MCQ

Question 1

C: “The spinocerebellum is involved both in the control of posture and gait and the coordination of limb movements.”
T/F

Answer 1

T

Question 2

SZ: Which answer is incorrect?

Abnormal dopamine, glutamate, and GABAergic signaling are all hypothesized to contribute to schizophrenia.

Variation in immune related genes are strongly associated with schizophrenia.

Schizophrenia only effects a small proportion of the population.

Schizophrenia is a disorder of the brain.

Clinical presentation of schizophrenia is heterogeneous.

Answer 2

Schizophrenia only effects a small proportion of the population.

Question 3

SZ: Schizophrenia is a genetic disorder, and its heritability is

Answer 3

80%

Question 4

C: Which of the following assignments is correct?
1.
Multiple system atrophy, cerebellar type (MSA-C) – autosomal dominant disorder
2.
Sporadic adult onset ataxia (SAOA) – autosomal recessive disorder
3.
Spinocerebellar ataxia type 1 (SCA1) - autosomal dominant disorder
4.
Spinocerebellar ataxia type 3 (SCA3) - autosomal recessive disorder
5.
Spinocerebellar ataxia type 6 (SCA6) – nonhereditary degenerative ataxia

Answer 4

Spinocerebellar ataxia type 1 (SCA1) - autosomal dominant disorder

Question 5

C: Which is not a typical finding in Friedreich’s ataxia?

1. Renal failure
2. Progressive Ataxia
3. Araflexia
4. Dysarthria
5. Diabetes mellitus

Answer 5

Renal failure

Question 6

EF: Which cognitive functions are typically impaired in patients with lesions of the lateral prefrontal cortex?
A. Patients typically show impaired social behavior, poor judgments and impaired decision making.
B. Patients typically show impaired long-term memory functions.
C. Patients typically show impaired language comprehension.
D. Patients are typically impaired in planning, abstract reasoning and maintenance of task-relevant information.
E. Patients typically have lost the ability to accurately attribute mental states to other people.

Answer 6

Patients are typically impaired in planning, abstract reasoning and maintenance of task-relevant information.

Question 7

C: Which of the five clinical signs is not a typical cerebellar sign?
Dysmetria	
Intentiontremor
Ataxia
Paresis
Nystagmus

Answer 7

Paresis

Question 8

CE: Which of the following statements is correct?
Idiopathic epilepsies commonly have a single-gene inheritance.

Symptomatic epilepsies never have a genetic background.

Rolando-epilepsy of childhood is a symptomatic epilepsy syndrome.

Frontal lobe epilepsies may be idiopathic.

The correct diagnosis of epilepsy is made from the EEG.

Answer 8

Frontal lobe epilepsies may be idiopathic.

Frontal lobe epilepsies may be purely genetic is also true

Question 9

C; Which of the five clinical signs is a typical cerebellar sign?
Dysmetria	
Intentiontremor
Ataxia
Paresis
Nystagmus

Answer 9

Ataxia

Question 10

C: Which statement about spinocerebellar ataxia type 6 (SCA6) is correct?
Autosomal recessive disorder

Extensor plantar responses (positive Babinski sign)

Mitochondriopathy

Olivopontocerebellar atrophy (OPCA) in MRI scans

Typical age of onset around 50 years of age

Answer 10

Typical age of onset around 50 years of age

Question 11

The mean ‘translation lag’ (=time between discovery of a drug (date of IP or publication) and success full use in patients (date of highly cited positive study)) in medicine is typically

Answer 11

> 20 years

Question 12

EE: Which of the following statements is correct?
In patients, stroke causes subsequent chronic epilepsy in more than 50 % of patients.

In patients, epileptogenesis after brain injuries can take up to several years.

Status epilepticus rarely induces epileptogenesis in patients and rodents.

Epileptogenesis can be prevented by pharmacological and non-pharmacological treatment approaches.

Primary prophylaxis (i.e. treatment before occurrence of the first seizure) is commonly advised in patients with brain tumors.

Answer 12

In patients, epileptogenesis after brain injuries can take up to several years.

Question 13

A: Neglect is
a language disorder caused by damage to the temporal lobe or in the frontal lobe.

a motor disorder in which volitional or voluntary movement is impaired without muscle weakness.

the failure to recognize or identify objects despite intact sensory function.

manifested by difficulties in receptive and expressive language, including phonological processing, in reading, writing, spelling.

a lateralized disruption of spatial attention.

Answer 13

a lateralized disruption of spatial attention.

