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CNS module - 4th year > 2014 final > Flashcards

2014 final Flashcards

1
Q

A 70-year-old man presents with this visual field defect (The dark shaded areas indicate the areas of loss of visual field), what is the most likely cause?

a. Berry aneurysm
b. Meningioma
c. Prolactinoma
d. Glioma

A

c. Prolactinoma

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2
Q

A lady with a recent seizure, CT revealed a hemorrhagic left temporal lobe. CSF revealed few mononuclear cells and normal glucose. What could be the causative organism?

a. N. Meningitis
b. Herpes Simplex Virus
c. Candida Albicans

A

b. Herpes Simplex Virus

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3
Q

What causes non-communicating hydrocephalus?

a. Meningitis
b. Cerebral aqueduct stenosis
c. Hydramnios
d. Premature closure of membranes

A

b. Cerebral aqueduct stenosis

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4
Q

10% of stroke patients die before hospital assessment. How will this impact the incidence, prevalence, disability adjusted life years, and mortality of stroke?

a. Incidence will increase
b. Prevalence will increase
c. Incidence will decrease but prevalence will increase
d. Disability adjusted life years will increase
e. Mortality will decrease

A

e. Mortality will decrease

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5
Q

A young man who was recently diagnosed with schizophrenia. What will help treat his apathy and bluntness affect?

a. Olanzapine
b. Thioridazine
c. Haloperidol
d. Chlorpromazine e. Carbidopa

A

a. Olanzapine

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6
Q

Which brain structure is involved in acquiring procedural memory?

a. Amygdala
b. Basal ganglia
c. Hippocampus
d. Prefrontal cortex

A

b. Basal ganglia

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7
Q

What type of infarcts is caused by hemodynamic compromise?

a. Lacunar infarct
b. Watershed infarct
c. Hemorrhagic infarct
d. Basal ganglia infarct

A

b. Watershed infarct

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8
Q

What is required to convert all trans retinal to 11 cis retinal in the photo transduction?

a. Isomerase
b. Light
c. Vitamin A
d. Adenylate cyclase

A

a. Isomerase

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9
Q

What is the treatment for cerebral malaria?

a. I.V. quinine
b. I.V. chloroquine

A

a. I.V. quinine

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10
Q

What nerve is responsible for afferent limb of corneal reflex?

a. Ophthalmic nerve
b. Maxillary nerve
c. Mandibular nerve
d. Facial nerve

A

a. Ophthalmic nerve

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11
Q

which of the following is true about the supplementary motor area?

a. Selection of movement to external cues
b. Can control movement independent of the primary motor cortex
c. Stimulation can lead to movement in both ipsilateral and contralateral limbs

A

c. Stimulation can lead to movement in both ipsilateral and contralateral limbs

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12
Q

The blood flow to the brain is 50 ml/100g/minute. What happens to the brain tissue if the blood flow through the brain is decreased by 50%?

a. The function is lost forever
b. The electrical activity of the neurons will be lost
c. Neurons die
d. The neurons will die if the decrease in BF is maintained

A

b. The electrical activity of the neurons will be lost

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13
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

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14
Q

Which of the following thalamic nuclei is responsible for receiving temperature and pain sensation of the face?

a. Anterior nucleus
b. Lateral nucleus
c. Ventroposteriolateral nucleus
d. Ventroposteriomedial nucleus

A

d. Ventroposteriomedial nucleus

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15
Q

Which part of the hypothalamus is responsible for the cardiovascular system regulation?

a. Lateral
b. Medial
c. Periventricular
d. Dorsal

A

a. Lateral

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16
Q

There is a new diagnostic test for iron deficiency anemia with sensitivity 91% and specificity 83%. Your patient has microcytic anemia with duodenal ulcer. You estimate a pretest probability of 95%. What is the probability that the patient has IDA if the test is negative?

a. 9%
b. 67%

A

b. 67%

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17
Q

Patient in the hospital with enlargement of the central canal at the level of C3-C5. Which of the following does he most likely have?

