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CNS module - 4th year > 2015 final > Flashcards

2015 final Flashcards

1
Q

Where is the most likely problem located according to the audiogram on the right?

A. Middle ear
B. Auditory nerve
C. Organ of corti
D. Inner hair cells

A

A. Middle ear

(We did not take audiograms but this is an example of conductive hearing loss where bone conduction is longer than air conduction, but even if you don’t know how to interpret it B, C, and D are all examples of sensorineural hearing loss and are impossible to differentiate through just an audiogram so the most likely answer is A)

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2
Q

Patient with a stroke (UMN lesion) what will he present with within 24 hrs?

A. Hyperreflexia, spastic paralysis, hypertonia
B. Hypotonia, hyporeflexia, flaccid paralysis

A

B. Hypotonia, hyporeflexia, flaccid paralysis (The concept is that in UMN lesions the body first undergoes a state of spinal shock and the UMN lesion symptoms would develop after a week or so)

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3
Q

Where are the temporo-pontine fibers located in the midbrain?

A. Lateral1/6 of the crus cerebri
B. Medial2/3 of the crus cerebri
C. Medial1/6 of the crus

A

A. Lateral1/6 of the crus cerebri

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4
Q

Proliferation of which cell is needed for peripheral nerve regeneration?

A. Macrophages
B. Schwanncell
C. Microglialcell
D. Fibroblast

A

B. Schwanncell

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5
Q

What two veins form the great cerebral vein?

A

Right internal cerebral and left internal cerebral vein

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6
Q

Where do axons of cerebellar granule cells originate from?

A. Mossyfibers
B. Parallelfibers

A

B. Parallelfibers

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7
Q

Main output of the cerebellum?

A

Deep cerebellar nuclei

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8
Q

Lesion in which nucleus causes loss of abduction of the eye?

A. Oculomotor
B. Abducent

A

B. Abducent

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9
Q

When you pick up a cup, what is the function of the premotor area?

A

Selection of the muscles needed for movement

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10
Q

Why is it possible for a skilled tennis player to accurately hit and return a fast flying tennis ball?

A. Short reaction time due to training
B. Cerebellar integration of occipital and visual stimuli
C. Integration of visual, mechanoreceptor and vestibular via feedback
D. Path of the flying ball is pre-calculated by feedforward mechanisms

A

D. Path of the flying ball is pre-calculated by feedforward mechanisms

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11
Q

Autoregulation is a mechanism that maintains cerebral blood flow more or less constant despite large variation in the mean arterial blood pressure. Which blood vessels play a key role in this mechanism?

A. Carotidarteries
B. Pialarteries
C. Penetratingarteries
D. Parenchymal arterioles

A

B. Pialarteries

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12
Q

Which of the following is true about long term potentiation?

A. Opening of AMPA receptors triggers calcium influx and phosphorylation and activation
of kinases
B. Removal of the Mg+2 block on pre-synapse
C. Opening of NMDA receptors triggers an IPSP
D. Trafficking of more AMPA receptors to the post synaptic membrane because of
calcium influx

A

D. Trafficking of more AMPA receptors to the post synaptic membrane because of
calcium influx

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13
Q

A person went into a cold room and shivered within few minutes, what’s responsible for the thermoregulation

A. Activation of the peripheral receptors of the skin
B. Activation of core body receptors
C. Increased input to anterior nuclei
D. Change in the blood temperature in the lateral hypothalamus

A

A. Activation of the peripheral receptors of the skin

A, B, and C could all be correct if the patient stayed for a long time for the blood to change its temperature

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14
Q

In cross extensor reflex, to which neuron the afferent alpha neuron will synapse with in the extensor muscle?

A. Excitatoryinterneuron
B. Inhibitoryinterneuron
C. Gammaneuron
D. 1B sensory afferent neuron

A

A. Excitatoryinterneuron

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15
Q

We can differentiate between different frequencies of voices; what structure helps us to do so?

A. Innerhaircells
B. Outerhaircells
C. Basilar membrane
D. Neurons of the spiral ganglion

A

C. Basilar membrane

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16
Q

What is the consequence of a strong input from mossy fibers to the cerebellar cortex? (Zoran note cerebellar circuit)

A

Enabling error correction

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17
Q

What occurs if the “reticular activating system” is damaged completely?

A. Spasticity arms extended
B. Spasticity arms flexed
C. Deep coma

A

C. Deep coma

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18
Q

What precipitates seizures?

A

Decreased GABA from reticular nucleus

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19
Q

What is observed in polio disease?

