Mid Sem Questions Flashcards
Male pt develops severe headaches as adult. He’s diagnosed with a congenital disorder and undergoes deceompression surgery, which lessens his symptoms. Which of the following was he suffering from:
* spina bifida occulta
* Chiari Type I malformation
* Chiari Type II malformation
* syringomyelia
* tethered spinal cord syndrome
Chiari Type I
during development of the neural tube, the morphogen sonic hedgehog:
* binds to receptor encoded by PTCH1 gene
* directly activates G-protein coupled receptor
* is cleaved from the precursor protein ‘desert hedgehog’
* is found at high conc in dorsal parts of neural tube
* requires N terminal glycosylation for full activity
- binds to receptor encoded by PTCH1 gene
increased maternal intake of folic acid has been shown to reduce the risk of a baby developing a neural tube defect. the micronutrient:
* can cause megaloblastic anaemia in overdose
* increases the risk of thrombosis in older mothers
* is a potent anti-oxidising agent
* is highly lipid solubke
* requires enzymatic reduction to become biologically active
requires enzymatic reduction to bedcome biologically active
a researcher is studying the development of the brain in 6 week old human embryos. they want to isolate the cells that will ultimately develop into the medulla oblongata. the researcher will find these cells in the:
* mesencephalon
* metencephalon
* myelencephalon
* prosencephalon
* telencephalon
myelencephalon
male pt has symptoms consistent with sciatica. the pain worsens when he moves and is triggered when he carries wallet in back pocket of his trousers. this is because his sciatic nerve runs through a certain muscle instead of behind it. this muscle is the:
* gluteus minimus
* obturator externus
* piriformis
* quadratus femoris
* superior gemellus
piriformis
pt presented ED with pins and needles and shooting pains in legs. previously visited dr several times with lower back pain. examination shows saddle anaesthesia and lack of anal tone. MRI shows large central L5/S1 prolapsed intervertebral disc.
which management approach will achieve the best long term outcome:
* bed rest with cocodamol for pain relief
* epidural cortisone injection
* immediate discectomy
* physical therapy and ibuprofen for pain relief
* traction therapy
immediate discectomy
during the process of photoreception, activation of opsin by light:
* causes the activation of transducin, leading to a decline in rod cell cGMP
* causes the inhibition of phosphodiesterase
* involves the conversion of 11-trans retinal to the 11-cis form
* leads toa ctivation of cGMP gated sodium channels in rod cell membrane
* leads to depolarisation of rod cell membrane and release of glutamate
causes the activation of transducin, leading to a decline in rod cell cGMP
on entering the eyeball, light passes through the layers of the retina in the following order:
* inner plexiform, outer plexiform, inner nuclear
* ganglion cell, inner plexiform, inner nuclear
* ganglion cell, outer plexiform, inner nuclear
* outer plexiform, inner plexiform, ganglion cell
* outer nuclear, outer plexiform, inner plexiform
- ganglion cell, inner plexiform, inner nuclear
pt wears glasses with lenses that are both strongly concave and cylindrical. when they are not wearing thier glasses:
* close and middle distant objects are clear but far-distant objects are clear
* close objects and middle distant objects are blurred but far distant objects are clear
* close objects are blurred but middle distant and far distant objects are clear
* close objects are clear but middle distant and far distant objects are blurred
* close, middle and far distant objects are all blurred
close, middle and far distant objects are all blurred
keratoconus is a progressive disorder in which the cornea distorts and bulges irregularly. in early stages, the disorder most closely resembles:
* astigmatism
* hypermetropia
* macular degeneration
* myopia
* retinal detachment
astigmatism
in the visual cortex, certain neurons fire action potentials when a particular stimulus enters their receptive field. such responses are described as:
* activity dependent plasticity
* homeostatic plasticity
* neuronal facilitation
* neuronal tuning
* synaptic augmentation
neuronal tuning
the brain area, shaped like a bent knee, receives feedback signals from the primary visual cortex. it is the:
* inferior colliculus
* lateral geniculate nucleus
* pretectum
* spinal trigeminal nucleus
* superior colliculus
lateral geniculate nucleus
a patient has a lesion on cranial nerve VI - which muscle will this affect?
* inferior oblique
* inferior rectus
* lateral rectus
* medial rectus
* superior oblique
lateral rectus
3 yr old has been deaf since birth. the child’s parents are deaf and have been told any further children will aslo be deaf. one of the child’s cousins, but none of the child’s grandparents, has also been deaf since birth. which of the following conditions is the most likely cause of the child’s deafness?
