Neuro 2020 Combined PDF Past Paper

## Medical School Exam ### Question 1 **The blood brain barrier is not found in one of the following areas** Select one: - The cerebellum - The primary visual area in the occipital lobe - The organum vasculosum of the lamina terminalis (OVLT) - The pons - The basal ganglia ### Question 3 **A vi...

## Medical School Exam ### Question 1 **The blood brain barrier is not found in one of the following areas** Select one: - The cerebellum - The primary visual area in the occipital lobe - The organum vasculosum of the lamina terminalis (OVLT) - The pons - The basal ganglia ### Question 3 **A visual exam in an 80-year-old man shows he has a reduced ability to see objects in the upper and lower quadrants of the left visual fields of both eyes but some vision remains in the central regions of the visual field. The diagnosis is** Select one: - retinopathy. - central scotoma - homonymous hemianopia with macular sparing. - lesion of the optic chiasm. - heteronymous hemianopia with macular sparing. ### Question 4 **Higher motor commands originate in all the following centres, except :-** Select one: - cerebral cortex - thalamus - caudate nucleus - None of the above - cerebellum ### Question 17 **The following does not constitute motor innervations pathway to the muscle spindle** Select one: - The final common pathway - Secondary type II fibres - Alpha motor neuron - Beta motor neurons - Descending gamma fibres ### Question 19 **One of the following statements regarding language function is wrong** Select one: - Destruction of the anterior speech area (Broca's area) causes non-fluent (motor) aphasia - The anterior speech area (Broca's area) controls the motor aspects of speech e.g. word production - Destruction of the posterior speech area causes fluent aphasia (jargon aphasia) - The speech disorders are commoner in females than in males - The posterior speech area (Wernicke's area) enables one to understand speech, written language or sign language ### Question 22 **The upper motor neuron impairment produces the following change of muscles tone:** Select one: - flaccidity - none of the above - "cog wheel" rigidity - myoclonia - spasticity ### Question 23 **Cerebellar ataxia is manifested by all the following, except :-** Select one: - resting tremors - staccato speech - dysdiadochokinesia - static tremors - dysmetri ### Question 24 **One of the structures (named below) does not take part in the circulation of the cerebrospinal fluid (CSF) as outlined below** Select one: - From the two lateral ventricles though the foramina of Monroe into the third ventricle - Up towards the superior sagittal sinus where arachnoid granulations enable 70% of the CSF to entre the sinus blood down - Via the sub arachnoid space of the mid brain into the fourth ventricle - Through the two lateral foramina of Luschka and the medial foramen of Magendie to the sub arachnoid space of the brain and the spinal cord - 30% of the CSF flows down following the olfactory receptor nerve sub arachnoid space to entre the lymphatics of the nasal mucosa which drain into the neck lymphatics ### Question 26 **Functions of basal ganglia include all the following, except :-** Select one: - planning of voluntary movements - executing learned pattern of movement. - programming of voluntary movements - postural regulation - initiation of reflex movement. ### Question 27 **In many elderly individuals** Select one: - The hippocampus shows evidence of dysfunction - Retrograde amnesia is a common memory system dysfunction - Recalling events that they were involved when they were young is much more difficult than recalling events that they participated in more recently - Long term memory works less effectively than short term memory - Some degree of anterograde amnesia can be observed ### Question 28 **Chief inhibitory neurotransmitter in the basal ganglia is:** Select one: - GABA - Dopamine - Acetylcholine - Glutamate - Noradrenaline ### Question 36 **One of the following listed areas is not in the frontal lobe of the brain** Select one: - The frontal eye fields - The pre frontal cortex - The primary motor cortex - The auditory association area - The premotor cortex ### Question 37 **Huntington's disease is a genetic disorder that is** Select one: - autosomal dominant - None of the above - only identifiable after 50 yrs of age. - treatable - not inherited ### Question 41 **Striatum sends stimulatory output to:** Select one: - Substantia nigra - None of the above - External segment of globus pallidus - Internal segment of globus pallidus - Subthalamic nuclei ### Question 45 **A 45-year-old woman who had never needed to wear glasses had trouble reading a menu in a dimly-lit restaurant. She then recalled that as of late she needed to have the newspaper closer to her eyes to read it. Her ophthalmologist told her she was experiencing age-related loss of accommodation for near vision (presbyopis) that is due to** Select one: - relaxation of the sphincter muscle of the iris - the inability to increase the curvature of the lens. - the inability to increase the tension on the lens ligaments - contraction of the ciliary muscle - increased softness of the lens. ### Question 55 **The correct sequence of events involved in phototransduction in rods and cones in response to light is:** Select one: - activation of transducin, structural changes in rhodopsin, closure of cGMPgated cation channels, decrease in intracellular cGMP, and decreased release of glutamate. - decreased release of glutamate, activation of transducin, closure of cGMPgated cation channels, decrease in intracellular cGMP, and structural changes in rhodopsin. - structural changes in rhodopsin, decrease in intracellular cGMP, decreased release of glutamate, closure of cGMP-gated cation channels, and activation of transducin. - structural changes in rhodopsin, activation