2015 module exam Flashcards by Susan w

What will be recorded by an electrode that measure membrane potential of a cortical neuron if a recording that is shown in picture below is detected by EEG above this cortical area?

Action potential
Interictal Paroxysmal depolarization shift
sustained depolarization

Interictal Paroxysmal depolarization shift (according to Dr. Zoran)

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Which of the following waves is the most desynchronized?

a. A
b. B
c. C

a.A

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Which of the following is present in the midline in MRI sagittal section of the brain?

a. Thalamus
b. Basilar artery
c. Transverse sinus
d. PICA

b. Basilar artery

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intracranial vault is made up of three compartments, the brain, CSF and?

a. Blood
b. Vessels
c. Choroid plexus d. Ventricles

a. Blood

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A young man who was recently diagnosed with schizophrenia. What will help treat his apathy and bluntness affect?

a. Olanzapine
b. Thioridazine
c. Haloperidol
d. Chlorpromazine e. Carbidopa

a. Olanzapine

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Which of the following drugs blocks nicotinic receptors and stimulates dopamine release for the treatment of Parkinson?

a. Valproate
b. Benzotropine
c. Amantadine

c. Amantadine

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What is a contraindication for treatment with all anti-psychotics?

a. Sickle cell anemia
b. Alzheimer’s disease
c. Epilepsy
d. MS
e. Arthritis

c. Epilepsy

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where are the cell bodies of the rods and cones located?

a. Inner plexiform layer
b. Outer plexiform layer
c. Inner nuclear layer
d. Outer nuclear layer

d. Outer nuclear layer

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What pathway connects the entorhinal cortex to the dentate gyrus?

a. Mossy fibers pathway
b. Perforant pathway
c. Schaffer

b. Perforant pathway

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

a. Loss of pain sensation on the right side
b. Loss of pain sensation on the left side
c. Loss of vibratory sensation on the left side
d. Loss of vibratory sensation on the right side

c. Loss of vibratory sensation on the left side

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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. medulloblastoma
b. Glioblastoma

b. Glioblastoma

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What is the origin of the preganglionic parasympathetic fibers to the submandibular
gland?

Inferior olivary nucleus
Superior salivatory nucleus
Inferior salivatory nucleus

Superior salivatory nucleus

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What nerve is associated with the corneal reflex?

Oculomotor nerve
Optic nerve
Facial nerve
Trochlear nerve

Facial nerve

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Weakness of pupillary light reflex results from a defect in what nerve?

Facial
Trigeminal
Oculomotor

Oculomotor

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What stage of plasmodium falciparum is the form that causes cerebral malaria/disease?

Sporozoite?
Trophozoite
Merozoites
Gametozoites

Trophozoite

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What is the mechanism of tiagabine?

Blocks dopamine receptors 2. Enhances GABA A receptors
Inhibits GABA reuptake
Enhances dopamine receptors

Inhibits GABA reuptake

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What type of headache lasts for 5-240 seconds?

SUNCT
Cluster
Tension
Migraine

SUNCT

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Which gives dopamergic projections to the straitum?

Substantia nigra pars compacta

not pars reticulata

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What type of headache is associated with autonomic features with tearing of the eye?

a. Cluster
b. Migraine
c. SUNCT (Short-lasting unilateral neuralgiform headache with conjunctival
injection and tearing)
d. Tension

c. SUNCT (Short-lasting unilateral neuralgiform headache with conjunctival
injection and tearing)

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A man lost his wife a year ago and has been complaining of a mild to moderate headache and described it as a “tight band on the head” what is this patient suffering from?

a. Cluster headache
b. SUNCT
c. Tension headache
d. Right migrain

c. Tension headache

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Which of the following will sharply increase upon decrease in the cerebral perfusion pressure (cpp)?

a. OEF (oxygen extraction fraction)
b. ICP
c. Cerebral blood volume

a. OEF (oxygen extraction fraction)

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The cerebral metabolic rate of oxygen is estimated by measuring the (CMRO2) which is an important marker for brain function and brain health. What happens on an EEG when it decreases to <40% due to limitation in the available energy?

appearance of theta waves
resuction in frequency of EEG
reduction in amplitude of EEG
absence of EEG activity

absence of EEG activity

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What is the normal intracranial pressure in adults?