* stickler syndrome
* pendred syndrome
* mutated DFNB1 gene
* meniere’s disease
* presbyacusis
mutates DFNB1 gene
a person has difficulty hearing high frequency sounds. this finding suggests their basilar membrane could be damaged nearest to:
* external auditory meatus
* helicotrema
* medial geniculate nucleus
* oval window
* spiral ganglion
oval window
38yr old male pt presents with hearing difficulties. Weber’s test reveals that sound of tuning fork appears louder in his right ear than his left. Rinne’s test reveals he can hear tuning fork when its base is located on his right mastoid process but not when the prongs are subsequently placed adjacent to his REAM. tuning fork is equally loud in either position when left ear is tested.
which of the following hearing loss patterns explains these findings?
* bilateral conductive
* left conductive
* left sensorineural
* right conductive
* right senorineural
right conductive
8 yr olf girl presents with middle ear infection. this has spread to mastoid air cells and antrum. if the infection spreads superiorly through petrosquamous fissure to middle cranial fossa it could cause osteomyelitis of her:
* chorda tympani
* stapedius
* tegmen tympani
* tensor tympani
* tympanic membrane
tegmen tympani
child born with bilateral congenital defect in auditory pathways. they are unaware of sound but respond reflexively to loud noises. the defect is likely to be in the:
* auditory cortex
* auditory nerve
* ganglion of scarpa
* spiral ganglion
* superior olive
auditory cortex
pt undergoes a diagnostic procedure in which X ray source is rotated around their abdomen in order to image their organs. this scanning technique is called:
* 2D raidography
* CT
* NMRI
* PET
* SPECT
CT
pt suffered from a stroke and the result has impaired their language. whilst they can speak fluently in long sentences, the content of their language makes little sense to others. you suspect the pt is suffering from:
* broca’s dysphasia
* conduction dysphagia
* dysphagia
* global dysphasia
* wernicke’s dysphagia
wernicke’s dysphasia
when blood supply is respoted to an ischameic area following stroke, a ‘reperfusion injury’ can occur. a major component of the tissue damage that occurs during reperfusion injury is caused by:
* acidosis
* cerebral microhaemorrhage
* excitotoxicity
* hypoxemia
* inflammatory responses
inflammatory responses
a pt asks for suggestions to help them remember the name of a new medication they have started. according to the levels of processing approach to memory, this information is more likely to be remembered if the pt is asked to:
* concentrate on the sound of the word
* look at the word written down
* relate the word to themselves in some way
* repeat the word aloud
* rhyme the word with something else
relate the word to themselves in some way
the social model of disability differs from the medical model of disability because the former stresses that the experience of disability is the direct result of an individuals:
* deviation from biomedical norms
* exposure to prejudice
* handicap
* impairment
* social environment
sociel environment
which of the following are catecholamines?
* dopamine and serotonin
* tryptophan and serotonin
* noradrenaline and dopamine
* noradrenaline and serotonin
* tyrosine and dopamine
noradrenaline and dopamine
the chronic use of which of the following causes resistance to the action of antidiuretic hormone or vasopressin, and so requires monitoring of kidney as well as thyroid function:
* citalopram
* diazepam
* lithium
* pregabalin
* venlafaxine
lithium
which of the following will displace diazepam from its receptor binding site?
* alcohol
* flumazenil
* GABA
* pentobarbitone
* picrotoxin
flumazenil
anxiety disorders have been suggested to be assoicated with dysfunction of the:
* amygdala
* entorhinal cortex
* hippocampus
* hypothalamus
* nucleus accumben
amygdala
proprioceptie neurons from left medial rectus form synapses ipsilaterally in which nucleus of the brain stem?
* abducens
* edinger-westphal
* mesencephalic
* oculomotor
* trochlear
mesencephalic
75 yrd olf male pt had a myocardial infarction 3 years ago. has had ongoing sciatica for 15 years. the doctor advises he stop taking ibuprofen and offers a prescription of co-codamol and refers the pt to physiotherapy.
co-codamol in addition to paracetamol, contains codeine. codeine differs from morphine in that it:
* does not cause physical dependance
* does not cause constipation
* binds to the mu opioid receptor
* is a synthetic drug
* is a pro-drug
is a pro drug
a drummer in a heavy metal band has suffered noise induced hearing loss in his left ear. he decides to invest in heading protection. to safeguard his hearing, he should aim to ensure that their noise exposure (with protection) does not exceed:
* 20dB
* 80dB
* 120dB
* 160dB
* 200dB
80dB
a drummer in a heavy metal band has suffered noise induced hearing loss in his left ear. he decides to invest in heading protection.
what pattern of test results is expected when his hearing is examined?
* rinne’s test positive in both ears; weber’s test lateralizes right
* rinne’s test negative in both ears; weber’s test lateralises right
* rinne’s test positive in both ears; weber’s test lateralises left
* rinne’s test negative in both ears; weber’s test lateralises left
* rinnes’ test negative in left ear; weber’s test symmetrical
rinne’s positive in both ears; weber’s lateralises right
a drummer in a heavy metal band has suffered noise induced hearing loss in his left ear. he decides to invest in hearing protection and investigates the possibility of a cochlear implant.
successful adaptation to cochlear implant is least likely in which group?
