Quick Facts 6 Flashcards
(111 cards)
1
Q
Describe the effect of tiagabine on GABAnergic transmission? [1]
A
selective GABA reuptake inhibitor.
2
Q
Parkinsons disease pathophysiology:
Name A [1]
Which protein is is A enriched with? [1]
A
Lewys body: enriched with protein α-synuclein
3
Q
Which of the following is implicated in SCH?
A
B
C
D
E
A
A dorsolateral prefontal
4
Q
A 57-year-old male comes to the office for a routine visit. His symptoms are a shuffling gait, pill-rolling tremor, and a masked face. What is the underlying pathology of the disease?
A. Loss of alpha-synuclein, leading to a destruction of the caudate of the basal ganglia
B. Lesions in bilateral aspects of the internal capsule
C. Destruction of the substantia nigra pars compacta and striatum
D. Apoptosis in the substantia nigra pars reticulata
A
A 57-year-old male comes to the office for a routine visit. His symptoms are a shuffling gait, pill-rolling tremor, and a masked face. What is the underlying pathology of the disease?
A. Loss of alpha-synuclein, leading to a destruction of the caudate of the basal ganglia
B. Lesions in bilateral aspects of the internal capsule
C. Destruction of the substantia nigra pars compacta and striatum
D. Apoptosis in the substantia nigra pars reticulata
5
Q
A 43-year old cerebral vascular accident patient was diagnosed as having persistent unilateral spatial agnosia or “visual neglect”. What cerebral region was most likely involved?
A. Non-dominant parietal-occipital cortex
B. Dominant parietal-occipital cortex
C. Dorsal prefrontal cortex
D. Dominant temporal-occipital cortex
E. Non-dominant temporal-occipital cortex
A
A 43-year old cerebral vascular accident patient was diagnosed as having persistent unilateral spatial agnosia or “visual neglect”. What cerebral region was most likely involved?
A. Non-dominant parietal-occipital cortex
B. Dominant parietal-occipital cortex
C. Dorsal prefrontal cortex
D. Dominant temporal-occipital cortex
E. Non-dominant temporal-occipital cortex
6
Q
What is Xanthochromia? [1]
A
Xanthochromia is the presence of bilirubin in the cerebrospinal fluid and is sometimes the only sign of an acute subarachnoid hemorrhage.
7
Q
Neuroleptic side effects of schizophrenic drugs arise from blockade of dopamine receptors in which striatum [1]
Exam Q
A
Extrapyramidal symptoms
8
Q
Frontal eye field
Parahippocampus
Insula
Supplementary motor cortex
Cingulate cortex
Prefrontal cortex
A
Prefrontal cortex
9
Q
Describe the location of locus ceruleus compared to raphe nucleus [1]
A
LC on top of RN
10
Q
A
A: Dentate gyrus
B: Parahippocampal gyrus
C: Uncus of parahippocampal gyrus
11
Q
A 24-year-old patient presents to the hospital complaining of sharp pain on the left side of her forehead. Which of the following artery supplies the part of the brain necessary for the sensory processing of this pain?
A. Right posterior inferior cerebellar artery
B. Left posterior cerebral artery
C. Left posterior inferior cerebellar artery
D. Anterior communicating artery
A
C. Left posterior inferior cerebellar artery
The left posterior inferior cerebellar artery supplies the spinal trigeminal nucleus on the left lateral medulla.
12
Q
Anosmia is caused by a stroke to which of the following:
ACA
MCA
PCA
Anterior Choroidal
Lenitculate striate
A
Anosmia is caused by a stroke to which of the following:
ACA: olfactory bulb
MCA
PCA
Anterior Choroidal
Lenitculate striate
13
Q
Ballismus occurs due to lesions to which region?
Subthalamic nuclei
Substantia nigra
Pre supplementary motor area
Lentiform nucleus
Dorsal striatum
A
Subthalamic nuclei
14
Q
Label 5, 7, 10, 11, 12 & 13
A
15
Q
Label 5, 7, 10, 11, 12 & 13
A
16
Q
Amantadine helps patients recover from TBI. What is its mechanism of action?