a. Lack of pain sensation in the right side of his neck
b. Lack of pain sensation in the left side of his neck
c. Lack of pain sensation on both sides
d. Lack of proprioception in the right side
e. Lack of discriminative touch in the left

A

c. Lack of pain sensation on both sides

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18
Q

Generalized epileptic seizures result from enhanced oscillations of the thalamocortical loops. Loss of function mutation in which receptors can cause this type of epilepsy?

a. GABA receptors in excitatory thalamic neurons
b. Ach receptors of cortical neurons
c. Glutamate receptors of cortical neurons
d. Glutamate receptors of thalamic neurons

A

a. GABA receptors in excitatory thalamic neurons

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19
Q

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

A

a. Inhibition of adenylate cyclase, decreasing the production of cAMP

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20
Q

Patient HM had his both medial temporal lobes removed to treat the epileptic seizures he had. What was the consequence?

a. Inability to remember memories 10 years back
b. Inability to form new procedural memories
c. Inability to form new long-term memories

A

c. Inability to form new long-term memories

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21
Q

A brain mass beneath the dura was incidentally found in a 42 years old female. Gross examination showed whorls. On histology, it showed spindle cells with psamomma bodies. What is the diagnosis?

a. Meningioma
b. Medulloblastoma
c. Astrocytoma

A

a. Meningioma

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22
Q

Which of the following describes myelination in the central nervous system?

a. One oligodendrocyte myelinates multiple axons
b. One axon is myelinated by one oligodendrocyte
c. Multiple axons are myelinated by one Schwann
d. One Schwann cell myelinates one axon

A

a. One oligodendrocyte myelinates multiple axons

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23
Q

What does an EEG dipole represent?

a. EPSP/electrical charges in the dendrites
b. EPSP in the neuron body
c. EPSP in the axon

A

a. EPSP/electrical charges in the dendrites

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24
Q

What is the primary justification for placebo in RCT?

a. To have an unbiased randomization procedure
b. Because no proven/beneficial treatment plan for the disease being studied
c. To make the trial ethical

A

b. Because no proven/beneficial treatment plan for the disease being studied

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25
Q

Which of the following muscles are affected in ptosis of the eye?

A

Levator palpebrae superioris

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26
Q

Which of the following is the effect of tubocurarine on neurotransmission?

a. Antagonism of Ach receptors in neuromuscular junction
b. Antagonism of Ach receptors in autonomic ganglia
c. Antagonism of Ach receptors in prevertebral ganglia

A

a. Antagonism of Ach receptors in neuromuscular junction

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27
Q

What type of vaccine is Hib?

a. Conjugate
b. Polysaccharide

A

a. Conjugate

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28
Q

What causes variant Creutzfeldt Jacob disease in young?

a. Ingestion of contaminated meat
b. Ingestion of meat from a genetically modified cattle

A

a. Ingestion of contaminated meat

29
Q

What is the cause of amyloid deposition in Alzheimer’s disease according to amyloid hypothesis?

a. Abnormal protease activity
b. Misfolded myelin basic protein

A

a. Abnormal protease activity

30
Q

Which of the following causes feedback inhibition of granule cells?

a. Activation of basket and stellate cells
b. Stimulation of golgi cells by mossy fibers
c. Activation of golgi cells by parallel fibers

A

c. Activation of golgi cells by parallel fibers

31
Q

A patient known to have sickle cell anemia developed nuchal rigidity, fever and headache. CSF gram staining showed gram positive diplococci. What the treatment plan?

a. Vancomycin
b. Penicillin
c. Vancomycin and cefotaxime

A

c. Vancomycin and cefotaxime

32
Q

An elderly patient had an injection of methylprednisolone for his chronic back pain. Later on, he developed meningitis. Examination of CSF showed dematiaceous fungi with pigmented hypha. What is the causative organism?

a. Candida albicans
b. Cryptococcus neoformans
c. Cladophialophora bantiana
d. Rhozipus
e. Exserohilum Rostratum

A

e. Exserohilum Rostratum

33
Q

A patient had neck stiffness, fever, and headache. He was confirmed to have N. Meningitides meningitis. Which of the following is an effective infection control method?

a. Negative pressure room
b. Positive pressure room
c. Contact caution

A

a. Negative pressure room

34
Q

A patient with aphasia died and autopsy showed prominent knife edge gyri and frontal and temporal lobes atrophied. On microscopic examination, neurons had positive tau stain. What is the diagnosis?

