2013 module exam Flashcards by Susan w

The following EEG was taken from a 20 year old subject during sleep. What does this waveform indicate?

A typical interictal discharge
A sharp wave that does not indicate any abnormality
Typical ictal discharge

A sharp wave that does not indicate any abnormality

Note: the picture in the exam had a drop below the baseline BEFORE the sharp wave which confused some students and made them choose A. Interictal sharp waves usually have a drop below the baseline by the descending limb of the sharp wave (not before the sharp wave itself).

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An 18 year old male suffered from a car accident, resulting in a right hemi cord section. What would you see in clinical examination?

A. Loss of pain and sensation on right side
B. Loss of right proprioception and vibration
C. Loss of left proprioception and vibration D. Left Babinski sign

B. Loss of right proprioception and vibration

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A 28 year old woman had right ulnar nerve palsy and left perineal nerve palsy then left facial paralysis. All of that within 10 days. What is the diagnosis?

A. Mononeuropathy
B. Polyneuropathy
C. Mononeuropathy Multiplex

C. Mononeuropathy Multiplex

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What is the functional significance of having 5 diff types of Noradrenaline in sympathetic postganglionic system?

A. To potentiate each other
B. To prevent damage from drugs
C. To have organ specific sympathetic activity
D. Backup

C. To have organ specific

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A diabetic patient presented with loss of sensation in his lower limb below the knee bilaterally. He also lost sensation below his wrist

A. Mononeuritis multiplex
B. Mononeuropathy
C. Polyneuropathy

C. Polyneuropathy

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What is the origin of the medial lemniscus?

Gracile and cuneate nucleus

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A patient presented with weakness and atrophy of his lower limb muscles, no sensory deficit, fasciculation, and absent reflexes. What is his condition?

A. Polio
B. Carpel tunnel syndrome
C. Mononeuropathy
D. Amyotrophic lateral sclerosis

A. Polio

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A 19 year old came w bilateral ascending paralysis. His CSF is clear, with normal glucose and protein levels and a high lymphocyte level. What’s the diagnosis?

A. Guillain-Barre syndrome.
B. Acute disseminated encephalitis
C. Subacute sclerosing panencephalitis.

A. Guillain-Barre syndrome.

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What happens in the reciprocal excitation of the Golgi tendon reflex?

A. Activation of 1b afferents and excitation of antagonist muscles
B. Activation of 1a afferents and excitation of antagonist muscles

A. Activation of 1b afferents and excitation of antagonist muscles

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Paralysis of the lower limb caused by occlusion of?

A. Great anterior medullary artery
B. Anterior spinal artery
C. Segmental artery

A. Great anterior medullary artery

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Which receptor detects different modalities of sensation?

Free nerve ending

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Through what mechanism do mechanoreceptors send signals when there is stimulation by touch?

A. Voltage gated channels open B. Ligand channels open
C. Stretch channels open

C. Stretch channels open

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Which receptor detects vibration?

Pacinian corpuscle

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Which of the following is important in degeneration and regeneration when peripheral nerves are damaged?

A. Macrophages
B. Schwann cells
C. Microglia

A. Macrophages

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What could be the presentation of a patient with amyotrophic lateral sclerosis?

A. Hoffman’s sign, fasciculation, extensor plantar reflex
B. Babinski sign, spasticity, clonus only
C. Fasciculations, atrophy, intention tremor

A. Hoffman’s sign, fasciculation, extensor plantar reflex

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Histopathological examination showed patches of demyelination in the sub-cortex and viral antigens in oligodendrocytes?

Progressive multifocal encephalopathy

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A patient presented with loss of sensation in right side of his face, loss of balance in right side of his body, paralysis of right face. What is the syndrome?

A. Right lateral pontine syndrome
B. Left lateral pontine syndrome
C. Right lateral medullary syndrome

A. Right lateral pontine syndrome

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Which nucleus carries pain and temperature sensations from the face?

A. Spinal nucleus of trigeminal
B. Main sensory nucleus of trigeminal

A. Spinal nucleus of trigeminal

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Which part of the body will be affected if there is a lesion in the rostral pyramid of the medulla?

