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CNS module - 4th year COPY > 2014 module exam > Flashcards

2014 module exam Flashcards

1
Q

The following picture represents EMG recordings from an antagonist muscle in a normal person, and a person with cerebellar damage (blue) upon the movement of the arm. What is the cause of the delayed action of the antagonist muscle?

a. Lack of impulses coming from climbing fibers
b. Lack of inhibition of the antagonist muscle by the long loop
c. Lack of excitation of the antagonist muscle by the short loop

A

c. Lack of excitation of the antagonist muscle by the short loop

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2
Q

What is the response seen in EEG recording for a patient that has tendency to epilepsy and develops the shown in the following picture?

a. Polyspike
b. Spike-slow wave complex
c. Spike

A

c. Spike

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3
Q

Which of the following diagrams of the visual field represent damage to the left occipital lobe? (note the dark shaded area indicate loss of vision area in that part while the blue ones indicate normal areas of vision)

a. 1
b. 2
c. 3
d. 4

A

d. 4

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4
Q

The table compares results of the gold standard test with another test X. If the patient presents with a positive result of test X, what will be the probability of him having the disease?

a. 13.5 %
b. 84.3%

A

a. 13.5 %

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5
Q

What is the purpose of rapidly adapting receptors?

a. Detect stimuli which are progressively increasing
b. Fire at the beginning and the end of the stimulus

A

b. Fire at the beginning and the end of the stimulus

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6
Q

What is the principle of reciprocal excitation in Golgi tendon organ?

a. Afferent fiber Ib goes to the spinal cord and inhibits the motor neuron of the antagonist muscle
b. Afferent fiber Ia goes to the spinal cord and stimulates the motor neuron of the antagonist muscle
c. Afferent fiber Ib goes to the spinal cord and stimulates the motor neuron of the antagonist muscle

A

c. Afferent fiber Ib goes to the spinal cord and stimulates the motor neuron of the antagonist muscle

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7
Q

What is the purpose of 5 noradrenergic receptors in the postsynaptic sympathetic neurons?

a. To compensate if one type of receptors not working
b. To produce an organ specific response in the sympathetic system

A

b. To produce an organ specific response in the sympathetic system

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8
Q

Which of the following is responsible for increasing the blood flow to the brain in normal conditions?

A

Glutamate release

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9
Q

Which of the following when decreased will not cause much increase in the cerebral blood flow?

A

PO2

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10
Q

Which of the following will sharply increase upon a decrease in the cerebral perfusion pressure?

a. O2 extraction fraction
b. Cerebral blood flow
c. Cerebral metabolic rate of O2

A

a. O2 extraction fraction

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11
Q

Which of the following arteries plays a major role in Auto-regulation of cerebral blood flow?

a. Pial arteries
b. Penetrating arteries
c. Intraparenchymal arterioles

A

a. Pial arteries

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12
Q

What is the function of the reticular nucleus of the thalamus?

A

Modulates the flow of information between the thalamus and the cortex

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13
Q

Fires only when a motor response is required?

a. Posterior association cortex
b. Prefrontal cortex
c. Premotor cortex
d. Primary motor cortex
e. Limbic association cortex

A

b. Prefrontal cortex

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14
Q

Involved in retaining memories that were consolidated previously and regulating emotion?

a. Posterior association cortex
b. Prefrontal cortex
c. Premotor cortex
d. Primary motor cortex
e. Limbic association cortex

A

e. Limbic association cortex

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15
Q

Apperceptive agnosia?

a. A patient can name objects but can’t draw them
b. A patient can’t name objects but can draw them
c. A patient can’t recognize the world on his left
d. A patient can’t recognize his left half of the body
e. A patient can’t recognize the left side of a well-remembered image of a well-known landmark
f. A patient can’t recognize the movement of an object, its speed, or location
g. A patient can’t visually scan objects or reach for an object of interest.

A

a. A patient can name objects but can’t draw them

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16
Q

Representational agnosia?

a. A patient can name objects but can’t draw them
b. A patient can’t name objects but can draw them
c. A patient can’t recognize the world on his left
d. A patient can’t recognize his left half of the body
e. A patient can’t recognize the left side of a well-remembered image of a well-known landmark
f. A patient can’t recognize the movement of an object, its speed, or location
g. A patient can’t visually scan objects or reach for an object of interest.

A

e. A patient can’t recognize the left side of a well-remembered image of a well-known landmark

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17
Q

Damage to the dorsal stream of the posterior association cortex?

a. A patient can name objects but can’t draw them
b. A patient can’t name objects but can draw them
c. A patient can’t recognize the world on his left
d. A patient can’t recognize his left half of the body
e. A patient can’t recognize the left side of a well-remembered image of a well-known landmark
f. A patient can’t recognize the movement of an object, its speed, or location
g. A patient can’t visually scan objects or reach for an object of interest.

A

?

f. A patient can’t recognize the movement of an object, its speed, or location

OR

g. A patient can’t visually scan objects or reach for an object of interest.