150-220 mmH2O
100-150 mmH2O
200-220 mmH2O

150-220 mmH2O

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A person lost complete vision of her right eye, where is the defect?

a. Optic nerve
b. Optic tract
c. Optic chiasma

a. Optic nerve

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A person sees a pie in the sky and CT shows he has hemorrhage, where is the lesion? a. Temporal lobe b. occipital lobe c. optic nerve d. optic tract

a. Temporal lobe

What present the myelin antigen to T cell by MHC class 2? a. Dendritic cells b. Astrocytes c. Tcell- CD4 d. Tcell-CD8 e. Tcell –CD17

a. Dendritic cells

Where are the corticonuclear fibers supplying the abducent nucleus found in the internal capsule? 1. Genu 2. Anterior limb 3. Posterior limb

1. Genu (All cranial nerves fibers pass thru the Genu)

What is the origin of the trigeminal lemniscus? 1. motor nucleus of trigeminal nerve 2. Spinal nucleus of trigeminal nerve 3. Spinal tract of trigeminal nerve

2. Spinal nucleus of trigeminal nerve | There are other origins, like the mesencephalic and main sensory nucleus, but only the spinal nucleus was mentioned

What differentiates a screening test from a Diagnostic one? 1. Nature of the assay 2. sensitivity and specificity

2. sensitivity and specificity

What is found in diffuse axonal injury? 1. Necrosis 2. Eosinophilic globoid axons 3. Basophilic something

2. Eosinophilic globoid axons

Which of the following is seen under the microscope in a patient with acute contusion? 1. Hemorrhage 2. Hemosiderin pigment

1. Hemorrhage (its acute) | Note: Hemosiderin pigment is seen in chronic cases

A 78-year-old man suffered from stroke. He lost movement and sensation in right lower limb below the knee. Which structure is affected? a. Left anterior cerebral artery b. Right anterior cerebral artery c. Right middle cerebral artery d. Left middle cerebral artery

a. Left anterior cerebral artery

What forms great cerebral vein? a. Superior thalamostriate and superior choroid b. Right and left internal cerebral vein

b. Right and left internal cerebral vein

The brain of a 63-year-old man, known to have pick disease, is dissected at autopsy. What is the expected pathological finding? a. Gyral atrophy in the frontal and temporal lobe b. Atrophy of cerebellum c. Pallor of subsantia nigra in midbrain

a. Gyral atrophy in the frontal and temporal lobe

Which one of the following auras is mostly associated with migraine? a. Speech b. Visual c. Sensory d. Auditory

b. Visual

A brain mass beneath the dura was incidentally found in a 42 years old female. Gross examination showed whorls. On histology, it showed spindle cells with psamomma bodies. What is the diagnosis? a. Medulloblastoma b. Meningioma c. Astrocytoma d. Glioblastoma

b. Meningioma

A child came to the clinic and presented with jerky movements and eventually died, his mother and brother had the same condition and died from it too, what is he suffering from? a. Myoclonus b. hemiballism c. Huntington disease

c. Huntington disease

A 3yr old girl ruptured her eardrum when she inserted a pencil into her ear. Her mother took her to the emergency department after noticing that she was crying and complaining of pain in her ear with a few drops of blood in the external auditory meatus. The attending dr examined the child for possible injury to a nerve that runs across the eardrum. What’s the most likely nerve that is injured? a. Chorda tympani b. Trigeminal nerve c. Oculomotor nerve d. Vagus nerve

a. Chorda tympani

Mechanism behind eliciting the symptoms in hemiballism? a. Decreased tonic inhibition from GPi b. Chronic thalamus disinhibition c. Increase Gpe tonic discharge d. Decrease thalamo-cortical pathway

a. Decreased tonic inhibition from GPi

What is true regarding Fragile X syndrome? a. loss of function of FMR1 by silencing b. expansion of polyglut FMR1 dinucleotide expansion c. shortening of CGG in promoter region of FMR1 d. high dinucliotide in inotron of FMR1

