Neuroscience 1 (CNS) - كلية الطب theory exam .. EHSAN 2014 6 Q41. All of the followings are therapeutic uses of the benzodiazepines, EXCEPT: Ethanol and barbiturate over dose

CNS theory exam .. EHSAN 2014

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Neuroscience 1 (CNS)

EHSAN 2014


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ANATOMY

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Q1. One of the following statements is correct:

Blood brain barrier is not present in circumventricular organs

Q2. . One of the following statements is correct:

tanycytes detect hormonal concentrations in CSF

Q3. The discriminative touch from the upper limbs are carried by:

Cuneate tract

Q4. Pain and temperature is carried by:

Lateral spinothalamic tract.

Q5. Postural movements of the head in response to visual stimuli are mediated by:

Tectospinal tract

Q6. The fibers that arise from the gracile and cuneate nuclei and cross the medline

are called:

Internal arcuate fibers.

Q7. Paralysis of the right lower quadrant of the face is most probably caused by

lesion in:

Left internal capsule

Q8. A sign of lower motor neuron injury:

Loss of reflexes


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LMN lesion accompanied mostly with muscle paralysis(flaccid Note>>

paralysis) , fibrillation ,, hypotonia,, and hyporeflexia. This is contrast to

UMN lesion that accompanied by severe hypertonia

Q9. Broca's area is connected to wernicke's area by:

Long association fibers

Q10. The structure located between corpus callosum and fornix is called:

Septum pellucidum

Q11. One of the following statements is correct about the blood supply of the brain:

Internal cerebral veins are united just inferior to splenium of corpus callosum

Q12. Posterior inferior cerebellar artery arises from:

Vertebral artery

Q13. The pyramid of the medulla is supplied by:

The anterior spinal artery

Q14. Denticulate ligament is an extention of:

Pia and arachnoid matters

Q15. Lumbar enlargement is present in:

L2-S3

Q16. Which of the following is present in all segments of the spinal cord?

Medial motor group


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Q17. Villi that absorb the CSF Are part of:

The dura matter

Q18. Located between the external and extreme capsules is the:

Claustrum

Q19. The layer # 4 of the cerebral cortex is the:.

Internal granular layer of the cerebral cortex.

Q20. The primary taste cortex is part of the

Parietal

Q21. The internal capsule continues downward as:

Crus cerebri

Q22. Brodmann area 43 is supplied by the:

Middle cerebral artery

Q23. The cerebrospinal fluid (CSF) is formed by the:

Choroid plexuses.

Q24. The only part of the ventricular system connected to the subarachnoid space is:

Fourth ventricle

Q25. basal ganglia arise from:

neural tube


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Q26. One of the following is a feature of spina bifida occulta:

Vertebral canal remains open posteriorly

Q27. Which of the following is not a clinical manifestation of Weber's Syndrome:

Ipsilateral paralysis of lower part of the face

Weber syndrome characterized by the presence of an ipsilateral oculomotor Note >>

nerve palsy . contralateral hemiparesis and typical upper motor neuron findings.

Difficulty with Contralateral lower facial muscles and hypoglossal nerve functions.

Q28. Which cranial nerve nucleus is located in the rostral part of Pons?

Trigeminal

Q29. One of the following statements is correct:

The pontine nuclei are located in the anterior part of the pons

Stellate cells are located in: .30Q

The outer part of the molecular layer of the cerebellar cortex

Q31. Which intracerebellar nucleus is largest in size?

Dentate nucleus

Q32. The neostriatum of basal nuclei is formed by:

Caudate and putamen

Q33. The extreme capsule separates which parts of the grey matter?

Insula and claustrum.

Q34. Parkinson's disease is a clinical condition that happens due to:


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Damage to substantia nigra

PHARMACOLOGY

Q35. Which of the following is NOT an expected action of chlorpromazine?

Nausea and vomiting

the most appropriate side effect of it is weight gain , sedation , acute movement Note>>

disorder , parkinsonism , and decrease blood supply with dizziness.

Q36. Haloperidol as a butyrophenone derivative:

Is likely to be complicated by extrapyramidal symptoms.