GABA-A antagonist
GABA-A agonist
NMDA Glutamate antagonist
NMDA Glutamate agonist
AMPA Glutamate antagonist
A
Amantadine helps patients recover from TBI. What is its mechanism of action?
GABA-A antagonist
GABA-A agonist
NMDA Glutamate antagonist
NMDA Glutamate agonist
AMPA Glutamate antagonist
16
Q
TCAs cause weight gain due a blockage of [] receptors
A
TCAs cause weight gain due a blockage of histamines 1 receptors
17
Q
Where is the lesion?
A
B
C
D
E
F
A
Where is the lesion?
A
B
C
D
E
F
18
Q
Where is the lesion?
A
B
C
D
E
F
A
Where is the lesion?
A
B
C
D
E
F
19
Q
Identify the aperture.
Obex
Median aperture
Lateral aperture
Cerebral aqueduct
Interventricular foramen
A
Identify the aperture.
Obex
Median aperture
Lateral aperture
Cerebral aqueduct
Interventricular foramen
20
Q
Identify the aperture.
Obex
Median aperture
Lateral aperture
Cerebral aqueduct
Interventricular foramen
A
Cerebral aqueduct
21
Q
Lorraine describes her father’s recent behavioural changes in more detail: he seems uninterested in doing things, is missing bills, and does not seem to enjoy playing with his great grandchildren as he usually did.
Wich part of the brain is most likely affected?
Cingulate cortex
Hypothalamus
Thalamus
Hippocampus
Mamillary bodies
A
Lorraine describes her father’s recent behavioural changes in more detail: he seems uninterested in doing things, is missing bills, and does not seem to enjoy playing with his great grandchildren as he usually did.
Wich part of the brain is most likely affected?
Cingulate cortex
Many types of behavioural changes are common in Alzheimer’s Disease, but this picture suggests apathy, characterised by poor motivation and altered affect (this also commonly coexists with depression). This suggests involvement of the cingulate cortex (probably anterior cingulate cortex) as well as the prefrontal and orbital frontal cortex.
22
Q
Which part of the limbic system is the nuclei involved in reward circuits? [1]
Amygdala
Nucleus accumbens
Septal nuclei
Uncus
A
Which part of the limbic system is the nuclei involved in reward circuits? [1]
Amygdala
Nucleus accumbens
Septal nuclei
Uncus
23
Q
Name a function of the basal ganglia other than to play a role in movement initiation; stopping and starting movements? [1]
A
- Regulate movement force
24
Axons of which pathway are found in the SCP?
Spinocerebellar
Olivocerebellar
Trigeminocerebellar
Pontocerebellar
Dentothalamic
**Dentothalamic**
a tract which originates in the dentate nucleus and follows the ipsilateral superior cerebellar peduncle, decussating later on and reaching the contralateral red nucleus and the contralateral thalamus
25
The fornix axons end in the [] and the [] of the hypothalamus
The fornix axons end in the **septal nuclei** and the **mammillary** **body** of the hypothalamus
26
The sprouting of which fibres in the dorsal horn can modulate chronic pain
Aalpha
Abeta
Adelta
C
The sprouting of which fibres in the dorsal horn can modulate chronic pain
Aalpha
Abeta
Adelta
C
27
The cingulum connects which two parts of the limbic system? [1]
Anterior cingulate gyrus and parahippcampal gyrus
28
Which of the following serve to transmit information primarily relating to proprioception (muscle sense)
Aα
Aγ
Aδ
Aβ
C
Which of the following serve to transmit information primarily relating to proprioception (muscle sense)
**Aα**
Aγ
Aδ
Aβ
C
29
selegiline utilise utilise which of the following mechanisms?
Dopamine agonist
COMT inhibitor
Decarboxylase inhibitor
MAO inhibitor
selegiline utilise utilise which of the following mechanisms?
Dopamine agonist
COMT inhibitor
Decarboxylase inhibitor
**MAO inhibitor**
30
Hofbeaur cells are associated with which type of IUGR? [1]
Lymphocytic infiltration is associated with which type of IUGR?