a. loss of function of FMR1 by silencing

Which biomolecule act as a prosthetic group for Rhodopsin protein? a. Cholesterol b. 11-cis retinal c. Omega 3 fatty acid

b. 11-cis retinal

Where is the cochlear nucleus located? a. medial eminence b. dorsal to ICP c. ventral to ICP d. ventral SCP e. ventral to tegmentum ofpons f. ventral to basilar part of pons

b. dorsal to ICP

Where do the fibers connecting the right cerebral hemisphere to the left cerebellum located? a. basilar part of pons b. Tegmentum part of pons c. Superior cerebellar peduncle d. Inferior cerebellar peduncles

a. basilar part of pons

A patient is suffering from internuclear ophthalmoplegia. What structure is involved? a. MLF b. Thalamus c. basal ganglia

a. MLF

If a patient can’t abduct his left eye, what nerve is injured? a. abducent b. oculomotor c. trochlear

a. abducent

Case where a patient was given chemotherapy and later developed areas of demyelination, what would be seen histologically? a. alpha synuclein inclusions b. AB42 plaques c. ground glass cells d. Lewy bodies

c. ground glass cells | the patient became immunocompromised with the chemo and then a latent JC polyoma virus got activated

What nucleus has an important role in cortical arousal and integration of sub-modalities? a. intralaminar nuclei of the thalamus b. medial nucleus of the thalamus c. anterior thalamic nuclei

a. intralaminar nuclei of the thalamus

amino acid is associated with spinocerebellar ataxia? a. Glycine b. Asparagine c. glutamate

c. glutamate

In which stage does the Beta waves start to appear in the sleep cycle? a. Stage 1 b. Deep sleep c. REM d. stage 2

c. REM

Patient presented with endocarditis and on CT he had ring enhancing lesion of the brain, what is the diagnosis? 1. brain abscess 2. brain hemorrhage

1. brain abscess

What causes long term depression of Purkinje fibers? 1. simultaneous stimulation of parallel and climbing releasing glutamate 2. stimulation of parallel fibers only releasing glutamate

1. simultaneous stimulation of parallel and climbing releasing glutamate

What is true about supplementary motor area? 1. Bilateral limb movements 2. selection of movement from external ques

1. Bilateral limb movements

Neurons in what location hold on to information while performing a task? a. prefrontal cortex b. occipital cortex c. temporal cortex

a. prefrontal cortex

Which of the following reflexes are used to correct posture after being unexpectedly pushed from the back? a. feedback involving brainstem b. feedforward reflex

a. feedback involving brainstem

A patient underwent bilateral resection of the amygdala, what is expected to be seen? a. can’t relate memory with emotional attributes b. can’t remember episodic memories that happened 2 years ago c. can’t remember how to play music tunes learned during childhood d. inability to register the context of previous traumatic event

a. can’t relate memory with emotional attributes

What is the reciprocal inhibition in the stretch reflex? a. Ipsilateral flexor inhibition b. Contralateral flexor inhibition c. Ipsilateral extensor inhibition

a. Ipsilateral flexor inhibition

What is the effect of gamma fiber stimulation? a. Contraction of central part. b. Increased sensory firing of central part c. Lengthening of peripheral part.

b. Increased sensory firing of central part

Which of the following best describes processing of information in cortical columns?

One muscle can be stimulated by many columns

What stimulates thirst? a. Increased baroreceptor firing. b. Decreased CVP c. Decreased osmolality. d. Increased plasma volume.

b. Decreased CVP

A patient presents with diffuse cortical atrophy, memory loss and microinfarcts, where is the issue?

Hippocampus (AD)