Question 14

Which of the following statements is correct?
1.
Simple partial seizures are characterized by loss of conciousness
2.
Complex partial seizures always indicate frontal lobe epilepsy
3.
Fear may be the clinical manifestation of an epileptic aura
4.
Absence seizures originate in the frontal lobe (fronto-orbital part)
5.
Visual symptoms at the onset of a seizure indicate temporal lobe seizure origin

Answer 14

Fear may be the clinical manifestation of an epileptic aura

Question 15

C: If you are interested to study cerebellar function, which disorders is not a good human lesion model?

Answer 15

Friedreich’s ataxia

Question 16

C: Which of the following statements is correct?
A) The cerebellum is involved in timing
B) The cerebellum is a learning device
C) The cerebellum contributes to certain cognitive tasks
D) The cerebellum is a likely place where internal models are build
E) The cerebellum is a likely place where internal models are stored

Answer 16

ALL

Question 17

EP:Which of the following statements is correct?

Epilepsy is a rare condition.

Epilepsy is characterized by epileptic seizures occurring at least once a day.

Epilepsy is in the majority of patients genetically determined.

Epilepsy with generalized seizures needs to be treated by hippocampectomy.

Epilepsy in many cases responds well to antiepileptic drugs.

Answer 17

Epilepsy in many cases responds well to antiepileptic drugs.

Question 18

IG: Which of these clinical features can be found in Parkinson’s disease?
Paresis
Spasticity
Postural instability
Muscle atrophy

Answer 18

Postural instability

Question 19

C: Which of the following assignments is correct?

1.	 Paleocerebellum - Vestibulocerebellum - Flocculonodular lobe, inferior vermis
2.	 Neocerebellum - Spinocerebellum - Cerebellar hemispheres
3.	 Archicerebellum - Vestibulocerebellum - Cerebellar Hemispheres
4.	 Neocerebellum - Pontocerebellum - Anterior lobe
5.	 Paleocerebellum - Spinocerebellum - Superior vermis and paravermal cerebellar areas

Answer 19

Paleocerebellum - Spinocerebellum - Superior vermis and paravermal cerebellar areas

Question 20

A: Agnosia is
a language disorder caused by damage to the temporal lobe or in the frontal lobe.

a motor disorder in which volitional or voluntary movement is impaired without muscle weakness.

the failure to recognize or identify objects despite intact sensory function.

manifested by difficulties in receptive and expressive language, including phonological processing, in reading, writing, spelling.

a speech disorder that is due to a weakness or incoordination of the speech muscles.

Answer 20

the failure to recognize or identify objects despite intact sensory function.

Question 21

IG: DG: Which of these anatomic structures is not part of the basal ganglia?
Striatum	
Pontine nucleus
Subthalamic nucleus
Globus pallidus internus

Answer 21

Pontine nucleus

Question 22

C: If you are interested to study cerebellar functions, which of the following disorders are not good human lesion models?

A) Stroke within the territory of the superior cerebellar artery
B) Spinocerebellar ataxia type 3 (SCA 3)
C) Surgical removal of cerebellar astrocytoma
D) Spinocerebellar ataxia type 6 (SCA 6)
E) Friedreich’s ataxia

Answer 22

Spinocerebellar ataxia type 3 (SCA 3) & Friedreich’s ataxia

Question 23

AD: Manic-depressive mixed states are
1.
Characterized by fluctuations in mood symptoms of opposite polarity

2.	 More often associated with a good prognosis than pure episodes

3.	 More frequent in men than in women

4.	 Easy to treat

5.	 A combination of 2 depressive and 4 manic symptoms

Answer 23

Characterized by fluctuations in mood symptoms of opposite polarity

Question 24

S: A transient ischemic attack
always leads to changes in signal intensity on CT or MR in affected brain areas

precedes a stroke in approx. 60 % of patients

carries an annual risk of stroke during the first 5 years of 5%

is characterized by brief focal neurological deficits, which resolve within 12 hours

produces a persistent neurological deficit

Answer 24

carries an annual risk of stroke during the first 5 years of 5%

Question 25

A: The neglect syndrom (more than one) is a loss of half of the visual field a deficit in attention to one side of space occurs more frequently after damage to the right hemisphere is a reading disorder is a multisensory syndrome

Answer 25

a deficit in attention to one side of space occurs more frequently after damage to the right hemisphere is a multisensory syndrome

Question 26

A patient with akinetic mutism ...(more than one) A) tends neither to speak nor move B) typically shows tactless behavior C) eats and drinks only if being fed D) utilizes items instantly within the visual field independent of the situation E) is profoundly apathetic and displays no emotions even in pain

Answer 26

A,C and E

Question 27

AD: Selective serotonine reuptake inhibitors have been proven to be ineffective in moderate depression. are more effective in carriers of the 5-HTTLPR L-Allele. are more effective than serotonine-noradrenaline reuptake inhibitors. should not be used in patients with suicidal ideation. are most effective in bipolar depression.

