1[QUESTION]A 50-year-old man was admitted to the emergency room after a head injury resulting from an automobile accident. The patient was diagnosed as having a subarachnoid hemorrhage. Which of the following changes are most likely in the composition of the cerebrospinal fluid of this patient?

Decreased protein, normal glucose, and presence of a few WBCs

Increased protein, normal glucose, and presence of RBCs

Increased protein, decreased glucose, and presence of polymorphonuclear leukocytes

Decreased protein, normal glucose, and presence of a small number of lymphocytes

Decreased protein, decreased glucose, and presence of tumor cells

2 [QUESTION]An adult male suffering from chills, fever, headache, nausea, vomiting, and painin the back was admitted to the emergency room and diagnosed as having viral meningitis. Which of the following changes are most likely in the composition ofthe cerebrospinal fluid of this patient?

Increased protein, decreased glucose, and increased polymorphonuclear WBCs

Increased protein, normal glucose, and excessive number of lymphocytes

Increased protein, normal glucose, and a few WBCs

Increased protein, normal glucose, and presence of tumor cells and WBCs

Increased protein, increased glucose, and a few WBCs

3 [QUESTION]A 75-year-old man was admitted to the emergency room complaining that he had trouble walking and that he could not move his arms as well. An MRI revealed thepresence of a brain tumor which was occluding foramen of Monro. Tumor in which one of the following locations can explain these features?

Head of the caudate nucleus

Cerebellum

Hippocampus

Posterior part of pons

Corpus Callosum

4 [QUESTION]A 22-year-old man was admitted to the emergency room after a motorcycle accident. A clinical examination showed that he had an elevated intracranial pressure due to head trauma. The patient suffered from severe bradycardia. In which of the following brain regions would elevated intracranial pressure most likely cause bradycardia?

Cerebral cortex

Medulla oblongata

Basal ganglia

Thalamus

Cerebellum

5 [QUESTION]The membranes that line the cisterns in the cranial cavity are:

Dura and arachnoid mater

Dura mater and ependymal cell layer

Neuronal cell membrane and the pia mater

Pia and arachnoid mater

Periosteal and meningeal layers of dura mater

6 [QUESTION]The spinal cord

Has an outer covering of gray matter and an inner core of white matter.

has a terminal end called as cauda equina

Cells in the posterior gray horn that give rise to efferent fibers that supply skeletal muscles.

A central canal that is situated in the white commissure.

contains motor neurons in the anterior horn arising from basal plate

7 [QUESTION]The following statements concern the peripheral nervous system. Pick the right one.

There are twelve pairs of cranial nerves.

There are seven pairs of cervical spinal nerves.

The posterior root of a spinal nerve contains many efferent motor nerve fibers.

A spinal nerve is formed by the union of an anterior and a posterior ramus in anintervertebral foramen.

A posterior root ganglion contains the cell bodies of autonomic nerve fibers leaving the spinal cord

8 [QUESTION]The following statements concern the cerebrospinal fluid. Pick the right one.

The cerebrospinal fluid in the central canal of the spinal cord is unable to enter the fourth ventricle.

With the patient in the recumbent position, the normal pressure is about 60 to 150 mm of water.

It plays only a minor role in the protection of the brain and spinal cord from traumatic injury.

Compression of the internal jugular veins in the neck lowers the cerebrospinal fluid pressure.

The subdural space is filled with cerebrospinal fluid.

9 [QUESTION]A 23-year-old woman was unconscious when admitted to the emergency department. While crossing the road, she had been hit on the side of the head by a bus. Within an hour, she was found to have a large dough-like swelling over the righttemporal region. She also had signs of muscular paralysis on the left side of the body. A lateral radiograph of the skull showed a fracture line running downward and forward across the anterior inferior angle of the left parietal bone. Her coma deepened, and she died 5 hours after the accident.Select the mostlikely cause of the swelling over the right temporal region in this patient.