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18
Q

What is the consequence of damaged occipitotemporal association cortex?

a. The patient can draw an object but can’t name it
b. The patient can’t draw an object but can name it

A

a. The patient can draw an object but can’t name it

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19
Q

A patient suffered from an ischemic stroke due to occlusion of the MCA. He wasn’t able to choose words about what he intended to say. His ability of repeating words was also compromised. Additionally, he had a problem in word comprehension. Which of the following conditions might this patient have?

a. Wernicke’s aphasia
b. Conductive aphasia
c. Broca’s aphasia

A

a. Wernicke’s aphasia

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20
Q

Which of the following is primarily responsible for long term depression seen in cerebellar cortex?

a. Binding of glutamate released from parallel fibers to purkinji cells membrane
b. Raise in the intracelluar calcium concentration

A

b. Raise in the intracelluar calcium concentration

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21
Q

What is the result of increased cortex impulses to the indirect pathway of the striatum?

a. Phasic activation of the thalamus
b. Phasic activation of the subthalamic nucleus
c. Tonic inhibition of GPe

A

b. Phasic activation of the subthalamic nucleus

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22
Q

What is the result of loss of dopamine effect on the indirect pathway of the striatum?

a. Increased inhibition from the striatum to GPi and SNr/ increased inhibition of the GPi and SNr
b. Increased inhibition from the striatum to GPe

A

b. Increased inhibition from the striatum to GPe

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23
Q

What is the result of excessive damage to striatal neurons?

a. Akinesia
b. Bradykinesia
c. Rigidity
d. Huntington’s chorea
e. Hemiballismus

A

a. Akinesia

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24
Q

What is the result of damage to the subthalamic nucleus?

a. Akinesia
b. Bradykinesia
c. Rigidity
d. Huntington’s chorea
e. Hemiballismus

A

e. Hemiballismus

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25
Q

Which of the following is correct regarding the lateral premotor area?

a. It is responsible for selecting movements based on external cues
b. It has no direct connection with the spinal cord
c. Its stimulation causes the movement of a discrete muscle

A

a. It is responsible for selecting movements based on external cues

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26
Q

Which of the following areas is activated when a person imagines a movement?

a. Lateral premotor area
b. Primary motor area
c. Supplementary motor area

A

c. Supplementary motor area

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27
Q

Why are the waves that are recorded from EEG or MEG not typical sine waves?

a. Because the activity of the brain has low frequency
b. Because the neurons that produce sine wave lie deep in the brain
c. Because the electrical activity is obscured by non-synchronous activity of the brain

A

c. Because the electrical activity is obscured by non-synchronous activity of the brain

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28
Q

Which of the following is the first to develop in an epileptic focus when a seizure begins?

a. Sustained depolarization of neurons
b. A burst of action potentials
c. Paroxysmal depolarization shift

A

c. Paroxysmal depolarization shift

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29
Q

Seen in EEG in an anxious or highly intellectually active individual?

a. Alpha waves
b. Beta waves
c. Delta waves
d. Theta waves
e. Polyphasic spikes
f. Sharp wave
g. Spike-slow wave complex

A

b. Beta waves

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30
Q

Seen in EEG in the tonic phase of grand mal seizure?

a. Alpha waves
b. Beta waves
c. Delta waves
d. Theta waves
e. Polyphasic spikes
f. Sharp wave
g. Spike-slow wave complex

A

e. Polyphasic spikes

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31
Q

Seen in EEG upon the development of interictal Paroxysmal depolarization shift?

a. Alpha waves
b. Beta waves
c. Delta waves
d. Theta waves
e. Polyphasic spikes
f. Sharp wave
g. Spike-slow wave complex

A

f. Sharp wave

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32
Q

What is the mechanism of sodium entry into taste receptors responsible for salt?

a. Active transport of sodium
b. Voltage gated sodium channels opening
c. Entry of sodium along its gradient

A

c. Entry of sodium along its gradient

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33
Q

Which of the following stages of sleep is considered as “restart” to the brain so that beta waves are seen in EEG?

a. REM
b. Stage 1
c. Stage 2
d. Deep sleep

A

a. REM

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34
Q

A person is feeling thirsty although his total volume of fluid is normal. What is the mechanism responsible for
this thirst?

a. Baroreceptors activation
b. Hypothalamic osmoreceptors activation

A

b. Hypothalamic osmoreceptors activation

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35
Q

What is the driving force of CSF production in the choroid plexus?

a. Active transport of sodium along the capillary epithelial cells
b. Osmotic gradient along the choroidal cells (osmotic gradient of Na in choridal epithelial cells)
c. Filtrate of the plasma
d. Bulk flow from the brain to CSF

A

b. Osmotic gradient along the choroidal cells (osmotic gradient of Na in choridal epithelial cells)

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36
Q

Which hypothalamic nucleus is responsible for shivering in a cold environment?

a. Supraoptic nucleus
b. Preoptic nucleus
c. Arcuate nucleus
d. Mammillary nucleus
e. Posterior nucleus
f. Ventromedial Nucleus

A

e. Posterior nucleus

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37
Q

Which nucleus is responsible for dissipating heat?

a. Supraoptic nucleus
b. Preoptic nucleus
c. Arcuate nucleus
d. Mammillary nucleus
e. Posterior nucleus
f. Ventromedial Nucleus

A

b. Preoptic nucleus

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38
Q

Which nucleus causes satiety when stimulated?

a. Supraoptic nucleus
b. Preoptic nucleus
c. Arcuate nucleus
d. Mammillary nucleus
e. Posterior nucleus
f. Ventromedial Nucleus

A

f. Ventromedial Nucleus

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39
Q

Which nucleus functions to induce hunger?

