Page 1 of 19
SCMD 4000 - Block Examination 3, Neurosciences MCQ 2009
Group No: _________
Seat No: _____________ Student No: _________________
UNIVERSITY OF THE WITWATERSRAND,
JOHANNESBURG
Faculty of Health Sciences
MB BCh IV / GEMP II
INTEGRATED BASIC MEDICAL
AND HUMAN SCIENCES
(SCMD 4000)
Block Examination 3 (NEUROSCIENCES)
Paper 1
MCQ Model Answers
Venue: _____________________________________
Group Number:
_____________________________
Seat Number:
_____________________________
Student Number: _____________________________
Time allowed: 120 minutes
Date: 15th October 2009
Page 2 of 19
SCMD 4000 - Block Examination 3, Neurosciences MCQ 2009
Group No: _________
Seat No: _____________ Student No: _________________
GENERAL INSTRUCTIONS
Please read the following carefully:
1. There are 60 multiple choice questions (MCQ’s) in this paper.
2. Two (2) minutes have been allocated per question.
3. Write your group number, seat number and student number on each page of this
question paper.
4. Please hand in all cellphones, calculators and removable drives prior to the start of the
examination.
5. You may not remove any question papers from the examination room.
A-TYPE QUESTIONS
Select the single best answer to each question. (Note: several options may be correct
but only one is the best answer.)
Answers must be entered on the question paper and online.
If you give more than one answer for a question, you will score zero for that question.
There will be no penalty for incorrect answers.
If you do not know an answer you may leave it blank, in which case you will neither earn
a mark nor be penalised.
X-TYPE QUESTIONS
There is at least one correct statement and at least one incorrect statement.
Identify BOTH the correct and incorrect statements.
Answers must be entered on the question paper and online.
If you are unsure of a statement do not leave it blank (Tick the “Don’t know” box)
Negative marking will be applied to wrong answers but negative marks will not be carried
forward. This means the minimum mark for a question is zero.
R-TYPE QUESTIONS
Here you are offered a number of answers. This is followed by a set of questions.
Select the single best answer to each question.
Note that each answer may be used more than once or not at all unless you are
specifically instructed otherwise.
Fill in your answers in the spaces provided on the question paper and online.
If you do not know an answer you may leave it blank, in which case you will neither earn
a mark nor be penalised.
Note: Each A-type, X-type and R-type question has the same mark value.
Answers must be entered on the question paper and online.
Please SUBMIT your exam.
Page 3 of 19
SCMD 4000 - Block Examination 3, Neurosciences MCQ 2009
Group No: _________
1.
Seat No: _____________ Student No: _________________
A - Types
Mr. B, a 57 year old retired schoolteacher was brought into casualty this morning in a wheelchair by
his daughter. She says that he has been unsteady on his feet since last night, and is now unable to
stand up without falling over to his left side. Following a CT scan, it is discovered that Mr B has
developed a thrombosis of the posterior spinal artery on the left side, interrupting the ascending tracts
of the posterior column of the spinal cord on that side.
Which of the following statements most applies to Mr B?
a. He will be unable to perceive pain and temperature on the right side of his body
b. He will not have 2-point tactile discrimination sense on his left side.
c. He has right-sided sensory ataxia
d. Position sense will be lost, but vibration sense will be intact on the affected side.
e. He has a condition called the Brown-Sequard syndrome
2.
The development of the neural tube is a crucial aspect of embryonic development and leads to the
formation of the brain and spinal cord. Initially the neural tube extends into the caudal part of the
developing embryo but due to changes in its growth and that of its surroundings, it will appear to
retreat up the developing vertebral column.
At
3.
birth, the conus medullaris of the spinal cord lies at the level of:
a. lumbar vertebra 7
b. sacral vertebra 5
c. the disc between lumbar vertebra 1 and 2
d. lumbar vertebra 3
e. the disc between sacral vertebra 1 and 2.
In the case of the abnormality spina bifida, experimental studies have shown that the abnormality in
the vertebral column is due to an underlying defect/disruption in neural tube development. Thus, spina
bifida is often accompanied by defects in the neural tube and its meningeal coverings.
The condition described as spina bifida meningocoele consists of a:
a. A neural tube as well as the vertebral arch which have both failed to close
b. Herniated meningeal sac often filled with cerebrospinal fluid, which protrude through a
deficiency of the vertebral arches.
c. Both a normal spinal cord and meninges but with a spino-laminar defect affecting one or more
vertebrae. The effected portion of the back is covered with normal skin.
d. A herniated spinal cord covered by meninges which protrude through the vertebral deficiency.
e. An intact neural tube, covered by meninges and intact vertebral arches
4.