Answer 27

are more effective in carriers of the 5-HTTLPR L-Allele.

Question 28

AX: The lifetime prevalence of anxiety disorders is about:

Answer 28

20%

Question 29

EF: The model of cognitive control proposed by Norman and Shallice suggests (more than one) that the control by the SAS is required for example in planing and decision making, in situations that require unpracticed or new actions. the existence of a “contention Scheduling (CS)“ that the SAS-mode can not be consciously controlled. the existence of a prefrontal “executive committee” for perception, working memory, attention, long-term memory, motor control and thinking. that the SAS is always then required when an no acting scheme is available for a certain situation

Answer 29

- that the control by the SAS is required for example in planing and decision making, in situations that require unpracticed or new actions. - the existence of a “contention Scheduling (CS)“ - that the SAS is always then required when an no acting scheme is available for a certain situation

Question 30

What is the main advantage of bipolar electrophysiological recordings, compared to a common reference better spectral resolution better time resolution better spatial resolution higher amplification

Answer 30

better spatial resolution

Question 31

EP: Which of the following statements regarding antiepileptic drugs (AED) are correct? - The “new generation” AEDs (marketed since 1990) significantly reduced pharmcoresistance. - AEDs with multiple molecular targets are more efficient. - AEDs with multiple molecular targets have more side-effects. - AED treatment regimens usually start with monotherapy. - Most clinically relevant AED have been discovered by chance.

Answer 31

- AED treatment regimens usually start with monotherapy. | - Most clinically relevant AED have been discovered by chance.

Question 32

``` SZ: The following are effective treatments for schizophrenia antipsychotic medication stimulate medication cognitive behavior therapy (CBT) social skill training electroconvulsive therapy (ECT) ```

Answer 32

antipsychotic medication cognitive behavior therapy (CBT) social skill training electroconvulsive therapy (ECT)

Question 33

EF; The following statement is true in regard to Von Holst and Mittelstaedts Reafference prinicple 1. The efference copy has to match the reafferent signal in amplitude but has to have the opposite sign 2. Reafference is the repetition of an afferent signal that occured only briefly and is important to strengthen short stimuli 3. Reafferent signals use different sensory receptors and pathways as do exafferent signals 4. The efference copy has to match the reafferent signal in amplitude and sign 5. Reafference enhances the perception of unconscious sensory stimuli

Answer 33

The efference copy has to match the reafferent signal in amplitude but has to have the opposite sign

Question 34

ST: What are types of bias affecting the "internal validity" of a study? selection bias (creating groups with different confounders; solved by randomization) performance bias and detection bias (investigators respectively treating or assessing more positively those subjects on the treatment arm; controlled by blinding interventions and outcome assessments); attrition bias (dropouts of subjects with a negative outcome not included in the final result) all of the above

Answer 34

all of above

Question 35

``` ST: Ownership of intellectual property in academic research in Germany and the US is held by the inventor(s) ``` the funding agency the University Researcher(s) who are not employed by the University but inventor(s)

Answer 35

the University | Researcher(s) who are not employed by the University but inventor(s)

Question 36

EP: The following condition is epilepsy One unprovoked seizures with normal cMRI and EEG. Three acute symptomatic seizures. One unprovoked seizure at least 1 week after ischemic stroke. One acute symptomatic seizure with 3 Hz spike-wawe in EEG. One unprovoked seizure and one dissociative seizure.

Answer 36

One unprovoked seizure at least 1 week after ischemic stroke.

Question 37

AD: Which symptoms can be associated with a depressive episode? 1) Insomnia 2) Disinhibition 3) Weight loss 4) Anhedonia 5) Psychomotor retardation

Answer 37

1, 3, 4 and 5 are correct

Question 38

R: The dopaminergic input-neurons of monkeys (mediated by midbrain structures) contacting prefontal cortex - are unable to adapt to changes in context-conditions. - don’t fire if there is an unexpected reward. - can be conditioned with a neutral stimulus, so that the neutral stimulus alone leads to firing of the dopaminergic neurons. - show increased activity by withdrawing an earlier given reward. - are heavily interconnected with the cerebellum.

Answer 38

can be conditioned with a neutral stimulus, so that the neutral stimulus alone leads to firing of the dopaminergic neurons.

