MCQ Mid sem Flashcards
Which of the following areas of your brain is characterised by the statement “the site of polysensory integration and language”?
a. Pre-frontal cortex
b. Limbic association area
c. Parieto-occipito-temporal association area
d. Post-central gyrus
c. Parieto-occipito-temporal association area
Which of the following is the dominant receptor that determines whether long term potentiation will occur in hippocampal neurones?
a. GABA activating the GABA receptor (GABAR)
b. Glutamate activating the NMDA receptor (NMDAR)
c. Glutamate activating the AMPA receptor (AMPAR)
d. Dopamine activating dopamine receptor 2 (DR2).
b. Glutamate activating the NMDA receptor (NMDAR)
“Warm” thermoreceptors contain ion channels that are activated by temperatures that range from 30 - 45 degrees Celsius. “Cold” thermoreceptors contain ion channels that are activated by temperatures that range from 10 - 35 degrees Celsius. Your core body
temperature is 37 degrees Celcius, but you are conducting an experiment in a cold room (20
degrees Celcius). You warm up a blunt metal probe to 32.5 degrees Celcius and then apply it to an area of skin containing ONLY polymodal nociceptors containing BOTH “warm” and “cold” ion channels inducing action potentials in these nerves.
What sensation do you experience from the probe?
a. Cold
b. Warm
c. Both warm and cold
d. Pain
d. Pain
Your auditory Scala media is filled with which of the following fluids?
a. Endolymph that is high in potassium
b. Endolymph that is low in potassium
c. Perilymph that is high in potassium
d. Perilymph that is low in potassium
a. Endolymph that is high in potassium
Which scheme best describes the neural pathway of phototransduction at the retina?
a. photoreceptor -> bipolar cell -> ganglion cell
b. photoreceptor -> ganglion cell -> bipolar cell
c. photoreceptor -> amacrine cell -> bipolar cell
d. photoreceptor -> ganglion cell -> bipolar cell
a. photoreceptor -> bipolar cell -> ganglion cell
The area of the brain’s cortex that the third order neurones from your optic nerves project to is known as a:
a. Primary sensory area.
b. Secondary sensory area.
c. Tertiary sensory area.
d. Association area.
a. Primary sensory area
First order - Ganglion cells –> Optic nerve
Second order - Synapse at the LGN
Third order - Primary visual cortex (V1)
Your locus coeruleus is an important component of the ascending activating system. Which of the following neurotransmitters/neurohormones does it produce?
a. Acteylcholine
b. Noradrenaline
c. Dopamine
d. Serotonin
b. Noradrenaline
Acetylcholine - Produced by cholinergic neurons in the basal forebrain and brainstem, as well as by motor neurons in the spinal cord.
Dopamine - primarily produced by dopaminergic neurons in the substantia nigra and VTA of the midbrain.
Serotonin - is primarily produced by serotonergic neurons in the raphe nuclei of the brainstem.
In which lobe of the brain is the human hippocampus located?
a. Frontal
b. Occipital
c. Parietal
d. Temporal
d. Temporal
Damage to which of the following areas will cause anterograde amnesia of declarative memories?
a. Hippocampus
b. Ventral tegmental area
c. Thalamus
d. Locus coeruleus
a. Hippocampus
Which of the following statements is CORRECT? Osteonecrosis:
a. is only rarely associated with trauma.
b. is usually the result of ischaemia of a segment of bone.
c. is the most common cause of osteoarthritis.
d. occurs primarily in children.
b. is usually the result of ischaemia of a segment of bone.
