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NeuroScience

NEUROSCIENCE – 2023

Questions from the 2023 Module Exam

Think about the midbrain’s role in modulating pain signals through descending pathways rather than other autonomic or motor functions.

1 / 100

Category: Neurosciences – Physiology

Damage to  periaqeductal gray area of midbrain results in loss of which one of the following functions?

Think about which layer of the developing spinal cord evolves into gray matter, where the neuronal cell bodies are located.

2 / 100

Category: Neurosciences – Embryology

During the development of the spinal cord, the central canal is lined by three layers. Which of the three layers contains cell bodies of neurons? – 2023

Consider whether the vein is superficial or deep. The superior sagittal sinus primarily collects blood from superficial veins on the brain’s convexity, not deep or basal structures.

 

3 / 100

Category: NeuroSciences – Anatomy

Which of the following veins drains into the superior sagittal sinus? – 2023

Think about the term that describes diseases that are regularly present and expected in a specific population or area.

4 / 100

Category: Neurosciences – Community Medicine + Behavioural Sciences

Which of the following terms refers to the constant presence of a disease or infectious agent within its usual or expected frequency in a given geographical area or population group?

5 / 100

Category: Neurosciences – Physiology

The myelin sheath of the neurons is altered due to the formation of plaques in which of the following disorders of the nervous system?

When you see bilateral sensory and motor deficits below the lesion, think about complete disruption of the spinal cord. Pay attention to whether both ascending and descending tracts are involved.

6 / 100

Category: NeuroSciences – Anatomy

A 53-year-old patient was brought to the emergency department after a fall. MRI scan reveals a slipped disc at the L3 level. Neurological examination shows that the patient has a bilateral loss of pain, temperature, and light touch sensation below the level of the lesion, bilateral lower motor neuron paralysis in the segment of the lesion, and bilateral spastic paralysis below the level of the lesion. Which of the following is the most likely diagnosis in this case? – 2023

Think about the arteries that form a “ring” at the base of the brain. Focus on whether the artery contributes to the circular structure or branches off to supply other regions directly.

7 / 100

Category: NeuroSciences – Anatomy

Which of the following arteries is not a part of the circle of Willis? – 2023

Focus on the chronic meningitis with high fibrin content in CSF, leading to the formation of the cobweb-like clot.

8 / 100

Category: Neurosciences – Biochemistry

On CSF Examination, Cobweb coagulum is a characteristic finding of?

Focus on the process that results in lasting synaptic changes

9 / 100

Category: Neurosciences – Physiology

Which of the following mechanisms is involved in the conversion of short-term memory to long-term memory?

Focus on the dorsal column system when you see discriminative touch, vibration, or proprioception. The fasciculus gracilis handles input from the lower limbs, and the medial lemniscus continues this pathway to the brain.

10 / 100

Category: NeuroSciences – Anatomy

The sensation of discriminative touch, vibratory sense, and conscious muscle joint proprioception of the lower limbs passes from the posterior root ganglia to the postcentral gyrus through which of the following pathways? – 2023

Focus on the linear acceleration of the utricle and saccule, which are unique to the otolith organs.

11 / 100

Category: Neurosciences – Physiology

A 60-year-old male patient is suspected to be suffering from impairment of the otolith organs based on a detailed neurological examination and a CT scan. Which of the following functions is most likely to be disturbed in this case?

Think about the brain wave patterns seen during deep sleep and how the same waves may appear in abnormal conditions like brain damage in awake individuals.

12 / 100

Category: Neurosciences – Physiology

Which of the following brain waves are most likely to be present in the EEG of a healthy sleeping person and a brain-damaged awake person?

Think about the pathway of the fornix and the portion that curves anteriorly near the ventricles to connect with the diencephalon structures.

13 / 100

Category: NeuroSciences – Anatomy

Which of the following structures forms the anterior boundary of the interventricular foramen of Monro? – 2023

Think about the medial surface of the brain and the artery (ACA) supplying it. Consider which areas control the lower limbs, as this region is typically involved in infarctions affecting the medial cerebral hemispheres.

14 / 100

Category: NeuroSciences – Anatomy

An unconscious male patient is brought to the emergency room. An MRI of the brain is performed and reveals infarction of the medial surface of the cerebral hemispheres. Which of the following cortical areas is likely to be affected in this case?

The name of the enzyme signifies its function.

15 / 100

Category: Neurosciences – Biochemistry

Which of the following key enzymes is required for the synthesis of acetylcholine? – 2023

Focus on the embryological organization of the neural tube. The dorsal part is associated with sensory processing, while the ventral part relates to motor control. Which embryological structure matches this description?