Regarding oculomotor control, when the head moves right, the eyes:
a. Move separately to each other
b. Move to the right
c. Move up and to the right
d. Move down and to the left
e. Move to the left
Page 4 of 19
SCMD 4000 - Block Examination 3, Neurosciences MCQ 2009
Group No: _________
5.
Seat No: _____________ Student No: _________________
A 17-year-old male presents with a four-day history of auditory hallucinations, delusions of grandeur
and disorganized behaviour. A collateral history reveals that his mother died unexpectedly one day
prior to the onset of his symptoms. This is his first psychiatric presentation and he does not abuse
substances. On mental status examination he is oddly groomed and has formal thought disorder. His
physical examination is normal. He is treated and recovers totally within 2 weeks, with full return to his
premorbid level of functioning.
The most likely diagnosis in this case is:
a. Brief Psychotic Disorder
b. Schizophreniform Disorder
c. Bipolar mania episode with psychosis
d. Schizophrenia
e. Schizoaffective Disorder
6.
A 40-year-old man sees you due to poor sleep two weeks after he was held up at gunpoint. He has
experienced difficulty falling or staying asleep as well as difficulty concentrating. He reports avoidance
of reminders of the event and has intrusive recollections.
The most likely diagnosis is:
a. Acute Stress Disorder
b. Adjustment disorder
c. Dysthymia
d. Major depression
e. Post Traumatic Stress Disorder
7.
A 25-year-old man reports intrusive concerns about having hit pedestrians while driving and turns back
to check his route while driving. He has to recount money before bank deposits several times and has
intrusive distressing thoughts that he may hurt his young son. He feels his anxiety is unreasonable.
His most likely diagnosis is:
a. Adjustment disorder
b. Generalized anxiety disorder
c. Obsessive compulsive disorder
d. Simple phobia
e. Social phobia
8.
A 29-year-old man reports ongoing anxiety about his health despite extensive medical investigations.
He has had 2 episodes of right-sided chest pain with shortness of breath and palpitations without any
clear precipitant. He is now avoiding social events after the original attack at a social event.The most
likely diagnosis is:
a. Adjustment Disorder without agoraphobia
b. Generalized Anxiety Disorder without agoraphobia
c. Panic Disorder with agoraphobia
d. Social Phobia with agoraphobia
e. Social Phobia without agoraphobia
Page 5 of 19
SCMD 4000 - Block Examination 3, Neurosciences MCQ 2009
Group No: _________
9.
Seat No: _____________ Student No: _________________
The family brings a 35-year-old woman after conflict at home. She has not slept for two nights and
believes she is a prophet in the church. She became violent after an argument at home as the family
did not support her plans to start a new business. When seen she is very talkative and reports
increased energy. She suddenly starts crying and says she wishes she were dead, as her family have
rejected her.
The most likely diagnosis is:
a. Major depression with psychosis
b. Bipolar Type I - mania
c. Bipolar Type II - depression
d. Schizoaffective disorder
e. Personality disorder with dissciation
10. A 65-year-old man has a 5-day history of confusion that is worse at night. He is disorientated for the
place and date. He is fearful about his safety and reports hearing the voice of a man who wants to kill
him. He was moved into an old age home 1 month ago. He appears sedated but has had no
medication you are told.
The most likely diagnosis is:
a. Adjustment Disorder
b. Delirium
c. Dementia
d. Brief Psychotic Disorder
e. Acute Stress Disorder
11. A child of 12 years is referred to the local Mental Health Clinic, with complaints from his teachers that
he is under performing. He is described as 'too playful' and has poor concentration. His parents have
frequent heated quarrels with him, usually about his failure to complete his homework. He dislikes
school and has been truant in the past. He has repeated grade 2 and is now in grade 3 and is
performing below average. His worst subjects are reading, writing and spelling. He has also recently
developed bullying.behaviour towards his younger sister, who is doing well at school.