Q37. The antidepressant drug "fluoxetine":

Has a relatively long duration of action

Q38. Therapeutic uses of the tricyclic antidepressant drugs include all the following,

EXCEPT:

Arrhythmia

The TCAs are used primarily in the clinical treatment of mood disordersNote >>

Q39. General therapeutic principles in treatment with antiepileptic drugs (AEDs)

include:

Therapeutic drug monitoring is very useful in AED therapy

Q40. Phenytoin is characterized by:

Zero order kinetics metabolism with in therapeutic concentration.


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Q41. All of the followings are therapeutic uses of the benzodiazepines,

EXCEPT:

Ethanol and barbiturate over dose

Q42. Zolpidem:

Has a rapid onset hypnotic effect.

prescription medication that used for tt of insomnia and some brain it’s a NOTE>>

disorder . It is a short-acting nonbenzodiazepine hypnotic that potentiates GABA, an

inhibitory neurotransmitter, by binding to GABAA receptors at the same location as

benzodiazepines.[4] It works quickly, and has a short half-life of two to three hours.

Q43. Bromocriptine is :

A dopamine receptor agonist

and various serotonin , is a potent agonist at dopamine D2 receptorsits NOTE>>

receptors.

Q44. The main reason of avoiding the combined administration of L-dopa and the

non selective mono amine oxidase inhibitor as phenelizine is the:

High risk of hypertensive crisis.

Q45. An inverse agonist drug means a drug that:

Reduces the activity of a receptor that was active in the absence of agonist.

Q46. Which of the following statements about neurotransmission in central nervous

system is TRUE?

G-protein coupled receptors are example of metabotropic receptors.

Q47. You have the following 3 general anesthetics with their [blood : gas partition

coefficient (BGPC)] and [minimal alveolar concentration (MAC)]:


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Drug X:--------- BGPC = 2%------------ MAC = 5%

Drug Y:-------- BGPC = 0.7%---------- MAC = 33%

Drug Z:--------- BGPC = 3.5%----------MAC = 90%

The drug that has the least solubility in the blood is drug ____ , and the drug that has

the least potency is drug ___ . (Choose the best answer to fill both blanks,

respectively):

Y , Z, X

Q48. A 27 years-old male came to Emergency room with dyspnea, low blood

pressure, and purple skin. Upon examination, his blood pressure was 90/45, and his

respiratory rate was 3 shallow breaths per minute, and extremely small pupils (i.e.

Miosis). There were marks of needle injections on his left arm. The drug of choice to

reverse these symptoms is:

Naloxone

is useful both in acute opioid overdose and in reducing respiratory NaloxoneNOTE>>

or mental depression due to opioids.

Opiate overdose symptoms and signs include: decreased level of consciousness and

pinpoint pupils. Heart rate and breathing slow down, sometimes to a stop. Other

symptoms include seizures and muscle spasms. A person experiencing an opiate

overdose usually will not wake up even if their name is called or if they are shaken

vigorously

Q49. Identify the INCORRECT match between the general anesthetic and its

property:

Thiopental ------------------ Anterograde amnesia.

anterograde amnesia mostly caused by benzodiazepine drugs and Alcohol NOTE>>

intoxication.

Thiopental is an anesthetic drug that has S/Es like cardiovascular and respiratory

depression , prolonged somnolence and nausea.


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Q50. One of the following is FALSE regarding opioid agonists:

Remifentanyl has very long duration of action.

id analgesic drug. It is given to patients acting synthetic opio-is a potent, short NOTE>>

during surgery to relieve pain and as an adjunct to an anaesthetic.

Q51. Identify the CORRECT match between the drug and its mechanism of action:

Methylxanthins ----------- Inhibit phosphodiesterase (PDE)

Methylxanthines are bronchodilators used in the treatment of asthma and NOTE>>

chronic obstructive pulmonary disease (COPD)

Q52. A third year medical student started to play FIFA 2014 video game on a daily

basis for at least 6 hours. It affected his academic performance by being absent

from lectures, and getting very low grades in the exams. He continued playing this

game regardless of the adverse consequences. This is an example of:

Addiction.

PHYSIOLOGY

Q53. Which of the following is INCORRECT regarding the cerebral blood flow?

