Neuro Quiz and BOFs Flashcards
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For the following questions, choose the description that best fits the gait pattern that each patient would present with.
a) A 34-year-old man is diagnosed with cerebellar ischaemia.
The correct answer is: a) A 34-year-old man is diagnosed with cerebellar ischaemia. → Patient experiences a broad based, lurching gait.,
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b) A 50-year-old woman with a herniated disk is diagnosed with sciatica. → Patient lifts their foot high to clear foot during swing phase, has inability to dorsiflex their foot.,
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For the following questions, choose the description that best fits the gait pattern that each patient would present with.
c) A 67-year-old man with a history of smoking and hypertension suffers a stroke to the right posterior limb of the internal capsule. → Patient’s leg is stiff, which circumducts while walking. Trunk exhibits lateral flexion and arm is flexed.
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a) In the light, rods become hyperpolarised due to decreased cGMP levels, resulting in which process? → Closing of voltage-gated Na+ channels, Na+ remains outside cell,
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b) Neurotransmitters are released from the presynaptic terminal by which process? → Opening of voltage-gated Ca2+ channels, Ca2+ enters the cell,
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c) A 24-year-old woman suffering from anxiety is treated with a benzodiazepine. Benzodiazepines act on GABA channels, resulting in which process? → Opening of chemically-gated Cl- channels, Cl- enters the cell
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a) A 34-year-old man presents with a loss of peripheral vision the right hand side of both eyes. The central vision is preserved in both eyes.
a) A 34-year-old man presents with a loss of peripheral vision the right hand side of both eyes. The central vision is preserved in both eyes. → I,
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b) A 26-year-old woman presents with excessive lactation despite never having children before and has lost her peripheral vision.
b) A 26-year-old woman presents with excessive lactation despite never having children before and has lost her peripheral vision. → C
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A 49-year-old man also experiencing memory loss presents with a deficit in the right upper quadrant of his field of vision.
A 49-year-old man also experiencing memory loss presents with a deficit in the right upper quadrant of his field of vision. → F
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The correct answer is: Increased muscle spindle activation, leading to an increase in gamma-motor neuron activity
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The correct answer is: Muscarinic agonists
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The correct answer is: The vertebrae do not completely fuse and the meninges and neural tube are displaced out of the vertebral canal
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The correct answer is: Facial nerve
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The correct answer is: Increased noradrenaline and serotonin, decreased acetylcholine and GABA
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The correct answer is: Increased firing of osmoreceptors in the neurohypophysis causing increased release of ADH, reducing water excretion
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The correct answer is: The left eye is elevated in the adducted position
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The correct answer is: Left optic nerve
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The correct answer is: inhibiting sodium channel function.
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The correct answer is: reduction in the amygdala and hippocampal volumes.
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The correct answer is: Fluctuating consciousness
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The correct answer is: prominent negative symptoms.
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The correct answer is: Temporal lobe
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The correct answer is: Bipolar affective disorder
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The correct answer is: Hypotension
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The correct answer is: As a band of pain diffusely spread across the forehead or occipital area
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Grounded theory approach is used to understand a phenomenon without having previous ideas.
The correct answer is: Lacks preconceived ideas
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The case study approach is used to study a unique phenomenon of interest. It describes the subject of research in detail to show its uniqueness. Action research is a continuous cyclic process of having research findings and applying those to change a phenomenon. It solves a problem and produce guidelines. Content analysis is to analyze piece of writing like books, documents, and other published material including pictures, audios, and videos. Ethnography is the study of people and their cultures. Phenomenology is the philosophical study of structures of experiences and consciousness.
The correct answer is: Case study
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The correct answer is: There is no requirement to seek consent to undertake this research
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The correct answer is: Region D
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A patient presents with loss of sensation in her right little finger.
Which dermatome does this correspond to?
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c7
c8
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The correct answer is: C8
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The correct answer is: Artery E
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An autopsy is performed on a 56-year-old patient who died from complications associated with Huntington’s disease. A coronal section of the brain is show above, along with a control comparison.
