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  • Question 1 - In a patient with an ongoing seizure, after what time period should treatment...

    Correct

    • In a patient with an ongoing seizure, after what time period should treatment be commenced?

      Your Answer: 5 minutes

      Explanation:

      Immediate emergency care and treatment should be given to children, young people and adults who have prolonged or repeated convulsive seizures.Prolonged seizures last 5 minutes or more. Repeated seizures refer to 3 or more seizures in an hour.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      12.1
      Seconds

  • Question 2 - A patient complains of headache and visual loss. CT scan demonstrates a lesion...

    Incorrect

    • A patient complains of headache and visual loss. CT scan demonstrates a lesion of the temporal lobe. What type of visual field defect would you most expect to see in this patient:

      Your Answer: Contralateral homonymous hemianopia

      Correct Answer: Contralateral homonymous superior quadrantanopia

      Explanation:

      Axons from the lateral geniculate nucleus (LGN) carry visual information, via the upper and lower optic radiations, to the visual cortex in the occipital lobe:The upper optic radiation carries fibres from the superior retinal quadrants (corresponding to the inferior visual field quadrants) and travels through the parietal lobe to reach the visual cortex. The lower optic radiation carries fibres from the inferior retinal quadrants (corresponding to the superior visual field quadrants) and travels through the temporal lobe to reach the visual cortex of the occipital lobe.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      14.4
      Seconds

  • Question 3 - A lesion to which part of the optic radiation will result in contralateral...

    Incorrect

    • A lesion to which part of the optic radiation will result in contralateral homonymous inferior quadrantanopia?

      Your Answer: Right temporal lobe

      Correct Answer: Right parietal lobe

      Explanation:

      A visual loss in the lower left quadrant in both visual fields is an indication of an inferior homonymous. This is due to a lesion of the superior fibres of the optic radiation in the parietal lobe on the contralateral side of the visual pathway.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      116.5
      Seconds

  • Question 4 - Regarding CSF (cerebrospinal fluid) production, approximately how much is produced per day? ...

    Incorrect

    • Regarding CSF (cerebrospinal fluid) production, approximately how much is produced per day?

      Your Answer: 250 ml

      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.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      5.1
      Seconds

  • Question 5 - Which of the following clinical features is most suggestive of a lesion of...

    Incorrect

    • Which of the following clinical features is most suggestive of a lesion of the temporal lobe:

      Your Answer: Homonymous hemianopia

      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.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      413.4
      Seconds

  • Question 6 - A 7-year old boy is referred to the Paediatrics Department due to slurred...

    Correct

    • A 7-year old boy is referred to the Paediatrics Department due to slurred speech. Upon further examination, the attending physician noted the presence of dysdiadochokinesia, intention tremors, and nystagmus. An MRI is taken, which revealed a brain tumour.Which of the following options is the most probable diagnosis given the clinical features of the patient?

      Your Answer: Astrocytoma of cerebellum

      Explanation:

      Pilocytic astrocytoma (PCA), previously known as cystic cerebellar astrocytoma or juvenile pilocytic astrocytoma, was first described in 1931 by Harvey Cushing, based on a case series of cerebellar astrocytomas; though he never used these terms but rather described a spongioblastoma. They are low-grade, and usually well-circumscribed tumours, which tend to occur in young patients. By the World Health Organization (WHO) classification of central nervous system tumours, they are considered grade I gliomas and have a good prognosis.PCA most commonly occurs in the cerebellum but can also occur in the optic pathway, hypothalamus, and brainstem. They can also occur in the cerebral hemispheres, although this tends to be the case in young adults. Presentation and treatment vary for PCA in other locations. Glial cells include astrocytes, oligodendrocytes, ependymal cells, and microglia. Astrocytic tumours arise from astrocytes and are the most common tumour of glial origin. The WHO 2016 categorized these tumours as either diffuse gliomas or other astrocytic tumours. Diffuse gliomas include grade II and III diffuse astrocytomas, grade IV glioblastoma, and diffuse gliomas of childhood. The other astrocytic tumours group include PCA, pleomorphic xanthoastrocytoma, subependymal giant cell astrocytoma, and anaplastic pleomorphic xanthoastrocytoma.PCA can present with symptoms secondary to the posterior fossa mass effect. This may include obstructive hydrocephalus, with resultant headache, nausea and vomiting, and papilledema. If hydrocephalus occurs before the fusion of the cranial sutures (<18-months-of-age), then an increase in head circumference will likely occur. Lesions of the cerebellar hemisphere result in peripheral ataxia, dysmetria, intention tremor, nystagmus, and dysarthria. In contrast, lesions of the vermis cause a broad-based gait, truncal ataxia, and titubation. Posterior fossa lesions can also cause cranial nerve palsies. Diplopia may occur due to abducens palsy from the stretching of the nerve. They may also have blurred vision due to papilledema. Seizures are rare with posterior fossa lesions.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      12.5
      Seconds

  • Question 7 - All of the following predisposes to lithium toxicity in patients taking long-term therapy...

    Correct

    • All of the following predisposes to lithium toxicity in patients taking long-term therapy EXCEPT:

      Your Answer: Hypernatraemia

      Explanation:

      A common complication of long term lithium therapy results in most cases of lithium intoxication. It is caused by reduced excretion of the drug which can be due to several factors including deterioration of renal function, dehydration, hyponatraemia, infections, and co-administration of diuretics or NSAIDs or other drugs that may interact.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      24.1
      Seconds

  • Question 8 - Which of the following is most likely to cause a bitemporal hemianopia: ...