The most appropriate first step in management would be:
a. Taking a detailed family history of psychiatric disorders
b. Administering psycho-educational tests
c. Ordering blood tests to assess liver function, FBC and glucose levels
d. Administering a self-report questionnaire to assess if he is depressed
e. Organising a social work referral to investigate the child's home circumstances
12. Which of the following is the correct definition for coma?
a. Its state of quadriplegia, vertical eye movements and inability to talk
b. Its a state of disturbed consciousness with motor restlessness, hallucinations and disorientation
c. Its a state of drowsiness and unresponsiveness to external stimuli
d. Its condition characterized by brief loss of consciousness, followed by full recovery without focal
signs
e. Its a state of continuous fits with recovery of consciousness between the intervals of fits
Page 6 of 19
SCMD 4000 - Block Examination 3, Neurosciences MCQ 2009
Group No: _________
Seat No: _____________ Student No: _________________
13. Mr John Mlambo who was involved in a motor vehicle accident is brought to you in the emergency
department. On examining him you find that he cannot open his eyes, he localizes to pain and is
unable to talk and can only make sounds.
What is the correct Glasgow Coma Scale (GCS)?
a. GCS = 14
b. GCS = 5
c. GCS = 6
d. GCS = 8
e. GCS = 12
14. Mr Jerry Vilakazi, a known hypertensive patient who often defaults treatment presents to the
emergency medical department, with left hemiplegia and dilated right pupil.
Which of the following are appropriate investigation/s in this case scenario?
a. A full blood count (FBC), urea and electrolytes and (U+E)
b. Skull x-ray
c. Skull bone scan
d. Cranial ultrasound
e. CT-Brain/MRI Brain
15. X - Types
Regarding the functional and anatomical divisions of the cerebellum
a. The neocerebellum is involved with maintaining
balance.
True
False
b. The archicerebellum is composed of the
flocculonodular lobe and fastigial nucleus.
True
False
c. The archicerebellum receives afferent fibres from
the vestibular nuclei.
True
False
d. The paleocerebellum is composed of the cerebellar
hemispheres and dentate nucleus.
True
False
e. The paleocerebellum is involved with the
maintenance of muscle tone and posture.
True
False
Page 7 of 19
SCMD 4000 - Block Examination 3, Neurosciences MCQ 2009
Group No: _________
Seat No: _____________ Student No: _________________
16. Concerning sensory pathways of the nervous system:
a. The lateral spinothalamic tract conveys pain and
temperature impulses for the contralateral side of
the body.
True
False
b. The branches of fibres which transmit pain
impulses may ascend up to 10 spinal levels before
decussating.
True
False
c. The dorsal columns convey proprioception and
discriminative touch for the contralateral side of the
body.
True
False
d. Fibres within the fasciculus gracilis of the dorsal
column transmit impulses from the lower limbs.
True
False
e. Fibres of the ventral (anterior) spinocerebellar
tracts pass through the inferior cerebellar peduncle.
True
False
a. Fibres of the corticospinal tracts form the fasciculi
cuneatus and gracilis.
True
False
b. The hypoglossal triangle (in the floor of the fourth
ventricle) overlies the hypoglossal nucleus.
True
False
c. The stria medullaris (in the floor of the fourth
ventricle) forms the pontomedullary junction.
True
False
d. The fibres of the dorsal columns of the spinal cord
decussate as the decussation of the pyramids.
True
False
e. The vestibulocochlear nerve lies ventral to the
middle cerebellar peduncle.
True
False
a. Anterograde amnesia is a common consequence of
minor head injuries.
True
False
b. Transient global amnesia involves an inability to
form new memories.
True
False
c. Concussion involves retrograde amnesia.
True
False
d. The pathology of Alzheimer’s disease includes
degenerative changes in the hippocampus.
True
False
e. Korsakoff’s psychosis involves lesions of the
thalamus caused by alcohol.
True
False
17. Within the medulla oblongata
18. Regarding memory disorders:
Page 8 of 19
SCMD 4000 - Block Examination 3, Neurosciences MCQ 2009
Group No: _________
Seat No: _____________ Student No: _________________
19. Regarding the corpus striatum and basal ganglia:
a. The putamen and globus pallidus form the
lentiform nucleus.
True
False
b. The efferents of the globus pallidus mainly project
to the thalamus.
True
False
c. The posterior limb of the internal capsule
separates the putamen from the head of the caudate
nucleus.
True
False
d. Afferent fibres to the putamen and caudate
nucleus arise in the motor and premotor cortices.
True
False
e. In Huntington’s chorea, abnormalities in the
subthalamic nucleus give rise to the symptom of
chorea.