16 / 100

Category: Neurosciences – Embryology

Which of the following embryological structures gives rise to the dorsal sensory horn of the spinal cord? – 2023

Focus on the layer where dendrites of Purkinje cells branch extensively and interact with parallel fibers and interneurons.

17 / 100

Category: Neurosciences – Histology

The cerebellar cortex is composed of three layers. Which of the following layers is a synaptic zone that is mainly composed of dendritic arborizations of Purkinje cells? – 2023

Think about the vitamin critical for methylation reactions, myelin maintenance, and DNA synthesis, whose deficiency causes both anemia and neurological damage.

18 / 100

Category: Neurosciences – Biochemistry

The deficiency of which of the following vitamins is marked by anemia, impaired neurotransmitter production, increased homocysteine levels, and neuronal demyelination?

Think of the final step as ensuring ongoing support and preventing further distress by formalizing a follow-up plan.

19 / 100

Category: Neurosciences – Community Medicine + Behavioural Sciences

During a flood, a mental health professional is given the responsibility to provide psychological first aid and conduct crisis intervention. Which of the following is the 7th and last stage of the crisis intervention model?

Remember that the spinothalamic tracts cross over near their entry point in the spinal cord. So, an injury to the left sideaffects pain and temperature on the opposite side.

20 / 100

Category: NeuroSciences – Anatomy

A patient suffers from a gunshot wound injuring his spinal cord on the left side. The patient now has loss of pain and temperature sensation on the right side of the body. Which of the following tracts is likely to be affected in this case? – 2023

Think about the cranial nerve that controls shoulder elevation and head turning through the sternocleidomastoid and trapezius muscles.

21 / 100

Category: Neurosciences – Physiology

A 72-year-old female visits a physician with complaints of difficulty in raising her shoulders and turning her head for the last few weeks. Investigations reveal a lesion in the Medulla. Which one of the following nerves is involved in this lesion to have the effects mentioned above?

Focus on the distinction between short association fibers (connecting nearby gyri) and long association fibers(connecting distant areas within the same hemisphere). Pay attention to the size and connections of these fibers.

22 / 100

Category: NeuroSciences – Anatomy

Which of the following statements regarding the long association fibers is incorrect? – 2023

Think of the midline suture running between the two parietal bones, forming the “roof” of the skull.

23 / 100

Category: NeuroSciences – Anatomy

The two parietal bones form the sides and the roof of the skull and articulate with each other in the midline. Which of the following sutures is present between these bones? – 2023

Think about which nerve/s play a role in pupillary reflex, and then what’s the location of the nuclei to which those nerve/s are linked to.

24 / 100

Category: Neurosciences – Physiology

A 32-year-old male presents to the emergency department with head trauma after he fell from a ladder. A physician shines a flashlight into the patient’s eyes and observes that the pupillary reflexes are normal. This reflex is used to test the functioning of which of the following structures of the brain?

Focus on the structure that is part of the brainstem and lies between the diencephalon and pons.

25 / 100

Category: Neurosciences – Embryology

During the 5th week of development, five brain swellings appear. These include the telencephalon, diencephalon, mesencephalon, metencephalon, and myelencephalon. The mesencephalon gives rise to which of the following structures? – 2023

Focus on the combination of autoimmune symptoms, neurological deficits, and oligoclonal bands in the CSF, which are hallmark findings

26 / 100

Category: Neurosciences – Pathology

A 50-year-old female patient who is a known case of an autoimmune disorder visits the neurology clinic with complaints of fatigue, tingling, numbness, muscle weakness, and muscle spasms. CSF analysis reveals oligoclonal bands. Which of the following is the most likely diagnosis in this case?

Focus on the brain area responsible for speech production rather than comprehension, particularly in the dominant hemisphere.

27 / 100

Category: Neurosciences – Physiology

A day after a head injury, a neurologist observed that his 45-year-old patient understood spoken and written words but his speech was slow, poorly articulated with a great effort. Which of the following cerebral areas may be affected in this patient?

Focus on the combination of X-linked inheritance, ABCD1 mutation, and the accumulation of very long-chain fatty acids

28 / 100

Category: Neurosciences – Pathology

A 5-month-old boy is brought to the outpatient clinic with complaints of global developmental delay, generalized weakness of the body, and jerky eye movement. There is also a family history of his 5-year-old brother having the same complaints. MRI scans of the brain reveal symmetrical lesions. Genetic studies reveal a mutation in the ABCD1 gene located at the X chromosome. Which of the following is the most likely diagnosis?