A

Lateral nucleus

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40
Q

Which of the following cells are the most important in center-surround phenomenon that is seen in retina?

a. Amacrine cells
b. Bipolar cells
c. Ganglion cells
d. Horizontal cells

A

d. Horizontal cells

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41
Q

A patient suffered from damage to the 2 hippocampi. The doctor wanted to test his memory. He sticked a thumbstick (pin) in his hand then shook hands with the patient, causing pain in the patient. What response do you expect from the patient next day when he comes to the hospital and shakes hands with the doctor?

a. He will shake hands normally because he doesn’t remember anything from the day before
b. He won’t shake hands because he can’t perceive the world on his left
c. He will pull his hands away at the last minute because of a feeling of fear

A

c. He will pull his hands away at the last minute because of a feeling of fear

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42
Q

Which of the following do you expect to occur in a patient who suffers from damage to the inhibitory reticular formation?

a. Dysfunction of the breathing rhythm
b. Breathing stops
c. Inhibition of the stretch reflexes
d. Increased arousal in the patient

A

c. Inhibition of the stretch reflexes

(C is the correct answer according to the doctor but only 9% of the batch chose it so he talked to the exam committee if they can consider D correct as well (although one would assume that destruction of the inhibitory reticular formation would lead to increase arousal it doesn’t happen in reality that’s why it isn’t correct but theoretically it could)

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43
Q

Which of the following is responsible for regaining the posture/ balance in a person after an unexpected push from his back while he is walking?

a. Activation of a polysynaptic reflex
b. Activation of a monosynaptic reflex
c. Feedback mechanism involving the brainstem
d. A complex feedback and feedforward mechanisms involving the spinal cord

A

c. Feedback mechanism involving the brainstem

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44
Q

What is responsible for spontaneous postural control?

a. Vestibular nuclei
b. Cerebellar neurons
c. Excitatory area of the reticular formation

A

c. Excitatory area of the reticular formation

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45
Q

Has afferents from the supplementary motor, premotor and somatosensory areas as well as from the substantia nigra?

a. Red nucleus
b. Deep cerebellar nuclei
c. Vestibular nuclei
d. Caudate nucleus
e. Globus pallidus
f. Caudate nucleus

A

d. Caudate nucleus

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46
Q

The cerebellum projects to the spinal cord via this nucleus?

a. Red nucleus
b. Deep cerebellar nuclei
c. Vestibular nuclei
d. Caudate nucleus
e. Globus pallidus
f. Caudate nucleus

A

a. Red nucleus

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47
Q

What supply superior oblique?

a. occulomotor
b. Abducent
c. Trochlear
d. Maxillary branch of trigeminal
e. Mandibular branch of trigeminal
f. Ophthalmic branch of trigeminal

A

c. Trochlear

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48
Q

What supply lateral rectus?

a. occulomotor
b. Abducent
c. Trochlear
d. Maxillary branch of trigeminal
e. Mandibular branch of trigeminal
f. Ophthalmic branch of trigeminal

A

b. Abducent

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49
Q

A patient suffered from a disk prolapse in the level of T6-T7 vertebrae which spinal nerve will be affected?

a. T4
b. T5
c. T6
d. T7

A

c. T6

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50
Q

What disease results from mutation in Chloride channel, CHRA4

a. Dravet syndrome
b. Benign familial neonatal seizure (BFNS)
c. Benign epilepsy with variable age of onset
d. Autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE)
e. Generalized epilepsy with febrile seizure plus (GEFS+)
f. Febrile seizures in childhood

A

d. Autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE)

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51
Q

What disease results from mutation in potassium channel, KCNQ2

a. Dravet syndrome
b. Benign familial neonatal seizure (BFNS)
c. Benign epilepsy with variable age of onset
d. Autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE)
e. Generalized epilepsy with febrile seizure plus (GEFS+)
f. Febrile seizures in childhood

A

b. Benign familial neonatal seizure (BFNS)

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52
Q

Typical cyclic antidepressant that is used in the case of severe depression:

a. Fluoxetine
b. Citalopram
c. Venlafaxine
d. Duloxetine
e. Mirtazapine
f. Imipramine
g. Phenelzine
h. Clozapine

A

f. Imipramine

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53
Q

Enhance serotonin and noradrenaline neurotransmission by antagonizing presynaptic a2-
adrenoceptors:

a. Fluoxetine
b. Citalopram
c. Venlafaxine
d. Duloxetine
e. Mirtazapine
f. Imipramine
g. Phenelzine
h. Clozapine

A

e. Mirtazapine

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54
Q

Is used to treat the negative symptoms associated with schizophrenia:

a. Fluoxetine
b. Citalopram
c. Venlafaxine
d. Duloxetine
e. Mirtazapine
f. Imipramine
g. Phenelzine
h. Clozapine

A

h. Clozapine

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55
Q

Can cause QT prolongation:

a. Phenelzine
b. Fluoxetine
c. Thioridazine
d. Mirtazapine
e. Haloperidol
f. Chlorpromazine
g. Aripiprazole

A

c. Thioridazine

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56
Q

Can lead to Extrapyramidal motor effects (EPS) due to its strong affinity (tight binding) to
dopaminergic receptors:

a. Phenelzine
b. Fluoxetine
c. Thioridazine
d. Mirtazapine
e. Haloperidol
f. Chlorpromazine
g. Aripiprazole

