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CNS module - 4th year COPY > 2017 module exam > Flashcards

2017 module exam Flashcards

1
Q

Which of the following processes will most likely elicit symptoms in patients with hemiballism?

A- Chronic disinhibition of thalamus
B- Reduced tonic discharge of Gpi
C- Deceased thalamocortical activity
D- Increased tonic discharge of Gpe

A

B- Reduced tonic discharge of Gpi

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2
Q

When examining a CT scan of a baby with hydrocephalus, you noticed that the lateral ventricle and third ventricle were greatly enlarged but NOT the fourth ventricle. What anatomical region is obstructing the CSF flow in this patient?

A- Interventricular foramen
B- Cerebral aqueduct
C- Lateral aperture of 4th ventricle
D- Superior sagittal sinus

A

B- Cerebral aqueduct

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3
Q

3- What is the best chemoprophylaxis for hemophilus influenza meningitis given to a 2 year old child?

A- Rifampicin
B- Gentamicin
C- Ciprofloxacin
D- Penicillin

A

A- Rifampicin

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4
Q

What is the energy and its source in the brain during ischemia-repurfusion?

A- Oxaloacetate, astrocyte
B- Ketone bodies, astrocyte
C- Lactate, microglia
D- Glycogen, microglia

A

B- Ketone bodies, astrocyte

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5
Q

A 15 year old boy presented to the ER with fever, headache, and seizures. HSV1
was identified by the PCR in the CSF. What is the appropriate treatment for this
patient?

A- Acyclovir
B- Ampicillin
C- Cefotaxime and vancomycin
D- Gentamycin

A

A- Acyclovir

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6
Q

The lesion at which level would most likely cause coma?

A- Cortical
B- Midbrain
C- Between medulla oblongata and spinal cord
D- Between thalamus and sensory cortex

A

B- Midbrain

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7
Q

Which of the following neurological disorders is characterized morphologically
by deposition of amyloid plaques and tau tangles?

A- Multiple sclerosis
B- Alzheimer disease
C- Huntington disease
D- Pick disease
E- Creutzfeldt- jacob disease
A

B- Alzheimer disease

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8
Q

Mr.Ali has been addicted to a drug for a very long time. He ended up having cirrhosis and liver failure. Which of the following drug of abuse he was addicted
to?

A- Heroin
B- LSD
C- Cannabis
D- Ethanol

A

D- Ethanol

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9
Q

Which of the following genes is associated with the lethal and autosomal recessive form of ataxia that is common in Caucasians?

A- MFRN
B- FRT
C- FDX2
D- FXN

A

D- FXN

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10
Q

What is the pathway that connects the amygdala and septal nuclei?

A- ventral amygdalofugal
B- Fornix
C- Striae terminalis
D- Perforant

A

A- ventral amygdalofugal

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11
Q

What is likely to be found in a microscopy of a man that got bitten by a bat, didn’t get a treatment, and died after 6 months?

A

Eosinophilic cytoplasmic inclusion in Purkinje cells

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12
Q

If someone was suffering from truncal ataxia, which part of the cerebellum is affected?

A

Vermis

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13
Q

Which of the following antiepileptic drugs can evoke cardiac arrhythmia is adults at more than 50 mg/min?

A- Carbamazepine
B- Diazepam
C- Phenobarbital
D- Clonazepam
E- Phenytoin
A

A- Carbamazepine

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14
Q

On brain MRI, a left-sided slow-growing astrocytoma was found in the pons of a 15 year old boy. What functional deficit is expected?

A- Left loss of hearing
B- Left superior oblique muscle paralysis
C- Left superior olivary nucleus dysfunction
D- Left sided hemiparesis

A

C- Left superior olivary nucleus dysfunction

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15
Q

Imaging of dopamine receptor can help in the management of which of the
following conditions?

A- Parkinson disease
B- AD
C- Transient ischemic attacks
D- Pick disease

A

A- Parkinson disease

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16
Q

What type of amacrine cells is responsible for saccadic suppression and object
motion?