A. Contralateral side
B. Bilateral
C. Ipsilateral

A. Contralateral side

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Patient with contralateral hemiplegia and his eye was dilated and displaced outward and downward. Where is lesion?

Midbrain

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What is a characteristic of myelin in the brain?

A. Has specific basic protein
B. Has very low phosphatidylamino

A. Has specific basic protein

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Which of the following controls breathing rhythm and heart rate?

Reticular formation in the medulla

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Post mortem exam of the brain of a patient showed plaques in optic nerve and demyelination of the spinal cord. Antibodies against aquaporin 4 were negative for life?

A. Multiple sclerosis
B. Neuromyelitis optica
C. CPM

A. Multiple sclerosis

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What is the mechanism of antibody- mediated damage in myasthenia gravis?

A. Opsonization by c3b
B. Ab mediated phagocytosis C. Complement mediated lysis

C. Complement mediated lysis

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Vagus supplies which nucleus?

Nucleus tractus solitaires

What connects the cortex to the contralateral cerebellum?

Pons

.Marked electrolyte imbalance with pseudo-coma occurs in?

Central Pontine Syndrome

What is the importance of peroxisome in the brain? A. Synthesize linoleic and linolenic fatty acids B. Degrade very long chain fatty acids

B. Degrade very long chain fatty acids

Preganglionic parasympathetic fibers to the Otic Ganglion are projected from?

Inferior salivary nucleus

Preganglionic parasympathetic fibers to the ciliary ganglion projected from? A. Oculomotor nucleus B. Dorsal nucleus of Vagus C. Edinger-Westphal nucleus

C. Edinger-Westphal nucleus

Upper part of the tympanic membrane was rupture and injured a nerve. Which function will be affected? A. Submandibular gland B. Lacrimal gland C. Parotid gland

A. Submandibular gland

A normotensive 19 year old male presented with spontaneous sudden lobar hemorrhage. Which of the following could be the cause?

Cerebral amyloid angiopathy

What nuclear medicine method is used to evaluate cerebral perfusion in someone? A. Tc-99m HMPAO and acetazolamide B. Tc-99m HMPAO

B. Tc-99m HMPAO

What is used to evaluate the risk of stroke in cerebral ischemia? A. Tc-99m HMPAO and acetazolamide B. Tc-99m HMPAO

A. Tc-99m HMPAO and acetazolamide

Damage to the inferior frontal gyrus results in which of the following conditions? A. Wernicke’s aphasia B. Broca’s aphasia C. Conductive aphasia

B. Broca’s aphasia

A young girl presented with a sudden severe headache. They found blood in her subarachnoid space. What is the most common cause of her condition? A. Atherosclerosis B. Congenital C. Hypertension

B. Congenital

Transient loss of retinal field vision with recovery after 6 hours

TIA

Subarachnoid hemorrhage case. Cause?

Congenital anomaly

What is the correct sequence of sensory-motor hierarachy?

Sensory > posterior association > anterior association > premotor > primary motor

Patient presents with paralysis of the right leg below the knee and loss of sensation in the same area. He also had urinary incontinence. Which artery is blocked?

Blockage of left ACA

Right lower face weakness and same side limb paralysis which artery is occluded? A. PICA B. AICA C. Rt MCA D. Lt MCA

D. Lt MCA

What would worsen the condition of a patient with stroke? A. Decreasing systolic BP below 140mmhg B. Decreasing blood sugar

A. Decreasing systolic BP below 140mmhg

A lady does not recognise the left side of her body. Which part of her brain is affected? A. Non dominant parietal lobe B. Dominant parietal lobe

A. Non dominant parietal lobe

A patient presented with leg weakness and apathy. Which area of the brain is affected? A. Parietal Lobe B. Frontal Lobe C. Occipital Lobe

B. Frontal Lobe

Which part of the lateral ventricle is related to calcar avis? A. Posterior horn B. Inferior horn C. Anterior horn

A. Posterior horn

Which part of the lateral ventricle is related to the hippocampus?