Which of the following is TRUE for gout?
a. Gout is caused by overconsumption of pyrimidine-rich foods
b. Acute gout attacks are self-limiting in the absence of any treatment
c. The main aim of acute gout treatment is to lower uric acid levels
d. Colchicine is a xanthine oxidase inhibitor
b. Acute gout attacks are self-limiting in the absence of any treatment
Which of the following are typical extra-articular manifestations of rheumatoid arthritis?
a. Multiple myeloma
b. Pancreatic cysts
c. Parathyroid hyperplasia
d. Subcutaneous nodules
d. Subcutaneous nodules
Which of the following statements is CORRECT regarding acute gouty arthritis?
a. It usually presents with sudden onset of pain in the mid-tarsal joint
b. It is caused by deposition of calcium pyrophosphate crystals in the synovium
c. It is characterised by the presence of urate crystals in the synovial fluid
d. It is a frequent complication of hypercalcaemia
c. It is characterised by the presence of urate crystals in the synovial fluid
Which of the following statements is CORRECT regarding multiple myeloma?
a. It usually produces lytic lesions on X-Ray
b. It results from a clonal proliferation of T-lymphocytes
c. It principally affects weight bearing joints
d. It is generally a disease of children and young adults
a. It usually produces lytic lesions on X-Ray
Which of the following statements is CORRECT regarding osteomyelitis of long bones?
a. These infections occur most commonly following haematogenous seeding of the bone by bacteria
b. Osteomyelitis in children most commonly involves the upper limb bones
c. An involucrum is a layer of new bone formed over the infected bone
d. Kingella kingae is a common cause of osteomyelitis in young adults
c. An involucrum is a layer of new bone formed over the infected bone
Which of the following treatments for rheumatoid arthritis does NOT directly target macrophage activity?
a. Anti-TNF-a antibodies
b. Anti-IL6 antibodies
c. Glucocorticoids
d. Leflunomide
d. Leflunomide
Leflunomide is an immunomodulatory drug that inhibits the proliferation and activation of T cells by inhibiting the enzyme dihydroorotate dehydrogenase, which is involved in the de novo synthesis of pyrimidines.
In contrast, the other treatments listed directly target macrophage activity:
Which one of the following muscles does NOT belong to the rotator cuff of the shoulder?
a. Infraspinatus
b. Subscapularis
c. Teres minor
d. Teres major
d. Teres major
The functional division of the cerebellum that coordinates and plans limb movements is called the:
a. Flocculonodular node.
b. Vermis.
c. Cerebrocerebellum.
d. Vestibulocerebellum
c. Cerebrocerebellum
The flocculonodular node (vestibulocerebellum) is responsible for coordinating balance and eye movements.
The vermis is involved in controlling axial and proximal limb movements.
The vestibulocerebellum (flocculonodular node) is responsible for coordinating balance and eye movements
Identify the CORRECT statement regarding osteoarthritis:
a. Characterized by immune system attack on joints
b. Can occur as a result of repetitive joint use
c. Increases cartilage formation
d. Obesity is not a risk factor
b. Can occur as a result of repetitive joint use
Which of the following pairs of muscles and their nerves are INCORRECTLY matched?
a. Fibularis (peroneus) longus : Superficial fibular (peroneal) nerve.
b. Soleus : Tibial nerve.
c. Tibialis anterior : Tibial nerve.
d. Extensor hallucis longus : Deep fibular (peroneal) nerve
c. Tibialis anterior: Tibial nerve
The correct pairing for the Tibialis anterior muscle is the deep fibular (peroneal) nerve.
Regarding sensation testing, which of the following statements is INCORRECT?
a. The L3 dermatome can be tested by assessing sensation over the medial aspect of the thigh
b. Reduced pain sensation over the distal deltoid area may indicate a lesion involving C5
c. Reduced sensation over the palmar surface of the thumb could indicate a lesion involving C6 or the median nerve
d. Vibration sense is tested using a 128Hz tuning fork on bony points and is an assessment of the spinothalamic tract
d. Vibration sense is tested using a 128Hz tuning fork on bony points and is an assessment of the spinothalamic tract
Examination to assess the function of the optic nerve involves all of the following EXCEPT:
a. observation of upper eyelid position.
b. mapping the patient’s blind spot.
c. performing fundoscopy.
d. examination of the pupillary light reflex
a. observation of upper eyelid position.