True
False
20. Functional areas correctly matched with the appropriate anatomical area are:
a. Primary motor cortex - anterior to the precentral
gyrus
True
False
b. Somatosensory association cortex - superior
parietal lobule
True
False
c. Primary auditory area - transverse temporal gyri
within the superior temporal gyrus
True
False
d. Receptive (Wernicke’s) language area - posterior
aspect of the superior temporal gyrus
True
False
e. Visual association cortex - within the calcarine
sulcus
True
False
a. GABAergic neurones play a role in generating the
sleep spindles observed in the electroencephalogram.
True
False
b. REM sleep is switched off by noradrenergic
neurone activity.
True
False
c. Caffeine is an adenosine receptor agonist.
True
False
d. An orexin deficiency is present in narcolepsy.
True
False
e. Acetylcholine agonists lead to EEG signs of
arousal.
True
False
21. Identify the correct and the incorrect statement(s)
Page 9 of 19
SCMD 4000 - Block Examination 3, Neurosciences MCQ 2009
Group No: _________
Seat No: _____________ Student No: _________________
22. In the treatment of primary insomnia
a. benzodiazepines increase the conduction of
chloride ions across the neuronal cell membrane.
True
False
b. first-generation antihistamines cause daytime
sleepiness.
True
False
c. non-benzodiazepines are selective for the α1
subunit of the GABAA receptor.
True
False
d. melatonin antagonists increase total sleep time.
True
False
e. sleep hygiene treatment includes daytime naps.
True
False
23. Identify the correct and the incorrect statements
a.
Prostaglandins lower the firing threshold for
nociceptors.
True
False
b.
Allodynia is mediated by peripheral sensitization of
touch receptors.
True
False
c.
Noradrenaline release in the dorsal horn inhibits
transmission of nociceptive signals through the
spinal cord.
True
False
d.
Nonsteroidal anti-inflammatory drugs (NSAIDs. are
analgesic.
True
False
e.
Opioid-induced analgesia is mediated within the
central nervous system.
True
False
24. Identify the correct and the incorrect statements
a.
Awareness requires a functioning cerebral cortex.
True
False
b.
Arousal is regulated by the reticular activation
system.
True
False
c.
Patients in vegetative states have lower levels of
awareness than do people who are fully
conscious.
True
False
d.
Patients with locked-in syndrome have lower levels
of awareness than do patients in vegetative states.
True
False
e.
Loss of brainstem reflexes is a sign of brain death.
True
False
Page 10 of 19
SCMD 4000 - Block Examination 3, Neurosciences MCQ 2009
Group No: _________
Seat No: _____________ Student No: _________________
25. Identify the correct and the incorrect statement(s)
a.
Declarative memories are encoded in the
hippocampus.
True
False
b.
Procedural memory includes memories of events.
True
False
c.
The amount of information working memory is able
to store increases as the complexity of the
information increases.
True
False
d.
Activation of the amygdala facilitates memory
encoding.
True
False
e.
The cerebellum encodes procedural memories.
True
False
26. A lesion of the left internal capsule may result in
a.
weakness of the lower half of the right side of the
face.
True
False
b.
a reduced corneal reflex on the right.
True
False
c.
increased muscle reflexes in the right arm.
True
False
d.
deviation of the tongue to the left on protrusion..
True
False
e.
a reduced consensual pupillary reflex when light is
shone in the right eye
True
False
27. The neurotransmitter
a.
glycine has an excitatory effect on antagonist
muscles.
True
False
b.
glutamate is synthesized from alpha-ketoglutarate.
True
False
c.
glutamate is excitatory at its ionotropic receptors.
True
False
d.
gamma amino butyric acid (GABA) is the major
excitatory neurotransmitter in the cerebral cortex.
True
False
e.
GABA provides the major excitatory activity in the
visual cortex.
True
False
28. The Babinski reflex
a.
is tested by applying a cold stimulus to the sole of
the foot.
True
False
b.
is positive if the patient plantar flexes the foot.
True
False
c.
is positive in infants of six months of age.
True
False
d.
if positive in the adult, indicates corticospinal tract
damage.
True
False
e.
if positive in the adult, indicates a lower motor
neurone lesion.
True
False
Page 11 of 19
SCMD 4000 - Block Examination 3, Neurosciences MCQ 2009
Group No: _________
Seat No: _____________ Student No: _________________
29. During a rugby match a teenage boy (Fred Smith) sustained a serious injury in a scrum.
He
•
•
•
was immediately admitted to hospital. On admission Fred was noted to have:
Decreased motor function in both arms and both legs
Decreased reflexes
Decrease in all somatic sensory function.