Patient presents with decreased visual acuity 20/100, relative afferent pupillary defect, oligoclonal bands, what is the diagnosis? a. MS of optic nerve b. Alzheimer’s disease

a. MS of optic nerve

A patient recently diagnosed with MS has anxiety and can’t sleep; what drug can be used for her muscle cramps/ spasms? a. Diazepam b. Tiagabine c. valporate

a. Diazepam

What drug acts on a2 and 5HT receptors? a. Mirtazepine b. Imipramine c. Phenytoin

a. Mirtazepine

Mutation of which receptor is associated with Autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE)? a. Ach nicotinic receptors b. GABA receptor c. Na receptor

a. Ach nicotinic receptors

Which is hypophosphorylated and make neurofibrillary tangles in Alzheimer's disease? a. Tau protein b. APP plaques

a. Tau protein

A patient with a congenital abnormality in the central canal (syringomelia) of C3-C5, what is expected to be seen? a. Bilateral neck pain b. Loss of pain sensation on left side c. Pain on right side of body

a. Bilateral neck pain

If the pre-test probability is 50, PPV is 99.9, NPV is 67, what are the sensitivity and specificity? a. Sensitivity low, specificity very high b. Sensitivity high, specificity very high c. Sensitivity and specificity are low

a. Sensitivity low, specificity very high

What afferent fibers to the basal ganglia release serotonin? a. Brainstem striatal to basal ganglia b. Thalamus to basal ganglia c. Substantia nigra to basal ganglia d. Thalamostrial

a. Brainstem striatal to basal ganglia

what infection control measure will you apply for a traveler to an area where Neisseria meningitides is endemic? a. contact precaution b. Wearing a mask c. Wearing long-sleeve shirt d. Vaccination

d. Vaccination

What separates the ventral and dorsal parts of the neural tube? a. Sulcus limitans b. Median eminence c. Alar plate d. Basal plate

a. Sulcus limitans

A patient with HIV and a budding organism with a mucoid capsule was seen; what is the organism? a. Toxoplasmosis b. Poliovirus c. herpes simplex virus d. Cryptococcus neoformans

d. Cryptococcus neoformans

What drug is used in a person with meningitis due to gram negative diplococci? a. Cefotaxime b. Vancomycin c. Streptomycin d. amikacin

a. Cefotaxime

What tract is associated with posture? a. Vestibulospinal tract b. Corticospinal tract c. Spinothalamic tract

a. Vestibulospinal tract

What may be the main cause of Alzheimer’s disease according to amyloid hypothesis? a. retroviral infection b. abnormal protease activity c. excessive microtubule degradation d. misfolding of Amyloid basic protein

b. abnormal protease activity

Receive taste fibers from the 7th CN? a. Nucleus tractus solitarius b. Superior salivary nucleus c. Inferior salivary nucleus d. Edinger westphal nucleus e. dorsals nucleus of vagus nerve

a. Nucleus tractus solitarius

Patient presented with infection in the brain. The brain got edematous through which mechanism? 1. Vasogenic 2. cytotoxic

1. Vasogenic

What is the best modality used for a DIAGNOSTIC brain angiography? 1. MRA (Magnetic resonance angiography) 2. CT angiography 3. PET

1. MRA (Magnetic resonance angiography)

What is true about the cochlear duct? 1. Basal part of basement membrane hears high pitched sounds 2. Apical part of basement membrane hears low pitched sounds

1. Basal part of basement membrane hears high pitched sounds

What two variables determine CPP? 1. MAP and ICP 2. systolic BP and ICP 3. diastolic BP and ICP 4. venous pressure and ICP

1. MAP and ICP

What occurs as a result of damage to the right medial part of medulla? a. Loss of proprioception on the left side of the body b. Loss of proprioception on the right side of the body c. Loss of pain + temperature sensation on left side of the body

a. Loss of proprioception on the left side of the body

Elderly patient with formation of spongy bone leading to conductive hearing loss on the affected ear would affect which site? a. Oval window b. Round window c. Tympanic recess d. Auditory tube

a. Oval window

What is true about brain wave entrainment?

Using 4 Hz to form theta waves

What characteristic of galactocerebrosidase allows tight interactions in myelin?

Its lack ofcharge

How does NMDA receptor activation initiate central sensation? a. Increase intracellular Ca+ through activation if adenyl cyclase b. Decrease intracellular Ca+ through inhibition of adenyl cyclase c. Increase Ca+ entry through linked receptor d. Decrease ca entry through linked receptor e. Increase Cl- entry through linked receptor

c. Increase Ca+ entry through linked receptor

what nerve would lead to ptosis if damaged? a. abducent b. trochlear c. oculomotor

c. oculomotor

damage to what would lead to unilateral loss of hearing?