of transducin, decrease in intracellular cGMP, closure of cGMP-gated cation channels, and decreased release of glutamate. - activation of transducin, decreased release of glutamate, structural changes in rhodopsin, closure of cGMP-gated cation channels, and decrease in intracellular cGMP. ### Question 57 **In relation to Parkinson's disease, all of the following happen except;** Select one: - Facial masking - rigidity in both flexors and extensors - there is static tremors - absence of arm swinging during walking - broad based steps ### Question 59 **One of the following statements regarding the brain's hemispherical specialization is wrong** Select one: - Broca's area of the non-dominant hemisphere does not enable one to tell jokes and stories - Sign language and all other types of non-verbal languages are processed by the areas that process spoken language - Dysfunction of the non-dominant Broca's area make one speak in monotones - Language function is mainly processed and controlled by the left hemisphere - The right hemisphere is concerned with spatio-temporal function of the brain (such as music production and appreciation and 3-dimension analysis) ### Question 60 **Regarding corticospinal (corticobulbar) tract:** Select one: - 30% of corticospinal (corticobulbar) tract is contributed by premotor cortex. - None of the above - 30% of corticospinal (corticobulbar) tract is contributed by motor cortex. - 40% of corticospinal (corticobulbar) tract is contributed by somatosensory cortex. - All of the above ### Question 64 **Saliva secretion is primarily a result of** Select one: - decreased parasympathetic stimulation. - increased somatic motor stimulation. - decreased somatic motor stimulation. - increased sympathetic stimulation. - increased parasympathetic stimulation. ### Question 65 **Which of the following pairing of parts of cerebellum & its function is CORRECT?** Select one: - None of the above - Cerebrocerebellum - motor planning - Spinocerebellum - motor execution - All of the above - Vestibulocerebellum - balance & eye movement ### Question 69 **Higher CNS function does not include** Select one: - Memory - Learning - Sleep. - Consciousness - Thermoregulation ### Question 70 **The propagation of an action potential across a chemical synapse consists of several steps. Which of the following steps is the slowest?** Select one: - Action potential propagation in the post-synaptic membrane - Diffusion of the neuro-transmitter. - Action potential propagation in the pre-synaptic membrane - Exocytosis of the neuro-transmitter - Opening of the receptor-operated channel. ### Question 72 **A medical student is studying neurons that are part of a descending pain modulating pathway. What brain region is correctly paired with the neurotransmitters it releases and the location where the neurotransmitter is released?** Select one: - Periaqueductal gray releases dynorphin in the rostral ventromedial medulla. - Nucleus raphe magnus releases serotonin in the dorsal root ganglion. - Locus coeruleus neurons release serotonin in the nucleus raphe magnus. - Periaqueductal gray neurons release endorphins in the spinal dorsal horn. - Locus coeruleus neurons release norepinephrine in the spinal dorsal horn. ### Question 75 **Regarding motor lesions;** Select one: - Upper motor neuron lesions produce flaccidity - Upper motor neuron lesions may produce atrophy in long standing cases - there are no weakness or paralysis in lower motor neuron lesions - hyperreflexia may be produced in lower motor neuron lesions - Upper motor neuron lesions shows a negative Babinski sign ### Question 79 **The magnocellular units where posterior pituitary nanopeptides are synthesized are found in** Select one: - Arcuate area of the hypothalamus - The cerebral cortex - Ventromedial nucleus of hypothalamus - Preoptic and paraventricular nuclei - The thalamus ### Question 82 **The crista ampullaris is sensitive to :-** Select one: - sound vibrations - linear acceleration - all of the above - force of gravity - angular acceleration ### Question 83 **The gross barriers that protect the brain from damage are** Select one: - The scalp - The arachnoid - The epi-Dural space - The dura mater - The hair ### Question 84 **Cerebellum receives input from the following sites EXCEPT:** Select one: - All of the above - Motor cortex - Labyrinth & vestibular nuclei - Visual impulses from tectum - Somatosensory pathways ### Question 86 **The following areas in the brain have no Blood Brain Barrier EXCEPT** Select one: - The infundibulum that connects the hypothalamus to the pituitary gland - The posterior lobe of the cerebellum - The Organum Vasculosum Lamina Terminalis - The Sub-fornical Organ of the third ventricle - The Area Postrema which overlies the vomiting centre ### Question 89 **One of the following statements regarding the electroencephalogram (EEG) is wrong** Select one: - Can be used for diagnosing whether the brain is alive or dead in intensive care units for patients who are maintained by life-support machines - Is used for diagnosing different types of epilepsy - Is the same as the electrocorticogram when the electrodes are placed directly over the surface of the brain after opening the skull - Can be used for studying the activity of single neurons - Is a recording waves of the electrical activity of the brain with electrodes placed on the scalp? ### Question 91 **One of the following is not an EEG wave** Select one: - Theta - T - Delta - Beta - Alpha ### Question 92 **Destruction of cerebellum leads to the following EXCEPT:** Select one: - Hypertonia - Impaired learning of coordination of repetitive tasks - Ataxia - Dysdiadochokinesia - Dysmetria ### Question 93 **Actions of Cortisol include** Select one: - Increasing fibroblast activity and accelerating wound healing - profound diuretic effect - Accelerating glycogenesis and