Based on the signs indicated above, it is evident that Fred had
a.
a transverse lesion of the lower thoracic spinal cord.
True
False
b.
a hemisection of the cervical spinal cord.
True
False
c.
bilateral lesions of his dorsal columns.
True
False
d.
bilateral lesions of his corticospinal tracts.
True
False
e.
spinal shock.
True
False
30. Two months later, after surgery to stabilize a fractured vertebra, Fred was discharged
from hospital. On discharge Fred was noted to have:
•
Decreased facial sweating on the left side
•
A constricted pupil on the left side
•
Normal motor and sensory function in both his legs
•
Weakness and decreased sensation in his left hand
Based on the signs indicated above, it is now evident that as a consequence of his injury,
Fred had
a.
damaged his cervical ganglia on the left side.
True
False
b.
damaged the parasympathetic nerve supply to his
face.
True
False
c.
damaged his cervical dorsal columns on the right.
True
False
d.
damaged his cervical corticospinal tracts on the
right.
True
False
e.
Horner’s syndrome.
True
False
31. On discharge Fred complained of:
•
•
Pins and needles in his left hand
Pain in his neck and shoulder on the left
The symptoms above described by Fred
a.
were due to damage to his cervical nerve roots on
the left.
True
False
b.
could be treated with the administration of a
serotonin reuptake inhibitor.
True
False
c.
were due to increased firing of the descending
inhibitory pain pathways.
True
False
d.
were due to denervation hypersensitivity.
True
False
e.
were due to increased release of enkephalin
neurotransmitters.
True
False
Both were
marked correct
Page 12 of 19
SCMD 4000 - Block Examination 3, Neurosciences MCQ 2009
Group No: _________
Seat No: _____________ Student No: _________________
32. Due to the weakness and altered sensation in his left hand, Fred’s mother always
assisted him with fine motor tasks involving his hands such as opening bottles and jars.
However, about 20 years after his injury, Fred noticed that his mother’s ability to perform
these fine motor tasks which required strength had deteriorated. In addition, Mrs. Smith
now needs glasses to read and frequently losses her balance.
As a consequence of normal aging in Mrs. Smith
a.
the decrease in motor strength was due to loss of
muscle fibres.
True
False
b.
the necessity to wear glasses for reading was due to
the loss of accommodation for far distances.
True
False
c.
the necessity to wear glasses for reading was due to
stiffening of the lenses in her eyes.
True
False
d.
the loss of balance was due to increased postural
reflexes.
True
False
e.
the visual changes contributed to her loss of
balance.
True
False
33. Reasons for students and clinicians avoiding involvement with the suffering in patients
include
a. “othering” where the clinician tries to magnify the
faults in the patient to preserve their own purity
True
False
b. Non Western concept of the need to conquer and
control illness and suffering
True
False
c. “Scientifise” the disease and lose the person
behind the disease
True
False
d. Fear of contamination with the suffering.
True
False
e. Have not come to terms with their own suffering
and with disease and death.