    Correct

    • Which of the following is most likely to cause a bitemporal hemianopia:

      Your Answer: Pituitary adenoma

      Explanation:

      A bitemporal hemianopia is most likely due to compression at the optic chiasm. This may be caused by pituitary tumour, craniopharyngioma, meningioma, optic glioma or aneurysm of the internal carotid artery. A posterior cerebral stroke will most likely result in a contralateral homonymous hemianopia with macular sparing.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      11.1
      Seconds

  • Question 9 - Carbamazepine is indicated for all of the following EXCEPT for: ...

    Incorrect

    • Carbamazepine is indicated for all of the following EXCEPT for:

      Your Answer: Complex focal seizures

      Correct Answer: Myoclonic seizures

      Explanation:

      Carbamazepine is a drug of choice for simple and complex focal seizures and is a first-line treatment option for generalised tonic-clonic seizures. It is also used in trigeminal neuralgia and diabetic neuropathy. Carbamazepine may exacerbate tonic, atonic, myoclonic and absence seizures and is therefore not recommended if these seizures are present.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      27.6
      Seconds

  • Question 10 - After what time period should intravenous phenytoin be used as second-line treatment of...

    Incorrect

    • After what time period should intravenous phenytoin be used as second-line treatment of status epilepticus?

      Your Answer: 10 minutes

      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.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      19.2
      Seconds

  • Question 11 - A well recognised adverse effect of metoclopramide is which of the following? ...

    Correct

    • A well recognised adverse effect of metoclopramide is which of the following?

      Your Answer: Acute dystonic reaction

      Explanation:

      Side effects of metoclopramide are commonly associated with extrapyramidal effects and hyperprolactinemia. Therefore its use must be limited to short-term use. Metoclopramide can induce acute dystonic reactions which involve facial and skeletal muscle spasms and oculogyric crises. These dystonic effects are more common in the young girls and young women, and in the very old. These symptoms usually occur shortly after starting treatment with this drug and subside within 24 hours of stopping it. Abortion of dystonic attacks can be carried out by injection of an antiparkinsonian drug like procyclidine.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      8.7
      Seconds

  • Question 12 - The most common complication of paracetamol overdose is: ...

    Correct

    • The most common complication of paracetamol overdose is:

      Your Answer: Hepatic failure

      Explanation:

      The maximum daily dose of paracetamol in an adult is 4 grams. Doses greater than this can lead to hepatotoxicity and, less frequently, acute kidney injury. Early symptoms of paracetamol toxicity include nausea, vomiting, and abdominal pain, and usually settle within 24 hours. Symptoms of liver damage include right subcostal pain and tenderness, and this peaks 3 to 4 days after paracetamol ingestion. Other signs of hepatic toxicity include encephalopathy, bleeding, hypoglycaemia, and cerebral oedema.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      9.1
      Seconds

  • Question 13 - A patient is referred to the Medicine Department for complaints of unilateral hearing...

    Correct

    • A patient is referred to the Medicine Department for complaints of unilateral hearing loss, tinnitus and facial numbness. Upon further investigation, an acoustic neuroma is given as the final diagnosis.Which of the following nerves is least likely to be affected in acoustic neuroma?

      Your Answer: Trochlear nerve

      Explanation:

      Acoustic neuroma is also called vestibular schwannoma (VS), acoustic neuroma, vestibular neuroma or acoustic neurofibroma. These are tumours that evolve from the Schwann cell sheath and can be either intracranial or extra-axial. They usually occur adjacent to the cochlear and vestibular nerves and most often arise from the inferior division of the latter. Anatomically, acoustic neuroma tends to occupy the cerebellopontine angle. About 5-10% of cerebellopontine angle (CPA) tumours are meningiomas and may occur elsewhere in the brain. Bilateral acoustic neuromas tend to be exclusively found in individuals with type 2 neurofibromatosis.The following nerves may be affected due to nerve compression:Facial nerve: usually minimal with late presentation except for very large tumours. Depending on the degree of engagement of the nerve, the symptoms may include twitching, increased lacrimation and facial weakness.Trigeminal Nerve: paraesthesia in the trigeminal distribution, tingling of the tongue, impairment of the corneal reflex, and less commonly pain which may mimic typical trigeminal neuralgia.Glossopharyngeal and Vagus nerves: palatal paresis, hoarseness of voice and dysphagia

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      317
      Seconds

  • Question 14 - A 54 year old patient presents with vertigo, ipsilateral hemiataxia, dysarthria, ptosis and...

    Correct

    • 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: 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.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      1052.2
      Seconds

  • Question 15 - Which of the following is a contraindication to the use of opioid analgesics: ...

    Incorrect

    • Which of the following is a contraindication to the use of opioid analgesics:

      Your Answer: Acute angle-closure glaucoma

      Correct Answer: Raised intracranial pressure

      Explanation:

      Opioids should be avoided in people who have: A risk of paralytic ileus (opioids reduce gastric motility)Acute respiratory depressionAn acute exacerbation of asthma (opioids can aggravate bronchoconstriction as a result of histamine release)Conditions associated with increased intracranial pressure including head injury (opioids can interfere with pupillary response making neurological assessment difficult and may cause retention of carbon dioxide aggravating the increased intracranial pressure)

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      54.6
      Seconds

  • Question 16 - A 70-year-old man has a resting tremor, rigidity, bradykinesia, and a shuffling gait....

    Correct

    • A 70-year-old man has a resting tremor, rigidity, bradykinesia, and a shuffling gait. Parkinson's disease is caused by one of the following mechanisms:

      Your Answer: Loss of dopaminergic neurons in the substantia nigra

      Explanation:

      Parkinson’s disease (PD) is one of the most common neurologic disorders, affecting approximately 1% of individuals older than 60 years and causing progressive disability that can be slowed but not halted, by treatment. The 2 major neuropathologic findings in Parkinson’s disease are loss of pigmented dopaminergic neurons of the substantia nigra pars compacta and the presence of Lewy bodies and Lewy neurites. See the images below.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      54.9
      Seconds

  • Question 17 - What is the main mechanism of action of metoclopramide: ...