HB: Type 2
Lymphocytes: Type 1
31
Which sensory receptor is most sensitive to angular acceleration?
A. Crista
B. Utricle
C. Saccule
D. Organ of Corti
Which sensory receptor is most sensitive to angular acceleration?
**A. Crista**
B. Utricle
C. Saccule
D. Organ of Corti
32
Which of the following is the most common cause of subarachnoid haemorrhage?
arteriovenous malformation
berry aneurysm
cerebral amyloid angiopathy
dural arteriovenous fistula
trauma
Which of the following is the most common cause of subarachnoid haemorrhage?
arteriovenous malformation
berry aneurysm
cerebral amyloid angiopathy
dural arteriovenous fistula
**trauma**
33
Zolpidem is a drug that causes patients to temporarily leave vegetative state. What is its MoA?
GABA-A antagonist
GABA-A agonist
NMDA Glutamate antagonist
NMDA Glutamate agonist
AMPA Glutamate antagonist
Zolpidem is a drug that causes patients to temporarily leave vegetative state. What is its MoA?
GABA-A antagonist
**GABA-A agonist**
NMDA Glutamate antagonist
NMDA Glutamate agonist
AMPA Glutamate antagonist
34
The corticobulbar tracts provide innervation to the musculature of which region of the body?
Head and neck
Upper limbs
Lower limbs
Neck
The corticobulbar tracts provide innervation to the musculature of which region of the body?
**Head and neck**
35
A
A 56-year-old right-handed man is brought to the emergency department 90 minutes after acute-onset right arm weakness, difficulty forming words, and sustained dizziness. His past medical history is significant for well-controlled type 2 diabetes and hypertension. A CT head without contrast demonstrates no acute hemorrhage or lesion, but shows an area of hypodensity and associated mild parenchymal swelling deep within the left peri-Sylvian fissure. Which of the following vessels is most likely implicated in the etiology of this patient’s current condition?
A. M1 segment of the middle cerebral artery
B. A2 segment of the anterior cerebral artery
C. A3 segment of the anterior cerebral artery
D. M2 segment of the middle cerebral artery
A
A 56-year-old right-handed man is brought to the emergency department 90 minutes after acute-onset right arm weakness, difficulty forming words, and sustained dizziness. His past medical history is significant for well-controlled type 2 diabetes and hypertension. A CT head without contrast demonstrates no acute hemorrhage or lesion, but shows an area of hypodensity and associated mild parenchymal swelling deep within the left peri-Sylvian fissure. Which of the following vessels is most likely implicated in the etiology of this patient’s current condition?
A. M1 segment of the middle cerebral artery
B. A2 segment of the anterior cerebral artery
C. A3 segment of the anterior cerebral artery
**D. M2 segment of the middle cerebral artery insula is supplied by the M2 MCA**
36
Uncal
Central (transtentorial)
Cingulate (Subfalcine)
Transcalvarial
Upward cerebellar (transtentorial)
Downward cerebellar (Tonsillar)
**Uncal**
Central (transtentorial)
Cingulate (Subfalcine)
Transcalvarial
Upward cerebellar (transtentorial)
Downward cerebellar (Tonsillar)
37
A
B
C
D
E
A
**B**
C
D
E
38
Which of the following is key in modulation of pain and empathy
Anterior cingulate cortex
Prefrontal cortex
Insula
Amygdala
Which of the following is key in modulation of pain and empathy
Anterior cingulate cortex
Prefrontal cortex
**Insula**
Amygdala
39
Which viral infection is associted with MS?
Epstein-Barr Virus
Toxoplasmosis gondii
Cytomegalovirus
Human papilloma virus
Which viral infection is associted with MS?
**Epstein-Barr Virus**
Toxoplasmosis gondii
Cytomegalovirus
Human papilloma virus
40
What are the values for normal intracranial pressure? [1]
normal is **7-15mmHg**
41
The lateral and anterior temporal cortex, prefrontal cortex are involved with which type of memory?
episodic memory
semantic memor
procedural memory (skills and habits)
classical conditioning
The lateral and anterior temporal cortex, prefrontal cortex are involved with which type of memory?
episodic memory
**semantic memor**
procedural memory (skills and habits)
classical conditioning
42
Locked in syndrome is due to damage to which artery? [1]
**Basilar artery**
43
Which drug class has the highest risk for mania if used to treat depression in bipolar patients?
