2024 Physiology MCQ Module 2 Part 1

Question 1

• A 72-year-old man experienced frequent falls
• Symptoms included generalized rigidity, bradykinesia, and exaggerated gag reflex
• Possible diagnoses included Myasthenia gravis, Frontotemporal dementia, Parkinson's Disease, Corticobasal degeneration, and Lewy body dementia

Question 2

• Patient was unconscious with extension of both upper and lower extremities
• This posture suggests a lesion at the midbrain level

Question 3

• Lesions of the frontal lobe affect a person's attitude towards pain, not intensity
• Nerve lesions cause permanent pain loss
• Thalamus lesions increase pain thresholds
• Endorphins and enkephalins influence pain transmission
• Referred pain is felt in a peripheral site, associated with deep visceral trauma

Question 4

• Majority of pyramidal tract axons do not synapse directly on spinal motoneurons
• Vestibulospinal tract controls extensor, not flexor, motor neurons in the lumbar spinal cord
• Tectospinal tract neurons control head and body orientation
• Complete pyramidal tract section in the medulla causes permanent motor imprecision
• Rubrospinal tract significantly affects axial and girdle musculature

Question 5

• Hemicholinium block prevents choline uptake
• Choline uptake is mediated by Ca2+-dependent carriers
• Vesamicol inhibits ACh vesicle storage
• ACh is hydrolyzed by acetylcholinesterase (AChE)
• ACh is synthesized in the varicosity

Question 6

• Albuterol is a sympathomimetic drug that only activates beta2-adrenoceptors

Question 7

• A 53-year-old woman has 6-month history of difficulty rising from a chair and lifting
• Also experienced rash on the hands and eyelids
• Possible diagnosis is Motor Neurone Disease, Dermatomyositis, Myasthenia gravis, Vitamin B12 deficiency, and Myotonic dystrophy

Question 8

• Depolarization of cochlear hair cells involves entry of Na+ ions
• Adequate stimulus is sound waves
• K+ ions exit during depolarization
• Mechanical shearing stimulates cation entry
• Cochlear nerve action potentials are generated without synaptic transmission

Question 9

• Klumpke's paralysis often follows a fall
• Causes paralysis and wasting of hand muscles
• Horner syndrome is an associated symptom
• Caused by traction on the abducted arm
• Associated with C5-C6 root injury

Question 10

• Wilson's disease is caused by low copper levels

Question 11

• Apraxia is the inability to make voluntary movements related to object use

Question 12

• A 50-year-old woman demonstrates loss of pain, temperature, vibratory, and proprioception in her left leg
• Possible explanations include peripheral neuropathy, tumor affecting the right posterior paracentral gyrus, tumor on the right lumbar ventrolateral spinal cord, tumor on the left medial lemniscal pathway in the sacral spinal cord, or tumor on the right medial lemniscal pathway in the sacral spinal cord.

Question 13

• A patient with loss of vision in the left-most part of their left visual field may have a lesion in the right optic tract, left optic nerve, optic chiasm, right optic nerve, or left optic tract.

Question 14

• Phenylephrine is a sympathomimetic drug that activates alpha adrenoceptors.

Question 15

• Symptoms not associated with autonomic neuropathy in a diabetic patient include Stridor

Question 16

• Classic features of Parkinson's disease include Chorea, Akinesia, Tremor at rest, and Rigidity

Question 17

• Antagonistic control of efferent output is typical of the autonomic division

Question 18

• Cognitive impairment, ataxia, myoclonus, and behavioral changes suggest Lewy body dementia, Creutzfeldt-Jacob disease, Alzheimer's disease, or Huntington's disease.

Question 19

• Bilateral lower limb weakness in a 22-year-old woman points to a lesion in the left genu of the internal capsule, a lesion caudal to the pyramidal decussation, a lesion rostral to the pyramidal decussation, the right posterior limb of the internal capsule, or the right genu of the internal capsule

Question 20

• The parasympathetic division of the nervous system is dominant in resting and digesting. Ganglia are near target organs and Epinephrine (not a key neurotransmitter for the parasympathetic pathway)

Question 21

• Sympathetic drive to the heart increases in excitement, exercise, and hypotension, but not during a vasovagal attack or when parasympathetic drive increases

Question 22

• Autonomic nervous system functions include blood pressure, heart rate, water balance, and temperature regulation.