Organ of corti

tubocurarine acts on which of the receptors? a. N2 b. N1

a. N2

what is the origin of suprarenal (adrenal) medullary cells?

Neural crest

what is the microscopic feature of diffuse axonal injury?

Axonal retraction balls

which drug induces metabolism of other antiepileptics, anticoagulants, and oral contraceptives? a. Ethosuximide b. Diazepam c. Tiagabine d. Phenytoin e. Lamotrigine f. Vigabatrin

d. Phenytoin

which drug causes irreversible visual field defects in some patients? a. Ethosuximide b. Diazepam c. Tiagabine d. Phenytoin e. Lamotrigine f. Vigabatrin

f. Vigabatrin

What mainly affects the blood flow when activity of neurons increases under normal conditions? a. Release of glutamate from neurons b. Metabolism of arachidonic acid into 20-HETE in smooth muscles c. Increased O2 in the interstitial fluid d. NO e. High partial pressure of CO2 f. Low partial pressure of CO2

a. Release of glutamate from neurons

Which of the following has the major cause of vasodilation in case of hypoperfusion? a. Release of glutamate from neurons b. Metabolism of arachidonic acid into 20-HETE in smooth muscles c. Increased O2 in the interstitial fluid d. NO e. High partial pressure of CO2 f. Low partial pressure of CO2

e. High partial pressure of CO2

Which of the following causes vasoconstriction of cerebral arterioles? a. Release of glutamate from neurons b. Metabolism of arachidonic acid into 20-HETE in smooth muscles c. Increased O2 in the interstitial fluid d. NO e. High partial pressure of CO2 f. Low partial pressure of CO2

b. Metabolism of arachidonic acid into 20-HETE in smooth muscles

Which of the following produces minimal change in CBF? a. Release of glutamate from neurons b. Metabolism of arachidonic acid into 20-HETE in smooth muscles c. Increased O2 in the interstitial fluid d. NO e. High partial pressure of CO2 f. Low partial pressure of CO2

c. Increased O2 in the interstitial fluid

.Inclusions in upper and lower motor neurons in patients with Amyotrophic lateral sclerosis (ALS) would be positive for which of the following? a. sod1 b. FUS c. TDP43 d. Tau e. Amyloid beta f. Alpha-synuclein g. Huntington h. ApoE 4

a. sod1

Which of the following represents cellular energy (ATP) failure? a. Cytotoxic edema b. Vasogeneic edema

a. Cytotoxic edema

Patient fell down, CT showed a mass that was below the dura (subdural hemorrhage) what vessel is damaged? a. MCA b. ACA c. superior sagittal vein d. great cerebral vein e. basilar artery f. superficial cerebral vein

c. superior sagittal vein

what drug causes serious side effects such as bone marrow suppression? a. Valproate b. Clozapine c. Amantadine d. Chloramphenicol e. Tiagabine

b. Clozapine | this was a question from previous years and Dr. Munya’s omitted the information from her lecture

What is inhibited by Sildenafil and can cause blindness? a. 11 cis retinal b. all trans retinal c. arrestin d. rhodopsin e. transducin f. cGMP g. PDE

g. PDE

What inhibits rhodopsin binding to transducin? a. 11 cis retinal b. all trans retinal c. arrestin d. rhodopsin e. transducin f. cGMP g. PDE

c. arrestin

Closes Na channels when you decrease its concentration? a. 11 cis retinal b. all trans retinal c. arrestin d. rhodopsin e. transducin f. cGMP g. PDE

f. cGMP

What decreases to increase sensitivity? a. sensitivity b. specifity c. NPV d. PPV e. Pretest probability

b. specifity

What varies with prevalence and rules out the disease? a. sensitivity b. specifity c. NPV d. PPV e. Pretest probability

e. Pretest probability

A gene that codes for a structural protein in several peripheral neuropathies? a. GALC b. SEPT9 c. PMP22 d. SOD1 e. TTR f. HHT

c. PMP22

Krabbedisease? a. GALC b. SEPT9 c. PMP22 d. SOD1 e. TTR f. HHT

a. GALC

What prophylactic is used for mother of a 5-year-old child who has hemophilus influenza? a. ceftriaxone b. rifampicine c. vancomycin d. hib vaccine e. cefotaxime f. ciprofloxacine