True
False
34. Drugs which stimulate dopamine receptors in the brain cause:
a. extrapyramidal tremor
True
False
b. vomiting
True
False
c. postpartum lactation
True
False
d. psychosis
True
False
e. anhedonia (lack of pleasure in activities which
were previously enjoyed)
True
False
Page 13 of 19
SCMD 4000 - Block Examination 3, Neurosciences MCQ 2009
Group No: _________
Seat No: _____________ Student No: _________________
35. The cornea:
a. Is continuous with the sclera
True
False
b. Maintains its clarity by means of an epithelial
pump
True
False
c. Is 1mm thick in the centre
True
False
d. Derives its sensory nerve supply from the
trigeminal nerve
True
False
e. Has a good vascular supply
True
False
a. Has 6 million rods mostly in the macula
True
False
b. Uses cones for colour vision
True
False
c. Is transparent
True
False
d. Needs vitamins A, B and E for rhodopsin
True
False
e. Derives all its blood supply from the central
retinal artery
True
False
a. Spread of infection from the middle ear can result
in the development of a brain abscess
True
False
b. Symptoms and signs of a brain abscess include
fever, headache and focal neurological deficit
True
False
c. In brain abscesses of bacterial aetiology,
streptococci are infrequently isolated
True
False
d. For a brain abscess <2.5cm in diameter, a
combination of intravenous antibiotics and surgical
therapy, is mandatory
True
False
e. The presenting clinical features of a brain abscess
are related to the size and location of the abscess
True
False
a. Mental retardation is coded on axis I
True
False
b. Inability to work is coded on axis II
True
False
c. Asthma is coded on axis III
True
False
d. Stress due to death of parents is coded on axis IV
True
False
e. Major depression is coded on axis V
True
False
36. The retina:
37. Regarding brain abscesses:
38. With respect to the DSM-IV-TR multi-axial coding:
Both correct
Page 14 of 19
SCMD 4000 - Block Examination 3, Neurosciences MCQ 2009
Group No: _________
Seat No: _____________ Student No: _________________
39. Poor prognostic features in Schizophrenia include:
a. Gradual onset of negative symptoms
True
False
b. Early age of onset
True
False
c. High premorbid level of functioning
True
False
d. Predominant positive symptoms with
hallucinations and delusions
True
False
e. Hostility, criticism and over-protectiveness within
the family
True
False
40. Examples of negative symptoms of schizophrenia include:
Lack of motivation
True
False
b. Auditory hallucinations
True
False
c. Thought disorder
True
False
d. Social withdrawal
True
False
e. Paranoid delusions
True
False
a.
41. In terms of the Mental Health Care Act, No. 17 of 2002, a person may be admitted to
hospital under the Act on involuntary basis in the following circumstances:
a. if they have antisocial personality disorder
True
False
b. psychotic with no insight, and are aggressive and
refusing treatment
True
False
c. incapable of making a decision about their
treatment but do not refuse it
True
False
d. homeless and neglected, but is not aggressive
and does not refuse treatment
True
False
e. The person has a history of alcohol use and has
withdrawal symptoms with hallucinations
True
False
42. Maintenance treatment of Bipolar Mood Disorder includes:
a. Lithium
True
False
b. Phenytoin
True
False
c. Lamotrigine
True
False
d. Carbamazepine
True
False
e. Sodium Valproate
True
False
Option
removed
Page 15 of 19
SCMD 4000 - Block Examination 3, Neurosciences MCQ 2009
Group No: _________
Seat No: _____________ Student No: _________________
43. Regarding children with disorders of learning:
a. Anxiety disorders are frequently co-morbid
True
False
b. A full developmental history is not necessary in
their work-up
True
False
c. Language disorders typically develop in
adolescence
True
False
d. Absence seizures may be mistaken for a learning
disorder
True
False
e. School drop-out rates are less than average
True
False
44. The following antiepileptic drugs enhance the effects of GABA:
a. lamotrigine
True
False
b. ethosuximide
True
False
c. phenobarbitone
True
False
d. diazepam
True
False
e. carbamazepine
True
False
45. Antiepileptic drugs are correctly matched with other indications for which they are used:
a. Carbamazepine
-
mood stabilisation
True
False
b. topiramate
-
migraine prophylaxis
True
False
c. levetiracetam
-
antiarrhythmic agent
True
False
d. gabapentin
-
neuropathic pain
True
False
e. ethosuximide
-
anaesthetic agent
True
False
46. Antiepileptic agents are correctly matched with the adverse effects which they cause:
a. phenobarbitone
-
insomnia
True
False
b. phenytoin
-
hirsuitism
True
False
c. valproic acid
-
weight gain
True
False
d. gabapentin
-
gingival hyperplasia
True
False
e. lamotrigine
-
maculopapular rash
True
False
Page 16 of 19
SCMD 4000 - Block Examination 3, Neurosciences MCQ 2009
Group No: _________
Seat No: _____________ Student No: _________________
47. John Kennedy is a 37 year old male who is referred to you from his doctor who has been
treating him for epilepsy for the past 3 years. The referring doctor says he would like
you to help him to manage the patient as he is having recurrent episodes of strange
behaviour including thrashing around and strange leg movement.