Question 23

• Upper quadrant hemianopia is due to a lesion in the occipital lobe

Question 24

• Intense stimulation of any peripheral nerve fiber does not always result in pain
• A Brown-Sequard syndrome leads to contralateral pain/thermal loss, ipsilateral loss of pain/thermal; below the lesion
• Visceral pain is poorly localized and often radiates
• Visceral hollow organs are not sensitive to touch and temperature

Question 25

• Phototransduction in rods and cones involves activation of transducin, structural changes in rhodopsin, closure of cGMP-gated cation channels, decreased intracellular cGMP, and decreased glutamate release

Question 26

• Cerebral autoregulation maintains blood flow at 50 mL/min/100 g of brain. Neural activity doesn't lead to ATP formation. ADP is a weak vasodilator, and increased metabolism is associated with increased oxygen consumption and decreased carbon dioxide.

Question 27

• Both cold and warmth receptors are stimulated in the temperature range of 30–38°C

Question 28

• Mean arterial pressure is shown by curve
• Partial pressure of oxygen is shown in curve
• Passive collapse at phase
• Normal autoregulation at phase
• Partial pressure of carbon dioxide is shown in curve A.

Question 29

• Glutamate and glycine, Nicotine and trimethaphan, Acetylcholine and phenylephrine, Strychnine and atenolol, or Nicotine and atropine

Question 30

• Agnosias involve damage to the posterior parietal cortex, sensory neurons, ventral posterior nucleus of the thalamus, or posterior parietal cortex

Question 31

• The synaptic contacts of Purkinje cell axons are all inhibitory. Cerebellar projection of proprioceptors & exteroceptive impulses from limbs are ipsilateral. Direct electrical cerebellar cortex stimulation cannot cause discrete muscle contractions. Purkinje cells have efferent axons leaving the cerebellar cortex.

Question 32

• Urinary frequency, urgency, and nocturia in Parkinson's Disease patients with prostatic hypertrophy is a problem, not directly attributable to Parkinson's itself
• Shoulder pain in Parkinson's patients warrants orthopedic evaluation
• REM sleep behavior disorder in patients with parkinsonism may indicate Lewy body dementia, not idiopathic Parkinson's
• Constipation is a frequent early symptom in PD; it may precede motor symptoms

Question 33

• Acetylcholine is not the chemical transmitter at all postganglionic sympathetic endings
• Atropine blocks acetylcholine

Question 34

• Tetany is increasing the frequency of stimulation to cause muscle contraction without relaxation

Question 35

• Liepmann's patient MT's damage involved the left hemisphere and corpus callosum; their inability to make spontaneous hand movements with either hand, and couldn't follow commands to use objects; Left hemisphere and the corpus callosum. Their inability to mimic actions with the left hand but making spontaneous actions with the right hand revealed involvement of the left hemisphere and corpus callosum. Inability to recognize visual objects revealed involvement of the right hemisphere.

Question 36

• Heat stroke, hypothalamic lesion, sedative drug intoxication, pontine hemorrhage, and status epilepticus

Question 37

• The Tympanic membrane does not modify sound frequencies
• It bulges outwards when the Eustachian tube is blocked.
• It stops vibrating almost immediately after the sound ends
• Its effectiveness is increased when the middle ear muscles contract

Question 38

• Mean arterial pressure is demonstrated by curve C
• Partial pressure of oxygen is illustrated by curve B
• A phase D corresponds to normal autoregulation
• Phase represents the loss of normal autoregulation
• Partial pressure of carbon dioxide is represented by curve A

Question 39

• The amygdala is not an autonomic control center

Question 40

• A fibres are less susceptible to hypoxia than B fibres
• A fibres are more sensitive to pressure than C fibers
• Motor nerves are affected more by sleep than sensory fibers
• Sensory nerves are closer to bone and less affected by pressure
• C fibers are more sensitive to pressure than A fibres

Question 41

• Cerebrospinal fluid contains less K+ and glucose than plasma

Question 42

• The lesion in internuclear ophthalmoplegia is in the right medial longitudinal fasciculus (MLF)