glycogen storage - Synergizing with insulin to promote entry of glucose into cells - inhibiting mast cells response and allergic response ### Question 94 **One of the steps regarding the way in which the brain executes voluntary movements is incorrect** Select one: - Nerve impulses are sent to the pre motor cortex and the visual cortex - The decision to carry out the movement is made in emotion and motivation brain (the cingulate gyrus and the pre frontal lobe) - The pre motor cortex sends impulses to primary motor cortex - The primary motor cortex then sends nerve impulses via descending pathways to lower centres and finally the brain stem and the spinal cord to activate the specific alpha motor neurons to stimulate the muscles required for the voluntary muscle movement - The premotor cortex rehearses the sequence of muscle movement pattern required ### Question 95 **Neural transplantation in Parkinson's disease has been found to be generally effective:** Select one: - Under no circumstances - If the patient is under 60 yrs of age and immunosuppressant treatment is given - If the patient is over 60 yrs of age and immunosuppressant treatment is given - only if the transplant came from multiple donors. - immunosuppressants do not help ### Question 101 **One of the sequential processes, listed below, which the brain executes in learning new verbal facts and committing them to memory, is incorrect** Select one: - The sensory memory holds all the information and noise coming from the ears for seconds - The short-term memory processes trigger long term memory processes in the association and pre frontal cortex which causes permanent neuronal and synaptic changes which are called long term memory - The emotion brain and the central executive area of the prefrontal lobe decide to learn the verbal information - The information is transferred to the short-term memory systems in the hippocampus, the prefrontal and occipital lobes - The information triggers active neuronal processes in these areas lasting from minutes to days in the form termed short term memory ### Question 102 **Pain Sensation: -** Select one: - produces reactions that block transmission of pain impulses - occurs when the stimulus causes damage of the sensory receptors - is evoked by strong stimulation of specific receptors - none of the above - arises from small encapsulated receptors ### Question 105 **One of the following terms is not used for classifying human memory** Select one: - Declarative - Sensory - Long term - Short term - Retroactive ### Question 109 **Which of the following parts of the eye has the greatest concentration of rods?** Select one: - Fovea - Parafoveal region - Optic disk - Iris - Ciliary body ### Question 111 **The following areas in the central nervous system are not involved in the direct control of higher CNS functions** Select one: - The temporal lobe of the brain - The limbic system - The lumbar spinal cord - The pre-frontal lobe of the brain - The posterior part of the parietal lobe ### Question 112 **Vertigo :-** Select one: - is a post-rotational sense of being rotated toward opposite side of original rotation - is a rotational sense of being rotated toward same side of original rotation - is a rotational sense of being rotated toward opposite side of original rotation - the responses in b and c - is a post-rotational sense of being rotated toward same side of original rotation ### Question 113 **One of the following statements regarding language function is wrong** Select one: - The older a person is the easier it is for them to learn new languages - Allowing children to be fluent in their mother tongue enables them to learn foreign languages better. - There is no natural language which is inferior or superior to any other one - All world languages can be classified as either tonal or non-tonal language - Most of the mother tongues in Kenya are tonal ### Question 116 **Polysynaptic reflexes does not serve to** Select one: - translocate the entire organism from danger spot - regulate the rate of change of muscle fibre length - withdraw affected part of the body from danger - keep the withdrawn part away from danger - preserve the entire organism ### Question 118 **The EEG has the following waves forms EXCEPT** Select one: - T - Beta - Delta - Gamma - Theta ### Question 133 **Which of the following statement regarding vision is FALSE?** Select one: - Binocular vision relies on the fusion of images from the central visual field of both eyes at the cortical level. - Depth can be perceived by monocular vision alone. - Bilateral occipital cortical destruction results in subjective blindness but the subject still has residual responses to visual stimuli. - Lesions in the lateral geniculate nuclei result in contralateral heteronymous hemianopia with normal pupillary reflex. - Visual acuity is a measurement of visual threshold. ### Question 134 **Huntington's disease and Parkinson's disease are examples of;** Select one: - dementia - Extrapyramidal disorders - gabaergic disorders - perceptual disorders - dopaminergic disorders ### Question 139 **A 62-year-old man went to his ophthalmologist for his routine eye exam. It included ophthalmoscopy to visualize the interior surface of his eye, opposite to the lens. This portion of the eye is called** Select one: - the conjunctiva. - the sclera. - the fundus. - the macula. - the optic disk. ### Question 142 **One of the following structures is not part of the Papez emotion circuit** Select one: - The cingulate gyrus - The hippocampal gyrus - The anterior thalamus - The hypothalamus - The primary visual cortex ### Question 149 **With relation to lesions in the basal ganglia'** Select one: - None of the above - Change in muscle tone always leads to hypertonia - there is no involuntary movement - tremor may be present during movement (intentional tremor) - All of the above