TCAs
SNRIs
MAOIs
SSRIs
Q
Which drug class has the highest risk for mania if used to treat depression in bipolar patients?
**TCAs**
SNRIs
MAOIs
SSRIs
44
Targeting which area of the brain may help AD?
Brodmann area 25 (Subcallosal cingulate)
Hypothalamus
Thalamic centromedian/parafascicular complex
Nucleus Accumbens
Anterior of the fornix
A
Targeting which area of the brain may help AD?
**Brodmann area 25 (Subcallosal cingulate)**
Hypothalamus
Thalamic centromedian/parafascicular complex
Nucleus Accumbens
Anterior of the fornix
A
45
Which anti-epileptic treatment would be used to treat status epilepticus
Sodium Valproate
Ethosuximide
Lamotrigine
Levetiracetam
Lorazepam
Which anti-epileptic treatment would be used to treat status epilepticus
Sodium Valproate
Ethosuximide
Lamotrigine
Levetiracetam
**Lorazepam**
46
Q
Deficiency in which vitamin is associated with MS?
Vitamin B1
Vitamin C
Vitamin B6
Vitamin D
Vitamin B12
Q
Deficiency in which vitamin is associated with MS?
Vitamin B1
Vitamin C
Vitamin B6
**Vitamin D**
Vitamin B12
47
The [] is a pivotal structure positioned between the hippocampus proper (CA1) and entorhinal and other cortices
Subiculum
Schaffer Collaterals
Mossy fibres
Pyramidal cells
Granule cells
The [] is a pivotal structure positioned between the hippocampus proper (CA1) and entorhinal and other cortices
**Subiculum**
Schaffer Collaterals
Mossy fibres
Pyramidal cells
Granule cells
48
Which of the following is A?
Mamillary Bodies
Hippocampus
Amygdala
Dentate gyrus
Parahippocampal gyrus
Fornix
Which of the following is A?
Mamillary Bodies
Hippocampus
**Amygdala**
Dentate gyrus
Parahippocampal gyrus
Fornix
49
**Split-brain syndrome**
ACA syndrome - because supplies corpus callosum
50
Which of the following is not a visible boundary of the hypothalamus in a hemisected brain?
A. The median eminence
B. The mammillary body
C. The optic chiasm
D. The internal capsule
E. The anterior commisure
Which of the following is not a visible boundary of the hypothalamus in a hemisected brain?
A. The median eminence
B. The mammillary body
**C. The optic chiasm**
D. The internal capsule
E. The anterior commisure
51
Which of the following opiods produces the least amount of respiratory depression?
Herion
Dextromoramide
Meptazinol
Methadone
Morphine
Which of the following opiods produces the least amount of respiratory depression?
Herion
Dextromoramide
**Meptazinol**
Methadone
Morphine
52
Describe the mechanism of action of agomelatin
Binds to MT1 and MT2 receptors only
Binds to MT1 and MT2 receptors; 5HT agonist
Binds to MT1 and MT2 receptors; 5HT antagonist
5HT agonist
5HT antagonist
Describe the mechanism of action of agomelatin
Binds to MT1 and MT2 receptors only
Binds to MT1 and MT2 receptors; 5HT agonist
**Binds to MT1 and MT2 receptors; 5HT antagonist**
5HT agonist
5HT antagonist
53
In HD which part of the basal ganlgia becomes hyperactive?