Which of the following are true:
a. An increased prolactin level may assist in the
diagnosis
True
False
b. The patient may be diagnosed by doing an EEG
at the same time that you video the
event(concurrent video-EEG monitoring)
True
False
c. The patient is definitely not epileptic
True
False
d. The patient may have frontal complex partial
seizures
True
False
e. The patient must be treated with an
antipsychotic
True
False
48. R - Types
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
Oculomotor nerve (CN III)
Trochlear nerve (CN IV)
Ophthalmic division of the trigeminal nerve (CN V1)
Maxillary division of the trigeminal nerve (CN V2)
Mandibular division of the trigeminal nerve (CN V3)
Abducent nerve (CN VI)
Facial nerve (CN VII)
Glossopharyngeal nerve (CN IX)
Vagus nerve (CN X)
Hypoglossal nerve (CN XII)
For each of the following clinical lesions identify the cranial nerve in the list above that is
most likely to be involved.
48. Loss of sensation on the upper lip and cheek.
A
B
C
D
E
F
G
H
I
J
F
G
H
I
J
I
J
49. Inability to close the eye.
A
B
C
D
E
50. Inability to open the jaw against resistance.
A
B
C
D
E
F
G
H
Page 17 of 19
SCMD 4000 - Block Examination 3, Neurosciences MCQ 2009
Group No: _________
Seat No: _____________ Student No: _________________
49.
John Brown is a 25 yr old lecturer who suffers from depression. He has recently returned
home after spending two weeks in a psychiatric clinic for an episode of depression.
From the options below select the BEST possible answer for each of the Statements.
Answers may be used more than once.
OPTIONS
A. Discreditable condition
B. Non maleficence
C. Beneficence
D. Discredited condition
E. Felt stigma
F. Patient autonomy
G. Enacted stigma
H. Patient-centredness
I. Destigmatisation
J. Stigma coach
51. At a follow up visit he says to his GP: “I feel fine …. But people at work are curious
about why I have been away? I’ve never really looked depressed or sick, so what do I
tell them? Do I tell them?”
A
B
C
D
E
F
G
H
I
J
52. Dr Naidoo says: “It’s understandable that you feel hesitant to disclose. What would
you like to do? What are your concerns about disclosure?”
A
B
C
D
E
F
G
H
I
J
53. John says:”Oh you know how people are about mental illness. Rumours soon get
around that you’re unstable especially when you’ve been in a psych clinic. I struggle
quite a lot with this”.
A
B
C
D
E
F
G
H
I
J
Page 18 of 19
SCMD 4000 - Block Examination 3, Neurosciences MCQ 2009
Group No: _________
Seat No: _____________ Student No: _________________
50. A. Pain is subjective
B.
C.
D.
E.
F.
G.
H.
I.
J.
K.
Painlessness is dangerous
Pain sets the limits
Pain needs interpretation
Pain is a warning
Pain is felt in the brain
Pain is never imagined
Placebo effect
Distraction relieves pain
Care and support relieve pain
Understanding relieves pain
From the list of concepts related to pain above, indicate which concept is best illustrated by
each of the following quotes:
54. “A diagnosis gives our pain meaning, situates it in a context of cause and effect,
and most importantly, in a context of action. When I know what my pain means, I know
what I have to do – I know how to act responsibly.” (Scott Clark)
A B C D E
Option D and K are correct
F
G
H
I
J
K
55. “Pain is personal. It really belongs to the one feeling it. Probably the only thing that
is your own.” (Henry Rollins)
A
B
C
D
E
F
G
H
I
J
K
56. “Given the choice between the experience of pain and nothing, I would choose
pain.” William Faulkner)
A
B
C
D
E
F
G
H
I
J
K
Page 19 of 19
SCMD 4000 - Block Examination 3, Neurosciences MCQ 2009
Group No: _________
Seat No: _____________ Student No: _________________
51.
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
phenytoin
carbamazepine
ethosuximide
valproic acid
lamotrigine
topiramate
phenobarbitone
oxcarbazepine
pregabalin
levetiracetam
57. Lesedi is an 8 year old boy who has been diagnosed with absence seizures. He is
started on medication and, although he takes the medicine exactly as instructed, 2
weeks later he has a tonic-clonic seizure. What is the most likely medication that was
prescribed for the absence seizures?
A
B
C
D
E
F
G
H
I
J
58. From the given list of neuroprotective agents, this drug is prescribed in the
management of neuropathic pain, but it does not undergo hepatic metabolism.
A
B
C
D
E
F
G
H
I
J
59. From the list above, this neuroprotective agent is used as an adjuvant in the drug
management of weight loss.
A
B
C
D
E
F
G
H
I
J
60. Spina bifida occurs in 1-2% of exposures in the first month after fertilisation
A
B
C
D
E
F
G
H
I
J