Question 39

ST; Preclinical studies are often over-powered of low internal validity predictive for clinical efficacy the basis for claiming intellectual property replicated

Answer 39

of low internal validity

Question 40

Commissural fibers of the corpus callosum 1. make up to 100-125 x106 fibers in each direction 2. functionally interconnect the cerebral hemispheres 3. connect only homotopic areas of the brain 4. are arranged in topographical order 5. connect only association areas of the cerebral cortex (according to Flechsig`s rules

Answer 40

connect only homotopic areas of the brain

Question 41

EF: The frontal lobe Spans 1/8 of the total cortex in humans Is separated to the temporal lobe by the postcentral sulcus Is subdivided into primary motor cortex, the premotor cortex and the prefrontal cortex Is separated to the parietal lobe by the precentral sulcus Greatly enlarged in the course of evolution in parallel to the development of motor abilities

Answer 41

Is subdivided into primary motor cortex, the premotor cortex and the prefrontal cortex

Question 42

EF: The frontal lobe includes premotor area primary somatosensory cortex prefrontal cortex primary motor cortex precuneus

Answer 42

premotor area prefrontal cortex primary motor cortex

Question 43

C: Which of the following hypotheses about cerebellar function is not correct? 1. The cerebellum is involved in feedback (reactive) but not feedforward (predictive) motor control. 2. The cerebellum is a learning device. 3. The cerebellum is a likely place where internal models for sensory motor control are build. 4. The cerebellum contributes to certain cognitive tasks. 5. The cerebellum is involved in timing.

Answer 43

The cerebellum is involved in feedback (reactive) but not feedforward (predictive) motor control.

Question 44

C; The output of the cerebellar cortex is transmitted by: 1. The medial, vestibular, interposed and lateral cerebellar nuclei 2. The medial, interposed and lateral cerebellar nuclei 3. The nucleus fastigii, emboliformis, globosus and dentatus 4. The largest cells of the cerebellar cortex: the Purkinje and Golgi cells 5. Purkinje cells

Answer 44

Purkinje cells

Question 45

One of the following statements is WRONG – Which one? ? Alexia without agraphia is disconnection syndrom typpically with the following characteristricts 1. a visual field defect 2. a left hemispheric lesion 3. patients can´t read but write 4. language difficulties 5. a lesion in the splenium

Answer 45

language difficulties

Question 46

AD: Bipolar disorder is characterized by predominant delusions of persecution. is a psychiatric disorder with low heritability. is one of the most frequent psychiatric disorders. can be treated with antipsychotics. is five times more frequent in women than in men.

Answer 46

can be treated with antipsychotics.

Question 47

C: Which statement about Friedreich’s ataxia is not correct? 1. Mitochondriopathy 2. Marked cerebellar atrophy early in the disease 3. Autosomal recessive disorder 4. Trinucleotide repeat disorder 5. Typical age of onset prior 20 years of age

Answer 47

Marked cerebellar atrophy early in the disease

Question 48

AD: Depression is associated with increased amygdala responses to negative emotional stimuli. is caused by reduced activity of the nucleus accumbens. is related to an overactivation of the pineal gland. is known to be associated with increased activity of the posterior cingulate cortex. is related to decreased hippocampus activity during REM sleep.

Answer 48

is associated with increased amygdala responses to negative emotional stimuli.

Question 49

C; Which of the five clinical signs is not a typical cerebellar sign? Dysmetria Intention tremor Akinesia Dysarthria Asynergia

Answer 49

Akinesia

Question 50

IGDG: Which of these anatomic structures is not part of the basal ganglia? Corpus striatum Red nucleus Subthalamic nucleus Caudate nucleus

Answer 50

Red nucleus

Question 51

AD: Which of the following is not a typical somatic symptom of depression? Chest tightness Knee pain Menstrual irregularities Back pain Headaches

Answer 51

Knee pain

Question 52

REP:Which statement about Friedreich’s ataxia is wrongt? Autosomal recessive disorder Trinucleotide repeat disorder Mitochondriopathy Marked cerebellar atrophy early in the disease Typical age of onset prior 20 years of age

Answer 52

Marked cerebellar atrophy early in the disease

Question 53

The prevalence rate of panic disorder is:

Answer 53

3-5%

Question 54

``` AD: Which medications are approved for the prophylaxis of bipolar disorder? A Lithium B Benzodiazepines C Valproic acid D Serotonin-Reuptake Inhibitors E Hypnotics ```

Answer 54

A and C

Question 55

Which of the following statements is true regarding the striatum? receives inhibitory input from the cortex receives dopaminergic input from the substantia nigra pars compacta contains cells that use GABA as their transmitter all of the above statements are true

Answer 55

receives dopaminergic input from the substantia nigra pars compacta contains cells that use GABA as their transmitter

Question 56

AD; Posttraumatic stress disorder is in most cases not associated with Hyperarousal Flashbacks Delusions Avoidance of stimuli associated with the trauma Nightmares

Answer 56

Delusions

Question 57