A. Hyporeflexia, sensory loss in leg, weakness
B. Hyporeflexia in arm not in the leg
C. Hyporeflexia, hypotonia, muscle wasting

A

C. Hyporeflexia, hypotonia, muscle wasting

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20
Q

What occurs because of segmental demyelination?

A

Muscle weakness and decreased deep tendon reflexes

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21
Q

Defect in which step of phototransduction will result in Leber congenital amaurosis (LCA)?

A

Regeneration of 11-cis retinal

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22
Q

What is a characteristic of myelin membrane?

A. Contain specific basic protein
B. Low content of cholesterol
C. Has very low phosphatidylserine
D. Glycosphingolipids are absent

A

A. Contain specific basic protein

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23
Q

What nuclear medicine study is useful to evaluate a patient with cerebral ischemia and if he is at risk of developing stroke?

A. F18 deoxyglucose PET
B. Tc99m HMPAO brain SPECT
C. Tc99m HMPAO brain SPECT with acetazolamide
D. 015 water brain PET with calculation of oxygen extraction

A

C. Tc99m HMPAO brain SPECT with acetazolamide

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24
Q

Which fungal organism most likely to cause meningitis in people with AIDS? A. pneumocystis jiroveci

A

Cryptococcus neoformans

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25
Q

Hereditary spastic paraplegia is a heterogeneous neurological disorder cause by genetic mutations. Which of the following pathways is affected in this disorder?

A

Axoplasmic transport

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26
Q

What is the gross morphological finding in diffuse axonal injury?

A. Edema
B. Petechial hemorrhage

A

B. Petechial hemorrhage

27
Q

What is a part of the auditory system?

A. Medial lemniscus
B. Lateral lemniscus

A

B. Lateral lemniscus

28
Q

What do we mean by vision of 20/100?
A. You can see something at 20 feet that someone with normal eyes can see at 100 feet
B. 20 out of 100 people have this disease

A

A. You can see something at 20 feet that someone with normal eyes can see at 100 feet

29
Q

What is the mechanism of action of ropinirole?

A. Dopamine agonist
B. increases dopamine release

A

A. Dopamine agonist

30
Q

What decreases the peripheral side effects of levodopa (arrhythmias)?

A. Carbidopa
B. Benztropine

A

A. Carbidopa

31
Q

A male with a BP of 192/60 presented with right sided whole-body weakness and severe headache?

A. Intracerebral hemorrhage
B. SAH

A

A. Intracerebral hemorrhage

32
Q

A 60-year-old male presented with sudden onset of grand mal seizure, CT of head showed sharply defined lesion, non-enhanced, at the junction of the grey and white matter located in the parietal and frontal lobe, what is the disease?

A. cysticercosis
B. metastasis

A

B. metastasis

33
Q

What is the molecule that is found to be highly phosphorylated in Alzheimer’s disease?

A. Tau
B. AB
C. APP

A

A. Tau

34
Q

Through which part of the internal capsule does the cortico-nuclear fibers pass through?

A. Posterior limb
B. Genu
C. Anterior limb

A

B. Genu

35
Q

A question about +ve Babinski sign (because he suffered from a massive superolateral infarct/hemorrhage):

A

Extension, up going big toe with fanning of the little toes

36
Q

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

A

Negative pressure room

37
Q

Patient presented with involuntary movements of limbs and chorea, what protein is most likely to be affected

A

HHT (huntingtin)

38
Q

Which drug inhibits the reuptake of GABA

A

Tiagabine

39
Q

Second generation antipsychotics are preferred over 1st generation, why is that?

A

Less likely to cause extra pyramidal symptoms

40
Q

Male had 180/90 BP with right sided weakness of the whole body and severe headache, what’s the cause?

A. Sub arachnoid hemorrhage
B. Intracerebral hemorrhage

A

B. Intracerebral hemorrhage

41
Q

Patient presented with ptosis & constricted eye pupils “bilateral”, what is the diagnosis?