A- Horizontal cells
B- Wide field cells
C- Medium field cells
D- Narrow field cells

A

B- Wide field cells

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17
Q

What is the mechanism of CSF formation?

A

Osmotic gradient in choroid plexus

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18
Q

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

A

Modulates signals between thalamus and cortex

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19
Q

A student was reading in a quiet room and suddenly a metal plate fell in the floor making a loud noise, the student involuntary turn his head to face the sound and moved his head and torso away from the sound, what brain structure is responsible for this response?

A- inferior olivary nucleus
B- medial geniculate body
C- superior colliculus
D- lateral lemniscus

A

C- superior colliculus

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20
Q

Which structure is least affected in case of a lesion in the striate branches of
the middle cerebral artery?

A- Hippocampus
B- Thalamus
C- Caudate nucleus

A

B- Thalamus

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21
Q

What causes rostral vermal syndrome (anterior lobe lesion)?

A- Alcohol consumption
B- Brain tumor
C- Ischaemia

A

A- Alcohol consumption

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22
Q

What is the primary component of amyloid plaque in patient with Alzheimer
disease?

A- Aβ peptide
B- Amyloid precursor protein
C- Aα peptide
D- β-secretase

A

A- Aβ peptide

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23
Q

What is the function of the superior temporal gyrus?

A- Motor speech
B- Wernich’s area
C- Primary auditory
D- Visual cortex

A

C- Primary auditory

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24
Q

“Patient went into a coma and had a headache, what can you use to diagnose the patient?”

A- Chyene stokes breathing
B- Brisk tendon reflex
C- Nuchal rigidity

A

A- Chyene stokes breathing

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25
Q

“What allows you to recognize objects through touch and proprioception?”

A- Superior parietal lobule
B- Parietal cortex
C- Occipital cortex
D- Temporal lobe

A

B- Parietal cortex

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26
Q

“Patient had a vascular lesion, with left hemiplegia, left homonymous
hemianopia, the right internal capsule affected. What else will this patient
present with?”

A- left macular vision loss
B- left hemianesthesia

A

B- left hemianesthesia

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27
Q

Which of these is least affected by the straits branch of ACA?

A- Hippocampus
B- Caudate nucleus
C- Thalamus
D- Posterior limb of internal capsule

A

C- Thalamus

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28
Q

A patient with increased ICP, uncle herniation through the tentorium. What is the least possible manifestation that he could present with?

A- Contralateral hemianesthesia
B- Contralateral hemiplegia
C- Contralateral homonymous hemianopia

A

C- Contralateral homonymous hemianopia

29
Q

What manifestation of middle ear infection is least noticed in elderly patients?

A- Mastoiditis 
B- Loss of taste in anterior 2/3 of tongue 
C- Weakness in facial muscles
D- Inability to chew food 
E- Slight loss of hearing
A

?

30
Q

If you perform Head flexion on a seven month old baby without tilting the
head what could happen?

A- Flexion of the arms and extension of the legs
B- Extension of arms and flexion of legs
C- Flexion of all limbs
D- Extension of all limbs

A

A- Flexion of the arms and extension of the legs

31
Q

What is the best state that describes a patient with minimal consciousness?

A- Unconscious awareness
B- Wakeful with fluctuating consciousness
C- Wakeful but unaware
D- Wakeful with impaired motor control

A

B- Wakeful with fluctuating consciousness

32
Q

What is the effect of dopamine of the striatal pathway?

A

Activate D1 in high cortical activity, inhibit D1 in LOW cortical activity, and
inhibit D2

33
Q

A 50 year old man presented with a vascular lesion in inferior cerebellar peduncle, what part of the vestibular pathway is affected?

A- Vestibulofasigial
B- Vestibulo-thalamic
C- Medial longitudinal lemniscus

A

A- Vestibulofasigial

34
Q

What is the chemoprophylactic agent given to people going to hajj?