Think about the term that describes the lack of coordination between different components of a movement, resulting in fragmented or jerky motor activity.

29 / 100

Category: Neurosciences – Physiology

Which of the following cerebellar disorders results in an inability to combine the various components of a movement to create a smooth action?

Think of large signaling molecules like hormones, which require specialized mechanisms (receptor-mediated transcytosis) to cross the BBB.

30 / 100

Category: Neurosciences – Biochemistry

Which of the following compounds crosses the blood-brain barrier by means of receptor-mediated transcytosis?

31 / 100

Category: Neurosciences – Pathology

The parents of a 9-year-old child take him to a pediatrician because he has become more clumsy and complaining of headaches. For the past three weeks, the child’s parents have noticed that he has trouble using his right hand to grab or pick up items like cups or toys. He also has a significant decline in his ability to draw lines and figures for around two weeks. He’s been complaining about worsening headaches for the previous four days.

The boy has been properly immunized and reached all developmental milestones.
On examination an intention tremor of the right hand is observed. There is a lack of finger-nose coordination and impairment of rapid alternating movements. His further examination revealed that he was unable to stop movement precisely at the intended spot preventing the overshoot. The patient showed deterioration of both fine and gross skilled movements.

An MRI shows a cyst at the junction of vermis and intermediate zone of the right cerebellum. Lumbar puncture showed a slight increase in intracranial pressure.

Which of the following functions will be affected due to the lesion of the above-mentioned area?

Think about the cranial nerve responsible for the sense of smell and the bone that separates the nasal cavity from the cranial cavity. Which cranial nerve would pass through this structure?

32 / 100

Category: NeuroSciences – Anatomy

A 24-year-old patient presents to the emergency department after a road accident with complaints of headache, nausea, vomiting & an altered level of consciousness. An X-ray of the skull reveals a fracture of the cribriform plate of the ethmoid bone. Which of the following cranial nerves passes through the foramina of this fractured bone? – 2023

Focus on the swimming history, rapid onset, and flask-shaped amoebae, which are hallmark features

33 / 100

Category: Neurosciences – Pathology

A young male patient presents to the emergency department in an unconscious state. The parents give a history of him swimming in a pool for the last few days. CSF analysis reveals small flask-shaped amoeba. Which of the following is the most likely diagnosis in this case?

Focus on the schedule of routine immunization in the EPI program, where IPV is strategically given to complement oral polio vaccine doses.

34 / 100

Category: Neurosciences – Community Medicine + Behavioural Sciences

Polio is now endemic only in 2 countries Pakistan and Afghanistan. Two very effective polio vaccines Oral and injectable are being given in EPI program and in addition special immunization campaigns are repeatedly conducted all over Pakistan so as to eradicate polio. In routine EPI schedule injectable polio vaccine IPV is given at age of

Focus on the location of the tumor (midbrain) and the pathway of CSF. Think about which structure in the midbrain could block the flow from the third to the fourth ventricle.

35 / 100

Category: NeuroSciences – Anatomy

A 50-year-old male patient undergoes a CT scan which reveals a tumor of the midbrain. It shows symmetrical distension of the lateral ventricles and the third ventricle. Which of the following structures is most likely obstructed by the tumor in this case? – 2023

Think about the vitamin that is converted into PLP, a coenzyme required for decarboxylation and transamination reactions in neurotransmitter pathways.

36 / 100

Category: Neurosciences – Biochemistry

Which of the following vitamins is required for the synthesis of neurotransmitters like dopamine, serotonin, and GABA?

Focus on the combination of macrocephaly and ventriculomegaly, which are hallmark features of CSF accumulation..

37 / 100

Category: Neurosciences – Pathology

A female infant born after a full-term pregnancy weighing 3.4kg has an enlarged head with the occipitofrontal circumference (OFC) being 49.5 cm. A cranial ultrasound reveals bilateral ventriculomegaly. Which of the following is the most likely diagnosis?

Focus on the body vs. face distinction for sensory input.

38 / 100

Category: Neurosciences – Physiology

A 65-year-old male patient suffers from a cerebrovascular accident resulting in a complete loss of sensation on the right side of the body sparing the head and face. Which of the following nuclei of the thalamus is most likely to be affected by this lesion?

Think about the structure most commonly associated with memory processing and learning. It is part of the limbic system and is critical for creating lasting memories.

