2009 module exam

Question 1

Patient with loss of vibration and movement of a limb is due to damage to the lateral side of the left medial leminisci in the pons, what nucleus is affected?

Answer 1

Right hand

Question 2

Which tract is responsible for coordination of eye movement?

Answer 2

MLF

Question 3

A patient with left corticospinal tract lesion

Answer 3

Positive Babinski sign of the left foot

Question 4

Which is a fast adapting receptor?

Answer 4

Meissner corpuscle

Question 5

How do fast adapting receptors perceive the stimulus and generate the potential?

Answer 5

Get stimulus at beginning and end

Question 6

What increases the sensitivity of the muscle to stretch?

Answer 6

Gamma motor neuron

Question 7

What is the afferent pathway elicited in a clinically tested knee jerk?

Answer 7

I-a

Question 8

What is an example of a bilateral reflex?

Answer 8

Withdrawal reflex

Question 9

What initiates the movement in a muscle?

Answer 9

Multisynapse in the spinal circuit

Question 10

What is a function of stretch reflex?

Answer 10

Compensates for the unexpected disturbances during maintenance of posture

Question 11

A patient with muscle atrophy, weakness, flaccid paralysis, diminished reflexes, have a problem in

Answer 11

Anterior horn cells

Question 12

Damage to last finger and ring weakness

Answer 12

Ulnar nerve injury

Question 13

A patient with loss of vibration in left leg and loss of motor functions at the same leg with loss of pain and temperature of the right leg

Answer 13

Hemiplegia of the left part of the spinal cord at (T6-T12) (mo mohem mn wain lay wain elmohem elconcept)

Question 14

Which nerve is related to the red nucleus?

Answer 14

Occulomotor

Question 15

What is the function of the spinal nucleus of CN V?

Answer 15

Ipsilateral pain and temperature of the face

Question 16

What is supplied by the trochlear nerve?

Answer 16

Superior oblique

Question 17

What supplies the pharynx and larynx?

Answer 17

Nucleus ambiguous

Question 18

What is the main cause of CN III palsy?

Answer 18

PCA aneurysm

Question 19

Tubocurarine usually blocks (N1) ach receptors, why does it have no effect on the ANS?

Answer 19

Because N1 receptors are not found in ANS

Question 20

What increases activity of NA receptors?

Answer 20

ATP

Question 21

Demyelination of posterior and lateral spinal columns is caused by

Answer 21

Vitamin B deficiency

Question 22

Patient with MS and INO due to lesion in

Answer 22

MLF

Question 23

Alcoholic patient with MS is probably

Answer 23

Central pontine myelinolysis

Question 24

What is the best way to diagnose MS?

Answer 24

IgG index

Question 25

A patient with headaches, vision problems, and claudications, what is the best way to diagnose him?

Answer 25

ESR

Question 26

Type of immune-mediated activity against MG?

Answer 26

Complement

Question 27

Patient with loss of vision for 3 hours, then returned and after check up tests are normal

Answer 27

TIA

Question 28

Which part of the internal capsule contains corticospinal tract?

Answer 28

Posterior limb

Question 29

Which thalamic nuclei connect to cingulate gyrus?

Answer 29

Anterior thalamic nuclei

Question 30

Which nucleus connect to ML and SL ?

Answer 30

VPL

Question 31

Which cerebral cortex layers are well developed in motor cortex?

Answer 31

III and V

Question 32

Which artery is seen in the circle of willis?

Answer 32

Anterior cerebral artery

Question 33

A patient with shock due to MI

Answer 33

Watershed infarction

Question 34

Which fibers affect the alertness of a person?

Answer 34

Reticular formation afferents

Question 35

The main effector on cerebral blood flow

Answer 35

Partial pressure of CO2

Question 36

Patient with hypotension and cerebral blood flow from 50 became 25. What is a way to increase?

Answer 36

Increase in systemic BP

Question 37

Patient with hypotension and cerebral blood flow from 50 became 25 for half an hour, and then restored. What happened to the neurons at that time?