This condition results from the degeneration of a specific population of neurons, containing which of the following neurotransmitters?
The correct answer is: GABA
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A 63-year-old woman with a history of hypertension presents with posterior cerebral artery stenosis, specifically affecting the highlighted region shown.
What are the symptoms she will most likely present with?
The correct answer is: Contralateral weakness in the arms and legs, ipsilateral eye points down and out
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The correct answer is: Sites A and D
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A 68-year-old woman presents with an infarct to the highlighted region shown on the MRI shown.
What symptoms is she likely to present with?
The correct answer is: Ataxia, left-sided intention tremor, loss of pain and temperature sensation to the right side of the body and the left side of the face
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A 58-year-old man with a headache undergoes imaging studies and the following CT scan is produced.
Based on the image provided, what would be the location of injury and the type of vessel that was damaged?
Select one:
Extradural, arterial
Subdural, arterial
Subdural, venous
Subarachnoid, arterial
Subarachnoid, venous
The correct answer is: Subarachnoid, arterial
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An infection present in which of the following labelled sinuses will reach the internal jugular vein first?
The correct answer is: Sinus D
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The correct answer is: Site B
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Taken from: Cole SA, Christensen JF, Raju Cole M, Cohen H, Feldman MD. Chapter 22. Depression. In: Feldman MD, Christensen JF. eds. Behavioural Medicine: A Guide for Clinical Practice, 3e. New York: McGraw-Hill; 2008.
Table 22–1. Diagnosis of major depression.
1. Depressed mood
2. Anhedonia (lack of interest or pleasure in almost all activities)
3. Sleep disorder (insomnia or hypersomnia)
4. Appetite loss, weight loss; appetite gain or weight gain
5. Fatigue or loss of energy
6. Psychomotor retardation or agitation
7. Trouble concentrating or trouble making decisions
8. Low self-esteem or guilt
9. Recurrent thoughts of death or suicidal ideation
Five symptoms from the above are required to make the diagnosis of depression and must include depressed mood and/or anhedonia. The symptoms must have been present most of the day, nearly every day for 2 weeks
The correct answer is: Two weeks
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Anti-psychotic medication is the most effective treatment for severe positive symptoms of psychosis (e.g. delusions and halucinations). Individuals with schizophrenia often additionally have impairments in social functioning, negative symptoms (e.g. affective flattening, alogia, avolition, anhedonia, and attentional impairment) and residual symptoms (e.g. perceptual disturbance, cognitive distortions, delusions). Outcomes are better when treatment is augmented with social/ cognitive/ behavioural therapy.
The correct answer is: Drugs with social and behavioural therapy
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Severe confusion and disorientation are the hallmarks of delirium. In mental disorders (such as psychosis) level of consciousness need not be impaired.
The correct answer is: Level of consciousness
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Negative symptoms are deficits in thinking, behaviour or emotional experiences, including blunted or flat affect, poverty of speech, inability to experience pleasure, lack of desire to form relationships, and lack of motivation. Positive symptoms are in excess of normal experience, e.g. delusions, hallucinations.
The correct answer is: Anhedonia
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See lecture on “Bipolar disorder”
The correct answer is: Decreased libido
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In depressive episodes with biological symptoms (e.g. reduced appetite and weight, constipation, sleep disturbance, diurnal variation of mood and reduced libido) there is a likely disruption in the normal circadian rhythm of cortisol secretion, with morning peaks being increased and longer lasting (see The Biology and psychopharmacology of depression GOAL).
The correct answer is: Cortisol
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See lecture on Depression
The correct answer is: SSRI
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The role of the hippocampus is to convert short-term memories into long-term memories. This involves Papez’s circuit. Review lecture on memory and practical on the limbic system.
The correct answer is: Hippocampus
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Perseveration is the pathological, persistent repetition of a word, gesture, or act when it is not appropriate. The frontal lobes usually inhibit responses when they are inappropriate by overriding and selecting a more adaptive behaviour, hence damage to them can cause perseveration.