A- Ciprofloxacin
B- Gentamicin
C- Vancomycin
D- Penicillin

A

A- Ciprofloxacin

[Ciprofloxacin is not given to children or pregnant women in case of Neisseria infections]

35
Q

What is the chemoprophylaxis for H influenza in 2 years old boy?

A
  • Rifampicin
36
Q

36- In which direction we pull the auricle in otoscopy test in adults?

A
  • Posterosuperiorly
37
Q

A 60 year old man presented with intermittent palpitation, preserved consciousness, and difficulty talking. what is affected?

A- Damage to middle cerebral A.
B- Basal ganglia hemorrhage
C- Infarction to putamen

A

A- Damage to middle cerebral A.

38
Q

Which of the following conditions is associated with jerky involuntary
movements due to increased activity of direct pathway?

A- Alzheimer disease
B- Parkinson’s disease
C- Huntington disease
D- Cerebellar disease

A

C- Huntington disease

39
Q

What antipsychotic causes the strongest EPS?

A
  • Haloperidol
40
Q

What is the mechanism of action of donepezil?

A- Inhibition of GABA A
B- Inhibition of GABA B
C- Inhibition of Acetylcholinesterases

A

C- Inhibition of Acetylcholinesterases

41
Q

41- Which of the following is a manifestation of blocking the PICA which supplies medulla oblongata?

A- Contralateral loss of pain and temp sensation of the body
B- Contralateral loss of vibration and proprioception
C- Contralateral flaccid hemiplegia in the upper and lower limbs
D- Hemiparesis or hemiplegia ipsilateral in the tongue
E- Protrusion of the tongue to the affected side

A

A- Contralateral loss of pain and temp sensation of the body

42
Q

A 50 year old women presented with forgetfulness to the extent that affected her job performance. She had a bariatric surgery and lost 60 kg in the past 7 months. What is the most likely cause of her cognitive impairment?

A- Alzheimer’s dementia
B- Fronto-temporal dementia
C- B12 deficiency
D- Vitamin D deficiency

A

C- B12 deficiency

43
Q

What will sharply increase when CPP decrease?

A
  • Oxygen extraction Fraction
44
Q

A 65 year old male with personality changes and aggressive behavior at work
place died accidentally. At autopsy, his brain showed remarked asymmetric atrophy limited time the frontal and temporal lobes with water thin gyri. What is
the most likely diagnosis?

A- Alzheimer disease
B- Huntington’s disease
C- pick disease
D- Parkinson’s disease
E- viral disease
A

C- pick disease

45
Q

A 75 year old man presented with one year history of decrease in all motor activity, resting tremor, and severe rigidity. He also has been more forgetful from the onset of his symptoms and he sees people that aren’t there with on and off confusion and paranoia What is the diagnosis?

A- Alzheimer’s disease
B- Lewy body dementia
C- Parkinson’s disease
D- Pick disease

A

B- Lewy body dementia

46
Q

What is the epidemiologic basis of MS?

A- Incidence increases when approaching equator
B- Incidence increases when vitamin D is lacking
C- Men and women are affected equally
D- Concordance in twins = 80%

A

B- Incidence increases when vitamin D is lacking

47
Q

A 2 year old boy presents with espin gene mutation, which part of the hair cell structure will be affected?

A-Nuclear membrane
B-Basal body
C- Stereocilia

A

C- Stereocilia

48
Q

A Patient presents with loss of pain and temperature on the right side of the face and the left side of the rest of the body as well as asymmetrical smile on the right side. Which artery is occluded?

A- Right posterior Inferior cerebellar A.
B- Right anterior Inferior cerebellar A.
C- Left posterior Inferior cerebellar A.
D- Left anterior Inferior cerebellar A.

A

B- Right anterior Inferior cerebellar A.

49
Q

A histological exam of the brain is performed on a 45 year old male who suffered from a contusion 15 years ago. What is the most likely thing you will find?

A- Hemorrhage
B- Gliosis
C- Ischemia

A

B- Gliosis

50
Q

Which of the following will increase glutamate release in rods?