A

e. Haloperidol

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57
Q

Drug to drug or drug to food interaction:

a. Phenelzine
b. Fluoxetine
c. Thioridazine
d. Mirtazapine
e. Haloperidol
f. Chlorpromazine
g. Aripiprazole

A

a. Phenelzine

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58
Q

Where is the location of the frontal eye field in the cerebral cortex?

a. Superior frontal gyrus
b. Middle frontal gyrus
c. Inferior frontal gyrus
d. Superior temporal gyrus
e. Occipital lobe

A

b. Middle frontal gyrus

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59
Q

The embryological origin of hypoglossal nucleus?

a. Alar plate
b. Basal plate
c. Rhombic lip
d. Marginal zone
e. Mantle zone
f. Ventricular zone
g. Neural crest cells

A

b. Basal plate

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60
Q

The embryological origin of dentate nucleus?

a. Alar plate
b. Basal plate
c. Rhombic lip
d. Marginal zone
e. Mantle zone
f. Ventricular zone
g. Neural crest cells

A

a. Alar plate

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61
Q

chemoprophylaxis used for a mother whose child is suffering from H. influnzae meningitis?

a. Ampicillin
b. Gentamicin
c. Rifampicin
d. Vancomycin
e. Cefotaxime
f. Ceftriaxone
g. Dexamethasone

A

c. Rifampicin

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62
Q

chemoprophylaxis used for a pregnant woman whose husband is suffering from meningococcal meningitis after returning from haj?

a. Ampicillin
b. Gentamicin
c. Rifampicin
d. Vancomycin
e. Cefotaxime
f. Ceftriaxone
g. Dexamethasone

A

f. Ceftriaxone

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63
Q

A group of people are traveling to a country known for being an endemic area for meningococcal meningitis. What infection control measure should be followed/done?

a. Vaccines
b. Contact precaution

A

a. Vaccines

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64
Q

Which of the following is present in abnormal prion PRPsc but not in the normal prion PRPc?

a. Increased beta sheets folding
b. Extensive alpha helix structure
c. Is easily degraded by protease enzymes

A

a. Increased beta sheets folding

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65
Q

Which of the following nerves is the least likely one to be affected in case of cavernous sinus thrombosis?

a. Abducent nerve
b. Trochlear nerve
c. Ophthalmic branch of trigeminal
d. Maxillary branch of trigeminal
e. Mandibular branch of trigeminal

A

e. Mandibular branch of trigeminal

66
Q

Which one is found in large amounts during dark phase ?

a. Rhodopsin
b. cGMP
c. PDE
d. Guanylate cyclase
e. Transducin

A

b. cGMP

67
Q

All trans retinal separates from it after it absorbs light:

a. Rhodopsin
b. cGMP
c. PDE
d. Guanylate cyclase
e. Transducin

A

a. Rhodopsin

68
Q

what is the cause of leber’s congenital amaurosis (LCA)?

A

Inability to regenerate 11-cis retinal from all transretinal due to protein mutation (RPE isomerase mutation)

69
Q

Which of the following nerves is involved in corneal reflex?

a. Trigeminal
b. Optic
c. Oculomotor
d. Trochlear
e. Abducent

A

a. Trigeminal

70
Q

What is the major component of the extracellular plaques associated with Alzheimer’s disease?

a. Abeta
b. Amyloid precursor protein (APP)
c. Tau

A

a. Abeta

71
Q

Which one is a prion disease characterized by spongiform changes?

a. Alzheimer’s disease
b. Huntington
c. Creutzfeldt Jakob
d. Sydenham chorea
e. Pick’s disease
f. Vascular dementia
g. Amyotrophic lateral sclerosis

A

c. Creutzfeldt Jakob

72
Q

Which one is a frontotemporal lobar degeneration characterized by tau histopathology

a. Alzheimer’s disease
b. Huntington
c. Creutzfeldt Jakob
d. Sydenham chorea
e. Pick’s disease
f. Vascular dementia
g. Amyotrophic lateral sclerosis

A

e. Pick’s disease

73
Q

Which of the following is not associated with hypertension?

a. Lacunar infarct
b. Slit hemorrhage
c. Hyaline arteriosclerosis
d. Charcot bouchard microaneurysm
e. Cerebral amyloid angiopathy

A

e. Cerebral amyloid angiopathy

74
Q

What is a hallmark of neurodegenerative diseases?

a. Dementia is a main finding in all neurodegenerative diseases
b. White matter is affected
c. Aggregation of misfolded/abnormal proteins causes neuronal injury

A

c. Aggregation of misfolded/abnormal proteins causes neuronal injury

75
Q

What will occur if the most medial part of the cerebrum in area 4 (primary motor area) is affected?

a. Loss of sensation in the face
b. Inability to move toes
c. Difficulty swallowing

A

b. Inability to move toes

76
Q

The principle pathophysiology behind the active lesion of multiple sclerosis?

a. t-cell CD4 mediated inflammation against myelin protein
b. complement mediated damage
c. Auto immune reaction elicited after a viral infection

A

a. t-cell CD4 mediated inflammation against myelin protein

77
Q

responsible for the production of ketone bodies in the brain during ischemia?

a. Microglia
b. Oligodendrocytes
c. Astrocytes
d. Macrophages

A

c. Astrocytes

78
Q

What is the best treatment plan for a patient diagnosed with Parkinson’s disease?

a. Carbidopa-selegiline-amantadine
b. Levodopa-carbidopa-entacapone
c. Carbidopa-domperidone-benzotropine d. Domperidole-ropinirole-amantadine

A

b. Levodopa-carbidopa-entacapone

79
Q

What is the mechanism of action of ropinirole?