``` AD: Antidepressants ... 1. must not be taken by people driving cars 2. need 2-4 weeks to get effective 3. should not be taken continuously 4. change the character 5. have the risk of dependency ```

Answer 57

need 2-4 weeks to get effective

Question 58

R: What has the neurotransmitter dopamine been shown to encode? stop signals reward signals fear signals motor signals

Answer 58

reward signals

Question 59

EF: The executive system (more than one) is concerned with the co-ordination of other cognitive resources is needed when automatic psychological processes would not be sufficient, in cases of novel situations is a brain function charged with implementing, or executing, the law damage to the system can have a wide range of effects in different domains, for example in social interaction, executive memory and abstract thinking specifically describes the execution of motor commands

Answer 59

is concerned with the co-ordination of other cognitive resources is needed when automatic psychological processes would not be sufficient, in cases of novel situations damage to the system can have a wide range of effects in different domains, for example in social interaction, executive memory and abstract thinking

Question 60

EF: The Stroop task demonstrates that there is signigicant interference from incongruent colours when reading the words aloud (compared to reading words in black) is not a very sensitive test for executive dysfunction is particularly difficult for patients with lesions in the temporal cortex. demonstrates improved inhibition of irrelevant contents demonstrates that there is significant interference from incongruent words when naming colours (compared to naming colour patches)

Answer 60

demonstrates that there is significant interference from incongruent words when naming colours (compared to naming colour patches)

Question 61

C: Which statement about Friedreich's ataxia is not correct? Areflexia Trinucleotide repeat disorder Mitochondriopathy Atrophy of the cervical cord early in the disease Typical age of onset 70 years of age

Answer 61

Typical age of onset 70 years of age

Question 62

WRONG"Disconnection syndromes” 1. are characterized by anatomical lesion sites (and therefore disconnection symptoms might refer to different cognitive or neuronal systems) 2. may refer to interruption of intrahemispheric as well as interhemispheric fiber tracts 3. means that two cortical areas are linked together irregularly ( = dysconnection) by aberrant fiber tracts 4. may result from transection of the corpus callosum (so-called “split-brain” operations) 5. are functional deficits caused by focal lesions of fiber tracts that connect cortical brain areas

Answer 62

means that two cortical areas are linked together irregularly ( = dysconnection) by aberrant fiber tracts

Question 63

Which other description of the clinical symptom chorea is correct? Babinski sign akinesia rigidity uncontrollable involuntary movement spasticity

Answer 63

uncontrollable involuntary movement

Question 64

``` Symptoms of cerebellar disorder can be: 1. Dysarhtria, dysmetria and dyslexia 2. Intentional tremor, dysarthria and ataxia 3. Ataxia, dysmetria and rigor 4. Akinesis, ataxia and rigor 5. Rest tremor, akinesis and rigor ```

Answer 64

Intentional tremor, dysarthria and ataxia

Question 65

C; Which of the five clinical signs is a typical cerebellar sign? Aphasia Tremor at rest Akinesia Hemiballism Asynergia

Answer 65

Asynergia

Question 66

IG: DBS: The ventral intermediate nucleus (VIM) of the thalamus is the first described DBS target. Which symptom does DBS of the VIM alleviate? Hyperkinesia/Dyskinesia Bradykinesia/Akinesia Gait disturbance Tremor Dystonia

Answer 66

Tremor

Question 67

The cerebellum comprises of 1. A cerebellar cortex, white matter and deep cerebellar nuclei 2. A cerebellar cortex, white matter, deep cerebellar and nuclei and some parts of the vestibular nuclei 3. The cerebellar cortex and the DCN (dorsal cochlear nuclei) 4. A cerebellar cortex with the molecular, Purkinje cell and granular layer 5. Only the lobuli centralis, semilunaris inferior and superior

Answer 67

A cerebellar cortex, white matter, deep cerebellar and nuclei and some parts of the vestibular nuclei

Question 68

The following statement is true in regard to the cerebellar cortex 1. The granular cells are the only excitatory interneurons 2. Purkinje cells inhibit granule cells 3. Granule cells excite other granule cells 4. Golgi cells are contracted by climbing fibers and Purkinje cells 5. Only basket and stellate cells are inhibitory interneurons

Answer 68

1. | The granular cells are the only excitatory interneurons