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CNS module - 4th year > 2016 module exam > Flashcards

2016 module exam Flashcards

1
Q

What cells are responsible for this type of vision?

  1. Narrow amacrine cells
  2. Ganglion cells
  3. Wide-field amacrine cells
  4. Medium-field amacrine cells
A
  1. Wide-field amacrine cells
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2
Q

What nerve if affected causes ptosis?

a. II
b. III
c. IV
d. V

A

b. III

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3
Q

Compression of which of the following nerves will lead to slow papillary response to light?

a. II
b. III
c. V
d. VI

A

?

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4
Q

Where is the facial nerve taste nucleus?

  1. Nucleus ambiguous
  2. Nucleus tractus solitarius
  3. Superior salivatory nucleus
  4. Inferior salivatory nucleus
A
  1. Nucleus tractus solitarius
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5
Q

What are the main afferent projections from midbrain to striatum?

  1. Nigrostriatal
  2. Striatonigral
  3. Pallidotegmental
  4. Thalamostriate
A
  1. Nigrostriatal
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6
Q

A patient fails to name objects. Which cortical lesion is likely to be affected?

  1. Supramarginal
  2. Superior temporal gyrus
  3. Post-central gyrus
  4. Cingulum
A

?

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7
Q

What connects the two temporal temporal lobes

  1. Anterior commissure
  2. Posterior commissure
  3. Forcips major
  4. Forcips minor
A
  1. Anterior commissure
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8
Q

What connects the pretectal nuclei?

  1. Anterior commissure
  2. Posterior commissure
  3. Forcips major
  4. Forcips minor
A
  1. Posterior commissure
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9
Q

A patient has vertical diplopia when going downstairs and he tilts his head to the opposite side to avoid diplopia

  1. Lacteral rectus
  2. Inferior oblique
  3. Medial rectus
  4. Superior oblique
A
  1. Superior oblique
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10
Q

What kind of fibers connect the right cerebral hemisphere with the left cerebellar hemisphere?

  1. Pons
  2. Superior cerebellar decussation
  3. Midbrain
A
  1. Pons
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11
Q

What can be a source of energy when the brain is ischemic?

  1. Monosaccarides
  2. Glycerides
  3. Fatty acids
  4. Ketone bodies
A
  1. Ketone bodies
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12
Q

What characterizes the structure of myelin?

a. High lipid to protein ratio
b. Low cholesterol
c. Myelin specific lipids

A

a. High lipid to protein ratio

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13
Q

What causes leber’s congenital amaurosis?

A

RPE isomerase

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14
Q

A 66 year old patient came to the casualty with acute left-sided weakness and numbness. He hast hypertension and he is a heavy smoker. He was diagnosed with TIA. How long do TIA symptoms usually last?

a. Less than 5 minutes
b. 5-20 minutes
c. 30-60 minutes
d. 60-120 minutes
e. More than 24 hours

A

?

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15
Q

A 21 year old presented at the neurology clinic with hand numbness and he was diagnosed with
carpal tunnel syndrome. What best describes carpal tunnel syndrome?

a. Mononeuropothy
b. Polyneuropathy
c. Neuronopathy
d. Reticulopathy

A

a. Mononeuropothy

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16
Q

What is the best imaging modality to diagnose space occupying lesions?

a. MRI
b. CT
c. Ultrasound d. X-ray

A

a. MRI

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17
Q

Which of the following types of decreased memory causes is reversible?

  1. Alzheimer’s
  2. Lewy body dementia
  3. Depression
  4. Fronto-temporal dementia
  5. Parkinson’s disease
A
  1. Depression
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18
Q

What is the pathophysiological effect of a lesion in area 2 of sensory cortex?

  1. A deficit in tactile ability when the eyes are closed
  2. Inability to distinguish the shapes when holding with hands
  3. Loss of proprioception
  4. Loss of thermal sensation and pain
A

?

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19
Q

Which drug is used exclusively for absence seizures?

a. Ethosuxemide
b. Carbamazepine

A

a. Ethosuxemide

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20
Q

A 71 year-old with a history of head trauma had sodium concentration corrections using I.V fluid
but then she became blunted. What is the cause?

A

Central pontine myelinosis

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21
Q

Which drug combination produces leptoanalgesia?

A

Droperidol-fentanyl

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22
Q

A 24 year old man was involved in a car accident and has been awake but without awareness to the environment and no purposeful movements. He has been like that for 2 months.

a. Persistent vegetative state
b. Permanent vegetative sate
c. Minimally conscious state +
d. Minimally conscious state –

A

a. Persistent vegetative state

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23
Q

What is the mechanism of the analgesic effect on morphine?