Superficial bruising of the skin

Hemorrhage from a blood vessel in the temporalis muscle

Rupture of the right middle meningeal vessels

Edema of the skin

Hemorrhage from a blood vessel in the superficial fascia

10 [QUESTION]In the above case, the most likely diagnosis is

Laceration of the right side of the cerebral hemisphere

Right-sided epidural hemorrhage

Left-sided epidural hemorrhage

Injury to the cerebral cortex on the left side of the brain

Injury to the right cerebellar hemisphere

11. [QUESTION]In the above case, select the most likely cause of the muscular paralysis of theleft side of the body in this patient

Right-sided tonsillar herniation

Left-sided tonsillar herniation

Central herniation

Right-sided uncal herniation

Left-sided uncal herniation

12 [QUESTION]A patient who has a past history of osteoarthritis of lumbar spine presents to the clinic with the back pain that became more severe and radiated down the backof the left leg. The patient was also experiencing difficulty walking. Examination of the patient revealed weakness and some wasting of the muscles of the left leg. Radiologic examination showed that the osteoarthritic changes had spread to involve the boundaries of many of the lumbar intervertebral foramina.Explain the change in the symptoms and signs found in this patient.

The sciatic nerve was compressed in the pelvis by a spreading cancer.

The patient had developed advanced atherosclerosis of the arteries of the right lower limb.

The osteoarthritic process had produced osteophytes that encroached on the spinal cord, compressing the several spinal segments.

Neuritis had developed in the sciatic nerve trunk.

The patient was experiencing psychiatric problems.

Compression of the nerves exiting the foramena by osteophytes

[QUESTION]Due to the neurologic findings of muscle weakness, spasticity, and impairment ofvibratory/position, pain, temperature, and touch sensations, a 25-year-old womanwas diagnosed with multiple sclerosis. Which one of the following options constitutes one of the mechanisms for the impairment of her motor and sensory functions?

Schwann cells providing myelin sheaths on the axons in the central nervous system are degenerated.

Oligodendrocytes providing myelin sheaths on the axons in the peripheral nervoussystem are degenerated.

Oligodendrocytes providing myelin sheaths on the axons in the central nervous system are degenerated.

Noradrenergic neurons in the central nervous system responsible for maintaining muscle tone are degenerated.

A genetic defect resulting in proliferation of astrocytes impaired the insulation of neurons in the patient's central nervous system.

[QUESTION]A 20-year-old young man was admitted to an emergency room with serious traumaticinjury of the median nerve in his right forearm. The axons distal to the injurednerve were swollen and irregular, and the terminals were broken down into

fragments. In addition, Schwann cells were filled with lipid material. Which of the following describes this type of neuronal injury?

Chromatolysis

Wallerian degeneration

Transneuronal degeneration

Necrosis

Apoptosis

[QUESTION]While out on a hike, a 23-year-old young man was bitten on his left leg by a raccoon. Being in the remote woods of a State Forest, he could not receive immediate medical attention. Several weeks later, he developed profound changes in his emotional state and suffered from bouts of terror and rage. A clinician who examined the young man suspected that the raccoon that bit him was rabid, and the rabies virus had affected his hippocampus. The rabies virus may have traveled to the young man's brain by which of the following mechanisms?

Fast anterograde axonal transport

Pinocytosis

Phagocytosis

Fast retrograde transport

[QUESTION]

Which one of the following statements is correct regarding the components of a central nervous system neuron?

The Nissl substance is not present in the axon hillock.

The synthesis of proteins occurs in the mitochondria.

The Barr body represents a Y chromosome.

Nissl substance consists of DNA granules called ribosomes.

The axoplasm contains Nissl substance and Golgi apparatus.

[QUESTION]Which of the following statements is correct regarding the rising phase of an action potential in a neuron?

The membrane potential becomes more negative during this phase.

There is an influx of Na+ through the nongated ion channels.

Na+ flows into the neuron through voltage-gated Na+ channels.

K+ flows into the neuron through the voltage-gated K+ channels.

Energy for influx of Na+ is provided by the Na+-K+ pump.

[QUESTION]A 50-year-old man complained to his neurologist that he was suffering from a generalized muscle weakness that was exacerbated when he exercised. The patient's history revealed that he had suffered from a viral infection 4 to 5

weeks prior to the onset of muscle weakness. The neurologist suspected that the patient was suffering from myasthenia gravis and prescribed drug treatment with neostigmine, an acetylcholineesterase inhibitor, which acts in the synaptic cleft. Following this treatment, the patient reported a significant improvement in his symptoms. Which one of the following could have accounted for muscle weakness in this patient?