A

Agonist of dopamine D2 receptor in the CNS

80
Q

A patient presented with lose of sensation in the 3 lateral fingers and upon taping on the wrist the patient felt tingling sensation along the distribution of the nerve indicating positive tinel’s sign and it was confirmed that he has carpal tunnel syndrome. Which of the following describes the patient’s condition?

a. Mononeuropathy
b. Mononeuropathy multiplex
c. Polyneuropathy
d. Polyradiculoneuropathy

A

a. Mononeuropathy

81
Q

which one is a peripheral dopa decarboxylase inhibitor?

a. Amantadine
b. Benserazide
c. Ropinirole
d. Entacapone
e. Tolcapone
f. Selegiline
g. Benzotropine
h. Domperidone

A

b. Benserazide

82
Q

which one is a muscarinic antagonist?

a. Amantadine
b. Benserazide
c. Ropinirole
d. Entacapone
e. Tolcapone
f. Selegiline
g. Benzotropine
h. Domperidone

A

g. Benzotropine

83
Q

What is the mechanism of action of donepezil?

A

Acetylcholinesterase inhibitor

84
Q

Which of the following is true about local anesthetics?

a. They are weak acids
b. their effect could be prolonged with the use of adrenaline

A

b. their effect could be prolonged with the use of adrenaline

85
Q

how does NK-1 receptor participate in inducing central sensitization?

A

By increasing the release of calcium from intracellular stores by forming IP3

86
Q

What is the mechanism of action of benzodiazepines?

a. Enhance GABA-A mediated inhibition through binding to the receptor active site
b. Enhance GABA-A mediated inhibition through binding to the modulatory site of the receptor

A

b. Enhance GABA-A mediated inhibition through binding to the modulatory site of the receptor

87
Q

What does the striatum consist of?

a. Putamen and globus pallidus
b. Caudate and subthalamic nucleus
c. Caudate and putamen
d. Globus pallidus and caudate

A

c. Caudate and putamen

88
Q

What will happen in case of damage to the left posterior column of spinal cord?

a. Loss of pain and temperature sensation on the right side
b. Loss of pain and temperature sensation on the left side
c. Weakness of muscles on the left side
d. Loss of proprioception on the left side
e. Loss of proprioception on the right side

A

d. Loss of proprioception on the left side

89
Q

Increased phosphorylation of this leads to intracellular accumulation of neurofibrillary tangles:

a. Alpha synuclein
b. Polyglutamine
c. Tau
d. FUS
e. SOD1
f. APP
g. TDP-43

A

c. Tau

90
Q

an abnormal processing of this gives Abeta 42:

a. Alpha synuclein
b. Polyglutamine
c. Tau
d. FUS
e. SOD1
f. APP
g. TDP-43

A

f. APP

91
Q

Drug that induce metabolism/(interact with) of other antiepileptics, anticoagulants, and oral contraceptives:

a. Valproate
b. Ethosuximide
c. Diazepam
d. Tiagabine
e. Phenytoin
f. Lamotrigine
g. Vigabatrin

A

e. Phenytoin

92
Q

Causes irreversible visual field defects in some patients:

a. Valproate
b. Ethosuximide
c. Diazepam
d. Tiagabine
e. Phenytoin
f. Lamotrigine
g. Vigabatrin

A

g. Vigabatrin

93
Q

What is the function of memantine in Alzheimer’s disease?

A

NMDA receptor antagonist

94
Q

Which of the following cells proliferate in peripheral nerve injury for neuron regeneration?

a. Macrophages
b. Endothelial cells
c. Schwann cells
d. Oligodendroglia

A

c. Schwann cells

95
Q

Act as a mu (u) agonist and serotonin-norepinephrine reuptake inhibitor (SNRI)?

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

A

b. Tramadol

96
Q

What are the characteristics of a drug that crosses the blood brain barrier?

a. High lipid solubility, low molecular weight (<500 Da), high hydrogen bonds with water
b. Low lipid solubility, low molecular weight (<500Da), high hydrogen bonds with water
c. High lipid solubility, Low molecular weight (<500 Da), low hydrogen bonds with water
d. High lipid solubility, high molecular weight (>500 Da), low hydrogen bonds with water

A

c. High lipid solubility, Low molecular weight (<500 Da), low hydrogen bonds with water

97
Q

What’s the best treatment for herpes-simplex induced encephalitis?

a. Acyclovir
b. Ampicillin
c. Cefotaxime
d. Flucytosine
e. Gentamicin
f. Ganciclovir
g. Ceftriaxone

A

a. Acyclovir

98
Q

What’s the best treatment for cytomegalovirus? (don’t remember the scenario)

a. Acyclovir
b. Ampicillin
c. Cefotaxime
d. Flucytosine
e. Gentamicin
f. Ganciclovir
g. Ceftriaxone