A

Pick disease

35
Q

What is the most likely cause of damage to the anterior vermis of cerebellum?

a. Tumor
b. Alcohol abuse

A

b. Alcohol abuse

36
Q

What is responsible for central sensitization of pain?

a. GABA
b. Glycine
c. NMDA and NK1

A

c. NMDA and NK1

37
Q

In the flexor reflex, what is responsible for the inhibition of the contralateral flexor muscle?

a. Direct innervation of the alpha motor neuron by the afferent fiber
b. Afferent fiber activating an inhibitory interneuron

A

b. Afferent fiber activating an inhibitory interneuron

38
Q

Part of thalamus receiving pain and temperature from lower limbs?

a. VPM nucleus
b. Anterior nucleus
c. VPL nucleus

A

c. VPL nucleus

39
Q

Part of thalamus receiving input from mammillary bodies?

a. VPL nucleus
b. VPM nucleus
c. Anterior nucleus

A

c. Anterior nucleus

40
Q

Accumulation of which protein causes Creutzfeldt Jacob disease?

a. PrPc
b. PrPsc

A

b. PrPsc

41
Q

Changes in which protein’s secondary structure causes it to become infectious?

a. PrPc
b. PrPsc

A

a. PrPc

42
Q

Injury leading to medial deviation of the eye:

a. Abducent
b. Supraorbital
c. Infraorbital
d. Lacrimal
e. Frontal
f. Oculomotor
g. Trochlear

A

a. Abducent

43
Q

Efferent fibers for pupillary reflex:

a. Abducent
b. Supraorbital
c. Infraorbital
d. Lacrimal
e. Frontal
f. Oculomotor
g. Trochlear

A

f. Oculomotor

44
Q

Which structure is separated from the lentiform nucleus by the external capsule?

a. Putamen
b. Caudate
c. Indirect pathway
d. Direct pathway
e. Substantia nigra
f. Subthalamic nucleus
g. Claustrum

A

g. Claustrum

in our exam in our exam it was written as “what separates the lentiform nucleus from the external capsule?

45
Q

A 9-year-old boy presented with 1-week history of headache with vomiting and ataxia. CT showed a 4 cm mass in the cerebellar vermis and dilated ventricles. Histological examination found small, round blue cells. What is the diagnosis?

a. Pilocytic astrocytoma
b. Oligodendroglioma
c. Medulloblastoma

A

c. Medulloblastoma

46
Q

Excessive cortical excitotoxicity that kills the striatal neurons that innervate both direct and indirect pathways.

a. Akinesia
b. Bradykinesia
c. Dyskinesia
d. Hemiballismus
e. Rigidity
f. Chorea

A

a. Akinesia

47
Q

Contraction of both flexor and extensor muscles.

a. Akinesia
b. Bradykinesia
c. Dyskinesia
d. Hemiballismus
e. Rigidity
f. Chorea

A

e. Rigidity

48
Q

A 14-day old infant had irritability, fever and nuchal rigidity. His mother claimed to have flu-like symptoms before delivery. What is the causative organism?

a. E.coli
b. Listeria monocytogenes

A

b. Listeria monocytogenes

49
Q

A young child with stiff neck, photophobia, and purpuric rash. Lumbar puncture revealed gram negative diplococci. What is the causative organism?

a. Hemophilus influenzae b
b. N. Meningitidis
c. M.TB
d. S. Pneumonia

A

b. N. Meningitidis

50
Q

Which of the following is a drug that prevents the metabolism of levodopa to 3-o-methyldopa?

a. Selegiline
b. Benserazide
c. Entacapone

A

c. Entacapone

51
Q

A precursor of dopamine that crosses the blood brain barrier?

a. Levodopa
b. Domperidone
c. Carbidopa

A

a. Levodopa

52
Q

What drug decreases the peripheral side effects of levodopa?