In regard to shoulder examination, which statement is INCORRECT?
a. The “empty can” test and Hawkins test both assess for signs of impingement by causing compression of structures between the acromion and greater tuberosity
b. In making a diagnosis of rotator cuff pathology, the Hawkins test is both highly sensitive and specific
c. Infraspinatus can be assessed by asking the patient to externally rotate their shoulder against resistance
d. The presence of pain when performing the “empty can” test may indicate the presence of subacromial bursitis
b. In making a diagnosis of rotator cuff pathology, the Hawkins test is both highly sensitive and specific
The Hawkins test is not highly sensitive or specific for diagnosing rotator cuff pathology. Instead, it is used to assess for signs of impingement of the supraspinatus tendon and other structures between the acromion and greater tuberosity of the humerus
Which of the following statements is CORRECT?
a. Coup contusions occur opposite the site of impact
b. A laceration or tear in the brain tissue usually occurs where the inner skull is rough
c. Contrecoup contusions occur beneath the point of impact
d. Contusions are frequently associated with skull fracture at the point of impact
d. Contusions are frequently associated with skull fracture at the point of impact
Which of the following statements is INCORRECT in regard to fasciculations?
a. The presence of fasciculations indicates a lower motor neurone lesion and their presence is always abnormal
b. They are caused by denervation of whole motor units
c. They are fine movements of the muscle under the skin
d. They are present at rest when the muscle is relaxed
a. The presence of fasciculations indicates a lower motor neurone lesion and their presence is always abnormal
Which of the following statements is CORRECT regarding cerebrospinal fluid (CSF)? CSF:
a. is produced only in the lateral ventricles.
b. passes into subarachnoid space through the interventricular foramina.
c. is absorbed by the ciliated epithelium lining the ventricles.
d. fills the central canal of the spinal cord
d. fills the central canal of the spinal cord
All neurodegenerative disorders share the following features EXCEPT:
a. inflammatory aetiology.
b. disease progression over time.
c. degeneration of neurons.
d. accumulation of abnormal proteins.
a. inflammatory aetiology.
Regarding cerebral arteries and their area of supply, which of the following pairs is CORRECTLY matched?
a. Anterior cerebral artery: Broca’s motor speech area
b. Anterior cerebral artery: Primary motor cortex for the lower limb
c. Middle cerebral artery: Primary somatosensory cortex for the lower limb
d. Basilar artery: Basal ganglia
b. Anterior cerebral artery: Primary motor cortex for the lower limb
Which of the following features is NOT seen in multiple sclerosis?
a. Plaques may occur in different sites and at different times
b. Cardiac involvement
c. Relapsing remitting clinical course
d. Axonal loss
b. Cardiac involvement
When performing a lumbar puncture correctly, the order of the anatomical structures traversed is:
a. skin, supraspinal ligament, ligamentum flavum, subarachnoid space.
b. skin, supraspinal ligament, subarachnoid space, arachnoid mater.
c. skin, ligamentum flavum, supraspinal ligament, subarachnoid space.
d. ligamentum flavum, supraspinal ligament, dura mater, subarachnoid space
a. skin, supraspinal ligament, ligamentum flavum, subarachnoid space.
Joe suffered a head injury which damaged his hippocampus. Which type of memory is MOST
likely to be impaired?
a. Anterograde procedural
b. Anterograde declarative
c. Retrograde procedural
d. Retrograde declarative
b. Anterograde declarative
Which of the following statements is CORRECT? The pectoralis major muscle:
a. is a lateral rotator of the humerus.
b. is a member of the rotator cuff of the shoulder.
c. receives nerve supply from the musculocutaneous nerve.
d. adducts the humerus at the shoulder joint.
d. adducts the humerus at the shoulder joint.