GPin
Putamen
GPex
Caudate nucleus
GPex Result in inhibited STN = GPint is not able to inhibit thalamus
54
Which dopamine pathway is involved in reward and addiction? [1]
**Mesolimbic**
55
Which anti-epileptic treatment works by bind to synaptic vesicle protein SV2A causing a reduction in neurones
Sodium Valproate
Ethosuximide
Lamotrigine
Levetiracetam
Lorazepam
Which anti-epileptic treatment works by bind to synaptic vesicle protein SV2A causing a reduction in neurones
Sodium Valproate
Ethosuximide
Lamotrigine
**Levetiracetam**
Lorazepam
56
Foetal malformations represent a main unwanted effect of an antiepileptic drug. Name this drug [1]
Exam Q
**Phenytoin**
57
Which of the following genes involved in SCH is responsible for neurodevelopment and also signalling in corticolimbic areas
Dysbindin
DISC1
COMT
BDNF
Neuregulin 1
Which of the following genes involved in SCH is responsible for neurodevelopment and also signalling in corticolimbic areas
Dysbindin
**DISC1**
COMT
BDNF
Neuregulin 1
58
A: Minimally consciousness state
B: vegatative syndrome
C: locked in syndrome
D: REM sleep
E: coma
59
[] cortex acts as an interface between hippocampus and cerebral cortex.
Exam Q
**Entorhinal cortex**
60
Abulia is caused by a stroke to which of the following
ACA
MCA
PCA
Anterior Choroidal
Lenitculate striate
**Abulia: an absence of willpower or an inability to act decisively, a symptom of schizophrenia or other mental illness.**
ACA frontal lobe
MCA
PCA
Anterior Choroidal
Lenitculate striate
61
Q
Classical conditioning is an example of:
A. Semantic memory
B. Episodic memory
C. Implicit memory
D. Declarative memory
E. Nonassociative memory
Q
Classical conditioning is an example of:
A. Semantic memory
B. Episodic memory
**C. Implicit memory**
D. Declarative memory
E. Nonassociative memory
62
A mass lesion with an ICP of ≥ [] mmHg can cause herniation
12
14
16
18
20
A mass lesion with an ICP of ≥ [] mmHg can cause herniation
12
14
16
18
**20**
63
Which part of the limbic system is the thought to be the emotional content of experiences
**Amygdala**
64
Which of the following EEG frequencies are active during for ‘sleep & meditation’?
Gamma
Beta
Alpha
Theta
Delta
Which of the following EEG frequencies are active during for ‘sleep & meditation’?
Gamma
Beta
Alpha
**Theta**
Delta
65
Which waves are found between 8-12 Hz?
Gamma
Beta
Alpha
Theta
Delta
Which waves are found between 8-12 Hz?
Gamma
Beta
**Alpha**
Theta
Delta
66
Which waves are found between 13-30Hz?
Gamma
Beta
Alpha
Theta
Delta
Which waves are found between 13-30Hz?
Gamma
**Beta**
Alpha
Theta
Delta
67
Which waves are found between 4-8Hz?
Gamma
Beta
Alpha
Theta
Delta
Which waves are found between 4-8Hz?
Gamma
Beta
Alpha
**Theta**
Delta
68
Which waves are found over 30 Hz?
Gamma
Beta
Alpha
Theta
Delta
Which waves are found over 30 Hz?
**Gamma**
Beta
Alpha
Theta
Delta
69
Linear acceleration is transduced in the:
A. Cupula
B. Cristae
C. Maculae
D. Organ of Corti
E. Scarpa’s ganglion
Linear acceleration is transduced in the:
A. Cupula
B. Cristae
**C. Maculae**
D. Organ of Corti
E. Scarpa’s ganglion
70
Where are the 3rd order neurons that project to the anterior cingulate cortex that are involved in emotion / pain? [1]
**Medial dorsal** nucleus of the thalamus
71
At which level do the primary vestibular axons enter the brain stem?
A. The caudal medulla.
B. The pontomedullary junction.
C. The mid-pons.
D. Near the mammillary bodies in the interpeduncular fossa.
At which level do the primary vestibular axons enter the brain stem?
A. The caudal medulla.
**B. The pontomedullary junction.**
C. The mid-pons.
D. Near the mammillary bodies in the interpeduncular fossa.
72
A: Peri-aqueductal grey (PAG)
B: Locus coeruleus
C: Raphe nucleus
73
A: thalamus
B: sensory cortex
C: amygdala
74
Before finishing its path in the primary and secondary somatosensory cortex, in which two thalamic nuclei does the anterior spinal thalamic synapse? [2]
VPI / VPL
75
Label C
Subiculum
Schaffer Collaterals
Mossy fibres
Pyramidal cells
Perforant pathway
Label C
Subiculum
**Schaffer Collaterals**
Mossy fibres
Pyramidal cells
Perforant pathway
76
VGS treatment
Zolpidem is used orally as a short term treatment (2-6 weeks) for insomnia, but has been shown to cause patients to momentarily awake from PVS. What is its MoA?