39 / 100

Category: NeuroSciences – Anatomy

A 44-year-old patient presents to the outpatient clinic with the complaint of being unable to recall any recently occurring events. Which of the following brain structures is responsible for converting short-term memory into long-term memory? – 2023

40 / 100

Category: NeuroSciences – Anatomy

Loss of all sensations at the level of the lesion?

Think about which cranial nerve nucleus controls pupil constriction and its vulnerability in conditions like diabetes, where parasympathetic fibers may be affected without impairing motor function.

41 / 100

Category: NeuroSciences – Anatomy

A diabetic patient is observed to have mydriasis while undergoing an examination in an ophthalmology clinic. All other eye movements are normal. The nerve most likely affected in this case arises from which of the following brain stem nuclei? – 2023

Focus on the persistent low mood, anhedonia, and suicidal ideation as hallmarks

42 / 100

Category: Neurosciences – Community Medicine + Behavioural Sciences

A 32-year-old mother of two children visits a primary healthcare center with complaints of feeling sad, irritable, and empty, and often finds herself crying for no reason for the past three months. She has a loss of interest in all activities and finds it really hard to carry out her daily activities. She feels as if she would be better off dead and even has thoughts about taking her life at times. Which one of the following disorders is she most likely suffering from?

Focus on the medial-to-lateral organization of the cerebellar nuclei. The fastigial nucleus is closest to the midline, near the vermis.

43 / 100

Category: NeuroSciences – Anatomy

A cross-section of the cerebellum shows the cerebellar nuclei embedded in the white matter which is surrounded by the cortex. Which of the following nuclei is located most medially? – 2023

Think about the structure responsible for fear responses and emotional regulation, which, when damaged, results in loss of fear and hyperorality.

44 / 100

Category: Neurosciences – Physiology

In an animal laboratory, the change in the behavior of a monkey is observed. The monkey has a loss of fear, forgetfulness, and the tendency to place everything in its mouth. Ablation (medical procedure that destroys or removes tissues, cells, or functions in the body) of which of the following structures of the limbic system is the most likely cause for these behavioral changes?

Focus on the connection between the pons and the cerebellum. Damage in this region is likely to disrupt pathways that facilitate motor coordination, not autonomic or sensory functions.

45 / 100

Category: NeuroSciences – Anatomy

A 67-year-old male patient admitted to the neurology ward is observed to have intention tremor and cerebellar ataxia. Radiological scans reveal a pontine infarct. Which of the following fibers is most likely damaged in this case? – 2023

Focus on the receptor type specialized for detecting high-frequency vibrations in non-hairy skin, particularly under conditions of mechanical exposure.

46 / 100

Category: Neurosciences – Physiology

A 42-year-old jackhammer operator presents in the neurology clinic with decreased sensitivity to high-frequency vibrations in the non-hairy skin of his hands. Which of the following receptors is most likely affected in this case?

Focus on the slow, writhing movements of the hands and face. Damage to the globus pallidus is specifically associated with this type of involuntary movement.

47 / 100

Category: Neurosciences – Physiology

A 45-year-old male presented to a neurology clinic with complaints of spontaneous and continuous writhing movement of hands, an arm, and face. MRI scans reveal a lesion of the globus pallidus. The patient is manifesting which of the following signs in this case?

Focus on the patient’s symptoms and its role in weakening small cerebral arteries, leading to hemorrhages.

48 / 100

Category: Neurosciences – Pathology

A 60-year-old male patient with a history of hypertension for the last 10 years is brought to the emergency department in an unconscious state. History also reveals that the patient is non-compliant with his medication for hypertension. MRI and CT scan brain show a lobar hemorrhage. Which of the following is the most likely cause of this condition?

Focus on neutrophilic dominance, decreased glucose, and elevated protein as classic findings in bacterial meningitis.

49 / 100

Category: Neurosciences – Pathology

A 1-year-old girl is diagnosed with bacterial meningitis. Which of the following findings in the CSF analysis are suggestive of bacterial meningitis?

Think about the glial cells specific to the peripheral nervous system that actively support axonal regeneration and remyelination.

50 / 100

Category: Neurosciences – Physiology

A 40-year-old woman sustained a peripheral nerve injury while cutting vegetables. The distance between the cut ends was less than 3 mm. Which of the following cells is responsible for the regeneration of this nerve?

Think about the location of the largest fontanelle in the newborn’s skull. It lies at the junction of the coronal and sagittal sutures on the top of the head.

