yielded slow growing molds which turn to yeast at 37C. which of the following is the causative organism

A. Histoplasma
B. Candida Albican. 
C. Candida
D. Aspergillus
E. Malassezia furfur 
F. Mucor
G. Crytococcus
A

A. Histoplasma

114
Q

Microscopic Gelatinous exudate shows budding organism with PAS+, Mucicarmine and Silver stain?

A. Histoplasma
B. Candida Albican. 
C. Candida
D. Aspergillus
E. Malassezia furfur 
F. Mucor
G. Crytococcus
A

G. Crytococcus

115
Q

Has high predilection for CNS after lung infection?

A. Histoplasma
B. Candida Albican. 
C. Candida
D. Aspergillus
E. Malassezia furfur 
F. Mucor
G. Crytococcus
A

G. Crytococcus

116
Q

Which vitamin deficiency causes koraskoff-wernekie’s encephalopathy?

A. Vitamin B1
B. Vitamine B12
C. Vitamin E
D. Vitamin D

A

A. Vitamin B1

117
Q

Gross appearance of the brain showed purulent exudate in subarachnoid space with engorged vessels. Which of the following

A. Bacterial meningitis
B. Viral meningitis

A

A. Bacterial meningitis

118
Q

A 51 years old patient who has meningitis, CSF shows gram-positive diplococci. What is the most likely causative organism?

A. Strept. Pneumonia
B. Neisseria meningitides
C. Listeria monocytogene
D. Hemophilus influenzae

A

A. Strept. Pneumonia

119
Q

What is the mode of inheritance of Wilson’s disease?

A

Autosomal recessive

120
Q

A patient presented with nuchal rigidity, headache, fever, high white blood cells, and had bacterial meningitis. He was given dexamethasone with his treatment, what is the principal behind giving him dexamethasone?

A. Reduction of inflammation
B. Production of pro-inflammatory cytokines
C. Increases the permeability of BBB
D. Bactericidal

A

A. Reduction of inflammation

121
Q

Low glucose, high protein and lymphocytes, mucoid gelatinous meninges

A. Tuberculous meningitis
B. basal bacterial meningitis

A

A. Tuberculous meningitis
B. basal bacterial meningitis

*we don’t remember which one came but both are correct

122
Q

Post-mortem examination of a patient who died of a febrile illness showed bilateral temporal necrosis. What is the diagnosis?

A

Herpes encephalitis

123
Q

Dormant malaria in the liver?

A

Hypnozoites

124
Q

.In which structure does cataract occur?

A. Ciliary body
B. Retina
C. Lens
D. Iris
E. Conjunctiva
125
Q

A lady presented with headache and vomiting. Fundoscopy showed papilledema. Which of the following is associated with increased ICP?

A. Limited abduction of right eye
B. Ptosis

A

A. Limited abduction of right eye

126
Q

.What is the mechanism of inhibition of PDE in the dark?

A

Binding of PDE-gamma subunit

127
Q

Which of these nerves is involved in corneal reflex?

A. Facial
B. Abducens
C. Optic
D. Oculomotor

128
Q

Plays a role in Retinal blood barrier?

129
Q

What causes Leber’s Congenital Amaurosis (LCA)?

A

No regeneration of 11-cis retinal

130
Q

Collects Info from several photoreceptors?

A. Horizontal cells 
B. Bipolar cells
C. Ganglion cells 
D. Amacrine cells 
E. Rods
F. Cones
A

A. Horizontal cells

131
Q

Its axons forms optic nerve?

A. Horizontal cells 
B. Bipolar cells
C. Ganglion cells 
D. Amacrine cells 
E. Rods
F. Cones
A

C. Ganglion cells

132
Q

What is characteristic of multiple sclerosis?

A. Headache
B. Absence of oligo clonal bands
C. Worsening of symptoms in hot temperature

A

C. Worsening of symptoms in hot temperature

133
Q

Localization of sound is done by?

A

Superior olivary nucleus

134
Q

What are the main fibers that form the trapezoid body?

A. Cochlear Nuclei
B. Latral leminsci
C. Vestibular nuclei

A

A. Cochlear Nuclei

135
Q

Hereditary Spastic Paraplegia is a heterogeneous neurological disorder caused by genetic mutations. Which of the following pathways is affected in this disorder?

A. Rho signaling
B. Axoplasmic transport
C. FeS cluster biogenesis

A

B. Axoplasmic transport

136
Q

Which gene is associated with multiple hereditary motor and sensory neuropathies in human and targets myelination?

137
Q

Hereditary brachial plexus neuropathy is due to a mutation resulting in a dysfunction of which of the following signaling mechanism?

A. Rho-Rhotekin signaling
B. Excessive mitochondrial Iron accumulation
C. Transthyretin
D. Galactosylceramidase

A

A. Rho-Rhotekin signaling

138
Q

What is the role of the cerebellum in maintaining upright posture?

A. Sends stretch commands to the LMNs
B. Adjusts fine contractions in the skeletal muscles
C. Adjusts the sensitivity of the vestibular system
D. Adjusts the sensitivity of limb reflexes

A

B. Adjusts fine contractions in the skeletal muscles

Note: confirmed by Dr. Andreas.