Inferior horn

A 33 year old male with traumatic spinal injury. What is characteristic of corticospinal tract lesion? A. Fasciculation B. Spastic muscle tone

B. Spastic muscle tone

Which of the following causes vasoconstriction of cerebral arterioles?

Metabolism of arachidonic acid into 20-HETE in smooth muscles

What is the function of the main neurons of the principal sulcus of the frontal cortex? A. Scan objects in the visual field B. Select appropriate movements C. Correct unwanted motor movements D. Stores knowledge to guide motor behavior

D. Stores knowledge to guide motor behavior

A patient is comprehensive and can’t pronounce words, but he is having normal swallowing. Which area is affected? A. Motor Speech B. Wernicke’s C. Global D. Conduction

A. Motor Speech

A childe presented with enlargement of Lateral ventricle with normal 3rd and 4th ventricles. Where is the blockage in the ventricular system? A. Interventricular foramen B. Cerebral aqueduct C. Medial aperture D. Lateral aperture

A. Interventricular foramen

A right-handed man presented with aphasia. What is another sign he could present with? A. Left hemiparasis B. Right homonomus hemianopia C. Left lower quadrant hemianopia

B. Right homonomus hemianopia

Right handed man with aphasia. What other symptom?

Right homonymous hemianopia

A patient suffered of cardiac arrest. On post mortem examination brain section showed diffuse watershed infarcts and cortical laminar necrosis. What is the most probable etiology?

Global cerebral ischemia

Which of the following has the major cause of vasodilation in case of hypoperfusion? A. NO B. Glutamate from neurons C. High Partial pressure of CO2

C. High Partial pressure of CO2

After restoring reperfusion in a patient suffering from stroke, cerebral blood flow is not restored immediately. What is the reason for this delay?

Contraction of pericytes

What is the main source of fibers going to cerebellum through MCP? A. Pontine nuclei B. Medulla

A. Pontine nuclei

What is the main output of cerebellum? A. Red nucleus B. Axons of deep cerebellar nuclei C. Vestibular nuclei axons

B. Axons of deep cerebellar nuclei

Patient presented with limb ataxia and spasticity. On inspection she had muscle wasting, on examination she has a positive Babinski sign. Echo showed cardiomegaly. What is the diagnosis?

Fredrick Ataxia

What happens when the direct pathway is excited under low cortex activity? A. Increase K+ in striatum by acting on D1 receptors B. Increases calcium by acting on D1 C. Decrease K+ by acting on D2 receptors D. Increase K+ by acting on D2 receptors

A. Increase K+ in striatum by acting on D1 receptors

What forms the axons of granular cells? A. Parallel fibers B. Purkinje

A. Parallel fibers

Putamen receives most of its input from?

Motor and premotor area

A 60 year old male seen in causality complaining of waddling to the left. On finger-to- nose test he had dysdiadokokinesia, intention tremor, and dysmetria only on the left side. What is the pathology? A. Infarction of the left cerebellar hemisphere B. Paraneoplastic syndrome C. Tumor in the right cerebellar hemisphere D. Spinocerebellar infarction

A. Infarction of the left cerebellar hemisphere

Which of the following movement disorder can be classified as both hyperkinetic and hypokinetic? A. Huntington's Chorea B. Parkinson's disease C. Hemiballism

A. Huntington's Chorea

What happens with excessive stimulation of the indirect pathway? ``` A. Akinesia B. Bradykinesia C. Chorea D. Tremor at rest E. Intentional tremor ```

A. Akinesia

Ahmed was having a conversation with his friend who he thought suddenly stares in to space. What could he be experiencing?