  1. Adenylate cyclase: inhibited
    K+ conduction: Activated
    Ca conduction: inhibited

2.
Adenylate cyclase: inhibited
K+ conduction: inhibited
Ca conduction: inhibited

3.
Adenylate cyclase: Activated
K+ conduction: Activated
Ca conduction: Activated

4.
Adenylate cyclase: Activated
K+ conduction: inhibited
Ca conduction: inhibited

A
  1. Adenylate cyclase: inhibited
    K+ conduction: Activated
    Ca conduction: inhibited
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24
Q

In case of sub-threshold stimulation of the right supplementary motor area, what will happen?

  1. Movement of the right hand distal to the wrist
  2. Complex bilateral movements of the hands
  3. Urge to move the hand without motor output
A
  1. Urge to move the hand without motor output
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25
Q

What is the mechanism of action of the antidepressant citalopram?

A

Selective Rerotonin Re-uptake Inhibition

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26
Q

A 75 year old man is seen with symptoms of meningitis. CSF revealed many neutrophils and gram positive bacilli. What is the organism?

A

Listeria Monocytogenes

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27
Q

A 64 year-old man visited the clinic to follow up his Parkinson’s disease. Which of the following
is characteristic of idiopathic Parkinson’s disease?

a. Early dementia
b. Early visual hallucinations
c. Early resting tremors
d. Early falling

A

c. Early resting tremors

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28
Q

A 35 year-old female fell while riding a bike and had a head injury. She had headache and
confusion. CT showed hemorrhage in extradural space. What blood vessel was injured?

a. Middle cerebral artery
b. Middle meningeal artery
c. Basilar artery

A

b. Middle meningeal artery

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29
Q

A patient with right sided hemiparesis. What sign helps to localize the lesion in the brainstem?

a. Increased tone in the right side
b. Positive babinski sign in right side
c. Hyper-reflexes in the right side
d. Facial muscle weakness on the left side

A

d. Facial muscle weakness on the left side

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30
Q

What is true regarding haloperidol?

A

Increased extrapyramidal tract symptoms due to high potency

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31
Q

A person with Shwannoma, which protein is mutated in Neurofibromatosis 2.

A

Merlin

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32
Q

Patient presented with paralysis of the right side of the body with altered sensation of the right side of the body. The cranial nerves are normal. Where do you expect the lesion?

a. Left motor cortex
b. Genu of left internal capsule
c. Posterior limb of left internal capsule
d. Right corticospinal of upper cervical spinal cord

A

c. Posterior limb of left internal capsule

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33
Q

A 25 year old previously healthy female presented with an acute onset of confusion followed by a seizure. CT scan of her head showed hemorrhage of temporal lobe. CSF showed high mononuclear cells. Glucose and protein levels were normal.

A

Herpes simplex virus

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34
Q

A premature child developed fever, behavioral changes, and bulging fontanellae after three days of traumatic birth. CSF shows gram negative bacilli. What could the organism be?

a. Neiserria meningitidis
b. Listeria monocytogenes
c. Escherischia coli

A

c. Escherischia coli

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35
Q

What is the target of DAT scan, which differentiates between essential tremor and Parkinson’s tremor?

a. Vesicular monoamine transporter 2
b. Presynaptic dopamine plasmalemmal re-uptake transporter

A

b. Presynaptic dopamine plasmalemmal re-uptake transporter

36
Q

A patient presents with high grade fever, vomiting, and neck stiffness. What is the most likely finding in CSF analysis.

  1. Low lymphocytes
  2. High neutrophils
  3. Low protein
  4. High glucose
A
  1. High neutrophils
37
Q

What is the “labelled line” theory

A

receptor transports information to a certain area of the cortex

38
Q

What protein becomes hyperphosphorylated and forms tangles in Alzheimer’s disease?