Reduction of voltage-gated Ca2+ channels on the presynaptic terminals

Reduction in the number of functional nicotinic acetylcholine receptors on the muscle end-plates

Reduction in the release of acetylcholine at the muscle end-plates

Demyelination of nerves innervating the muscle end-plates

Demyelination of axons in the central nervous system

[QUESTION]Which of the following statements is correct concerning directly gated transmission at the nerve-muscle synapse?

The presynaptic boutons include synaptic vesicles containing norepinephrine.

Norepinephrine released from the presynaptic terminal acts on nor-adrenergic receptors located at the end-plate.

The transmitter-gated ion channel at the end-plate is permeable only to Ca2+.

Voltage-gated channels selective for Na+ are present in the junctional folds of the muscle-cell membrane.

Each muscle fiber receives both excitatory and inhibitory inputs.

[QUESTION]The neurologic examination of a 60-year-old man revealed that he is suffering from Parkinson's disease. Which one of the following statements is true concerning this disease?

It involves a degeneration of cholinergic neurons in the basal nucleus of Meynert.

It involves a degeneration of noradrenergic neurons of the locus ceruleus.

It involves a degeneration of dopaminergic neurons of the substantianigra.

Oral administration of dopamine is likely to relieve the symptoms of Parkinson'sdisease.

It is usually associated with hyperkinetic syndrome.

[QUESTION]A neuropathologist received a brain specimen from a deceased patient suffering with Bipolar disease. A postmortem histological examination was done. Which one of the following neuronal groups is likely to be degenerated in this specimen?

Basal nucleus of Meynert

Raphe magnus

substantia gelatinosa

Nucleus ambiguus

Substantia nigra

[QUESTION]Which of the following statements about the blood-brain barrier is correct?

It has well-developed capillary pores

Tight junctions between endothelial cells aid are useless in stopping material

It is found within all structures enclosed by the meninges

Tight junctions associated with the blood-brain barrier are formed exclusively by neuronal or glial processes

The blood-brain barrier is generally limited to highly vascular regions of the brain, such as those present at the level of the ventromedial hypothalamus

Astrocytes form part of the blood-brain barrier

[QUESTION]The neurons in spinal cord receiving A-beta inputs are derived from the

Alar plate

Basal plate

Sulcus limitans

Neural crest

Roof plate

[QUESTION]The dorsal root ganglia are derived from the

Alar plate

Basal plate

Sulcus limitans

Neural crest

Roof plate

[QUESTION]The anterior pituitary is derived from

Neural crest cells

Rhombic lips

Sulcus limitans

Telencephalon

Myelencephalon

RathkeÆs pouch

[QUESTION]The cerebellum is derived from

Neural crest cells

Rhombic lips

Mesencephalon

Sulcus limitans

Telencephalon

[QUESTION]After the occurrence of an action potential, there is a repolarization of the membrane. The principal explanation for this event is that

a. Potassium channels have been opened

b. Sodium channels have been opened

c. Potassium channels have been inactivated

d. The membrane becomes impermeable to all ions

e. There has been a sudden influx of calcium

[QUESTION]

During an in vitro experiment, the membrane potential of a nerve cell is hyperpolarized to -120 mV. At that time, a transmitter, known to be inhibitory in function, is applied to the preparation and results in a depo- larization of the membrane. The most likely reason for this occurrence is that

a. Inhibitory transmitters normally depolarize the postsynaptic membrane

b. The normal response of the postsynaptic membrane to any transmitter is depo-larization

c. The inhibitory transmitter activates ligand-gated potassium channels

d. Sodium channels become inactivated

e. Calcium channels become activated

[QUESTION]The trigger zone that integrates incoming signals from other cells and initiatesthe signal that the neuron sends to another neuron or muscle cell is the

a. Cell body

b. Dendritic trunk

c. Dendritic spines

d. Axon hillock and initial segment

e. Axon trunk

[QUESTION]

Based upon oneÆs knowledge of the typical distribution of ions across a cell membrane, one could predict that an appropriate resting membrane potential wouldbe

a. +70 mV

b. +30 mV

c. 0mV

d. -70 mV

e. -130 V

[QUESTION]Which of the following characterizes a principal feature of axosomatic synapses?