Complex partial seizure

Which of the following is a sign of cerebellar disorder? ``` A. Akinesia B. Bradykinesia C. Chorea D. Myoclonus E. Ballismus F. Tremor at rest G. Intentional tremor ```

G. Intentional tremor

A patient suffers from sudden vigorous forceful movements of his hand. What is this movement disorder called? ``` A. Akinesia B. Bradykinesia C. Chorea D. Myoclonus E. Ballismus F. Tremor at rest G. Intentional tremor ```

E. Ballismus

A 5 year old girls presented with enlarged tonsils. Later she had fidgety random seemingly semi purposive movements. What is the diagnosis? A. Tonsillitis B. Sydenham's Chorea

B. Sydenham's Chorea

Origin of climbing fibers

Inferior olivary nucleus

What are the main fibers of SCP?

Dento-thalamic fibers

A 35 year old male presented to the clinic with complaints of sudden electric like jerky movements of his right arm which he wasn’t able to suppress. What is the disorder? A. Tic disorder B. Myoclonus C. Tremor D. Dystonia

B. Myoclonus

What is true about the basal ganglia?

Head of caudate joins with putamen

What is responsible for long term motor learning in the cerebellum?

Long term depression of synapsis of Parallel to Purkinji fibers.

Neuron signals in the brain are affected by thalamo-cortical circuits? What could lead to epilepsy? A. Decreased excitatory signals to GABA interneurons B. Increased glutamate in neurons

A. Decreased excitatory signals to GABA interneurons

How is movement inhibited in REM sleep? A. Reticular inhibitory signals to lower motor neuron B. Reticular lateral area inhibits UMN C. Inhibition of UMN and LMN by reticular formation

A. Reticular inhibitory signals to lower motor neuron

What arises from the alar plate? A. Dorsal vagus B. Gracile

B. Gracile

What neurotransmitter after epilepsy causes neurotoxicity? A. Glutamate B. Aspartate C. Leucine D. Lysine

A. Glutamate

What causes the electrical current detected on the surface by EEG?

EPSP of Dendrites

What will happen if the connection between the cortex and red nucleus is cut? A. Shaking/Tremors B. Limbs will be flexed and held near the body C. Atonic and flaccid limbs D. Limbs extended away from the body

B. Limbs will be flexed and held near the body Note: A cut above the red nucleus in the location specified in the question targets corticospinal tract not rubrospinal tract, so limbs will be flexed (b) not extended (d)

What is seen with an anxious intellectually active adult? ``` A. alpha wave B. Beta wave C. Theta wave D. Sharp wave E. Spike F. Polyspikes G. Spike-slow wave complex H. Polyphasic spike pattern ```

B. Beta wave

What is seen with generalized absence seizure? ``` A. alpha wave B. Beta wave C. Theta wave D. Sharp wave E. Spike F. Polyspikes G. Spike-slow wave complex H. Polyphasic spike pattern ```

G. Spike-slow wave complex

What is seen with Grand mal tonic phase? ``` A. alpha wave B. Beta wave C. Theta wave D. Sharp wave E. Spike F. Polyspikes G. Spike-slow wave complex H. Polyphasic spike pattern ```

F. Polyspikes and H. Polyphasic spike pattern Note: H was the correct answer as it is more sustained but because the Dr. used the term polyspikes (transient) in the lecture he asked for it to be counted correct too- Dr. Zoran.

Bleeding of bridging veins

Subdural hematoma

Which condition is associated with mutations in SCN1A gene? A. GEFS B. Dravet syndrome

A. GEFS B. Dravet syndrome *both choices were in the exam, both counted correct

What results from mutation in KCNQ2? A. epileptic encephalopathy B. benign familial neonatal seizures

A. epileptic encephalopathy B. benign familial neonatal seizures *both counted correct

Which of the following best applies to Alzheimer's dementia? A. APOE 4 increases the risk B. Affects males more than females

A. APOE 4 increases the risk

A patient lost 1 L of blood in a car accident but he was still conscious and felt thirsty. What is the most likely signaling mechanism? A. Hypothalamic osmoreceptors B. Carotid baroreceptors C. Aortic chemoreceptors D. Glucocorticoid receptors

B. Carotid baroreceptors

Which part of the brain is responsible of procedural memory? ``` A. Thalamus B. Hypothalamus C. Hippocampus D. Sub thalamic nuclei E. Basal Ganglia ```

E. Basal Ganglia

What are the main efferent fibers of amygdala? A. Fornix B. Striae terminalis C. Dorsal forebrain bundle

B. Striae terminalis

Which of the following controls thermoregulation?