  1. Beta amyloid
  2. APP
  3. Tau
  4. Beta secretase
39
Q

Which of these symptoms is found on Tourette’s syndrome?

a. Continues during sleep
b. Can be suppressed voluntarily
c. Hypokinesia

A

b. Can be suppressed voluntarily

40
Q

What is the pathophysiology of transient visual disturbance in MS after exercise, which is known as Uhthoff’s phenomenon?

a. Increased metabolism of toxins in the circulation
b. Decreased nerve conduction velocity due to hyperthermia
c. Decreased perfusion to visual cortex

A

b. Decreased nerve conduction velocity due to hyperthermia

41
Q

How does NAMDA receptor activation initiate central sensitization

a. Increased intracellular calcium through activation of adenylate cyclase b. decrease intracellular calcium through inhibition of adenylate cyclase c. Increased calcium entry through linked receptors
d. decreased calcium entry through linked receptors

A

c. Increased calcium entry through linked receptors

42
Q

What forms the EEG signal?

a. Axons of thalamic neurons
b. Axons of cortical neurons
c. PSP of thalamic dendrites
d. PSP of cortical dendrites

A

d. PSP of cortical dendrites

43
Q

How is enterovirus transmitted?

a. Airborne
b. Mosquito bite
c. Contact with infected Stool

A

c. Contact with infected Stool

44
Q

A person had a car accident with a cervical spinal cord injury and developed right-sided hemiparesis. What is the cause?

a. Lesion in inpsilateral corticospinal tract
b. Lesion in the contralateral corticospinal tract

A

b. Lesion in the contralateral corticospinal tract

45
Q

Symptoms of loss of function of the inhibitory reticular area

a. Increased blood pressure
b. High cortical excitability
c. Increased muscle tone

A

c. Increased muscle tone

46
Q

The effect of administration of high doses of beta 1 antagonists of autoregulation on the
cerebral blood flow

a. Loss of autoregulation
b. No effect on autoregulation
c. lowering the upper limb of autoregulation
d. Lowering the lower limb of autoregulation

47
Q

An elderly man had a stroke due to a block in Left ACA. Which of the following manifestations will likely be present

a. Loss of sensation on the left lower limb
b. Loss of sensation on the right lower limb
c. Speech difficulty

A

b. Loss of sensation on the right lower limb

48
Q

A 66 year old hypertensive woman with sudden onset of left sided weakness and a speech problem, weakness of lower face and inability to name objects. What is the diagnosis?

  1. Complex partial seizure
  2. Complex migraine
  3. Ischemic stroke
  4. Multiple sclerosis
A
  1. Ischemic stroke
49
Q

What is the mechanism of procaine, a local anesthetic?

  1. Block Na channels
  2. Block K channels
  3. Block Ca channels
A
  1. Block Na channels
50
Q

A drug that causes blurred vision, dry mouth, and urinary retention

a. Imipramine
b. Phenelzine

A

a. Imipramine

51
Q

A patient arrived dead to the hospital. What do you expect to see in his postmortem autopsy?

a. Saccular aneurysm
b. Cysts

A

a. Saccular aneurysm

52
Q

A 66 year old woman complains of memory loss. She often forgets where she puts her keys. She lives independently and needs no help. Her condition doesn’t affect her daily life.

a. Alzheimer’s disease
b. Minimal cognitive impairment

A

b. Minimal cognitive impairment

53
Q

A 30 year old pregnant woman delivered a stillborn at the 28th week. Her previous pregnancies were normal. Autopsy of the brain showed perivascular necrosis and dystrophic calcifications.

a. Toxoplasma
b. Streptococcus B
c. Candida
d. Treponema pallidum

A

a. Toxoplasma

54
Q

Define the abnormal:

1.
Deviate from traditional norm: YES
deviate from statistic norm: YES
maladaptive: YES
feel distressed: YES
2.
Deviate from traditional norm: NO
deviate from statistic norm: YES
maladaptive: YES
feel distressed: YES
3.
Deviate from traditional norm: YES
deviate from statistic norm: YES
maladaptive: NO
feel distressed: YES
4.
Deviate from traditional norm: YES
deviate from statistic norm: NO
maladaptive: YES
feel distressed: YES
5.
Deviate from traditional norm: YES
deviate from statistic norm: YES
maladaptive: YES
feel distressed: NO
A 
1.
Deviate from traditional norm: YES
deviate from statistic norm: YES
maladaptive: YES
feel distressed: YES
55
Q

In an ischemic stroke in MCA.

a. Positive babinski
b. Positive brudnizki sign
c. Positive kurnig’s sign

A

a. Positive babinski

56
Q

Which muscle is responsible for corneal reflex?

A

Orbicularis oculi

57
Q

A case about a Lesion separated in time and space (defects in multiple areas of the body)

58
Q

A patient with transient ischemic attack. What investigation to use?

A

Acetazolamide (Diamox) Test

59
Q

Which of the following crosses at the level of the inferior colliculus?

a. Dentothalamic
b. Rubrospinal

A

a. Dentothalamic

60
Q

Post mortem examination of patient with Parkinson’s disease. What is found?

A

Lewy bodies

61
Q

What general anesthetic can cause malignant hyperthermia?