The correct answer is: Perseveration
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Genetic vulnerability and environmental factors interact in the development of schizophrenia. Although schizophrenia is strongly heritable, environmental influences must play a significant part because concordance rates between monozygotic twins are approximately 50%. Concordance rates for dizygotic twins are approximately 17%.
The correct answer is: 50% if twin is monozygotic
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Ammon’s horn and the dentate gyrus are structures within the hippocampus that participate in the conversion of short-term memories to long-term memories. The isthmus is an anatomical structure connecting the cingulate gyrus to the parahippocampal gyrus. The mammillothalamic tract connects the mammillary bodies of the hypothalamus to the anterior nucleus of the thalamus. All of these structures are a part of Papez’s circuit, however they are not direct efferents from the hippocampus.
The correct answer is: Fornix
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Only psychomotor agitation is a core symptom of a major depressive episode. Note that irritable mood can be a one diagnostic criterion of depression in children or adolescents. For further information consult the DSM diagnostic criteria and consult your lecture on depression.
The correct answer is: Psychomotor agitation
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A key differential between anxiety and depression related to insomnia: difficulty getting to sleep = anxiety, waking up early and not getting back to sleep = depression
The correct answer is: a major depressive episode because they are waking up earlier than usual and not getting back to sleep.
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Tricyclic antidepressants generally block amine re-uptake, however some TCAs are able to block a number of receptors (H1, 5-HT2, α1, dopamine and muscarinic).
The correct answer is: Via blockade of amine re-uptake
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This is due to their selectivity in targeting serotonin reuptake only. TCAs are able to act at a number of receptor sites (H1, 5-HT2, α1, dopamine and muscarinic) thus causing a range of unwanted side effects.
The correct answer is: fewer anticholinergic, sedative and postural hypotensive effects.
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Thought blocking is a sudden inability to recall a thought or to finish a thought. It may be noticeable as a long silence in an interview with a patient. It may be interpreted in a delusion way (e.g. someone has taken my thoughts away). It is usually associated with schizophrenia.
The correct answer is: Schizophrenia
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Bipolar disorder, previously termed manic-depressive illness, is characterized by the occurrence of mania cycling with periods of depression. A full manic syndrome is one of the most striking and distinctive conditions in clinical practice. The essential disturbance in mood is one of elation or irritability. Manic patients feel “on top of the world,” expansive, and energetic. The state is precarious, however, and patients may quickly become argumentative, hostile, irritable, and sarcastic, especially when their plans are thwarted. The vegetative signs of mania are a decreased need for sleep, increased activity, rapid and pressured speech, and racing thoughts. Manics may have grandiose ideas, such as unrealistic plans to start a business or run for public office, and if the grandiosity reaches delusional proportions, such patients may believe themselves to be famous, fabulously wealthy, or blessed with special powers and abilities. Poor judgment in spending money and sexual behaviour may lead to problems that prompt the families of manic individuals to seek treatment for them, because manics usually lack insight into their abnormal condition and deny that anything is wrong.
Taken from Zun L (2011). Chapter 284. Behavioral Disorders: Diagnostic Criteria. In Tintinalli J.E., Stapczynski J, Ma O, Cline D.M., Cydulka R.K., Meckler G.D., T (Eds), Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e.
The correct answer is: Bipolar disorder, manic
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These are all key diagnostic criteria of a manic phase bipolar disorder.
The correct answer is: Bipolar disorder, manic phase
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The amygdala, part of the limbic system, plays a key role in many emotional processes including enhanced encoding and storage during learning involving emotionally salient stimuli. Its connections with the prefrontal cortex (PFC) underlie many aspects of the interactions between emotion and cognition.
The correct answer is: Emotional coding of sensory cues
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Some key studies have found that patients with schizophrenia with “large” ventricles (cavities of the brain) had more "negative" symptoms (e.g., alogia, affective flattening, avolition, anhedonia), while those with small ventricles had more "positive" symptoms (e.g., delusions, hallucinations, positive formal thought disorder, bizarre behaviour). Enlarged ventricles are correlated with shrinking grey / white matter of the brain.
The correct answer is: Prominent negative symptoms