51 / 100

Category: NeuroSciences – Anatomy

During a routine examination of a newborn baby in the pediatric clinic, the physician notices a depression of the anterior fontanelle (membranous gap in between bones of the skull). The depressed fontanelle lies between which of the following bones? – 2023

Focus on the part of the cerebellum that communicates with the cerebral cortex and is involved in higher-order motor planning, especially for skilled and complex movements.

52 / 100

Category: Neurosciences – Physiology

Which of the following parts of the cerebellum is involved in the planning of sequential movements?

Focus on the motor protein responsible for retrograde transport, moving material toward the cell body along microtubules.

53 / 100

Category: Neurosciences – Physiology

A 2-year-old boy was infected by polio virus and developed flaccid paralysis. This virus enters the central nervous system from periphery and reaches the soma by retrograde transport. Which of the following proteins is used by the polio virus to reach the cell body?

Focus on the enzyme responsible for combining choline and acetyl-CoA, which is unique to acetylcholine synthesis.

54 / 100

Category: Neurosciences – Biochemistry

Acetylcholine is synthesized in the presynaptic axon by?

HIV encephalitis is a neurological complication of HIV infection, often presenting with symptoms such as cognitive decline, motor deficits, and behavioral changes. The characteristic histopathological findings of HIV encephalitis include:

  1. Microglial nodules: Focal aggregates of activated microglial cells.
  2. Multinucleated giant cells: Formed by the fusion of infected macrophages or microglia, these are considered pathognomonic for HIV encephalitis.
  3. Perivascular inflammation: Often with macrophages and lymphocytes.

These findings result from the infection of macrophages and microglia by HIV, leading to neuroinflammation and neuronal damage.


Why not the other options?

  1. Microglial nodules: Present in HIV encephalitis but are not sufficient alone; multinucleated giant cells are also required for diagnosis.
  2. Eosinophilia: Typically seen in parasitic infections or allergic conditions, not in HIV encephalitis.
  3. Gliosis: A nonspecific response to CNS injury, commonly seen in many neurological conditions, but it is not a defining feature of HIV encephalitis.
  4. Neutrophil infiltration: Characteristic of bacterial infections, not viral encephalitis like HIV.

55 / 100

Category: Neurosciences – Pathology

A 35-year-old male who has a history of HIV is admitted to the neurology ward with signs and symptoms of encephalitis. Which of the following is a characteristic histopathological finding of HIV encephalitis?

Focus on the hormone secreted during fasting that stimulates hunger and overrides satiety signals.

56 / 100

Category: Neurosciences – Physiology

Which of the following hormones/factors is responsible for inhibiting the action of leptin on the ventromedial nucleus of the hypothalamus and stimulating the lateral hypothalamic nucleus producing a sense of hunger?

Think about the structure connecting the third and fourth ventricles in the midbrain. Obstruction here would cause hydrocephalus affecting the ventricles upstream.

57 / 100

Category: NeuroSciences – Anatomy

A neonate is diagnosed with obstructive hydrocephalus. The parents were counseled and told that this condition is due to the blockage of a conduit between two ventricles of the brain. Which of the following is the most likely conduit obstructed in this case? – 2023

58 / 100

Category: NeuroSciences – Anatomy

Destruction of the tract produces loss of fine touch, vibration, proprioception, and two-point discrimination ipsilaterally in the lower limbs below the level of the lesion.

Focus on the anatomical origin of the cranial nerves. Does the nerve in question arise from the brainstem or elsewhere in the nervous system? Remember, the first two cranial nerves (olfactory and optic) bypass the brainstem.

59 / 100

Category: NeuroSciences – Anatomy

Which of the following cranial nerves does not originate at the pontomedullary junction of the brainstem? – 2023

60 / 100

Category: NeuroSciences – Anatomy

Destruction of this tract produces contralateral loss of pain and thermal sensibilities below the level of the lesion.

Focus on the smallest and unmyelinated fibers, as they are blocked first by local anesthetics, which target pain sensation.

61 / 100

Category: Neurosciences – Physiology

Before a minor surgical procedure, a local anesthetic is injected by the surgeon to ensure that the patient feels no pain. Which of the following nerve fibers is most likely to be blocked by the local anesthetic?

Focus on a reflex response that becomes stronger after a period of suppression, as seen when inhibitory control is lifted.

62 / 100

Category: Neurosciences – Physiology

During a study, the response of a particular reflex is inhibited for a while and then released suddenly, resulting in a response that is stronger than normal. This is known as which of the following properties of a reflex?

Focus on the tight junction proteins that are essential for sealing spaces between endothelial cells, preventing unwanted substances from entering the brain.