A

f. Ganciclovir

99
Q

A disorder secondary to mutation in ABCD1 resulting in a deficiency in the cellular transporter found in peroxisomes and accumulation of long chain fatty acids:

a. hereditary sensory neuropathy
b. X-ALD
c. hereditary neuropathy with liability to pressure palsies (HNPP)
d. friedrich ataxia
e. zelweger syndrome
f. familial amyloid neuropathy
g. krabbe disease
h. porphyrias
i. neurofibromatosis type 1
j. Axoplasmic transport

A

b. X-ALD

100
Q

A peroxisomal biogenesis disorder causes severe neurological dysfunction due to CNS malformation and myelin abnormalities also causes dysmorphic features and liver dysfunction along with skeletal abnormalities:

a. hereditary sensory neuropathy
b. X-ALD
c. hereditary neuropathy with liability to pressure palsies (HNPP)
d. friedrich ataxia
e. zelweger syndrome
f. familial amyloid neuropathy
g. krabbe disease
h. porphyrias
i. neurofibromatosis type 1
j. Axoplasmic transport

A

e. zelweger syndrome

101
Q

A patient presented with fever, headache, and nuchal rigidity, a CSF sample was obtained and revealed a Gram-positive bacilli infection, which of the following is most likely the causative microorganism?

a. Haemophilus influenzae
b. Streptococcus pneumonia
c. Neisseria meningitidis
d. E.coli
e. Listeria monocytogenes

A

e. Listeria monocytogenes

102
Q

A 14-year-old patient presented with headache, fever, and photophobia, examination revealed purpuric rash on the trunk and nuchal rigidity, what is expected to be found under the microscope if the causative organism is isolated and stained with Gram stain?

a. Gram negative diplococci.
b. Gram positive cocci.
c. Gram positive bacilli
d. Gram negative bacilli

A

a. Gram negative diplococci.

103
Q

A 5-year-old patient presented with fever, headache, and nuchal rigidity, a CSF sample was obtained and revealed a Gram-negative coccobacilli infection, which of the following is most likely the causative microorganism?

a. E.coli
b. Streptococcus pneumonia
c. Haemophilus influenzae
d. Neisseria meningitidis
e. Listeria monocytogenes

A

c. Haemophilus influenzae

104
Q

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

a. Dentotahalmic
b. Rubrospinal
c. Corticospinal
d. Medial lemniscus

A

a. Dentotahalmic

105
Q

What connects the right cerebral hemisphere with the left cerebellar hemisphere?

a. Superior cerebellar peduncles decussation
b. Motor decussation
c. Sensory decussation
d. Pontocerebellar fibers
e. Dorsal tegmental decussation

A

d. Pontocerebellar fibers

106
Q

What is the main output of the cerebellum?

a. Superior cerebellar peduncles decussation
b. Motor decussation
c. Sensory decussation
d. Pontocerebellar fibers
e. Dorsal tegmental decussation

A

a. Superior cerebellar

107
Q

Dentothalamic tract:

a. Superior cerebellar peduncles decussation
b. Motor decussation
c. Sensory decussation
d. Pontocerebellar fibers
e. Dorsal tegmental decussation

A

a. Superior cerebellar

108
Q

Post-mortem examination of a patient who died of a febrile illness showed bilateral temporal
necrosis. What is the diagnosis?

A

Herpes encephalitis

109
Q

Which drug can be given to reduce anxiety and relieve muscle strain?

A

Diazepam

110
Q

What is the mechanism of action of tiagabine?

A

Inhibits GABA reuptake

111
Q

Which of the following drugs predisposes to serotonin syndrome when taken with SSRI?

a. Imipramine
b. Phenylzine
c. Clozapine

A

b. Phenylzine

112
Q

What characterizes the mutation in Fragile X syndrome?

a. CAG trinucleotide repeats in the coding region of FMR protein
b. Dinucleotide repeats impairing protein function
c. Transcription initiation failure causing protein silencing

A

c. Transcription initiation failure causing protein silencing

113
Q

A 50-year-old patient developed a hemorrhagic stroke in the thalamus and basal ganglia. Which arteries are most likely affected?

a. Deep penetrating arteries
b. Arteries of the circle of willis

A

a. Deep penetrating arteries

114
Q

A patient complained of diplopia and inability to look downward especially when going downstairs. He also had to tilt his chin to the side of the damage. Which extraocular muscle is most likely affected?

a. Superior oblique
b. Inferior rectus

A

a. Superior oblique

115
Q

Visual reflexes:

a. Red nucleus
b. Inferior colliculus
c. Inferior olivary nucleus
d. Vestibular nuclei
e. Superior colliculus

A

e. Superior colliculus

116
Q

Auditory radiation:

a. Red nucleus
b. Inferior colliculus
c. Inferior olivary nucleus
d. Vestibular nuclei
e. Superior colliculus

A

b. Inferior colliculus

117
Q

What is the origin of the medial leminiscus?

a. dorsal root ganglia
b. ipsilateral cuneatus and gracilis nuclei
c. contralateral Cuneatus and gracilis nuclei

A

c. contralateral Cuneatus and gracilis nuclei

118
Q

A patient complains of paralysis of the facial muscles on one side of his face, inability to deviate his eye laterally, as well as spastic paralysis in his upper limbs. Where is the lesion most likely located?