It is controlled mainly through the autonomic system.

is the blood supply to the brain in a given period of time.NOTE>>

CBF is equal to the cerebral perfusion pressure (CPP) divided by the cerebrovascular

resistance (CVR):[9]

CBF = CPP / CVR

CVR is controlled by four major mechanisms:

** Metabolic control ,, Pressure autoregulation ,,Chemical control (by arterial pCO2

and pO2) and Neural control


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Which of the following is CORRECT regarding the functioning . 54Q

of the blood–brain barrier (BBB)?

The endothelial A-system helps in preventing accumulation of inhibitory neurotransmitters

in brain tissue.

brain barrier is formed by brain endothelial cells, which are –The blood NOTE>>

connected by tight junctions. BBB allows the passage of water, some gases, and lipid-

soluble molecules by passive diffusion, as well as the selective transport of molecules

such as glucose and amino acids that are crucial to neural function. BBB may prevent

the entry of lipophilic, potential neurotoxins by way of an active transport mechanism

mediated by P-glycoprotein.

Q55. A patient who is able to understand the meaning of the written word and the

thought conveyed by the word but lost the ability to properly vocalize words may be

associated with damage to which of the following brain structures?

Arcuate fasciculus.

Q56. A woman remembers that Amman is the capital of Jordan, but she has no idea

when or where she acquired this knowledge. This woman has a problem in which of

the following types of memory?

Episodic

Q57. Which of the following is LEAST likely to be involved in long-term potentiation

(LTP)?

Ca++ efflux from postsynaptic cell

lasting increase in -These are patterns of synaptic activity that produce a longNOTE>>

signal transmission between two neurons

Q58. According to the gate control theory of pain, which of the following is

INCORRECT?


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Substantia gelatinosa interneurons are active so pain is felt.

Q59. Regarding brain endogenous opioids, which of the following is INCORRECT?

They increase the excitability of neurons by closing K+ channels.

Q60. Which of the following is INCORRECT about petit mal epilepsy?

It is a partial seizure

that characterized by a brief loss and return of Absence seizuresIts also called NOTE>>

ly not followed by a period of lethargy.consciousness, general

Q61. Non-REM sleep differs from REM sleep in:

Metabolic rate is at its lowest levels.

-metabolic rate was higher throughout the cortex during REM sleep than NonNOTE>>

REM .

BIOCHEMISTRY

Q62. Neurotransmitter signal termination occurs mostly by re-uptake EXCEPT for:

Both acetylcholine and neuropeptides.

converts acetylcholine into the inactive acetylcholinesterase The enzymeNOTE>> metabolites choline and acetate. This enzyme is abundant in the synaptic cleft, and its

role in rapidly clearing free acetylcholine from the synapse is essential for proper

muscle function

Q63. Which of the following regarding Glutamate signaling is TRUE:

Is the neurotransmitter responsible for excitotoxicity in ischaemic injury

Q64. All of the following are TRUE regarding Myasthenia Gravis EXCEPT:


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Is due to production of autoimmune antibodies against presynaptic voltage

gated Ca+2 channels reducing ACh release

e weakness and it is a neuromuscular disease that leads to fluctuating muscl NOTE>>

fatigue. In the most common cases, muscle weakness is caused by circulating antibodies that

block acetylcholine receptors at the postsynaptic neuromuscular junction, inhibiting the

excitatory effects of the neurotransmitter acetylcholine on nicotinic receptors at

neuromuscular junctions.

Q65. Alzheimer’s is theorized to involve the function of all of the following proteins

EXCEPT:

Apolipoprotein A.

MICROBIOLOGY

Q66. All of the following are causes of chronic meningitis except: Neisseria meningitides.

Meningitis marked by persistent fever, headache, and stiff neck (associated, on NOTE>>

lumbar puncture, with cerebrospinal fluid pleocytosis and elevated spinal fluid pressure).

Q67.All the following are TRUE concerning the meningitis EXCEPT: TB meningitis treat in different way than pulmonary.