Question 43

• Glutamate is synthesized in glia, stored in vesicles, released into the synaptic cleft by Ca2+ influx, acts on ion channels, and inactivated by reuptake
• Serotonin is synthesized from tryptophan, stored in vesicles, released into the synaptic cleft, acts on GPCRs (G protein-coupled receptors), and inactivated by reuptake
• Norepinephrine is synthesized from phenylalanine; stored in vesicles, released by depolarization, binds to ion channels or GPCRs, and inactivated by reuptake.
• Acetylcholine is synthesized from acetyl coenzyme A and choline; stored in vesicles; released by depolarization; acts on ion channels; and inactivated by enzymatic degradation

Question 44

• Locus coeruleus neurons release norepinephrine in the spinal dorsal horn
• Periaqueductal gray releases endorphins into the dorsal horn
• Locus coeruleus neurons release serotonin in the nucleus raphe magnus.
• Periaqueductal gray releases dynorphin into the rostral ventromedial medulla
• Nucleus raphe magnus releases serotonin in the dorsal root ganglion

Question 45

• Recruitment and activation of motor units is assessed through electromyography, clinical examination of tendon jerks, nerve action potential recordings

Question 46

• The posterior parietal cortex is involved in initiating saccadic eye movements

Question 47

• Preganglionic neurons have cell bodies in the ganglia

Question 48

• Recruitment and activation of motor units are assessed through electromyography, clinical examination of tendon jerks, nerve action potential recordings

Question 49

• Dopamine is low in Parkinson's Disease

Question 50

• A PET scan of a patient with missing hand (phantom limb pain) might show expansion of the right hand area of the left primary somatosensory cortex, projection of fibers from neighboring sensory areas into the right-hand area of the left primary somatosensory cortex, or expansion of the right hand area in the right primary somatosensory cortex.

Question 51

• Four diseases associated with basal ganglia damage include Hemiballismus, Chorea, Parkinsonism, and Athetosis

Question 52

• Apathy, lack of motivation, poor judgment, and improper social behavior suggest frontal lobe dysfunction

Question 53

• Alzheimer's disease post-mortem studies show shrinkage of frontal and temporal gyri.

Question 54

• Ideomotor apraxia is the inability to perform movements involving planning and error commission

Question 55

• Decreasing cerebral blood flow (CBF) below 20 mL/100 g/min results in cell membrane ion pump failure, leading to loss of transmembrane electrochemical gradients

Question 56

• Brown-sequard syndrome is commonly caused by traumatic injury, has a good prognosis, involves ipsilateral motor deficits, and contralateral loss of pain and temperature.

Question 57

• Visceral pain is poorly localized, radiates to a distant somatic area, often accompanied by sweating, and relayed to the cortex via the spinothalamic tract.

Question 58

• Current neuroimaging research about Gilles de la Tourette syndrome suggests dysfunction of the connection between basal ganglia and the ORB, dysfunctional connections within the basal ganglia, and/or dopamine abnormalities.

Question 59

• Increased intracranial pressure compliance at D shows higher compliance. Minimum compliance at B. Increased risk of cerebral edema/herniation at C. Collapse of cerebral microvasculature at A

Question 60

• Deep brain stimulation targets the thalamus to treat essential tremor

Question 61

• Exaggerated gag reflex, dysphagia, brisk jaw jerk, and spastic tongue are seen in pseudobulbar palsy.

Question 62

• Huntington's disease and Parkinson's disease are examples of dopaminergic disorders

Question 63

• Inappropriate use of objects is called Ideational apraxia

Question 64

• Frontotemporal dementia is characterized by frontal lobe symptoms and possesses a specific histology

Question 65

• A ventrolateral cordotomy relieves pain by interrupting the right ventrolateral spinothalamic tract

Question 66

• Uptake of dopamine into vesicles is blocked by reserpine

Question 67

• L-Dopa increases dopamine availability, Prozac increases serotonin availability

Question 68

• Seizers are not secondary brain injuries

Question 69

• Facial expression or muscle weakness are not true lesions of the extrapyramidal tract

Question 70

• Incorrect association between receptor and stimulus includes Pacinian corpuscle and pressure, muscle spindle and tapping of the patellar tendon, receptor cells of the utricle and linear acceleration of the head, receptor cells of the auditory system and basilar membrane movement, and rod photoreceptors and red light.