    Correct

    • What is the main mechanism of action of metoclopramide:

      Your Answer: Dopamine antagonist

      Explanation:

      Metoclopramide is a dopamine-receptor antagonist. Blockade of inhibitory dopamine receptors in the GI tract may allow stimulatory actions of ACh at muscarinic synapses to predominate. Metoclopramide also blocks dopamine D2-receptors within the chemoreceptor trigger zone (CTZ). At high doses, it is also thought to have some 5-HT3antagonist activity.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      16
      Seconds

  • Question 18 - A 26 year old horse rider has a bad fall and sustains a...

    Incorrect

    • A 26 year old horse rider has a bad fall and sustains a neck injury which displays the following signs:- ability to extend the wrist against gravity- paralysis of the hands, trunk, and legs- absent sensation in the fingers and medial upper arms- normal sensation over the thumbs- absent sensation in chest, abdomen, and legsWhat is the neurological level of the injury?

      Your Answer:

      Correct Answer: C6

      Explanation:

      C1 – C4 INJURYMost severe of the spinal cord injury levels; paralysis in arms, hands, trunk and legs; patient may not be able to breathe on his or her own, cough, or control bowel or bladder movements; ability to speak is sometimes impaired or reducedC5 INJURYPerson can raise his or her arms and bend elbows; likely to have some or total paralysis of wrists, hands, trunk and legs; can speak and use diaphragm, but breathing will be weakenedC6 INJURYNerves affect wrist extension; paralysis in hands, trunk and legs, typically; should be able to bend wrists back; can speak and use diaphragm, but breathing will be weakenedC7 INJURYNerves control elbow extension and some finger extension; most can straighten their arm and have normal movement of their shouldersC8 INJURYNerves control some hand movement; should be able to grasp and release objectsC5 – Elbow flexors (biceps, brachialis)C6 – Wrist extensors (extensor carpi radialis longus and brevis)C7 – Elbow extensors (triceps)C8 – Finger flexors (flexor digitorum profundus) to the middle fingerC5 – Elbow flexed at 90 degrees, arm at the patient’s side and forearm supinatedC6 – Wrist in full extensionC7 – Shoulder is neutral rotation, adducted and in 90 degrees of flexion with elbow in 45 degrees of flexionC8 –Full flexed position of the distal phalanx with the proximal finger joints stabilized in a extended position

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 19 - Regarding aspirin at analgesic doses, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding aspirin at analgesic doses, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: It is contraindicated in patients with severe heart failure.

      Explanation:

      Aspirin (at analgesic doses) is contraindicated in severe heart failure. Aspirin irreversibly inhibits cyclooxygenase (COX) enzymes resulting in decreased production of prostaglandins (which can lead to irritation of the gastric mucosa). The analgesic dose is greater than the antiplatelet dose, and taken orally it has a duration of action of about 4 hours. Clinical features of salicylate toxicity in overdose include hyperventilation, tinnitus, deafness, vasodilatation, and sweating.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds

  • Question 20 - Which of the following is first-line for management of status epilepticus: ...

    Incorrect

    • Which of the following is first-line for management of status epilepticus:

      Your Answer:

      Correct Answer: Intravenous lorazepam

      Explanation:

      First-line treatment is with intravenous lorazepam if available. Intravenous diazepam is effective but it carries a high risk of thrombophlebitis so should only be used if intravenous lorazepam is not immediately available. Absorption of diazepam from intramuscular injection or from suppositories is too slow for treatment of status epilepticus. When facilities for resuscitation are not immediately available or if unable to secure immediate intravenous access, diazepam can be administered as a rectal solution or midazolam oromucosal solution can be given into the buccal cavity.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds

  • Question 21 - A 29-year-old man has been complaining about his recent headaches. Detailed history was...

    Incorrect

    • A 29-year-old man has been complaining about his recent headaches. Detailed history was taken and a neurological examination was performed.Which of the following cranial nerves is correctly paired with its lesion?

      Your Answer:

      Correct Answer: The oculomotor nerve: the eye appears to look ‘down and out’

      Explanation:

      The following are the lesions of the cranial nerves:1. Olfactory nerve (I)Reduced taste and smell, but not to ammonia which stimulates the pain fibres carried in the trigeminal nerve2. Optic nerve (II)Manifested by visual field defects, pupillary abnormalities, optic neuritis, optic atrophy, papilledema3. Oculomotor nerve (III)A fixed, dilated pupil which doesn’t accommodate, ptosis, complete internal ophthalmoplegia (masked by ptosis), unopposed lateral rectus causes outward deviation of the eye. If the ocular sympathetic fibres are also affected behind the orbit, the pupil will be fixed but not dilated.4. Trochlear nerve (IV)Diplopia due to weakness of downward and inward eye movement. The most common cause of a pure vertical diplopia. The patient tends to compensate by tilting the head away from the affected side.5. Trigeminal nerve (V)Reduced sensation or dysesthesia over the affected area. Weakness of jaw clenching and side-to-side movement. If there is a lower motor neuron (LMN) lesion, the jaw deviates to the weak side when the mouth is opened. There may be fasciculation of temporalis and masseter.6. Abducens nerve (VI)Inability to look laterally. The eye is deviated medially because of unopposed action of the medial rectus muscle.7. Facial nerve (VII)Facial weakness. In an LMN lesion the forehead is paralysed – the final common pathway to the muscles is destroyed; whereas the upper facial muscles are partially spared in an upper motor neurone (UMN) lesion because of alternative pathways in the brainstem. There appear to be different pathways for voluntary and emotional movement. CVAs usually weaken voluntary movement, often sparing involuntary movements (e.g., spontaneous smiling). The much rarer selective loss of emotional movement is called mimic paralysis and is usually due to a frontal or thalamic lesion.8. Vestibulocochlear nerve (VIII)Unilateral sensorineural deafness, tinnitus. Slow-growing lesions seldom present with vestibular symptoms as compensation has time to occur.9. Glossopharyngeal nerve (IX)Unilateral lesions do not cause any deficit because of bilateral corticobulbar connections. Bilateral lesions result in pseudobulbar palsy. These nerves are closely interlinked.10. Vagus nerve (X)Palatal weakness can cause ‘nasal speech’ and nasal regurgitation of food. The palate moves asymmetrically when the patient says ‘ahh’. Recurrent nerve palsy results in hoarseness, loss of volume and ‘bovine cough’.11. Accessory nerve (XI)Weakness and wasting of sternocleidomastoid and trapezius muscles12.Hypoglossal nerve (XII)An LMN lesion produces wasting of the ipsilateral side of the tongue, with fasciculation; and on attempted protrusion the tongue deviates towards the affected side, but the tongue deviates away from the side of a central lesion.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 22 - Which of the following clinical features is most suggestive of a lesion of...