63 / 100

Category: Neurosciences – Biochemistry

At the interface between blood and brain, endothelial cells are tightly packed together by the help of tight junctions that are specialized transmembrane proteins such as?

Focus on the C-shaped structure that runs along the lateral ventricle and is separated from the lentiform nucleus by the internal capsule.

64 / 100

Category: NeuroSciences – Anatomy

During a lecture on the basal nuclei, the professor mentions a part of the corpus striatum which is associated with the lateral ventricle medially and the internal capsule laterally. Which of the following structures of the corpus striatum is being mentioned? – 2023

Focus on the linear acceleration of the utricle and saccule, which are unique to the otolith organs.

65 / 100

Category: Neurosciences – Physiology

A 60-year-old male patient is suspected to be suffering from impairment of the otolith organs based on a detailed neurological examination and a CT scan. Which of the following functions is most likely to be disturbed in this case?

66 / 100

Category: Neurosciences – Pathology

The parents of a 9-year-old child take him to a pediatrician because he has become more clumsy and complaining of headaches. For the past three weeks, the child’s parents have noticed that he has trouble using his right hand to grab or pick up items like cups or toys. He also has a significant decline in his ability to draw lines and figures for around two weeks. He’s been complaining about worsening headaches for the previous four days.

The boy has been properly immunized and reached all developmental milestones.
On examination an intention tremor of the right hand is observed. There is a lack of finger-nose coordination and impairment of rapid alternating movements. His further examination revealed that he was unable to stop movement precisely at the intended spot preventing the overshoot. The patient showed deterioration of both fine and gross skilled movements.

An MRI shows a cyst at the junction of vermis and intermediate zone of the right cerebellum. Lumbar puncture showed a slight increase in intracranial pressure.

Lesion in which of the following areas is responsible for above finding?

Think about which cranial nerve provides parasympathetic innervation to the lungs. Trace its origin back to its brainstem nucleus.

67 / 100

Category: NeuroSciences – Anatomy

A parasympathetic nerve arising from the brainstem influences the lungs. The cell body of this nerve lies in which of the following nuclei? – 2023

Focus on the side of the body with symptoms and remember that motor pathways cross over. The contralateral substantia nigra will show more prominent early degeneration.

 

68 / 100

Category: NeuroSciences – Anatomy

A 62-year-old male patient is diagnosed with early-stage Parkinson’s disease. The neurological examination reveals a slight resting tremor of the left hand, slow gait, and lack of the normal range of facial expression. Which of the following is the most likely site of the degenerative changes at this stage of the patient’s disease? –  2023

Think about how neurons communicate intensity to the brain

69 / 100

Category: Neurosciences – Physiology

Brain can distinguish between the strengths of light touch and sustained pressure during sensory encoding. Which of the following properties is responsible for this action of the brain?

Focus on the condition where pain arises from nerve dysfunction rather than tissue damage, often manifesting as allodynia.

70 / 100

Category: Neurosciences – Physiology

A 40-year-old male was diagnosed to have increased sensitivity to pain, without major tissue damage. He complained that even touching cloth is painful for him 🙁 . Which one of the following types of pain is my guy suffering from?

71 / 100

Category: Neurosciences – Pathology

The parents of a 9-year-old child take him to a pediatrician because he has become more clumsy and complaining of headaches. For the past three weeks, the child’s parents have noticed that he has trouble using his right hand to grab or pick up items like cups or toys. He also has a significant decline in his ability to draw lines and figures for around two weeks. He’s been complaining about worsening headaches for the previous four days.

The boy has been properly immunized and reached all developmental milestones.
On examination an intention tremor of the right hand is observed. There is a lack of finger-nose coordination and impairment of rapid alternating movements. His further examination revealed that he was unable to stop movement precisely at the intended spot preventing the overshoot. The patient showed deterioration of both fine and gross skilled movements.

An MRI shows a cyst at the junction of vermis and intermediate zone of the right cerebellum. Lumbar puncture showed a slight increase in intracranial pressure.

Failure of which of the following processes is responsible for the problems in movement in this case?

Focus on the sensory modality processed by structures in the brainstem and midbrain

72 / 100

Category: Neurosciences – Physiology

The lateral lemniscus is part of a pathway carrying which of the following sensations?

Focus on preventative vaccination strategies for individuals who are at continuous risk of handling rabies-related viruses.

73 / 100

Category: Neurosciences – Community Medicine + Behavioural Sciences

A 36-year-old man is hired as a laboratory worker and he will be handling Rabies related viruses and vaccines. Which of the following vaccines is he advised to get?