Glutamate receptor agonist
Glutamate receptor antagonist
GABA-A receptor agonist
GABA-A receptor antagonist
VGS treatment
Zolpidem is used orally as a short term treatment (2-6 weeks) for insomnia, but has been shown to cause patients to momentarily awake from PVS. What is its MoA?
Glutamate receptor agonist
Glutamate receptor antagonist
**GABA-A receptor agonist**
GABA-A receptor antagonist
77
The amygdala and cerebellum are involved with which type of memory
episodic memory
semantic memor
procedural memory (skills and habits)
classical conditioning
The amygdala and cerebellum are involved with which type of memory
episodic memory
semantic memor
procedural memory (skills and habits)
**classical conditioning**
78
Which of the following targets GAT-1 transporter to inhibit GABA reuptake
Vigabatrin
Levetiracetam
Phenobarbitone
Tiagabine
Which of the following targets GAT-1 transporter to inhibit GABA reuptake
Vigabatrin
Levetiracetam
Phenobarbitone
**Tiagabine**
79
Which of the following opiods has a large half life so is used for long dosing?
Herion
Dextromoramide
Meptazinol
Methadone
Morphine
Which of the following opiods has a large half life so is used for long dosing?
Herion
Dextromoramide
Meptazinol
**Methadone**
Morphine
80
Which of the following does a migraine start from ?
A
B
C
D
E
Which of the following does a migraine start from ?
**hypothalamus:B**
C
D
E
81
A: normal
B: coma
C: Vegetative state
D: Minimally concious state
E: Locked in syndrome
82
Which of the following is associated with Guillain-Barre syndrome
Locked-in syndrome
Coma
Akinetic mutism
Minimally conscious state
Vegetative state (VS) / Unresponsive wakefulness syndrome (UWS)
Which of the following is associated with Guillain-Barre syndrome
**Locked-in syndrome**
Coma
Akinetic mutism
Minimally conscious state
Vegetative state (VS) / Unresponsive wakefulness syndrome (UWS)
83
Which of the following EEG frequencies are active during ‘active information processing’’?
Gamma
Beta
Alpha
Theta
Delta
Which of the following EEG frequencies are active during ‘active information processing’’?
**Gamma**
Beta
Alpha
Theta
Delta
84
Which of the following is the most cardiotoxic?
Amitriptyline
Nortriptyline
Citalopram
Sertraline
Fluoxetine
Which of the following is the most cardiotoxic?
**Amitriptyline**
Nortriptyline
Citalopram
Sertraline
Fluoxetine
85
What is indicated by letter A?
PAG
Nucleus raphe magnus
Nucleus reticularis paragigantocelluaris
Dorsal horn
VTA
What is indicated by letter A?
**PAG**
Nucleus raphe magnus
Nucleus reticularis paragigantocelluaris
Dorsal horn
VTA
86
ID the CN
CN II
CN III
CN IV
CN V
CN VI
Q
ID the CN
CN II
CN III
**CN IV**
CN V
CN VI
87
Which area is thought to be associated with the visuo-spatial sketchpad?
A
B
C
D
E
F
**F**
88
Which type of haemorrhage is seen here
Epidural
Subdural
Subarachnoid
Intracerebral
Which type of haemorrhage is seen here
Epidural
Subdural
**Subarachnoid**
Intracerebral
89
A 33 year-old married woman with a history of grand-mal seizures complains of gum hypertrophy, increased facial hair and diplopia. Which of the following anticonvulsants is the most likely cause of her symptoms?
A. Carbamazepine
B. Ethosuximide
C. Phenobarbitone
D. Phenytoin
E. Valproic acid
A 33 year-old married woman with a history of grand-mal seizures complains of gum hypertrophy, increased facial hair and diplopia. Which of the following anticonvulsants is the most likely cause of her symptoms?