    Incorrect

    • Which of the following clinical features is most suggestive of a lesion of the frontal lobe:

      Your Answer:

      Correct Answer: Conjugate eye deviation towards the side of the lesion

      Explanation:

      Conjugate eye deviation towards the side of the lesion is seen in damage to the frontal eye field of the frontal lobe. Homonymous hemianopia is typically a result of damage to the occipital lobe (or of the optic radiation passing through the parietal and temporal lobes). Auditory agnosia may been seen in a lesion of the temporal lobe. Hemispatial neglect may be seen in a lesion of the parietal lobe. Receptive dysphasia is seen in damage to Wernicke’s area, in the temporal lobe.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 23 - You proceed to administer lorazepam intravenously to a 21-year-old patient with status epilepticus....

    Incorrect

    • You proceed to administer lorazepam intravenously to a 21-year-old patient with status epilepticus. Which of the following best describes lorazepam's action?

      Your Answer:

      Correct Answer: Potentiates effect of GABA

      Explanation:

      Lorazepam is a type of benzodiazepine. Benzodiazepines are gamma-aminobutyric acid (GABA) receptor agonists with sedative, hypnotic, anxiolytic, anticonvulsant, and muscle relaxant characteristics that promote inhibitory synaptic transmission across the central nervous system.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds

  • Question 24 - You are reviewing a patient complaining of loss of vision. Previous images shows...

    Incorrect

    • 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:

      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
      0
      Seconds

  • Question 25 - A 70-year-old man presents with right-sided hemiplegia and loss of joint position sense,...

    Incorrect

    • A 70-year-old man presents with right-sided hemiplegia and loss of joint position sense, vibratory sense, and discriminatory touch. Upon further physical examination, it was observed that her tongue deviates to the left-hand side. An MRI and CT scan was ordered and results showed that he was suffering a left-sided stroke. Which of the following is considered the best diagnosis for the case presented above?

      Your Answer:

      Correct Answer: Medial medullary syndrome

      Explanation:

      Medial medullary syndrome is a form of stroke that affects the medial medulla of the brain. It is caused by a lesion in the medial part of the medulla, which is due to an infraction of vertebral arteries and/or paramedian branches of the anterior spinal artery.It is characterized by contralateral paralysis of the upper and lower limb of the body, a contralateral decrease in proprioception, vibration, and/or fine touch sensation, paresthesias or less commonly dysesthesias in the contralateral trunk and lower limb, and loss of position and vibration sense with proprioceptive dysfunction. Ipsilateral deviation of the tongue due to ipsilateral hypoglossal nerve damage can also be seen.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 26 - Which of the following is NOT an adverse effect of amitriptyline: ...

    Incorrect

    • Which of the following is NOT an adverse effect of amitriptyline:

      Your Answer:

      Correct Answer: Hypokalaemia

      Explanation:

      Adverse effects include:Antimuscarinic effects: Dry mouth, Blurred vision, Constipation, Urinary retention, Sedation, ConfusionCardiovascular effects: Heart block, Arrhythmias, Tachycardia, Postural hypotension, QT-interval prolongation, Hepatic impairment, Narrow-angle glaucoma

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds

  • Question 27 - The least likely feature expected to be seen in a lesion of the...

    Incorrect

    • The least likely feature expected to be seen in a lesion of the frontal lobe is which of the following?

      Your Answer:

      Correct Answer: Loss of two-point discrimination

      Explanation:

      Lesions in different areas give rise to different symptoms. Lesions of the parietal lobe give rise to loss of two-point discrimination. Lesions to Broca’s area give rise to expressive dysphasia results from damage Lesions to the primary motor cortex give rise to contralateral weakness of the face and arm. Lesions to the prefrontal cortex give rise to personality change. Lesions to the frontal eye field give rise to conjugate eye deviation towards side of lesion.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 28 - Which of the following best describes the mechanism of action of aspirin: ...

    Incorrect

    • Which of the following best describes the mechanism of action of aspirin:

      Your Answer:

      Correct Answer: Cyclo-oxygenase (COX) inhibitor

      Explanation:

      Aspirin is a non-steroidal anti-inflammatory drug (NSAID). Aspirin irreversibly inhibits cyclooxygenase (COX) enzymes and the resulting inhibition of prostaglandin synthesis results in analgesic, antipyretic and to a lesser extent anti-inflammatory actions.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds

  • Question 29 - At which opioid receptors do opioid analgesics act primarily? ...