A

Pons

119
Q

What is the most reliable/ commonly used test to diagnose viral CNS infections?

a. ELISA
b. CSF PCR

A

b. CSF PCR

120
Q

A patient suffers from paralysis of the facial muscles on one side on his face. He also has sensitivity to sound (perceives normal sounds as high and annoying). Which muscle is most likely the cause of this condition?

A

Stapedius

121
Q

Which of the following criteria is the most important one in justifying the use of screening tests?

A

Treatment in the early stage of the disease helps improve the outcome

122
Q

Which of the following is the most important preventive measure of blindness caused by cataract? (which of the following is true about cataracts?)

A

Surgery to correct for blindness due to cataracts is the most cost-effective method.

123
Q

Which of the following structures develops/ forms because of the formation of the pontine flexure?

a. cerebral aqueduct
b. Third ventricle
c. Fourth ventricle
d. Lateral ventricles

A

c. Fourth ventricle

124
Q

Which of the following causes depolarization in crista ampullaris?

a. Stereocilia deflection away from the kinocilium
b. Stereocilia deflection towards the kinocilium

A

b. Stereocilia deflection towards the kinocilium

125
Q

A young female developed a subarachnoid hemorrhage. What is the most likely cause?

a. Traumatic
b. Congenital
c. Infectious

A

b. Congenital

126
Q

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

A

Edinger Westphal nucleus

127
Q

Which of the following nuclei gives rise to the preganglionic parasympathetic fibers that go to the otic ganglion to supply the parotid gland?

a. Superior salivatory nucleus
b. Dorsal vagal nucleus
c. Nucleus ambiguus
d. Inferior salivatory nucleus

A

d. Inferior salivatory nucleus

128
Q

Which of the following nuclei gives rise to the preganglionic parasympathetic fibers that supply the sublingual/ mandibular gland?

a. Superior salivatory nucleus
b. Dorsal vagal nucleus
c. Facial nucleus
d. Inferior salivatory nucleus

A

a. Superior salivatory nucleus

129
Q

A patient underwent a renal transplantation surgery after which he was on immune suppressant therapy. He had demyelination plaques in several areas in the spinal cord and the cerebrum. Which of the following is most likely the cause?

a. HIV virus
b. JC virus

A

b. JC virus

130
Q

Demyelination plaques. On microscope, histocytes with globoid appearance, what is the cause?

A

Krabbe disease

131
Q

A patient suffered from three episodes of severe convulsions that were not separated in time. What is this condition? (medical emergency of continuous seizures which are not separated in time)?

a. grand mal seizure
b. tonic-clonic seizures
c. status epilepticus
d. juvenile myoclonic syndrome

A

c. status epilepticus

132
Q

A patient suffered from abnormal excessive electrical activity in both hemispheres from the start of the episode. How would you describe this episode? (or A seizure that involves the whole cerebrum from the beginning of its development)?

a. Primary generalized seizures
b. Secondary generalized seizures
c. Focal seizures

A

a. Primary generalized seizures

133
Q

An HIV patient in Arizona (west of USA) had an infection after inhalation of arthrospores:

a. Aspergillus fumigatus
b. Coccidioides immitis
c. Blastomyces dermatitidis
d. Histoplamsa capsulatum
e. Cryptococcus gatti
f. pneumocystis jiroveci

A

b. Coccidioides immitis

134
Q

Produces melanin and has a capsule as a virulence factor:

a. Aspergillus fumigatus
b. Coccidioides immitis
c. Blastomyces dermatitidis
d. Histoplamsa capsulatum
e. Cryptococcus gatti
f. pneumocystis jiroveci

A

e. Cryptococcus gatti

135
Q

A patient presents with left leg loss of proprioception and discriminative touch. Which of the following structures might be affected?

a. Left fasciculus cuneatus
b. Right fasciculus gracilis
c. Left fasciculus gracilis
d. Right fasciculus cuneatus

A

c. Left fasciculus gracili

136
Q

A patient with a history of head trauma after a fall presents to the ER. CT scans shows a hemorrhage between the dura and subarachnoid layers. What is the risk for bleeding in this case?

A

Brain atrophy

137
Q

What is the condition, in which antibodies against aquaporin 4 are found, known as?

a. Neuromyelitis Optica
b. Central pontine myelinosis
c. Progressive multifocal leukoencephalopathy

A

a. Neuromyelitis Optica

138
Q

A patient presents with muscle weakness on the left lower and upper limbs. Physical examination indicates loss of proprioception/discriminative touch on the same side. Which of the following is the most probable site of injury?

a. Left posterior limb of internal capsule
b. Right posterior limb of internal capsule
c. Right primary motor cortex
d. Left primary motor cortex

A

b. Right posterior limb of internal capsule

139
Q

A patient presents with inability to move his left upper and lower limbs. Physical examination shows positive Babinski sign. Which of the following is the most probable site of injury?

a. left lateral corticospinal tract
b. Left spinothalamic tract
c. Right lateral corticospinal tract
d. Right spinothalamic tract

A

a. left lateral corticospinal tract

140
Q

At brain autopsy, the specimen showed opacified and fibrosed basal meninges. Which of the following microorganisms are most likely to be responsible for this finding?

a. Mycobacterium Tuberculosis
b. Streptococcus pneumoniae
c. Staphylococcus aureus
d. Hemophilus Influenzea

A

a. Mycobacterium Tuberculosis

141
Q

A patient died due to untreated meningitis. Fungal meningitis was suspected, and the organism was stained with India ink stain. Which of the following organisms is responsible for the death of the patient? (An immunosuppressed patient after a transplantation suffered from meningitis. CSF staining was positive for India ink stain. What is the most likely cause?)