Question 71

• Neuroleptic drugs that block dopamine D2 receptors, do not increase coprolalia in Tourette's syndrome, may reduce depression, reduce coprolalia in Tourette's syndrome, or increase anxiety

Question 72

• Neuronal inhibition at some CNS sites may not be directly associated with the release of the neurotransmitter glycine, GABA, or nonspecific increases in postsynaptic neuron conductance

Question 73

• The neuropathologic feature prominent in Parkinson's disease is the loss of cholinergic pathway in the neostriatum and globus pallidus

Question 74

• Basal ganglia function includes control of movement, planning and programming of movements, cognition, and initiating movement

Question 75

• Receptors 1 is an innocuous warm receptor, receptor 2 is a thermal nociceptor, receptor 3 is an innocuous cold receptor

Question 76

• Most of the inhibitory synapses are found on the dendrites

Question 77

• The hypothalamus, pons, and medulla are involved in autonomic nervous system control

Question 78

• A patient with increased sensitivity to light and nausea after consuming foods high in tyramine while taking a MAOI inhibitor is likely experiencing a hypertensive crisis

Question 79

• The Meissner corpuscle responds to skin stretch stimuli
• Ruffini corpuscles detect sustained pressure.
• Merkel cells respond to slow vibration, Pacinian corpuscles respond to rapid vibration, and naked nerve endings are associated with touch.

Question 80

• Extra-hypothalamic parasympathetic outflow control sites include the central nucleus of the amygdala, parabrachial nucleus, dorsal sensory nucleus of the vagus, the nucleus ambiguus, and the raphe nuclei

Question 81

• The greatest corticospinal tract deficit occurs in the hand

Question 82

• Parkinson's disease onset usually occurs between the ages of 70-85 years

Question 83

• A 28-year old female patient with retinal detachment experiences pain when exposed to a temperature of 40°C. This suggests thermal nociceptors and allodynia, as the sensation should not be painful.

Question 84

• The most pronounced feature of Huntington's disease is involuntary choreiform movements and dementia.

Question 85

• Thalamic surgery leads to reduced tremor and rigidity

Question 86

• Damage to the oculomotor nerve can lead to incomplete pupillary light reflex in the same eye, not the other eye
• Contraction of the sphincter muscle of the iris is noradrenergic
• Pupil dilation happens simultaneously to near (accommodation/convergence) fixation, not when the pupils are dilated
• The pupil light reflex afferent pathway is from the retina to the lateral geniculate nucleus.

Question 87

• Types of cerebral edema include cellular (injury to glial, neuronal, and endothelial cells), osmotic (cells withdraw water form plasma causing edema), cytotoxic (lack of homeostasis mechanisms and intracellular edema, commonly in strokes). and vasogenic (BBB disruption causing interstitial flow).

Question 88

• Colorblindness is more common in men than women due to a recessive gene on the X chromosome

Question 89

• The most crucial hypothalamic nucleus in the central autonomic network is the paraventricular nucleus (PVN)

Question 90

• High ratio of photoreceptors to ganglion cells in the fovea, and abundance of blood vessels promote acuity because of the high metabolic demands of the specialized area.

Question 91

• Facial nerve, glossopharyngeal nerve, vestibulocochlear nerve are pain insensitive

Question 92

• False statement about CSF circulation is the arachnoid granulations are in contact with the endothelial cells of the venous sinuses, not the cells of the choroid plexus

Question 93

• The medial lemniscus carries touch and proprioceptive information

Question 94

• Lesion in the left superior temporal gyrus causes difficulty with speech, but patient understands speech. It is not left inferior temporal or superior.

Question 95

• False statement is that cerebellar lesions cannot affect speech

Question 96

• Chronic administration of antacids, H2 receptor antagonists, and proton pump inhibitors does not increase gastrin levels.

Question 97

• The inner nuclear layer of the retina is comprised of bipolar cells, horizontal cells and amacrine cells

Question 98

• Huntington's disease is an autosomal dominant genetic disorder; not necessarily identifiable after 50 years, treatable, or non-inherited

Question 99

• Propagation of neuronal action potentials is facilitated by gap junctions; tight junctions form the BBB & selective permeability of the brain's capillaries is affected; Selective permeability of the brain capillaries is lost with gap junction disruption

Question 100

• Sensory coding attributes include modality, location, intensity, duration