b. rifampicine

What prophylactic is used for a 35 y/o pregnant wife whose husband developed neisseria meningitidis meningitis afterreturningfromHaj? a. ceftriaxone b. rifampicine c. vancomycin d. hib vaccine e. cefotaxime f. ciprofloxacine

a. ceftriaxone

what receptor is used for sensing vibration? a. Pacinian receptor b. Ruffini receptor c. Free nerve ending d. Muscle spindle e. Golgi tendon f. Stretch receptor

a. Pacinian receptor

What maintains balanced muscle tone? a. Pacinian receptor b. Ruffini receptor c. Free nerve ending d. Muscle spindle e. Golgi tendon f. Stretch receptor

d. Muscle spindle (confirmed by the dr)

Through what mechanism do mechanoreceptors send signals when there is stimulation by touch? a. Pacinian receptor b. Ruffini receptor c. Free nerve ending d. Muscle spindle e. Golgi tendon f. Stretch receptor

f. Stretch receptor

Patient presented with high ICP, bradycardia, change in breathing, hypertension and had a headache

Cushing triad

Patient had tearing + autonomic features, and headache for for 5-240 sec?

SUNCT headache

patient can’t say the name of the object but was able to draw it, where is the lesion? a. Temporooccipital junction b. occipital lobe c. temporoparietal d. frontal lobe

a. Temporooccipital junction

What is involved in conjugate movement of the eye? a. calcarine sulcus b. middle frontal gyrus c. superior frontal gyrus d. inferior frontal gyrus e. medial frontal gyrus

b. middle frontal gyrus

Where is the primary visual cortex located? a. calcarine sulcus b. middle frontal gyrus c. superior frontal gyrus d. inferior frontal gyrus e. medial frontal gyrus

a. calcarine sulcus

where is the motor speech area located? a. calcarine sulcus b. middle frontal gyrus c. superior frontal gyrus d. inferior frontal gyrus e. medial frontal gyrus

d. inferior frontal gyrus

lesion to which structure causes red eye? a. conjunctiva b. lens c. cornea d. iris e. pupil

a. conjunctiva

Where is laser therapy performed for refractive error correction? a. conjunctiva b. lens c. cornea d. iris e. pupil

b. lens

Causes oxidation in Alzheimer’s

Aβ42

Causes paired helical fragments then NFTs?

Tau

Increased prolactin? a. Brain hemorrhage b. Sub arachinoid hemorrhage c. Extradural spinal cord lesion d. Pituitary microadenoma e. Space occupying lesion

d. Pituitary microadenoma

basal ganglia hyper density? a. Brain hemorrhage b. Sub arachinoid hemorrhage c. Extradural spinal cord lesion d. Pituitary microadenoma e. Space occupying lesion

a. Brain hemorrhage

hyper density in supra-cellar cistern? a. Brain hemorrhage b. Sub arachinoid hemorrhage c. Extradural spinal cord lesion d. Pituitary microadenoma e. Space occupying lesion

b. Sub arachinoid hemorrhage

A patient with a cortical lesion was speaking fluently without comprehension of what is being said. What region of the cortex is most likely affected?

Superior temporal gyrus (Wernicke’s area 22)

Used as a cough suppressor at a sub-analgesic dose?

Codeine

How peroxisome participate in lipid metabolism?

They oxidize the very-long-chain fatty acids

Premature newborn with fever and bulging frontalis. What is the most likely causative organism?

streptococcus agalactae

What modifies the stream of information to the cortex?

Reticular nucleus

what supplies the wall of calcarine sulcus?

Posterior cerebral artery

A young woman with a long history of depression accompanied by body aches and pain. Which drug is useful for her?

Diazepam

An Opioid given for asthma patients?

Pethidine

Non-specific and responds to more than one sensation/modality?

Free nerve ending

An antipsychotic drug that doesn’t have antiemetic effect?

Ariprazole

What effect would a Prolactinoma have on the visual field?

bitemporal hemianopia

what stabilizes wakefulness?

Orexin/hypocretin neurons