    Incorrect

    • At which opioid receptors do opioid analgesics act primarily?

      Your Answer:

      Correct Answer: Mu

      Explanation:

      Opioid receptors are widely distributed throughout the central nervous system. Opioid analgesics mimic endogenous opioid peptides by causing prolonged activation of these receptors, mainly the mu(μ)-receptors which are the most highly concentrated in brain areas involved in nociception.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds

  • Question 30 - A 70-year old male is taken to the Emergency Room after suffering a...

    Incorrect

    • A 70-year old male is taken to the Emergency Room after suffering a traumatic fall while showering. Upon physical examination, the attending physician noted a hyperextended neck, 1/5 muscle strength in both upper extremities, 4/5 muscle strength in both lower extremities, and variable loss in sensation. The patient is placed in the wards for monitoring. For the next 24 hours, anuria is noted.Which of the following spinal cord injuries is the most likely diagnosis?

      Your Answer:

      Correct Answer: Central cord syndrome

      Explanation:

      Central cord syndrome is the most common type of incomplete cord injury and almost always occurs due to a traumatic injury. It results in motor deficits that are worse in the upper extremities as compared to the lower extremities. It may also cause bladder dysfunction (retention) and variable sensory deficits below the level of injury.The majority of these patients will be older and present with symptoms after a fall with hyperextension of their neck. On examination, patients will have more significant strength impairments in the upper extremities (especially the hands) compared to the lower extremities. Patients often complain of sensory deficits below the level of injury, but this is variable. Pain and temperature sensations are typically affected, but the sensation of light touch can also be impaired. The most common sensory deficits are in a cape-like distribution across their upper back and down their posterior upper extremities. They will often have neck pain at the site of spinal cord impingement.Bladder dysfunction (most commonly urinary retention) and priapism can also be signs of upper motor neuron dysfunction. The sacral sensation is usually preserved, but the clinician should assess the rectal tone to evaluate the severity of the compression.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 31 - What is the main mechanism of action of cyclizine: ...

    Incorrect

    • What is the main mechanism of action of cyclizine:

      Your Answer:

      Correct Answer: Histamine-H1 antagonist

      Explanation:

      Antihistamines e.g. cyclizine, are effective against nausea and vomiting caused by many different conditions, including motion sickness and vertigo. These agents act by inhibiting histamine pathways, and cholinergic pathways involved in transmission from the vestibular apparatus to the vomiting centre. There is no evidence that any one antihistamine is superior to another but their duration of action and incidence of adverse effects differ. Adverse effects include drowsiness and antimuscarinic effects such as blurred vision, dry mouth, urinary retention, constipation and confusion.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds

  • Question 32 - Which of the following is most likely to cause a homonymous hemianopia: ...

    Incorrect

    • Which of the following is most likely to cause a homonymous hemianopia:

      Your Answer:

      Correct Answer: Posterior cerebral artery stroke

      Explanation:

      A posterior cerebral stroke will most likely result in a contralateral homonymous hemianopia with macular sparing.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 33 - Which of the following is an adverse effect of carbamazepine: ...

    Incorrect

    • Which of the following is an adverse effect of carbamazepine:

      Your Answer:

      Correct Answer: Aplastic anaemia

      Explanation:

      Common adverse effects include nausea and vomiting, sedation, dizziness, headache, blurred vision and ataxia. These adverse effects are dose related and are most common at the start of treatment.Other adverse effects include:Allergic skin reactions (and rarely, more serious dermatological conditions)Hyponatraemia (avoid concomitant use with diuretics)Leucopenia, thrombocytopenia and other blood disorders including aplastic anaemiaHepatic impairment

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds

  • Question 34 - Which of the following is NOT a typical side effect of opioid analgesics:...

    Incorrect

    • 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 spasmCentral nervous system effects – Sedation, euphoria, respiratory depression, miosisCardiovascular effects – Peripheral vasodilation, postural hypotensionDependence and tolerance

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds

  • Question 35 - Which of the following statements about lithium treatment is FALSE: ...

    Incorrect

    • Which of the following statements about lithium treatment is FALSE:

      Your Answer:

      Correct Answer: Concomitant treatment with NSAIDs decreases serum-lithium concentration.

      Explanation:

      Lithium levels are raised by NSAIDs because renal clearance is reduced. Lithium is a small ion (74 Daltons) with no protein or tissue binding and is therefore amenable to haemodialysis. Lithium is freely distributed throughout total body water with a volume of distribution between 0.6 to 0.9 L/kg, although the volume may be smaller in the elderly, who have less lean body mass and less total body water. Steady-state serum levels are typically reached within five days at the usual oral dose of 1200 to 1800 mg/day. The half-life for lithium is approximately 18 hours in adults and 36 hours in the elderly.Lithium is excreted almost entirely by the kidneys and is handled in a manner similar to sodium. Lithium is freely filtered but over 60 percent is then reabsorbed by the proximal tubules.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds

  • Question 36 - Which of the following clinical features is most suggestive of a lesion of...

    Incorrect

    • Which of the following clinical features is most suggestive of a lesion of the occipital lobe:

      Your Answer:

      Correct Answer: Homonymous hemianopia

      Explanation:

      Homonymous hemianopia is a visual field defect involving either the two right or the two left halves of the visual fields of both eyes. It is caused by lesions of the retrochiasmal visual pathways, ie, lesions of the optic tract, the lateral geniculate nucleus, the optic radiations, and the cerebral visual (occipital) cortex

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 37 - Regarding antiemetics, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding antiemetics, which of the following statements is INCORRECT:

      Your Answer:

      Correct Answer: Of the antiemetics, cyclizine is most commonly associated with acute dystonic reactions.