Anterior nucleus of hypothalamus

What is responsible of shivering and release of thyroxine from the thyroid gland?

Posterior nucleus of hypothalamus

The oxidizing effect on which protein could contribute to nerve damage in Alzheimer disease? A. Tau B. APP C. Aβ42

C. Aβ42

.Which of the following results from a non-coding trinucleotide repeat disorder?

Fredrick ataxia

Patient with a neurologic disorder caused by CGG repeats

Fragile X Syndrome

Which of the following is an autosomal dominant neurodegenerative disease?

Huntington

Defective processing of this protein forms (or causes accumulation of) Aβ42 in Alzheimer’s?

APP

What hypothalamic nucleus mediates heat loss?

Anterior hypothalamic nucleus

Unresponsive, unaraousable, EEG silence? A. Coma B. Brain death

B. Brain death

Which one of the following is a taupathy with coiled bodies and inclusions in oligodendrocytes?

Progressive supranuclear paralysis

A 70 year old patient has Alzheimer’s disease fell on her head and had subdural bleeding. What could contribute to her condition?

Brain atrophy

What changes, when occur, mediate long term memory? A. Increase presynaptic neurotransmitters B. Increase NMDA receptors on post synaptic receptors C. AMPA internalization

A. Increase presynaptic neurotransmitters

Superoxide dismutase mutation (SOD1) ?

ALS

Which structure has diffuse uniform decrease with aging? A. White matter B. Frontal C. Temporal D. Occipital

A. White matter

Which region when lesioned will cause excessive eating, rage, and aggressive behavior?

Ventromedial

Which area of the hypothalamus is responsible for heat loss?

Preoptic

Which of the following thalamic nuclei plays part in recent memory?

Anterior nucleus

Which of the following serotypes on Neisseria Meningitides cause outbreaks in Africa? A. Type A B. Type B C. Type W135 D. Type C

A. Type A Note: A for Africa, B for outBreaks/Britain, C for loCal outbreaks (College students), W135 for Haj.

What is the immediate control measure that you would take for a suspected case of meningitis caused by Neisseria Meningitides admitted to your hospital? A. Contact precaution B. Ampicillin C. Isolation in positive pressure room D. Isolation in negative pressure room

D. Isolation in negative pressure room

A post mortem examination of a patient revealed necrosis in temporal lobe. Which histological finding supports the diagnosis? A. Inclusion bodies B. Gitter cells

A. Inclusion bodies

A cerebellar tumor in a 3 year old boy with undifferentiated round to oval cells forming rosettes. What is the most likely diagnosis? A. Medulloblastoma B. Oligodenroglioma C. Ependymoma D. Glioblastoma

A. Medulloblastoma

Tumor in a 45 year old male shows pleomorphic cells with palisading around necrosis and endothelial cell proliferation? A. Ependymoma B. Glioblastoma C. Medullablastoma

B. Glioblastoma

CSF of AIDS patient yielded slow growing molds which turn to yeast at 37C. which of the following is the causative organism ``` A. Histoplasma B. Candida Albican. C. Candida D. Aspergillus E. Malassezia furfur F. Mucor G. Crytococcus ```

A. Histoplasma

Microscopic Gelatinous exudate shows budding organism with PAS+, Mucicarmine and Silver stain? ``` A. Histoplasma B. Candida Albican. C. Candida D. Aspergillus E. Malassezia furfur F. Mucor G. Crytococcus ```

G. Crytococcus

Has high predilection for CNS after lung infection? ``` A. Histoplasma B. Candida Albican. C. Candida D. Aspergillus E. Malassezia furfur F. Mucor G. Crytococcus ```

G. Crytococcus

Which vitamin deficiency causes koraskoff-wernekie’s encephalopathy? A. Vitamin B1 B. Vitamine B12 C. Vitamin E D. Vitamin D

A. Vitamin B1

Gross appearance of the brain showed purulent exudate in subarachnoid space with engorged vessels. Which of the following A. Bacterial meningitis B. Viral meningitis

A. Bacterial meningitis

A 51 years old patient who has meningitis, CSF shows gram-positive diplococci. What is the most likely causative organism? A. Strept. Pneumonia B. Neisseria meningitides C. Listeria monocytogene D. Hemophilus influenzae

A. Strept. Pneumonia

What is the mode of inheritance of Wilson's disease?