Which of the following statements is CORRECT regarding acute phase reactants?
a. Anti-CCP antibodies are an example of an acute phase reactant
b. Acute phase reactants rise or fall in titre by at least 50% in inflammatory states
c. Elevation of acute phase reactants occurs in most cases of osteoarthritis
d. C-reactive protein (CRP) is an example of an acute phase reactant
d. C-reactive protein (CRP) is an example of an acute phase reactant
Factors important in the healing of fractures include all of the following EXCEPT:
a. wound immobilisation.
b. vascular supply.
c. physical stress.
d. pain level
d. pain level
In adults, the development of raised intracranial pressure does NOT typically result in:
a. headache.
b. papilloedema.
c. vomiting.
d. meningism.
d. meningism.
Which one of the following statements is CORRECT with regard to herpes simplex encephalitis?
a. Most cases in immunocompetent individuals are caused by herpes simplex type 2.
b. The occipital lobes of the brain are most commonly affected.
c. There is no effective antiviral therapy for this infection.
d. Without appropriate medical intervention, the mortality of this condition is 70%.
d. Without appropriate medical intervention, the mortality of this condition is 70%.
Which of the following statements is CORRECT? The radial nerve:
a. crosses the “surgical neck” of the humerus.
b. gives off the lateral cutaneous nerve of the forearm.
c. supplies a flexor of the elbow joint.
d. supplies the dorsal interossei of the hand
c. supplies a flexor of the elbow joint.
You are assessing a 42 year old woman who presents complaining of pain in the small joints
of her hands and feet bilaterally. Which term best describes the distribution of her
arthralgia?
a. Monoarticular
b. Oligoarticular
c. Pauciarticular
d. Polyarticular
d. Polyarticular
A 50 year old man presents with an acutely painful right knee. The pain began spontaneously and has been increasing over the last 12 hours. No other joints are affected.
On examination the whole joint is tender and a moderate effusion is present. Movement is limited by pain. Aspiration of the knee joint is performed and a preliminary microscopy report shows the presence of white blood cells with a count of 6000/mm3 (normal, <1000) and the presence of negatively birefringent crystals.
This presentation is most suggestive of which of the following conditions?
a. Gout
b. Osteoarthritis
c. Rheumatoid arthritis
d. Trauma
a. Gout
You are assessing a 57 year old woman who presents with a painful, swollen knee. You examine her to assess if a joint effusion is present.
Which ONE of the following statements is correct in regard to the patellar tap test?
A palpable click, made when the patella strikes the tibia, represents a positive test
b. The patellar tap test is better than the bulge test at detecting smaller effusions
c. The test is performed with the knee in 30 degrees of flexion.
d. The test requires initial compression of any fluid out of the suprapatellar pouc
d. The test requires initial compression of any fluid out of the suprapatellar pouc
what nerve supplies the anterior compartment of the leg and dorsum of the foot?
Deep fibular nerve
Name the muscles in the anterior (dorsum) compartment of the foot
Extensor hallucis longus Extensor digitorum longus
Peroneus tertius
Name the muscles in the anterior compartment of the leg
Tibialis anterior
Extensor hallucis longus
Extensor digitorum longus,
Peroneus tertius
What nerve innervates the lateral compartment of the leg?
superficial fibular nerve
What nerve innervates the posterior compartment of the leg and the plantar surface of the foot?
Tibial nerve
Tibial nerve seperates into the medial and lateral plantar nerves in the foot
What muscles are supplied by the medial plantar nerve?
Abductor hallucis
Flexor digitorum brevis
Flexor hallucis brevis
Quadratus plantae
Lumbricals
what muscles are supplied by the lateral plantar nerve?
Abductor digiti minimi
Flexor digiti minimi
Name the muscles of the posterior compartment of the leg
Tibialis posterior
Flexor digitorum longus
Flexor hallicus longus
Gastrocnemius
Soleus
Plantaris
Describe the following terms:
A) “Fast” pain
A-delta fibres
Sharp and well localised
Transmitted by myelinated axons (@ 10 m/s)
Glutamate neurotransmitter (rapid acting, very short duration (milliseconds))
Desrcibe the following terms:
B) “Slow” pain
C fibres
Dull aching sensation, not well localised
Transmitted by unmyelinated axons (@1 m/s)
Substance P neurotransmitter (slower acting, long duration (minutes)