      Explanation:

      Cyclizine acts by inhibiting histamine pathways and cholinergic pathways involved in transmission from the vestibular apparatus to the vomiting centre. Metoclopramide is a dopamine-receptor antagonist which acts both peripherally in the GI tract and centrally within the chemoreceptor trigger zone. Prochlorperazine is a dopamine-D2 receptor antagonist and acts centrally by blocking the chemoreceptor trigger zone. Metoclopramide and prochlorperazine are both commonly associated with extrapyramidal effects, such as acute dystonic reaction. Cyclizine may rarely cause extrapyramidal effects.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds

  • Question 38 - Which of the following tracts must be affected if a patient presents with...

    Incorrect

    • Which of the following tracts must be affected if a patient presents with decreased pain and temperature sensation in both lower extremities?

      Your Answer:

      Correct Answer: The lateral spinothalamic tract

      Explanation:

      The main function of the spinothalamic tract is to carry pain and temperature via the lateral part of the pathway and crude touch via the anterior part. The spinothalamic tract pathway is an imperative sensory pathway in human survival because it enables one to move away from noxious stimuli by carrying pain and temperature information from the skin to the thalamus where it is processed and transmitted to the primary sensory cortex. The primary sensory cortex communicates with the primary motor cortex, which lies close to it, to generate rapid movement in response to potentially harmful stimuli. Furthermore, the spinothalamic tract has a role in responding to pruritogens, causing us to itch. Interestingly, itching suppresses the spinothalamic tract neuron response to the histamine effect.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
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      Seconds

  • Question 39 - Which of the following is NOT a side effect of phenytoin: ...

    Incorrect

    • Which of the following is NOT a side effect of phenytoin:

      Your Answer:

      Correct Answer: Ototoxicity

      Explanation:

      Adverse effects of phenytoin include:Nausea and vomitingDrowsiness, lethargy, and loss of concentrationHeadache, dizziness, tremor, nystagmus and ataxiaGum enlargement or overgrowthCoarsening of facial features, acne and hirsutismSkin rashesBlood disorders

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds

  • Question 40 - Which of these is NOT a lithium side effect: ...

    Incorrect

    • Which of these is NOT a lithium side effect:

      Your Answer:

      Correct Answer: Peptic ulcer disease

      Explanation:

      Adverse Effects of lithium IncludeLeucocytosis (most patients)Polyuria/polydipsia (30-50%)Dry mouth (20-50%)Hand tremor (45% initially, 10% after 1 year of treatment)Confusion (40%)Decreased memory (40%)Headache (40%)Muscle weakness (30% initially, 1% after 1 year of treatment)Electrocardiographic (ECG) changes (20-30%)Nausea, vomiting, diarrhoea (10-30% initially, 1-10% after 1-2 years of treatment)Hyperreflexia (15%)Muscle twitch (15%)Vertigo (15%)Extrapyramidal symptoms, goitre (5%)Hypothyroidism (1-4%)Acne (1%)Hair thinning (1%)

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds

  • Question 41 - Carbamazepine is contraindicated in which of the following: ...

    Incorrect

    • Carbamazepine is contraindicated in which of the following:

      Your Answer:

      Correct Answer: Atrioventricular block

      Explanation:

      Carbamazepine is contraindicated in:- People with known hypersensitivity to carbamazepine or structurally related drugs- People with atrioventricular block (may suppress AV conduction and ventricular automaticity)- People with a history of bone marrow depression (risk of agranulocytosis and aplastic anaemia)- People with a history of acute porphyrias- People taking a monoamine oxidase inhibitor (risk of serotonin syndrome)

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds

  • Question 42 - Which of the following clinical features would you least expect to see in...

    Incorrect

    • Which of the following clinical features would you least expect to see in a lesion of the frontal lobe:

      Your Answer:

      Correct Answer: Contralateral homonymous hemianopia with macular sparing

      Explanation:

      Contralateral homonymous hemianopia with macular sparing results from damage to the primary visual cortex of the occipital lobe. Incontinence may occur due to damage of the cortical micturition centre in the prefrontal cortex. Primitive reflexes and inability to problem solve may occur due to damage to the prefrontal cortex. Motor weakness of the contralateral limb with UMN signs may occur due to damage of the primary motor cortex.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 43 - A 16-year old boy is brought to the emergency room after suffering a...

    Incorrect

    • A 16-year old boy is brought to the emergency room after suffering a traffic accident. Upon examination, there is noted ipsilateral loss of proprioception and vibration, ipsilateral motor loss, and contralateral loss of pain and temperature sensation. A spinal cord injury is given as a diagnosis.Which of the following is the most probable cause of this manifestation?

      Your Answer:

      Correct Answer: Brown-Séquard syndrome

      Explanation:

      Brown-Sequard Hemicord Syndrome consists of ipsilateral weakness (corticospinal tract) and loss of joint position and vibratory sense (posterior column), with contralateral loss of pain and temperature sense (spinothalamic tract) one or two levels below the lesion. Segmental signs, such as radicular pain, muscle atrophy, or loss of a deep tendon reflex, are unilateral. Partial forms are more common than the fully developed syndrome.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 44 - Which of the following is NOT a typical cerebellar sign: ...

    Incorrect

    • Which of the following is NOT a typical cerebellar sign:

      Your Answer:

      Correct Answer: Resting tremor

      Explanation:

      An intention tremor is characteristic of cerebellar dysfunction. Resting tremor may be seen in Parkinsonism.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 45 - If a lesion is observed in Broca's area, which function is expected to...

    Incorrect

    • If a lesion is observed in Broca's area, which function is expected to become affected?