Answer 37

Transient loss of neuronal activity

Question 38

What is the main way of fuel utilization in ischemia?

Answer 38

Induction of glycolytic pathway

Question 39

What is the neurotransmitter responsible for neuronal death and apoptosis after ischemia?

Answer 39

L-glutamate

Question 40

What is the mechanism of death of neurons in ischemia?

Answer 40

Opening of Ca++ channels and precipitation of metabolites

Question 41

What is the radiopharmaceutical used to diagnose cerebral metabolism?

Answer 41

F-18 deoxy glucose

Question 42

Nuclear imaging from Tc-99m HMPAO showed no blood flow in a patient with stroke and hemiplegia. Which area is affected?

Answer 42

Fronto-parietal lobe

Question 43

What is the function of prefrontal cortex?

Answer 43

Creation of working memory

Question 44

Stroke is the ... leading cause of death in Kuwait?

Answer 44

4th

Question 45

Why is the prevalence of stroke low in Kuwait?

Answer 45

Young population

Question 46

What determines the output of globus pallidum?

Answer 46

Subthalamic nuclei

Question 47

What sends dopaminergic fibers to striatum?

Answer 47

Substania Nigra

Question 48

What is the reason for akinesia in Parkinson’s?

Answer 48

Overactivity of indirect circuit

Question 49

What is caused by degeneration of striatal neurons?

Answer 49

Huntington’s

Question 50

What is caused by selective subthalamic nucleus lesion?

Answer 50

Hemiballism

Question 51

What is caused by neuroleptics?

Answer 51

Tardive dyskinesia

Question 52

What is the main mechanism of damping effect of cerebellum?

Answer 52

Excitation of purkinji neuron by both fibers

Question 53

Neurophysiologic mechanism of motor skill learning is based on

Answer 53

Long term depression

Question 54

What is the main characteristic of essential tremor?

Answer 54

Sustained tremor

Question 55

Loss of neurons in substania nigra will lead to

Answer 55

Parkinson’s

Question 56

Patient with nystagmus, gaze paresis, bilateral hypotonia, gait ataxia

Answer 56

Pancerebellar ataxia

Question 57

Alcoholic patient with gait ataxia

Answer 57

Damage to superior vermix

Question 58

Boxer who used to take many blows in the past suffers from which type of tremor? - Cerebellar - Essential - Parkinsonism

Answer 58

(we’re not sure which is the right answer)

Question 59

Why is it urgent to diagnose cerebellar infarction?

Answer 59

Because surgical evacuation of the hematoma prevent death from brainstem compression

Question 60

What is a cause of Hungtinton’s disease?

Answer 60

Expansion of CAG repeats

Question 61

What is the mechanism of dopamine action on the striatum?

Answer 61

Inhibit D2 receptors by adenylyl cyclase

Question 62

EBM – when is the lead time?

Answer 62

From time of screening until usual time of diagnosis

Question 63

EBM – a pretest probability of 20% with sensitivity of 50% and specificity of 75%. What is the NPV?

Answer 63

87%

Question 64

Low O2 and what will lead to ketone bodies formation?

Answer 64

Glucose

Question 65

What is the brain wave?

Answer 65

Current of ions in dendrites

Question 66

What leads to high amplitude and low frequency of the waves?

Answer 66

Synchronization of the waves

Question 67

What causes the spike of the interictal charge?

Answer 67

Paroxysmal depolarization shift

Question 68

Patient who is 14 years old develops a seizure and suddenly falls. His brother also has the same condition mainly in the morning with generalized tonic-clonic seizure. What syndrome is this?

Answer 68

Juvenile-myoclonic syndrome

Question 69

Which nucleus is important for keeping consciousness?

Answer 69

Orexin

Question 70

Patient with fracture to temporal lobe and he is fine but after 30 minutes fell into a coma

Answer 70

Extradural hematoma

Question 71

Synchronization of circardian rhythms occur mostly due to

Answer 71

Morning light

Question 72

Normal sleep is initiated by activation of

Answer 72

VLPO

Question 73

Ventral horn is developed by

Answer 73

Basal plate

Question 74

What is the structure affected in kluver-bucy syndrome?