139
Q

Which condition is characterized by dysmorphic features, particularly holoprosencephaly, hypotelorism, and epicanthal folds?

A. Hereditary brachial plexus neuropathy
B. Hereditary motor and sensory neuropathy
C. Hereditary neuralgic amyotrophy
D. Familial amyloid polyneuropathy

A

C. Hereditary neuralgic amyotrophy

140
Q

Which is an autosomal dominant multisystemic disorder caused by deposition of defective transthyretin?

A. Hereditary brachial plexus neuropathy
B. Hereditary motor and sensory neuropathy
C. Hereditary neuralgic amyotrophy
D. Familial amyloid polyneuropathy

A

D. Familial amyloid polyneuropathy

141
Q

What relays signals from cerebellum to LMNs?

A. Red nuclear neurons
B. Vestibular nuclei neurons

A

A. Red nuclear neurons

*confirmed by Dr. Andreas Henkel

142
Q

Which structure of the ear is responsible for maintain balance?

A. Inner hair cells
B. Outer hair cells
C. Cochlear nerve
D. Crista ampullaris

A

D. Crista ampullaris

143
Q

What is the mechanism of action of Cannabis on CB1 receptor?

A

Block AC, close Ca, open K

144
Q

Parkinsonism’s drug cause insomnia when taken after mid-afternoon?

A. Selegiline
B. Domperidone

A

A. Selegiline

145
Q

What is the drug of choice for absence seizure?

A. Ethosuximide
B. Vigabatrin

A

A. Ethosuximide

146
Q

Which drug can un-mask manic behavior when given to a depressed patient?

A

Aminophylline

147
Q

Which drug causes purple mottling of the skin as a side effect?

A

Amantadine

148
Q

.Which drug causes gambling with excessive shopping as side effects?

A

Ropinirole

149
Q

Which drug causes hangover when used for a long period of time?

A

Nordazepam

150
Q

A patient should avoid tyramine containing food in which drug?

A

Phenelzine

151
Q

What is the mode of action of NK-1 receptors?

A

Increase intracellular CA2+ release from stores by IP3

152
Q

A drug that has side effects like neuromuscular paralysis and nephrotoxicity?

A

Gentamicin

153
Q

MOA of Dopezipel

A

Anticholenesterase inhibitor

154
Q

MOA of Memantine

A

NMDA anatagonist

155
Q

Agonist at m1 m2 melatonin receptors?

156
Q

Patient addicted to a drug and developed cirrhosis and liver failure?

157
Q

Dr. Bushra wants to perform a minor surgical procedure on her patient but she wants him to remain responsive to simple commands yet in deep state of sedation and analgesia. Which combination of drugs will she use?

A. Propofol and fentanyl
B. Droperidol and fentanyl

A

B. Droperidol and fentanyl

158
Q

Choose the best chemoprophylaxis in the following case: A sibling of a 3 year old boy who developed Hemophilus meningitis

A. Penicillin
B. Rifampicin
C. Ciprofloxacin 
D. Cifotaxime 
E. Vancomysin
A

B. Rifampicin

159
Q

.Choose the best chemoprophylaxis in the following case: A husband of a 30 year old lady who developed meningococcal meningitis after her return from haj

A. Penicillin
B. Rifampicin
C. Ciprofloxacin 
D. Cifotaxime 
E. Vancomysin
A

B. Rifampicin
and
C. Ciprofloxacin

Note: In Kuwait, rifampicin is better for prophylaxis of children & ciprofloxacin is better used for adults (because they want to avoid resistance to rifampicin as it is essential for TB treatment). In our exam both were counted correct.

160
Q

Which drug can be given to reduce anxiety and relieve muscle strain?

161
Q

What are the characteristics of a drug that crosses the blood brain barrier?

A

High lipid solubility, Low molecular weight (<500 Da) , low hydrogen bonds with water

162
Q

What is the mechanism of action of morphine?

A

Inhibits AC, Opens K+ channels, Closes Ca2+ channels

163
Q

Which drug crosses the blood brain barrier and is effective in treating herpes-simplex induced encephalitis?

164
Q

What is the mechanism of action of Memantine?

A

Blocks NMDA receptor

165
Q

MOA of imipramine?

A. Serotonin and NA
B. Serotonin and DA

A

A. Serotonin and NA

166
Q

What is the imaging modality of choice for diagnosis of cerebrovascular accident?

A. MRI
B. CT
C. Skull x-ray

167
Q

EBM: Which of the following test characteristics varies with prevalence and can help you rule in a diseases?

A. Pre-test
B. Gold standard
C. NPV
D. PPV
E. Specificity
A

A. Pre-test

168
Q

EBM: Sensitivity 50%, Specificity 75%, pre-test 20%. What is the NPV?

A. 15%
B. 33%
C. 67%
D. 86%

169
Q

EBM: Time between screening and clinical diagnosis

A

Lead period

170
Q

EBM: Which characteristic of a test that when decreased increases the specificity of the test?

A. Sensitivity
B. False Positives
C. NPV
D. PPV

A

B. False Positives

CNS module - 4th year (17 decks)

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