      Your Answer:

      Correct Answer: Formation of words

      Explanation:

      The primary functions of the Broca area are both language production and comprehension. While the exact role in the production is still unclear, many believe that it directly impacts the motor movements to allow for speech. Although originally thought to only aid in speech production, lesions in the area can rarely be related to impairments in the comprehension of language. Different regions of the Broca area specialize in various aspects of comprehension. The anterior portion helps with semantics, or word meaning, while the posterior is associated with phonology, or how words sound. The Broca area is also necessary for language repetition, gesture production, sentence grammar and fluidity, and the interpretation of others’ actions.Broca’s aphasia is a non-fluent aphasia in which the output of spontaneous speech is markedly diminished and there is a loss of normal grammatical structure. Specifically, small linking words, conjunctions, such as and, or, and but, and the use of prepositions are lost. Patients may exhibit interjectional speech where there is a long latency, and the words that are expressed are produced as if under pressure. The ability to repeat phrases is also impaired in patients with Broca’s aphasia. Despite these impairments, the words that are produced are often intelligible and contextually correct. In pure Broca’s aphasia, comprehension is intact.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 46 - Which of these drugs may reduce the efficacy of contraception? ...

    Incorrect

    • Which of these drugs may reduce the efficacy of contraception?

      Your Answer:

      Correct Answer: Carbamazepine

      Explanation:

      Antiepileptic medications such as carbamazepine (Tegretol), topiramate (Topamax), and phenytoin (Dilantin) are widely known for reducing the contraceptive effectiveness of OCPs.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds

  • Question 47 - Which of the following classes of drugs may predispose to lithium toxicity: ...

    Incorrect

    • Which of the following classes of drugs may predispose to lithium toxicity:

      Your Answer:

      Correct Answer: Thiazide diuretics

      Explanation:

      Excretion of lithium may be reduced by thiazide diuretics, NSAIDs, and ACE inhibitors thus predisposing to lithium toxicity. Loop diuretics also cause lithium retention but are less likely to result in lithium toxicity.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds

  • Question 48 - An 80-year-old woman with history of hypertension, diabetes, and ischemic stroke, presents with...

    Incorrect

    • An 80-year-old woman with history of hypertension, diabetes, and ischemic stroke, presents with left-sided hemiplegia of the face, tongue, and limbs and right-sided deficits in motor eye activity. A CT scan was ordered and showed 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:

      Weber syndrome is a midbrain stroke characterized by crossed hemiplegia along with oculomotor nerve deficits and it occurs with the occlusion of the median and/or paramedian perforating branches of the basilar artery. Typical clinical findings include ipsilateral CN III palsy, ptosis, and mydriasis (such as damage to parasympathetic fibres of CN III) with contralateral hemiplegia.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 49 - A 70-year-old man presents with right-sided hemiplegia and loss of joint position sense,...

    Incorrect

    • A 70-year-old man presents with right-sided hemiplegia and loss of joint position sense, vibratory sense, and discriminatory touch. Upon further physical examination, it was observed that her tongue deviates to the left-hand side. An MRI and CT scan was ordered and results showed that he was suffering a left-sided stroke. Branches of which of the following arteries are most likely implicated in the case?

      Your Answer:

      Correct Answer: Anterior spinal artery

      Explanation:

      Medial medullary syndrome is a form of stroke that affects the medial medulla of the brain. It is caused by a lesion in the medial part of the medulla, which is due to an infraction of vertebral arteries and/or paramedian branches of the anterior spinal artery.It is characterized by contralateral paralysis of the upper and lower limb of the body, a contralateral decrease in proprioception, vibration, and/or fine touch sensation, paresthesias or less commonly dysesthesias in the contralateral trunk and lower limb, and loss of position and vibration sense with proprioceptive dysfunction. Ipsilateral deviation of the tongue due to ipsilateral hypoglossal nerve damage can also be seen.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 50 - A 33-year-old woman demonstrates right-sided superior homonymous quadrantanopia upon visual field testing. A...

    Incorrect

    • A 33-year-old woman demonstrates right-sided superior homonymous quadrantanopia upon visual field testing. A diagnosis of a brain tumour has been established.Which of the following anatomical points in the visual pathway has the lesion occurred?

      Your Answer:

      Correct Answer: Lower optic radiation

      Explanation:

      Homonymous quadrantanopia is not a disease; it is a clinical finding that points towards a lesion of the optic radiations coursing through the temporal lobe.Homonymous superior quadrantanopia is caused by damage to the contralateral inferior parts of the posterior visual pathway: the inferior optic radiation (temporal Meyer loop), or the inferior part of the occipital visual cortex below the calcarine fissure.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 51 - You suspect that your patient with polycystic kidney disease has developed a berry...

    Incorrect

    • You suspect that your patient with polycystic kidney disease has developed a berry aneurysm as a complication of his disease. The patient complains of a sudden, severe headache. You are guessing subarachnoid haemorrhage secondary to a ruptured berry aneurysm as the cause of his severe headaches. What is the most likely location of his aneurysm?

      Your Answer:

      Correct Answer: Anterior communicating artery

      Explanation:

      One of the complications that polycystic kidney disease may cause is the development of a brain aneurysm. A berry aneurysm is the most common type of brain aneurysm. The Circle of Willis, where the major blood vessels meet at the base of the brain, is where it usually appears. The most common junctions of the Circle of Willis where an aneurysm may occur include the anterior communicating artery (35%), internal carotid artery (30%), the posterior communicating artery and the middle cerebral artery (22%), and finally, the posterior circulation sites, most commonly the basilar artery tip.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 52 - In which of the following cases is intravenous phenytoin contraindicated? ...

    Incorrect

    • In which of the following cases is intravenous phenytoin contraindicated?