A

Cryptococcus neoformans

142
Q

Histopathological examination of a brain specimen taken from a patient who died and had hydrocephalus due to blockage of the cerebral duct shows small round blue undifferentiated cells. (A 9-year-old boy presented with headache, vomiting, and ataxia. A 4 cm mass is shown on MRI in the cerebellar vermis, he also has enlarged ventricles. CSF examination showed small round dark blue cells.) Which of the following tumors is most likely?

A

Medulloblastoma

143
Q

An elderly patient passed away due to a brain tumor. Histopathological examination of the brain showed cells pallisading around central necrosis with proliferation of the capillaries/endothelium. Which of the following tumors is most likely the cause of death in this patient?

A

Glioblastoma

144
Q

A patient presents with reduced hearing ability and patches on her skin. Imaging techniques showed a mass in the cerebro-pontine angle, and the skin biopsy of the patches showed alternating areas of hypo- and hypercellularities as well as Verocay bodies. Which of the following tumors is most likely the cause?

A

Schwannoma

145
Q

Which of the following receives most of the efferent fibers from cochlear nerve?

A

Outer hair cells of both ears

146
Q

Which of the following, if damaged, would result in left unilateral loss of hearing?

A

Left cochlear nerve

147
Q

Which of the following, if damaged, would result in left unilateral loss of hearing?

A

Organ of corti

148
Q

A patient had hydrocephalus. Upon screening, the lateral and the third ventricles were enlarged, and the fourth ventricle was normal in size. Where is the blockage site?

A

Cerebral aqueduct

149
Q

A diabetic patient presents to the neurology clinic with complaints of loss of sensation. Upon physical examination, it was found that the loss of sensation affects the hand below the wrist and the leg below the knees in a bilateral distribution. What is this condition? (A patient with a history of diabetes for several years. He now presents with loss of sensation bilaterally and symmetrically in the legs below the knees and hands. What condition does this patient have?)

a. Polyneuropathy
b. Mononeuropathy
c. Mononeuropathy multiplex
d. Guillian-Barre syndrome
e. Polyradiculopathy

A

a. Polyneuropathy

150
Q

The rostrum of the corpus callosum forms its floor:

a. Third ventricle
b. Fourth ventricle
c. Cerebral aqueduct
d. Cerebellomedullary cistern
e. Anterior horn of lateral ventricle
f. Posterior horn of lateral ventricle
g. Inferior horn of lateral ventricle

A

e. Anterior horn of lateral ventricle

151
Q

The tail of the caudate nucleus forms its roof:

a. Third ventricle
b. Fourth ventricle
c. Cerebral aqueduct
d. Cerebellomedullary cistern
e. Anterior horn of lateral ventricle
f. Posterior horn of lateral ventricle
g. Inferior horn of lateral ventricle

A

g. Inferior horn of lateral ventricle

152
Q

Imaging techniques show multiple lesions/foci (at the junction between gray and white matter) of the brain. What would be the most probable diagnosis?

A

Brain metastasis.

153
Q

An elderly fell down & developed a hematoma sandwiched between the dura and arachnoid which of the following is the origin of bleeding?

a. bridging veins
b. anterior meningeal Artery
c. anterior meningeal vein
d. posterior meningeal artery

A

a. bridging veins

154
Q

A brain specimen showed purulent exudate and vessel congestion on the convexity of the cerebral cortex. Which of the following microorganisms is responsible for this finding?

a. Cryptococcus neoformans
b. Herpes simplex
c. Cytomegalovirus
d. Toxoplasma gondii
e. Neisseria meningitidis

A

e. Neisseria meningitidis

155
Q

The prevalence of gestational diabetes is 50%. A patient comes to you and you suspect her having gestational diabetes but with a pretest probability of 5%. What changes will occur to sensitivity, specificity, PPV and NPV?

A

same sensitivity, same specificity, decreased PPV, increased NPV

156
Q

Imaging techniques of a patient who is a known case of subacute endocarditis showed a ring- enhanced lesion. Analysis of a CSF sample showed high protein, normal glucose. What is the most probable diagnosis?

A

Brain abscess

157
Q

Sudden subarachnoid hemorrhage after lifting heavy object?

A

Ruptured Berry aneurysm

158
Q

A patient had a head trauma in a car accident. He was found unconscious, after which he gained consciousness then again went unconscious. Physical examination showed he had papilledema. The patient died. What is the most likely cause of death?

A

Brain herniation

159
Q

Efferent fibers from the cerebellum go to which of the following thalamic nuclei?

A

Ventrolateral nucleus

160
Q

A man had an accident through which he suffered from a neck injury. On examination, the patient couldn’t turn his head aside and he had a droopy shoulder. Which cranial nerve is most likely affected?

A

CNXI

161
Q

A patient had ipsilateral oculomotor nerve damage with contralateral hemiplegia. What condition is he suffering from?

A

Medial midbrain syndrome

162
Q

Which structure is first affected in Alzheimer’s disease?

A

Hippocampus

CNS module - 4th year COPY (19 decks)

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