62
Q

Eating salty food will lead to:

A

Increased Na gradient across the membrane

63
Q

What is the location of parasympathetic preganglionic fibers of the occulomotor nerve?

A

Edenger-Westphal nucleus

64
Q

Ultrasound examination of a pregnant women at 2nd trimester shows a defected superior end of the neural tube continuous with the amniotic fluid.

a. Macrocephaly
b. Microcephaly
c. Schiezencephaly
d. Anencephaly

A

d. Anencephaly

65
Q

A damage to the lateral area of the motor cortex will affect what?

a. Movement of legs
b. Chewing and vocalization

A

b. Chewing and vocalization

66
Q

Parasympathetic action antagonized by sympathetic action

  1. Constriction/dilation of the pupil
  2. Micturition
  3. Salivation
  4. Blood vessels
67
Q

prolongs REM sleep?

  1. GABA inhibition of locus coeruleus
  2. Noradrenegic effect of cholinergic locus coeruleus
68
Q

happens to the cerebellum when basket and stellate cells are knocked out?

  1. Diffuse purkinje stimulation by mossy fibers
  2. Long depolarization of purkinje cells by parallel fibers
A
  1. Diffuse purkinje stimulation by mossy fibers
69
Q

In ischemic brain damage in the 2nd week. What changes would be seen?

a. Neutrophils
b. Macrophages

A

b. Macrophages

70
Q

What is the function of reticular nucleus?

a. Modulate the signal between the thalamus and the cortex
b. Reduce arousal

A

a. Modulate the signal between the thalamus and the cortex

71
Q

Injury to the neck leading to droopy shoulder and head tilt. Which nerve is affected?

a. X
b. XI
c. IX
d. V
e. VI

72
Q

A patient presents with headache, fever, neck stiffness, and photophobia. What is the best investigation?

a. Blood culture
b. MRI
c. CSF sample

A

c. CSF sample

73
Q

What indicates the beginning of a seizure?

A

Disappearance of the after-hyperpolarization from the paroxysmal depolarization shift

74
Q

What is the effect produced by the gamma motor neurons?

a. Contraction of the polar part of the muscle spindle
b. Increased firing of the sensory Ia fibers

A

b. Increased firing of the sensory Ia fibers

75
Q

A person lost 1 liter of blood, after which he felt thirsty. What is the reason?

a. Hypothalamic osmoreceptors
b. Blood vessel baroreceptors

A

b. Blood vessel baroreceptors

76
Q

What occurs as a result of bilateral removal of amygdala?

a. Inability to co-relate new memory with emotions
b. Retrograde amnesia

A

a. Inability to co-relate new memory with emotions

77
Q

Found medial to the thalamus in the lateral wall of the lateral ventricle?

a. Striae medullaris
b. Striae terminalis
c. Anterior commissure

A

b. Striae terminalis

78
Q

Papez circuit includes which structure?

a. Amygdala and hippocampus
b. Entorhinal cortex and Hippocampus

A

b. Entorhinal cortex and Hippocampus

79
Q

A patient had a trauma, after which there was no deep tendon reflexes. Two weeks later hypertonia and hyperreflexia developed. What is the lesion?

a. UMNL
b. LMNL

80
Q

When standing, what is a prerequisite for lifting your leg sideways?

a. moving the center of gravity to the opposite side before executing the movement
b. moving the center of gravity to the opposite side after executing the movement
c. Moving away the opposite arm and shoulder

A

a. moving the center of gravity to the opposite side before executing the movement

81
Q

A lesion to the perforant pathway in the papez circuit leads to which of the following?

a. Increased sexual activity
b. Defective spatial memory consolidation

A

b. Defective spatial memory consolidation

82
Q

A drug that causes less GI effects and respiratory depression

a. Morphine
b. Tramadol
c. Codiene
d. Cocaine
e. Cannabis

A

b. Tramadol

83
Q

What structure is mostly affected in Parkinson’s disease?

A

Substantia nigra compacta

84
Q

Where is the location of retinal detachment?

a. Between the RPE and choroid
b. Between the RPE and photoreceptors

A

b. Between the RPE and photoreceptors

85
Q

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

a. Opening of voltage gated channels
b. Opening of ligand gated channels
c. Stretch channels open

A

c. Stretch channels open

86
Q

A patient with gait disturbance and loss of proprioception on the right side of the body. What structure is affected?

a. Left VPL
b. Right VPL
c. Left VPM
d. Right VPM

A

a. Left VPL

CNS module - 4th year (17 decks)

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