Mid Sem Questions

Question 1

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

Answer 1

Chiari Type I

Question 2

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

Answer 2

• binds to receptor encoded by PTCH1 gene

Question 3

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

Answer 3

requires enzymatic reduction to bedcome biologically active

Question 4

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

Answer 4

myelencephalon

Question 5

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

Answer 5

piriformis

Question 6

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

Answer 6

immediate discectomy

Question 7

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

Answer 7

causes the activation of transducin, leading to a decline in rod cell cGMP

Question 8

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

Answer 8

• ganglion cell, inner plexiform, inner nuclear

Question 9

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

Answer 9

close, middle and far distant objects are all blurred

Question 10

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

Answer 10

astigmatism

Question 11

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

Answer 11

neuronal tuning

Question 12

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

Answer 12

lateral geniculate nucleus

Question 13

a patient has a lesion on cranial nerve VI - which muscle will this affect?
* inferior oblique
* inferior rectus
* lateral rectus
* medial rectus
* superior oblique

Answer 13

lateral rectus

Question 14

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

Answer 14

mutates DFNB1 gene

Question 15

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

Answer 15

oval window

Question 16

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

Answer 16

right conductive

Question 17

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

Answer 17

tegmen tympani

Question 18

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

Answer 18

auditory cortex

Question 19

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

Answer 19

CT

Question 20

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

Answer 20

wernicke’s dysphasia

Question 21

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

Answer 21

inflammatory responses

Question 22

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

Answer 22

relate the word to themselves in some way

Question 23

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

Answer 23

sociel environment

Question 24

which of the following are catecholamines?
* dopamine and serotonin
* tryptophan and serotonin
* noradrenaline and dopamine
* noradrenaline and serotonin
* tyrosine and dopamine

Answer 24

noradrenaline and dopamine

Question 25

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

Answer 25

lithium

Question 26

which of the following will displace diazepam from its receptor binding site?
* alcohol
* flumazenil
* GABA
* pentobarbitone
* picrotoxin

Answer 26

flumazenil

Question 27

anxiety disorders have been suggested to be assoicated with dysfunction of the:
* amygdala
* entorhinal cortex
* hippocampus
* hypothalamus
* nucleus accumben

Answer 27

amygdala

Question 28

proprioceptie neurons from left medial rectus form synapses ipsilaterally in which nucleus of the brain stem?
* abducens
* edinger-westphal
* mesencephalic
* oculomotor
* trochlear

Answer 28

mesencephalic

Question 29

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

Answer 29

is a pro drug

Question 30

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

Answer 30

80dB

Question 31

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

Answer 31

rinne’s positive in both ears; weber’s lateralises right

Question 32

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

Answer 32

pre-lingually deaf adults

Question 33

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

Answer 33

cerebral angiography

Question 34

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

Answer 34

left pontine lesion

Question 35

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

Answer 35

• tissue plasminogen activator

Question 36

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

Answer 36

clopidogrel

Question 37

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

Answer 37

longitudinal cohort study

Question 38

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

Answer 38

on average, exenatide is likely to be beneficial in terms of movemenr disorder symptoms

Question 39

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

Answer 39

core belief

Question 40

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

Answer 40

frame of reference

Question 41

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

Answer 41

horizontal cell

Question 42

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

Answer 42

ganglion cell layer

Question 43

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

Answer 43

outer nuclear layer

Question 44

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

Answer 44

inner nuclear layer