A. Carbamazepine
B. Ethosuximide
C. Phenobarbitone
**D. Phenytoin**
E. Valproic acid
90
Which of the following is a useful intervention in the management of chronic pain?
A. Cognitive behavioural therapy (CBT)
B. Dialectical behavioural therapy (DBT)
C. Eye movement desensitization and reprocessing (EMDR)
D. Motivational interviewing
E. Psychoanalysis
Correct Answer: A. Cognitive behavioural therapy
91
Which of the following is the most common site for the development of a cerebral aneurysm?
A. Junction of the anterior cerebral artery and anterior communicating artery
B. Junction of the basilar artery and posterior cerebral artery
C. Junction of the middle cerebral artery and lentiostriate artery
D. Junction of the posterior communicating artery and middle cerebral artery
E. Junction of the vertebral artery and posterior inferior cerebellar artery
Which of the following is the most common site for the development of a cerebral aneurysm?
**A. Junction of the anterior cerebral artery and anterior communicating artery**
B. Junction of the basilar artery and posterior cerebral artery
C. Junction of the middle cerebral artery and lentiostriate artery
D. Junction of the posterior communicating artery and middle cerebral artery
E. Junction of the vertebral artery and posterior inferior cerebellar artery
92
Alcoholics can be treated with disulfiram, a deterrent drug which causes a quick unpleasant aftermath to any alcohol ingested. Which paradigm generates such atreatment approach?
A. Biological
B. Cognitive
C. Evolutionary
D. Learning
E. Psychodynamic
Alcoholics can be treated with disulfiram, a deterrent drug which causes a quick unpleasant aftermath to any alcohol ingested. Which paradigm generates such atreatment approach?
A. Biological
B. Cognitive
C. Evolutionary
**D. Learning**
E. Psychodynamic
93
The superior sagittal sinus lies below which layer of the meninges?
A. arachnoid mater
B. cranial bone
C. meningeal layer of the dura mater
D. periosteal layer of the dura mater
E. pia mater
The superior sagittal sinus lies below which layer of the meninges?
A. arachnoid mater
B. cranial bone
C. meningeal layer of the dura mater
**D. periosteal layer of the dura mater**
E. pia mater
94
A 48 year-old man with a history of hypertension presents with sudden onset of
loss of taste sensation. Which brainstem nucleus is most likely affected?
A. hypoglossal nucleus
B. nucleus ambiguus
C. salivatory nucleus
D. solitary nucleus
E. trigeminal main sensory nucleus
A 48 year-old man with a history of hypertension presents with sudden onset of
loss of taste sensation. Which brainstem nucleus is most likely affected?
A. hypoglossal nucleus
B. nucleus ambiguus
C. salivatory nucleus
**D. solitary nucleus**
E. trigeminal main sensory nucleus
95
ream sleep is thought to be triggered by a cessation of activity in:
A. Acetylcholine neurones
B. Dopaminergic neurones
C. Histaminergic neurones
D. Noradrenaline neurones
E. Serotonergic neurones
ream sleep is thought to be triggered by a cessation of activity in:
A. Acetylcholine neurones
B. Dopaminergic neurones
C. Histaminergic neurones
D. Noradrenaline neurones
**E. Serotonergic neurones**
96
12. A 15 year old is stabbed in the neck during a gang fight. Examination reveals a left sided hemiparesis, complete loss of joint position sense and vibration on the left side below C7. On the right side there is loss of pain sensation below C7. The lesion is:
A. A complete section of the spinal cord
B. A hemisection of the left side of the spinal cord
C. A hemisection of the right spinal cord
D. Damage to the C7 dorsal roots on the left side
E. Damage to the lateral funiculus on the left side
Correct Response: B A hemisection of the left side of the spinal cord
97
A 63 year-old man presents with left contralateral homonymous hemianopsia. Which artery is most likely occluded?