A- If you close the lights in a room
B- If you open lights in dark room
C- If you increase illumination of a room gradually
D- If you open your eyes

A

A- If you close the lights in a room

51
Q

What vitamin deficiency is associated with MS?

A- A
B- B
C- C
D- D
E- E
A

D- D

52
Q

A still born was seen with necrotic tissue in the head region, what is the anomaly?

A- Anencephaly
B- Spina bifida
C- Menengiocele
D- Hydrocephalus

A

A- Anencephaly

53
Q

A child was seen with hair on his lower back. He had vertebral anomaly, what is it?

A- Spina bifida oculta
B- Spina bifida cystica

A

A- Spina bifida oculta

54
Q

What Cerebellar tumor presents with bipolar cells and fibrillary background?

A
  • Pilocytic astrocytoma
55
Q

A middle aged women presented with adduction of her left eye & nystagmus of her right eye, the doctor confirmed the diagnosis of multiple sclerosis, what is this condition?

A- Bulbar palsy
B- Internuclear opthalmoplegia

A

B- Internuclear opthalmoplegia

56
Q

Which part of the lateral ventricle is related to the tail of the caudate nucleus?

A-Central
B-Inferior horn
C-Posterior horn
D-Lateral horn

A

B-Inferior horn

57
Q

What vaccine did the patient not take if gram positive diplococci were found?

A
  • Streptococcal vaccine
58
Q

What is increased in central sensitization?

A
  • Calcium
59
Q

A benign tumor of hypophysis that compress anterior hypothalamus GABAergic neurons located in VLPO, what is the effect of compression on
sleep/wake cycle?

A- Insomnia
B- Narcolepsy
C- Absence of REM

A

A- Insomnia

60
Q

Vascular lesion at which nuclei of the thalamus would interfere with motor functions?

A- Anterior
B- Ventral posterior
C- Ventral lateral
D- Pulvinar

A

C- Ventral lateral

61
Q

Which of the following is NOT associated with opioid treatment?

A- Bronchoconstriction
B- Diarrhea
C- Nausea
D- Pupil constriction

A

B- Diarrhea

62
Q

A 65 years old man with diabetes, hypertension and history of smoking for 20 years, Complains of weakness on the left side of the body and slurred speech. CT scan shows ischemic infarct on the right side. After one week of admission, what histological finding you will see?

A- Red neurons
B- Granuloma
C- Microphages
D- Edema Neutrophils

A

C- Microphages

63
Q

What is the mechanism of Lidocaine?

A

Block Na channels

64
Q

What is the striatum?

A- Caudate & putamen
B- Globus pallidus & putamen
C- Caudate & globus pallidus
D- Caudate & substantia nigra

A

A- Caudate & putamen

65
Q

Which of the following anti-depressants requires dietary restrictions?

A- Phenelzine
B- Venlafaxine
C- Duloxetine
D-Citalopram

A

A- Phenelzine

66
Q

What happens to TRN neurons when they depolarize during sleep?

A- Firing pattern changes to burst mode
B- Firing pattern changes to single spike mode
C- Cortical activity synchronizes
D- Cortical activity decreases

A

B- Firing pattern changes to single spike mode

Note: in sleep -> Burst mode
While awake -> Spike mode
If TRN fires -> Spike mode

67
Q

What is used to determine brain death in comatose patients on life support?

A- FDG brain metabolism study
B- Tc99m cerebral perfusion
C- CSF kinetic
D- Tc99m RBC analysis

A

A- FDG brain metabolism study

68
Q

A 60 year old man has double vision. he can adduct his eye medially but he cannot abduct his eye laterally. Which nerve is affected?

A- Optic nerve
B- Abducent nerve
C- Occulomotor nerve
D- Trochlear nerve

A

B- Abducent nerve

69
Q 
Which of the following layers accommodate cells bodies of the rods and
cones?
A- Inner nuclear
B- Outer nuclear
C- Inner plexiform
D- Outer plexiform
E- Retinal pigment epithelium
A

B- Outer nuclear

CNS module - 4th year COPY (19 decks)

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