Autosomal recessive

A patient presented with nuchal rigidity, headache, fever, high white blood cells, and had bacterial meningitis. He was given dexamethasone with his treatment, what is the principal behind giving him dexamethasone? A. Reduction of inflammation B. Production of pro-inflammatory cytokines C. Increases the permeability of BBB D. Bactericidal

A. Reduction of inflammation

Low glucose, high protein and lymphocytes, mucoid gelatinous meninges A. Tuberculous meningitis B. basal bacterial meningitis

A. Tuberculous meningitis B. basal bacterial meningitis *we don’t remember which one came but both are correct

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

Herpes encephalitis

Dormant malaria in the liver?

Hypnozoites

.In which structure does cataract occur? ``` A. Ciliary body B. Retina C. Lens D. Iris E. Conjunctiva ```

C. Lens

A lady presented with headache and vomiting. Fundoscopy showed papilledema. Which of the following is associated with increased ICP? A. Limited abduction of right eye B. Ptosis

A. Limited abduction of right eye

.What is the mechanism of inhibition of PDE in the dark?

Binding of PDE-gamma subunit

Which of these nerves is involved in corneal reflex? A. Facial B. Abducens C. Optic D. Oculomotor

A. Facial

Plays a role in Retinal blood barrier?

RPE

What causes Leber’s Congenital Amaurosis (LCA)?

No regeneration of 11-cis retinal

Collects Info from several photoreceptors? ``` A. Horizontal cells B. Bipolar cells C. Ganglion cells D. Amacrine cells E. Rods F. Cones ```

A. Horizontal cells

Its axons forms optic nerve? ``` A. Horizontal cells B. Bipolar cells C. Ganglion cells D. Amacrine cells E. Rods F. Cones ```

C. Ganglion cells

What is characteristic of multiple sclerosis? A. Headache B. Absence of oligo clonal bands C. Worsening of symptoms in hot temperature

C. Worsening of symptoms in hot temperature

Localization of sound is done by?

Superior olivary nucleus

What are the main fibers that form the trapezoid body? A. Cochlear Nuclei B. Latral leminsci C. Vestibular nuclei

A. Cochlear Nuclei

Hereditary Spastic Paraplegia is a heterogeneous neurological disorder caused by genetic mutations. Which of the following pathways is affected in this disorder? A. Rho signaling B. Axoplasmic transport C. FeS cluster biogenesis

B. Axoplasmic transport

Which gene is associated with multiple hereditary motor and sensory neuropathies in human and targets myelination?

PMP22

Hereditary brachial plexus neuropathy is due to a mutation resulting in a dysfunction of which of the following signaling mechanism? A. Rho-Rhotekin signaling B. Excessive mitochondrial Iron accumulation C. Transthyretin D. Galactosylceramidase

A. Rho-Rhotekin signaling

What is the role of the cerebellum in maintaining upright posture? A. Sends stretch commands to the LMNs B. Adjusts fine contractions in the skeletal muscles C. Adjusts the sensitivity of the vestibular system D. Adjusts the sensitivity of limb reflexes

B. Adjusts fine contractions in the skeletal muscles Note: confirmed by Dr. Andreas.

Which condition is characterized by dysmorphic features, particularly holoprosencephaly, hypotelorism, and epicanthal folds? A. Hereditary brachial plexus neuropathy B. Hereditary motor and sensory neuropathy C. Hereditary neuralgic amyotrophy D. Familial amyloid polyneuropathy