* post-lingually deaf adolescents
* post-lingually deaf adults
* post-lingually deaf children aged 2-5 years
* pre-lingually deaf adults
* pre-lingually deaf children aged 0-2
pre-lingually deaf adults
a man suffers a severe sudden onset headache and is taken to the emergency department - subarachnoid haemorrhage is diagnosed. as part of one procedure, a catheter is introduced into man’s femoral artery and an iodine-containing compound is introduced into circulation. this technique is:
* bolus tracking
* cerebral angiography
* CT
* gamma scintigraphy
* PET scanning
cerebral angiography
a man suffers a severe sudden onset headache and is taken to the emergency department - stroke is diagnosed. pt exhibits the following: weakness in right arm, right leg, and all left side of face. his gaze deviates right. he can perceive pain and temp in all four limbs and on both sides of face.
which of the following is most consistent with his symptoms:
* bilateral medullary lesion
* left medullary lesion
* left pontine lesion
* right medullary lesion
* right pontine lesion
left pontine lesion
a man suffers a severe sudden onset headache and is taken to the emergency department. approximately 2 hours after arrival in ED, ischaemic stroke is diagnosed. which of the following should be started?
* inhibitor of COX1
* thrombin receptor antagonist
* thromboxane A2 synthesis inhibitor
* tissue plasminogen activator
* vit K antagonist
- tissue plasminogen activator
a man suffers a severe sudden onset headache and is taken to the emergency department - ischaemic stroke is suspected. in order to reduce the long term risk of developing further ischaemic strokes, NICE guidelines suggest that the pt should be prescribed ongoing treatment with:
* ateplase
* clopidogrel
* epoprostenol
* ticlopidine
* warfarin
clopidogrel
a researcher wishes to study the assoication between alcohol consumption and risk of stroke. which of the following designs would be most appropriate to answer this question
* longitudinal cohort study
* randomised controlled trial
* cross sectional study
* prevalence study
* qualitative research study
longitudinal cohort study
randomised controlled trial compared subcutaneous injections of exenatide to a placebo for pts with moderate PD. at 60 weeks, scores on a movement disorder scale had improved by 1.0 point in the exenatide group compared to a deterioration of 2.5 points in the placebo group: adjusted mean difference of 3.5 points.
which of the following is an appropriate conclusion for the use of exenatide for the population of pts with moderate PD based on these results?
* exenatide is unlikely to lead to benefit in terms of movement disorder symptoms
* it is unclear whether or not exenatide is likely to imroved movement disorder symptoms
* on average, exenatide is likely to improve movement disorder symptoms by 3.5 points
* on average, exenatide is likely to be beneficial in terms of movement disorders
* all pts taking exenatide will experience a reduction in movement disorder symptoms
on average, exenatide is likely to be beneficial in terms of movemenr disorder symptoms
when talking with a pt, you hear them say ‘the world is a dangerous place’. which of the following is this an example of?
* assumption
* attitude
* belief system
* core belief
* stereotype
core belief
asking what the words ‘health’, ‘work’, ‘family’, and ‘mood’ mean to somebody is important in understanding their quality of life. what is this an example of?
- frame of reference
- health status
- standards of comparison
- sampling strategy
- response shift
frame of reference
which component of the retina projects laterally to modulate surrounding photoreceptors:
* amacrine cell
* ganglion cell layer
* horizontal cell
* inner nuclear layer
* inner plexiform layer
* layer of photoreceptor outer segments
* outer nuclear layer
* outer plexiform layer
* pigmented epithelium
* retinal fovea
horizontal cell
which component of the retina has axons that project to the brain:
* amacrine cell
* ganglion cell layer
* horizontal cell
* inner nuclear layer
* inner plexiform layer
* layer of photoreceptor outer segments
* outer nuclear layer
* outer plexiform layer
* pigmented epithelium
* retinal fovea
ganglion cell layer
which component of the retina contains cell bodies of rod cells:
* amacrine cell
* ganglion cell layer
* horizontal cell
* inner nuclear layer
* inner plexiform layer
* layer of photoreceptor outer segments
* outer nuclear layer
* outer plexiform layer
* pigmented epithelium
* retinal fovea
outer nuclear layer
which component of the retina contains the cell bodies of bipolar cells:
* amacrine cell
* ganglion cell layer
* horizontal cell
* inner nuclear layer
* inner plexiform layer
* layer of photoreceptor outer segments
* outer nuclear layer
* outer plexiform layer
* pigmented epithelium
* retinal fovea
inner nuclear layer