      Your Answer:

      Correct Answer: Second degree heart block

      Explanation:

      Phenytoin Contraindications include:HypersensitivitySinus bradycardiaSinoatrial blockSecond and third degree A-V blockAdams-Stokes syndromeConcurrent use with delavirdineHistory of prior acute hepatotoxicity attributable to phenytoin

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds

  • Question 53 - A patient presents complaining of visual loss. On examination you note a contralateral...

    Incorrect

    • A patient presents complaining of visual loss. On examination you note a contralateral homonymous hemianopia. Where is the most likely site of the lesion:

      Your Answer:

      Correct Answer: Optic tract

      Explanation:

      At the optic chiasm, fibres from the medial (nasal) half of each retina crossover, forming the right and left optic tracts.The left optic tract contains fibres from the left lateral (temporal) retina and the right medial retina.The right optic tract contains fibres from the right lateral retina and the left medial retina.Each optic tract travels to its corresponding cerebral hemisphere to reach its lateral geniculate nucleus (LGN) located in the thalamus where the fibres synapse.A lesion of the optic tract will cause a contralateral homonymous hemianopia.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 54 - In the emergency room, a 28-year-old woman complains of wobbly and slurred speech,...

    Incorrect

    • In the emergency room, a 28-year-old woman complains of wobbly and slurred speech, is unable to do the heel-shin test, and has nystagmus. The following signs are most likely related to damage to which of the following areas:

      Your Answer:

      Correct Answer: Cerebellum

      Explanation:

      Cerebellar injury causes delayed and disorganized motions. When walking, people with cerebellar abnormalities sway and stagger. Damage to the cerebellum can cause asynergia, the inability to judge distance and when to stop, dysmetria, the inability to perform rapid alternating movements or adiadochokinesia, movement tremors, staggering, wide-based walking or ataxic gait, a proclivity to fall, weak muscles or hypotonia, slurred speech or ataxic dysarthria, and abnormal eye movements or nystagmus.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 55 - A 65-year-old man complains of severe vertigo, nausea, and tinnitus. Upon presenting himself...

    Incorrect

    • A 65-year-old man complains of severe vertigo, nausea, and tinnitus. Upon presenting himself to the emergency room, it was observed that he is exhibiting ataxia, right-sided loss of pain and temperature sense on the face, and left-sided sensory loss to the body. An MRI and CT scan was ordered and the results showed that he is suffering from 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:

      The lateral pontine syndrome occurs due to occlusion of perforating branches of the basilar and anterior inferior cerebellar (AICA) arteries. It is also known as Marie-Foix syndrome or Marie-Foix-Alajouanine syndrome. It is considered one of the brainstem stroke syndromes of the lateral aspect of the pons.It is characterized by ipsilateral limb ataxia, loss of pain and temperature sensation of the face, facial weakness, hearing loss, vertigo and nystagmus, hemiplegia/hemiparesis, and loss of pain and temperature sensation.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 56 - After an accidental fall, a 75-year-old patient complains of neck pain and weakness...

    Incorrect

    • After an accidental fall, a 75-year-old patient complains of neck pain and weakness in his upper limbs. Select the condition that most likely caused the neck pain and weakness of the upper limbs of the patient.

      Your Answer:

      Correct Answer: Central cord syndrome

      Explanation:

      The cervical spinal cord is the section of the spinal cord that goes through the bones of the neck. It is injured incompletely in the central cord syndrome (CCS). This will result in arm weakness more than leg weakness.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 57 - Which of the following is NOT a contraindication to treatment with aspirin at...

    Incorrect

    • 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 ulcerationPeople with haemophilia or another bleeding disorderChildren younger than 16 years of age (risk of Reye’s syndrome)People with severe cardiac failurePeople with severe hepatic impairmentPeople 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.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds

  • Question 58 - What type of visual field defect are you likely to see in a...

    Incorrect

    • What type of visual field defect are you likely to see in a lesion of the visual cortex:

      Your Answer:

      Correct Answer: Contralateral homonymous hemianopia with macular sparing

      Explanation:

      A lesion of the visual cortex will result in a contralateral homonymous hemianopia with macular sparing.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

  • Question 59 - Which of the following is a contraindication for aspirin? ...

    Incorrect

    • Which of the following is a contraindication for aspirin?

      Your Answer:

      Correct Answer: Children under 16 years

      Explanation:

      Aspirin contraindications include: hypersensitivity to NSAIDs; asthma, rhinitis, and nasal polyps; and usage in children or teens.There is little evidence of allergic cross-reactivity for salicylates. However, due to similarities in chemical structure and/or pharmacologic activities, the possibility of cross-sensitivity cannot be completely ruled out.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds

  • Question 60 - Regarding cortical areas, which one is found in the posterior part of the...

    Incorrect

    • Regarding cortical areas, which one is found in the posterior part of the inferior frontal gyrus?

      Your Answer:

      Correct Answer: Broca’s area

      Explanation:

      Broca’s area is involved in the expressive aspects of spoken and written language (production of sentences constrained by the rules of grammar and syntax). It corresponds to the opercular and triangular parts of the inferior frontal gyrus (BA 44 and 45). These areas are defined by two rami (branches) of the lateral sulcus (one ascending, one horizontal) which ‘slice into’ the inferior frontal gyrus. In keeping with its role in speech and language, Broca’s area is immediately anterior to the motor and premotor representations of the face, tongue and larynx. A homologous area in the opposite hemisphere is involved in non-verbal communication such as facial expression, gesticulation and modulation of the rate, rhythm and intonation of speech.

    • This question is part of the following fields:

      • Anatomy
      • Central Nervous System
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Central Nervous System (10/17) 59%
Pharmacology (5/8) 63%
Anatomy (5/9) 56%
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