A. 3rd nerve palsy
B. Myasthenia gravis
C. Horner syndrome

A

C. Horner syndrome

42
Q

Rupture is involved with subdural hematoma

A. Posterior cerebral artery 
B. anterior cerebral artery 
C. middle cerebral artery 
D. superior cerebral vein 
E. middle cerebral vein
A

D. superior cerebral vein

43
Q

Supplies the wall of the calcarine sulcus

A. Posterior cerebral artery 
B. anterior cerebral artery 
C. middle cerebral artery 
D. superior cerebral vein 
E. middle cerebral vein
A

A. Posterior cerebral artery

44
Q

Fibers from the thalamus to post central gyrus

A. Optic radiation
B. Auditory radiation
C. Fasiculus subthalamicus
D. Fasiculus lenticularis
E. posterior limb of internal capsule
F. corticospinal fibers
A

E. posterior limb of internal capsule

45
Q

Fibers from the medial geniculate nucleus to the superior temporal gyrus

A. Optic radiation
B. Auditory radiation
C. Fasiculus subthalamicus
D. Fasiculus lenticularis
E. posterior limb of internal capsule
F. corticospinal fibers
A

B. Auditory radiation

46
Q

16-year-old patient with meningitis. CSF showed gram negative diplococci

A. Neisseria meningitides 
B. E. coli
C. Listeria monocytogenes 
D. Herpes simplex
E. Streptococcus pneumoniae 
F. Mycobacterium tuberculosis
G. Haemophilus influenzae
H. Enterococcus faecalis
A

A. Neisseria meningitides

47
Q

14-week-old neonate diagnosed with meningitis. CSF showed gram negative bacilli

A. Neisseria meningitides 
B. E. coli
C. Listeria monocytogenes 
D. Herpes simplex
E. Streptococcus pneumoniae 
F. Mycobacterium tuberculosis
G. Haemophilus influenzae
H. Enterococcus faecalis
A

B. E. coli

48
Q

Forms the CSF

A. Capillary endothelial choroidal cells
B. choroidal cells
C. tight junctions between capillary endothelial cells 
D. ependymal cells
E. capillary endothelial cells
A

B. choroidal cells

49
Q

Forms the Blood brain barrier

A. Capillary endothelial choroidal cells
B. choroidal cells
C. tight junctions between capillary endothelial cells 
D. ependymal cells
E. capillary endothelial cells
A

C. tight junctions between capillary endothelial cells

50
Q

Changes to its structure causes Creutzfeldt Jacob disease

A. PrPc
B. PrPsc

A

A. PrPc

51
Q

Changes in the secondary structure causes it to be infectious

A. PrPc
B. PrPsc

A

B. PrPsc

52
Q

Involves NMDA receptors

A. Increase in ISF CO2
B. Increase in ISF O2
C. Nitric oxide release by neurons
D. metabotropic receptors on astrocytes (increase in arachidonic acid metabolites)

A

C. Nitric oxide release by neurons

53
Q

Long-term (prolonged blood flow) response to increase blood flow

A. Increase in ISF CO2
B. Increase in ISF O2
C. Nitric oxide release by neurons
D. metabotropic receptors on astrocytes (increase in arachidonic acid metabolites)

A

D. metabotropic receptors on astrocytes (increase in arachidonic acid metabolites)

54
Q

low blood flow to neurons

A. Increase in ISF CO2
B. Increase in ISF O2
C. Nitric oxide release by neurons
D. metabotropic receptors on astrocytes (increase in arachidonic acid metabolites)

A

A. Increase in ISF CO2

55
Q

Patient when attempting to look laterally, one eye fails to adduct, the other has nystagmus, what is the condition?

A

Internuclear opthalmoplegia

56
Q

Patient has increased intracranial pressure, fundoscopy showed swelling of the optic disc of both eyes?

A

papilledema

57
Q

what receptors are stimulated by strong pressure

A. Ruffiniendorgan
B. Golgitendon
C. Merkel’sdisc
D. Freenerveendings
E. Musclespindle
F. T actile hair receptors
G. Meisner’s corpuscle
A

D. Freenerveendings

58
Q

what is located between collagen fibers

A. Ruffiniendorgan
B. Golgitendon
C. Merkel’sdisc
D. Freenerveendings
E. Musclespindle
F. T actile hair receptors
G. Meisner’s corpuscle
A

B. Golgitendon

59
Q

involved in grip modulation

A. Ruffiniendorgan
B. Golgitendon
C. Merkel’sdisc
D. Freenerveendings
E. Musclespindle
F. T actile hair receptors
G. Meisner’s corpuscle
A

A. Ruffiniendorgan

60
Q

which cell proliferates in long term brain tissue gliosis?

A

Astrocytes

61
Q

What is the pathophysiology of lateral medullary syndrome (Wallenberg)?

A

Obstruction of the vertebral artery

PICA would also be true but it was not there

62
Q

What is the most likely immune response that occurs with multiple sclerosis

A

Demyelination and destruction of oligodendrocytes + gliosis by astrocyte

63
Q

What opioid has less GI and respiratory effects?

A. pethidine
B. Tramadol

A

B. Tramadol

CNS module - 4th year (17 decks)

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