C. Hereditary neuralgic amyotrophy

Which is an autosomal dominant multisystemic disorder caused by deposition of defective transthyretin? A. Hereditary brachial plexus neuropathy B. Hereditary motor and sensory neuropathy C. Hereditary neuralgic amyotrophy D. Familial amyloid polyneuropathy

D. Familial amyloid polyneuropathy

What relays signals from cerebellum to LMNs? A. Red nuclear neurons B. Vestibular nuclei neurons

A. Red nuclear neurons *confirmed by Dr. Andreas Henkel

Which structure of the ear is responsible for maintain balance? A. Inner hair cells B. Outer hair cells C. Cochlear nerve D. Crista ampullaris

D. Crista ampullaris

What is the mechanism of action of Cannabis on CB1 receptor?

Block AC, close Ca, open K

Parkinsonism's drug cause insomnia when taken after mid-afternoon? A. Selegiline B. Domperidone

A. Selegiline

What is the drug of choice for absence seizure? A. Ethosuximide B. Vigabatrin

A. Ethosuximide

Which drug can un-mask manic behavior when given to a depressed patient?

Aminophylline

Which drug causes purple mottling of the skin as a side effect?

Amantadine

.Which drug causes gambling with excessive shopping as side effects?

Ropinirole

Which drug causes hangover when used for a long period of time?

Nordazepam

A patient should avoid tyramine containing food in which drug?

Phenelzine

What is the mode of action of NK-1 receptors?

Increase intracellular CA2+ release from stores by IP3

A drug that has side effects like neuromuscular paralysis and nephrotoxicity?

Gentamicin

MOA of Dopezipel

Anticholenesterase inhibitor

MOA of Memantine

NMDA anatagonist

Agonist at m1 m2 melatonin receptors?

Ramelton

Patient addicted to a drug and developed cirrhosis and liver failure?

Ethanol

Dr. Bushra wants to perform a minor surgical procedure on her patient but she wants him to remain responsive to simple commands yet in deep state of sedation and analgesia. Which combination of drugs will she use? A. Propofol and fentanyl B. Droperidol and fentanyl

B. Droperidol and fentanyl

# Choose the best chemoprophylaxis in the following case: A sibling of a 3 year old boy who developed Hemophilus meningitis ``` A. Penicillin B. Rifampicin C. Ciprofloxacin D. Cifotaxime E. Vancomysin ```

B. Rifampicin

.Choose the best chemoprophylaxis in the following case: A husband of a 30 year old lady who developed meningococcal meningitis after her return from haj ``` A. Penicillin B. Rifampicin C. Ciprofloxacin D. Cifotaxime E. Vancomysin ```

B. Rifampicin and C. Ciprofloxacin Note: In Kuwait, rifampicin is better for prophylaxis of children & ciprofloxacin is better used for adults (because they want to avoid resistance to rifampicin as it is essential for TB treatment). In our exam both were counted correct.

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

Diazepam

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

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

What is the mechanism of action of morphine?

Inhibits AC, Opens K+ channels, Closes Ca2+ channels

Which drug crosses the blood brain barrier and is effective in treating herpes-simplex induced encephalitis?

Acyclovir

What is the mechanism of action of Memantine?

Blocks NMDA receptor

MOA of imipramine? A. Serotonin and NA B. Serotonin and DA

A. Serotonin and NA

What is the imaging modality of choice for diagnosis of cerebrovascular accident? A. MRI B. CT C. Skull x-ray

B. CT

EBM: Which of the following test characteristics varies with prevalence and can help you rule in a diseases? ``` A. Pre-test B. Gold standard C. NPV D. PPV E. Specificity ```

A. Pre-test

EBM: Sensitivity 50%, Specificity 75%, pre-test 20%. What is the NPV? A. 15% B. 33% C. 67% D. 86%

D. 86%

EBM: Time between screening and clinical diagnosis

Lead period

EBM: Which characteristic of a test that when decreased increases the specificity of the test? A. Sensitivity B. False Positives C. NPV D. PPV

B. False Positives