A Left middle cerebral artery
B Left ophthalmic artery
C Left posterior cerebral artery
D Right ophthalmic artery
E Right posterior cerebral artery
**Correct Response: E Right posterior cerebral artery**
98
Hypoactivity of this pathway is thought to occur in Schizophrenia
A. mesocortical
B. mesolimbic
C. raphespinal
D. reticulospinal
E. striato-pallidal
Hypoactivity of this pathway is thought to occur in Schizophrenia
A. mesocortical
**B. mesolimbic**
C. raphespinal
D. reticulospinal
E. striato-pallidal
99
Pain arising from innocuous stimuli is termed what?
A. Allodynia
B. dysarthria
C. hyperalgesia
D. paraesthesia
E. spasticity
Pain arising from innocuous stimuli is termed what?
**A. Allodynia**
B. dysarthria
C. hyperalgesia
D. paraesthesia
E. spasticity
100
A man presents after having fallen down the stairs the previous night. He has total motor paralysis of the legs, and a loss of pain and temperature sensation below the waist. Position and vibration sensation are normal but there is a bilateral Babinski sign. What artery is the most likely to be the cause of these symptoms?
A. anterior cerebral artery
B. anterior communicating artery
C. anterior spinal artery
D. middle cerebral artery
E. posterior spinal artery
A man presents after having fallen down the stairs the previous night. He has total motor paralysis of the legs, and a loss of pain and temperature sensation below the waist. Position and vibration sensation are normal but there is a bilateral Babinski sign. What artery is the most likely to be the cause of these symptoms?
A. anterior cerebral artery
B. anterior communicating artery
C. anterior spinal artery
D. middle cerebral artery
**E. posterior spinal artery**
101
Define delirium [1]
delirium: an **acute** and **reversible** disturbance of **higher mental function**, with an **impaired level of consciousness**
102
3 Name a clinical test which can be used to assess intellectual function in patients with Alzheimer’s disease. (1 mark)
***The Mini-Mental State Examination**
103
4 Which brain structure is associated with learning and memory and is affected early in Alzheimer’s disease? Name 2 processes associated with the cellular plasticity linked with learning and memory, and name the neurotransmitter involved. (3 marks)
* The hippocampus is associated with learning and memory, and is affected early in the disease. (1 mark)
* **Long-term potentiation (LTP)** and **long-term depression (LTD)** underlie changes in **synaptic transmission** during learning and memory (1/2 mark each).
* Such neuroplastic changes in corticolimbic circuits involve **glutamate** (1 mark).
104
5 The drugs donepezil and rivastigmine can be used in the treatment of Alzheimer’s disease. Explain their mechanism of action and the rationale for their use. (2 marks)
* Some of the symptoms of Alzheimer’s disease are due to the loss of cholinergic neurons in the forebrain, and the subsequent reduction in acetylcholine (ACh) levels.
* Donepezil and rivastigmine increase ACh levels by inhibiting its breakdown by acetylcholinesterase (AChE).
* These AChE inhibitors have some effect in stabilising or even reversing some of the symptoms of Alzheimer’s disease (1/2 mark), and thus improving the quality of life of patients (1/2 mark).
105
13 This unwanted effect of anti-psychotic drugs emerges after years of treatment and is usually irreversible 1 mark
**Tardive dyskinesia**
106
14 How does deep brain stimulation alleviate symptoms associated with Parkinson’s disease? (1 mark)
Deep brain stimulation of the subthalamic nucleus **produces a depolarization block of the neurons**, thereby **reducing the input to GPi** and so alleviating the **rigidity and akinesia**.
107
What is the significance of a GCS < 8? [1]
Patients with a score of < 8 are in **coma**, and have a severe head injury (1/2)
108
17 What is the clinical significance of fixed and dilated pupils? (1 mark)
They indicate **brain** **herniation** (½ mark) causing brainstem compression of cranial nerves III, IV and VI (1/2 mark) controlling eye function.
109
19 Define the term delirium tremens (1 mark)
DT is a potential fatal form of alcohol withdrawal. It is common in severe alcoholism.
110
21 Name two types of receptors that are the targets of alcohol in the CNS (2 marks)
* GABAa.
* N-methyl D-aspartate receptor