A

Carbidopa

53
Q

Thrombosis of which artery leads to infarction of primary sensory cortex?

a. MCA
b. PCA
c. ACA

A

a. MCA

54
Q

How do touch receptors cause neurotransmission?

a. Activation of voltage gated Na channels
b. Increased Cl- entry into the cell
c. Stretch sensitive channels

A

c. Stretch sensitive channels

55
Q

Vasoconstriction, shivering, and increase in thyroxin are caused by the activation of which nucleus?

a. Anterior nucleus of hypothalamus
b. Preoptic nucleus of hypothalamus
c. Posterior nucleus of hypothalamus

A

c. Posterior nucleus of hypothalamus

56
Q

A patient has low frequency tremor and rigidity. Damage to which structure is the cause?

a. Subthalamic nucleus
b. Substantia nigra
c. Caudate nucleus

A

b. Substantia nigra

57
Q

Demyelinating process resulting in accumulation of plaques that stain brown with toluidine blue stain?

a. Krabbe disease
b. Metachromatic leukodystrophy

A

b. Metachromatic leukodystrophy

58
Q

Demyelination process occurring as a result of rapid osmotic correction of hyponatremia?

a. Krabbe disease
b. Metachromatic leukodystrophy
c. Multiple sclerosis
d. Central pontine myelinolysis

A

d. Central pontine myelinolysis

59
Q

Which receptor is responsible for serotonin excitatory action?

a. 5-HT1 receptor
b. 5-HT2 receptor
c. 5-HT3 receptor
d. 5-HT4 receptor

A

c. 5-HT3 receptor

60
Q

Degeneration of inferior olivary nucleus causes the degeneration of which fibers?

a. Climbing fibers
b. Mossy fibers

A

a. Climbing fibers

61
Q

A child with a tumor in the posterior cerebral fossa. The tumor was friable and had cystic spaces. Microscopic examination showed Rosenthal fibers.

A

Pilocytic astrocytoma

62
Q

What is the origin of the cochlear nerve?

A

Spiral ganglion

63
Q

Where is the foot plate of stapes located?

A

Oval window

64
Q
  1. What artery is affected if a patient presents with left face paralysis, left loss of sensation of face, and right loss of sensation of rest of the body?

a. Anterior spinal artery
b. Posterior spinal artery
c. Left posterior cerebral artery
d. Left superior cerebellar artery
e. Basilar artery
f. Right posterior inferior cerebellar artery
g. Left posterior inferior cerebellar artery
h. Left anterior inferior cerebellar artery

A

h. Left anterior inferior cerebellar artery

65
Q

What artery is affected in a patient who has spastic paralysis of the right side of his body, loss of proprioception on the right side, and deviation of the tongue to the right side?

a. Anterior spinal artery
b. Posterior spinal artery
c. Left posterior cerebral artery
d. Left superior cerebellar artery
e. Basilar artery
f. Right posterior inferior cerebellar artery
g. Left posterior inferior cerebellar artery
h. Left anterior inferior cerebellar artery

A

a. Anterior spinal artery

66
Q

What drug is used to treat muscle spasms in patients with multiple sclerosis and cerebral palsy?

A

Diazepam

67
Q

Simple spikes of purkinji fibers.

a. Repetitive stimulation of climbing fibers
b. Repetitive stimulation of mossy fibers
c. Action potentials spreading through parallel fibers
d. Action potential of purkinji cells

A

B/C (check)

b. Repetitive stimulation of mossy fibers
c. Action potentials spreading through parallel fibers

68
Q

Inhibition of deep cerebellar nuclei.

a. Repetitive stimulation of climbing fibers
b. Repetitive stimulation of mossy fibers
c. Action potentials spreading through parallel fibers
d. Action potential of purkinji cells

A

d. Action potential of purkinji cells

69
Q

Long-term depression between parallel fibers & purkinji cells

a. Repetitive stimulation of climbing fibers
b. Repetitive stimulation of mossy fibers
c. Action potentials spreading through parallel fibers
d. Action potential of purkinji cells

A

a. Repetitive stimulation of climbing fibers

CNS module - 4th year (17 decks)

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