Focus on the neuron type located in dorsal root ganglia, specialized for transmitting sensory information from the periphery to the CNS.

74 / 100

Category: Neurosciences – Physiology

A Neurophysician wants to conduct research on the properties of sensory neurons. Which one of the following types of neuron is appropriate for the study?

Focus on the metabolic needs of nerve fibers.

75 / 100

Category: Neurosciences – Physiology

Type B nerve fibers are most sensitive to which one of the following stimuli?

Focus on the receptor that is protecting it from overexertion.

76 / 100

Category: Neurosciences – Physiology

During voluntary movements, the Golgi tendon organs are involved in providing which of the following information to the central nervous system?

Focus on the receptor subtype that opioids like morphine and fentanyl primarily target for their potent pain-relieving effects.

77 / 100

Category: Neurosciences – Pharmacology

The analgesic properties of opioids are primarily mediated by which of the following receptors?

Focus on the indirect pathway, which involves the subthalamus increasing activity in the output nuclei of the basal ganglia to inhibit unwanted movements.

78 / 100

Category: Neurosciences – Physiology

Which of the following nuclei of the basal ganglia receives input from the sub-thalamus via the indirect pathway?

Focus on whether the strategy occurs before or after the emotional response is triggered. John’s behavior fits into post-emotional response regulation.

79 / 100

Category: Neurosciences – Community Medicine + Behavioural Sciences

John diverts his attention to stop thinking about disturbing events in order to prevent himself from experiencing any overwhelming negative emotions. Which of the following term best corresponds to this strategy?

Think about cranial nerves involved in autonomic control of glands, the pupil, and thoracoabdominal viscera.

80 / 100

Category: Neurosciences – Physiology

Which of the following cranial nerves are a part of the parasympathetic nervous system?

Focus on the unilateral pupillary dilation and impaired ocular movement, which are classic signs of CN III compression due to herniation.

81 / 100

Category: Neurosciences – Pathology

A 39-year-old female patient presents to the outpatient department with a severe headache for the last 3 days. On physical examination, she is afebrile and normotensive. Fundoscopic examination shows papilledema in the right eye. She was admitted to the hospital for further testing. A day later, she develops right pupillary dilation with impaired ocular movement. These findings are best explained by which of the following lesions?

Try to remember that K complexes and sleep spindles are unique markers of a certain stage of  sleep and play a role in transitioning from light to deeper stages of sleep.

82 / 100

Category: Neurosciences – Physiology

A 55-year-old male presented to the neurology clinic with the complaint of excessive daytime sleepiness. He was advised to undergo a sleep study. Just after midnight, the lab technician notices the EEG wave showing K complexes and sleep spindles. Which of the following stages of sleep is the patient in at that moment?

Focus on the neurotransmitter produced by neurons in the substantia nigra that is critical for motor control and affected in Parkinson’s disease.

83 / 100

Category: Neurosciences – Biochemistry

Parkinson’s disease is associated with the loss of specific neurons containing which of the following neurotransmitters?

Think about the location of the sinuses. The cavernous sinus is located around the sella turcica and primarily drains the orbit and nearby regions. Is the sinus in question near this area, or does it lie elsewhere in the cranial cavity?

84 / 100

Category: NeuroSciences – Anatomy

Which of the following veins is not a tributary of the cavernous sinus? – 2023

Think about the distribution of inputs from multiple neurons acting at the same time to create a combined effect on the postsynaptic neuron.

85 / 100

Category: Neurosciences – Physiology

In an experimental lab, multiple stimuli from different neurons are applied to a post-synaptic neuron simultaneously to generate an action potential. Which one of the following phenomena of a synapse is displayed here?

Focus on the investigation that directly assesses CSF abnormalities, which are specific for diagnosing meningitis.

86 / 100

Category: Neurosciences – Pathology

A 5-year-old boy is admitted to the neurology ward with complaints of headache, photophobia, and neck rigidity. He is a suspected case of meningitis. Which of the following is the best diagnostic investigation for meningitis?

Think about reflexes that involve both sides of the body and help maintain balance when a sudden withdrawal occurs.

87 / 100

Category: Neurosciences – Physiology

A 20-year-old male was walking barefoot when he suddenly withdrew his leg when he accidentally stepped on a nail. Which of the following reflexes is responsible for activating the antagonistic contralateral extensor muscles in this case?

