-
Question 1
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: Brown-Sequard syndrome
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
-
-
Question 2
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: Contralateral homonymous hemianopia
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
-
-
Question 3
Correct
-
Which of the following statements is correct regarding paracetamol?
Your Answer: Liver damage peaks 3 to 4 days after paracetamol ingestion.
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
-
-
Question 4
Incorrect
-
Which of the following is NOT an adverse effect of amitriptyline:
Your Answer: Narrow-angle glaucoma
Correct Answer: Hypokalaemia
Explanation:Adverse effects include:
Antimuscarinic effects: Dry mouth, Blurred vision, Constipation, Urinary retention, Sedation, Confusion
Cardiovascular 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
-
-
Question 5
Correct
-
Which of the following clinical features would you least expect to see in a lesion of the frontal lobe:
Your 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
-
-
Question 6
Correct
-
In which of the following cases is intravenous phenytoin contraindicated?
Your Answer: Second degree heart block
Explanation:Phenytoin Contraindications include:
Hypersensitivity
Sinus bradycardia
Sinoatrial block
Second and third degree A-V block
Adams-Stokes syndrome
Concurrent use with delavirdine
History of prior acute hepatotoxicity attributable to phenytoin -
This question is part of the following fields:
- Central Nervous System
- Pharmacology
-
-
Question 7
Incorrect
-
Which of the following clinical features is most suggestive of a lesion of the frontal lobe:
Your Answer: Hemispatial neglect
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
-
-
Question 8
Incorrect
-
What is the main mechanism of action of cyclizine:
Your Answer: Dopamine-D2 antagonist
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
-
-
Question 9
Incorrect
-
Which of the following clinical features is most suggestive of a lesion of the temporal lobe:
Your Answer: Hemispatial neglect
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
-
-
Question 10
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
-
SESSION STATS - PERFORMANCE PER SPECIALTY