a. It is referred to as a type I synapse

b. They have an electrical continuity linking the pre- and postsynaptic cells

c. They are typically inhibitory

d. Synaptic transmission is mediated by glutamate

e. They form the predominant synapse of cortical projections to the neostriatum

[QUESTION]Hyperpolarization of the neuron is governed by

a. Chloride and sodium

b. Chloride and potassium

c. Potassium and sodium

d. Sodium and calcium

e. Sodium only

[QUESTION]N-methyl-D-aspartate (NMDA), kainate, and quisqualate all act on which of the following receptors?

a. GABA receptors

b. Excitatory amino acid receptors

c. Adrenergic receptors

d. Opioid receptors

e. Dopamine receptors

[QUESTION]After an individual is admitted to the hospital, it is determined that he displays a variable weakness of cranial nerve and limb muscles but shows no clinical signs of denervation from tests, which include electromyogram (EMG) recordings. This disorder was partially reversed by the administration of drugs that inhibit acetylcholinesterase. The likely basis for this disorder is the result of

a. The production of excessive quantities of acetylcholine (ACh)

b. The production of antibodies that act against nicotinic ACh receptors

c. A minor stroke involving the motor strip of the cerebral cortex

d. A vitamin B deficiency

e. Viral encephalitis

[QUESTION]An individual is admitted to the emergency room of a hospital after taking a drug of abuse that destroyed selective groups of neurons in the brainstem. Afterthe individual became ambulatory, he became chronically depressed. The neurotransmitter loss most likely linked to the symptoms is

a. Enkephalin

b. Dopamine

c. Norepinephrine

d. Serotonin

e. Glycine

[QUESTION]A 50-year-old man suffers from anxiety attacks. He was given medication to control it. The mechanism underlying the action of this drug of choice is

a. Blockade of chloride channel permeability

b. Opioid receptor blockade

c. Binding of the drug to the GABA benzodiazepine site

d. Activation of muscarinic cholinergic receptor

e. Competitive binding of the GABAA-receptor site

[QUESTION]If there is diminished CSF absorption, where does the blockage occur?

a. Pyramidal cells

b. Renshaw cells

c. Arachnoid villi

d. Purkinje cells

e. Sagittal sinus

[QUESTION]Norepinephrine acts as a neurotransmitter at which of the following sites?

Preganglionic parasympathetic neurons

Preganglionic sympathetic neurons

Postganglionic parasympathetic neurons

Postganglionic sympathetic neurons supplying sweat gland

Postganglionic sympathetic neurons

[QUESTION]A person suffering with Parkinson's disease will shows which of the following abnormality?

Increase in Dopamine

Increase in Serotonin

Decrease in Serotonin

Decrease in Acetyl Choline

Increase in Acetyl Choline

Decrease in Dopamine

Decrease in Norepinephrine

[QUESTION]In the above patient, an abnormality will be noted in which of the following anatomical locations?

Raphe nucleus

Nucleus Basalis of Meynert

Locus Ceruleus

Substantia Nigra

Caudate Nucleus

Putamen

[QUESTION]Blood-Brain barrier is due to which of the following structures?

Gap junctions between endothelial cells

Tight junctions between ependymal cells

Foot processes of Astrocytes

Fenestrations in endothelial cells

Tight Junctions between endothelial cells

[QUESTION]While examining a new-born baby, it was noted that there are severe myelination defects in Peripheral Nervous System. Basing on the embryological origin, Which of the following cells will also be affected?

Ventral horn cells

Dorsal horn cells

Dorsal root ganglion

Oligodendroglial cells

Astrocytes

[QUESTION]As part of detailed neurological examination, the physician asked the patient toclose his eyes and then simultaneously touched 2 points on several areas of body. The patient was not able to differentiate the 2 points on the palm of his hand. which of the following receptors is injured?

Ruffini's corpuscles

Free nerve endings

Merkel's disk

Meissner's corpuscles

Neuromuscular spindle

[QUESTION]The conscious perception of movement is mediated by which of the following receptors?

a. MeissnerÆs corpuscles

b. Free nerve endings

c. MerkelÆs receptors

d. Joint capsules

e. Pacinian corpuscles

[QUESTION]PAG is derived from

a. Neural crest cells

b. Rhombic lips

c. Mesencephalon

d. Sulcus limitans

e. Telencephalon

f. Myelencephalon