88 / 100

Category: NeuroSciences – Anatomy

Destruction of the tract causes loss of position and movements of the ipsilateral upper limbs below the level of the lesion.

Focus on the bones forming the boundaries of the anterior cranial fossa. Consider the sphenoid bone’s unique contributions to different regions of the cranial cavity.

89 / 100

Category: NeuroSciences – Anatomy

A patient who suffered from a road traffic accident is brought to the emergency room with a skull fracture involving bones of the anterior cranial fossa. Which of the following skull bones is most likely to be fractured in this case? – 2023

Think about the inhibitory interneurons that regulate motor neuron activity and prevent overexcitation through feedback loops.

90 / 100

Category: Neurosciences – Physiology

Which of the following types of inhibition is mediated by inhibitory interneurons in the spinal cord and tends to produce the effect of lateral inhibition?

Focus on endogenous opioids released by interneurons that play a central role in inhibiting pain signals.

91 / 100

Category: Neurosciences – Physiology

Which of the following substances is released by interneurons in the dorsal horn of the spinal cord to inhibit ascending pain signals?

Focus on factors directly affecting how fast a signal travels along the fiber, not how far it has to travel.

92 / 100

Category: Neurosciences – Physiology

The speed of a nerve impulse is independent of which of the following factors?

Think about the location of sympathetic ganglia relative to the target organs. Sympathetic fibers must often travel long distances to reach their effectors.

93 / 100

Category: NeuroSciences – Anatomy

Which of the following is not a feature of postganglionic neurons of the sympathetic nervous system? – 2023

94 / 100

Category: Neurosciences – Pathology

The parents of a 9-year-old child take him to a pediatrician because he has become more clumsy and complaining of headaches. For the past three weeks, the child’s parents have noticed that he has trouble using his right hand to grab or pick up items like cups or toys. He also has a significant decline in his ability to draw lines and figures for around two weeks. He’s been complaining about worsening headaches for the previous four days.

The boy has been properly immunized and reached all developmental milestones.
On examination an intention tremor of the right hand is observed. There is a lack of finger-nose coordination and impairment of rapid alternating movements. His further examination revealed that he was unable to stop movement precisely at the intended spot preventing the overshoot. The patient showed deterioration of both fine and gross skilled movements.

An MRI shows a cyst at the junction of vermis and intermediate zone of the right cerebellum. Lumbar puncture showed a slight increase in intracranial pressure.

Which of the following best reflects his inability to perform rapid alternating movements?

Focus on the output neurons of the cerebellar cortex and the type of interneurons that regulate their activity by targeting the soma.

95 / 100

Category: Neurosciences – Histology

Within the cerebellar cortex, a basket-like nest is formed around the soma of which of the following cells? – 2023

96 / 100

Category: Neurosciences – Pathology

The parents of a 9-year-old child take him to a pediatrician because he has become more clumsy and complaining of headaches. For the past three weeks, the child’s parents have noticed that he has trouble using his right hand to grab or pick up items like cups or toys. He also has a significant decline in his ability to draw lines and figures for around two weeks. He’s been complaining about worsening headaches for the previous four days.

The boy has been properly immunized and reached all developmental milestones.
On examination an intention tremor of the right hand is observed. There is a lack of finger-nose coordination and impairment of rapid alternating movements. His further examination revealed that he was unable to stop movement precisely at the intended spot preventing the overshoot. The patient showed deterioration of both fine and gross skilled movements.

An MRI shows a cyst at the junction of vermis and intermediate zone of the right cerebellum. Lumbar puncture showed a slight increase in intracranial pressure.

Which of the following tests best verifies the aforementioned incapacity to halt motion precisely when needed?

Think about the neurotransmitter that directly inhibits neuronal activity by increasing chloride influx, leading to hyperpolarization.

97 / 100

Category: Neurosciences – Pharmacology

Which of the following is an inhibitory neurotransmitter that causes hyperpolarization of neurons?

Focus on risk factors related to immune system weakness, age extremes, or chronic infections, which predispose individuals to encephalitis.

98 / 100

Category: Neurosciences – Pathology

Which of the following is not a risk factor for encephalitis?

Think about the neurotransmitter from the Raphe nuclei that regulates mood and sleep and is involved in promoting NREM sleep.

99 / 100

Category: Neurosciences – Physiology

Which of the following neurotransmitters is released by the Raphe neurons nerve endings is associated with the induction of sleep?

100 / 100

Category: NeuroSciences – Anatomy

Destruction of this tract produces contralateral loss of light touch and pressure sensibilities 2–3 segments below the level of the lesion.

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