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Question 1
Incorrect
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A 55-year-old woman was complaining of headaches. On examination, the patient is found to have weakness on the left side of her body and her eyes are deviated towards the right hand side. These are signs of damage to which of the following areas?
Your Answer: Cerebellum
Correct Answer: Frontal lobe
Explanation:Some potential symptoms of frontal lobe damage can include loss of movement, either partial or complete, on the opposite side of the body.
In the patient’s case, it is a result of motor cortex damage on the right side since her left side of the body is affected. The conjugate eye deviation symptom towards the side of the lesion is a result of damage to the frontal eye field.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 2
Incorrect
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You are reviewing a patient complaining of loss of vision. Previous images shows a lesion at the optic chiasm. What type of visual field defect are you most likely to see in a lesion at the optic chiasm:
Your Answer: Contralateral homonymous superior quadrantanopia
Correct Answer: Bitemporal hemianopia
Explanation:A lesion at the optic chiasm will result in a bitemporal hemianopia.
A lesion of the optic nerve will result in ipsilateral monocular visual loss.
A lesion of the optic tract will result in a contralateral homonymous hemianopia. -
This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 3
Incorrect
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Which of the following is NOT a typical side effect of opioid analgesics:
Your Answer:
Correct Answer: Diarrhoea
Explanation:All opioids have the potential to cause:
Gastrointestinal effects – Nausea, vomiting, constipation, difficulty with micturition (urinary retention), biliary spasm
Central nervous system effects – Sedation, euphoria, respiratory depression, miosis
Cardiovascular effects – Peripheral vasodilation, postural hypotension
Dependence and tolerance -
This question is part of the following fields:
- Central Nervous System
- Pharmacology
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Question 4
Incorrect
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Which of the following clinical features is most suggestive of a lesion of the temporal lobe:
Your Answer:
Correct Answer: Receptive dysphasia
Explanation:Damage to the Wernicke’s speech area in the temporal lobe can result in a receptive dysphasia. Hemispatial neglect is most likely to occur in a lesion of the parietal lobe. Homonymous hemianopia is most likely to occur in a lesion of the occipital lobe. Expressive dysphasia is most likely to occur in a lesion of the Broca speech area in the frontal lobe. Conjugate eye deviation towards the side of the lesion is most likely to occur in a lesion of the frontal lobe.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 5
Incorrect
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A 54 year old patient presents with vertigo, ipsilateral hemiataxia, dysarthria, ptosis and miosis.
Which of these blood vessels has most likely been occluded?
Your Answer:
Correct Answer: Posterior inferior cerebellar artery
Explanation:Posterior inferior cerebellar artery (PICA) occlusion is characterised by vertigo, ipsilateral hemiataxia, dysarthria, ptosis and miosis. PICA occlusion causes infarction of the posterior inferior cerebellum, inferior cerebellar vermis and lateral medulla.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 6
Incorrect
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Which of the following is NOT a contraindication to treatment with aspirin at analgesic doses:
Your Answer:
Correct Answer: Myasthenia gravis
Explanation:Aspirin (at analgesic doses) is contraindicated in:
People with a history of true hypersensitivity to aspirin or salicylates (symptoms of hypersensitivity to aspirin or salicylates include bronchospasm, urticaria, angioedema, and vasomotor rhinitis)
People with active or previous peptic ulceration
People with haemophilia or another bleeding disorder
Children younger than 16 years of age (risk of Reye’s syndrome)
People with severe cardiac failure
People with severe hepatic impairment
People with severe renal impairmentN.B. Owing to an association with Reye’s syndrome, aspirin-containing preparations should not be given to children under 16 years, unless specifically indicated, e.g. for Kawasaki disease.
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This question is part of the following fields:
- Central Nervous System
- Pharmacology
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Question 7
Incorrect
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After what time period should intravenous phenytoin be used as second-line treatment of status epilepticus?
Your Answer:
Correct Answer: 25 minutes
Explanation:If seizures recur or fail to respond after initial treatment with benzodiazepines within 25 minutes of onset, phenytoin sodium, fosphenytoin sodium, or phenobarbital sodium should be used.
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This question is part of the following fields:
- Central Nervous System
- Pharmacology
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Question 8
Incorrect
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A 76-year-old man presents with complaints of double vision. Upon physical examination, it was observed that he exhibits left-sided hemiplegia and left-sided loss of joint position sense, vibratory sense and discriminatory touch. In addition, he has the inability to abduct his right eye and is holding his head towards the right side. A CT scan was ordered and showed that he has suffered a right-sided stroke.
Branches of which of the following arteries are most likely implicated in the case?Your Answer:
Correct Answer: Basilar artery
Explanation:Inferior medial pontine syndrome, also known as Foville syndrome, is one of the brainstem stroke syndromes which occurs when there is infarction of the medial inferior aspect of the pons due to occlusion of the paramedian branches of the basilar artery.
It is characterized by ipsilateral sixth nerve palsy, facial palsy, contralateral hemiparesis, contralateral loss of proprioception and vibration, ipsilateral ataxia, ipsilateral facial weakness, and lateral gaze paralysis and diplopia.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 9
Incorrect
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Regarding CSF (cerebrospinal fluid) production, approximately how much is produced per day?
Your Answer:
Correct Answer: 500 ml
Explanation:CSF fills the ventricular system, a series of interconnected spaces within the brain, and the subarachnoid space directly surrounding the brain. The intraventricular CSF reflects the composition of the brain’s extracellular space via free exchange across the ependyma, and the brain “floats” in the subarachnoid CSF to minimize the effect of external mechanical forces. The volume of CSF within the cerebral ventricles is approximately 30 mL, and that in the subarachnoid space is about 125 mL. Because about 0.35 mL of CSF is produced each minute, CSF is turned over more than three times daily. Approximately 500 mL of CSF is produced per day, at a rate of about 25 mL per hour.
CSF is a filtrate of capillary blood formed largely by the choroid plexuses, which comprise pia mater, invaginating capillaries, and ependymal cells specialized for transport. The choroid plexuses are located in the lateral, third, and fourth ventricles. The lateral ventricles are situated within the two cerebral hemispheres. They each connect with the third ventricle through one of the interventricular foramina (of Monro). The third ventricle lies in the midline between the diencephalon on the two sides. The cerebral aqueduct (of Sylvius) traverses the midbrain and connects the third ventricle with the fourth ventricle. The fourth ventricle is a space defined by the pons and medulla below and the cerebellum above. The central canal of the spinal cord continues caudally from the fourth ventricle, although in adult humans the canal is not fully patent and continues to close with age.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 10
Incorrect
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Regarding paracetamol, which of the following statements is CORRECT:
Your Answer:
Correct Answer: It has anti-pyretic action.
Explanation:Paracetamol is a non-opioid analgesic, similar in efficacy to aspirin, with antipyretic properties but no anti-inflammatory properties. It is well absorbed orally and does not cause gastric irritation. Paracetamol is a suitable first-line choice for most people with mild-to-moderate pain, and for combination therapy.
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This question is part of the following fields:
- Central Nervous System
- Pharmacology
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SESSION STATS - PERFORMANCE PER SPECIALTY