Answer 74

Amyglada

Question 75

Short term memory to long term memory is by

Answer 75

Long term potentiation

Question 76

Noxious receptors

Answer 76

Increase Ca influx

Question 77

AD is characterized by

Answer 77

Amyloid plaques, tangles, and neuronal loss

Question 78

What may be best regulated?

Answer 78

Energy expenditure

Question 79

What causes tangles formation?

Answer 79

Hyperphosphorylation of tau

Question 80

What forms amyloid plaques?

Answer 80

aB

Question 81

What is the mechanism of oxidant formation in AD?

Answer 81

aB peptides

Question 82

patient with neurodegenerative disorder that shows vacuoles in cerebral cortex w/o pathological findings?

Answer 82

Prions disease

Question 83

What is bypassed during visual information (reading)?

Answer 83

Wernicke’s area

Question 84

What characterizes Alzheimers?

Answer 84

Loss of cerebral cortex

Question 85

What is the normal ICP in supine position?

Answer 85

8-18

Question 86

What type of aura is least associated with migraines?

Answer 86

Auditory

Question 87

Which type of headache occurs for 15-180 and associated with severe pain?

Answer 87

Cluster

Question 88

How do we diagnose a patient with headaches?

Answer 88

CT scan

Question 89

7-year-old child with a tumor in the cerebellum and the presence of Homer Wright Rosettes

Answer 89

Medulloblastoma

Question 90

Mother with Toxoplasma Gandi and she is pregnant in the first trimester. What will be soon?

Answer 90

Ring enhancing lesion

Question 91

Pathogenesis of cerebral malaria

Answer 91

Microvascular pathology

Question 92

Patient with thick exudate at cerebellum and pons

Answer 92

Tuberculous meningitis

Question 93

Which infection usually causes meningitis in sickle cell patients?

Answer 93

Hemophilis influenza

Question 94

Which virus causes subacute sclerosing panencephalitis?

Answer 94

Measles

Question 95

Which virus causes fatal encephalitis and can be vaccinated by an inactivated vaccine?

Answer 95

Rabies

Question 96

Which virus can cause acute post exposure syndromes ADEM?

Answer 96

Measles

Question 97

What is the prophylaxis for pregnant women for meningococcal meningitis?

Answer 97

Ceftriaxone

Question 98

Patient with meningitis and lactate CSF is 2.5

Answer 98

Viral meningitis

Question 99

What is the main cuase of variant prion disease in young people?

Answer 99

Eat food with BSE

Question 100

Which nerve is responsible for tightening the tympanic | membrane?

Answer 100

Mandibular

Question 101

What causes hyperacusis?

Answer 101

Facial nerve injury

Question 102

What causes damage to LL?

Answer 102

Cochlear nerve damage

Question 103

Vestibular, visual, and somatosensory system function together in

Answer 103

Vestibular nuclei

Question 104

While walking to go sit in class, during swinging of your left leg, which tract is active?

Answer 104

Left lateral corticospinal

Question 105

Why does sound amplify in children 3 months?

Answer 105

Areolar changes resorption in middle ear

Question 106

Patient with blue eyes, eczema, blondie hair, mental retardation

Answer 106

Phenylketonuria

Question 107

Which cell cause AP in eyes?

Answer 107

Ganglion cells

Question 108

Between which does retinal detachment occur?

Answer 108

Photoreceptors and retinal pigmentation epithelium

Question 109

Patient with tunnel vision

Answer 109

Peripheral retina

Question 110

Object agnosia

Answer 110

Temporal lobe

Question 111

Patient presents with pie in the sky

Answer 111

Temporal lobe affected

Question 112

Someone eats a salty substance. What happens?

Answer 112

Membrane depolarization by Na+ through gradient change

Question 113

Which structure lies in the middle of a sagittal section of the brain

Answer 113

Pineal gland