Q68.All the following are clinical presentations of chronic Meningitis EXCEPT: High grade fever

The symptoms of chronic meningitis are similar to those of acute bacterial NOTE>> , usually over weeks more slowly and graduallyept that they develop meningitis, exc

. Symptoms may last for years. Some fever is often less severerather than days. Also, people get better for a while, then worsen (relapse)

Q69.All the following are typical cerebrospinal fluid findings in patients with bacterial meningitis EXCEPT: Protein 10-50 mg/dL

CSF in a pt with bacterial meningitis :NOTE>>

Appearance: Clear, cloudy, or purulent Opening pressure: Elevated (>25 cm H 2 O) WBC count: >100 cells/µL (>90% PMN); partially treated cases may have as low as 1 WBC/µL Glucose level: Low (< 40% of serum glucose) Protein level: Elevated (>50 mg/dL)


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Pathology

Q70.Gliosis refers to: The reactive proliferation of astrocytes & their processes in repair mechanisms in the brain

Q71.Diffuse axonal injury is most likely identified in which of the following cases ? A 20 year old comatose male dying two weeks after a car crash.

major cause of unconsciousness and persistent vegetative state after head It is a NOTE>>

trauma.The outcome is frequently coma.

Q72.Most likely to produce obliterative endarteritis & cerebral infarction is: Aspergillus encephalitis.

Q73.Least likely to be seen in viral encephalitis: Gliosis around acqueduct

Q74.Extensive arachnoidal fibrosis secondary to resolved acute meningitis is associated with: Communicating hydrocephalus.

obstructive hydrocephalus, is -Communicating hydrocephalus, also known as non NOTE>>caused by impaired cerebrospinal fluid reabsorption in the absence of any CSF-flow obstruction between the ventricles and subarachnoid space. It is due to functional impairment of the arachnoidal granulations, which are located along the superior sagittal sinus and is the site of cerebrospinal fluid reabsorption back into the venous system.

Q75. An acute subdural hematoma is primarily due to: Rupture of bridging vein

is a type of hematoma, usually associated with traumatic brain injury. It is a NOTE>>

Blood gathers between the dura mater, and the brain. Usually resulting from tears in

bridging veins which cross the subdural space, subdural hemorrhages may cause an

increase in intracranial pressure (ICP), which can cause compression of and damage to

delicate brain tissue

Q76. A patient developed a stroke, producing right sided hemiparesis which gradually improved in the next three months. Brain MR imaging now shows a 4 cm cystic area in the left parietal lobe. Which of the following is the most likely initiating vascular event? Thrombosis of the left middle cerebral artery


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Q77.Which is false of Creutzfelt-Jakob disease?

There is neuronophagia & microglial nodules early in the disease.

.is a degenerative neurological disorder that is incurable and invariably fatalNOTE>>

. are misfolded proteins which prionCJD is caused by an agent called a CJD causes the

brain tissue to degenerate rapidly, and as the disease destroys the brain, the brain develops

holes and the texture changes to resemble that of a kitchen sponge

Q78. A previously healthy female of 40years, had a sudden severe headache, after

playing tennis. She then fell unconscious. Her CSF showed numerous RBC’s, but no

WBC’s.The most likely cause of her condition is : Ruptured berry aneurysm.

is a cerebrovascular disorder in which weakness in the wall of a brain aneurysm NOTE>>

cerebral artery or vein causes a localized dilation or ballooning of the blood vessel.

If an aneurysm ruptures, blood leaks into the space around the brain. This is called a

Symptoms of a ruptured aneurysm can include: .subarachnoid hemorrhage

a sudden severe headache that can last from several hours to days

nausea and vomiting

drowsiness, confusion and/or loss of consciousness

visual abnormalities

Q79. During a prolonged surgical procedure on a 60 year old male, the blood pressure dropped to 40 mm.Hg. Which of the following is the most likely immediate complication? Loss of neurons in the hippocampus & purkinje cells.

Q80. During a prolonged surgical procedure on a 60 year old male, the blood pressure dropped to 40 mm.Hg. Which of the following is the most likely immediate complication? Loss of neurons in the hippocampus & purkinje cells.

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Neuroscience 1 (CNS) - كلية الطب theory exam .. EHSAN 2014 6 Q41. All of the followings are therapeutic uses of the benzodiazepines, EXCEPT: Ethanol and barbiturate over dose