Neuro Pace Quiz 1 Part 3

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Neuro Pace Quiz 1 Part 3 - Quiz

Questions and Answers
  • 1. 

    A 34-year woman suffers from narcolepsy. She complains of excessive sleepiness and sleep attacks. She falls asleep during work and earlier this week she barely avoided a traffic accident.  From your neuroscientific studies you know that this sleeping disorder is characterized by intrusions of a certain type of sleep during wakefulness. Name (i) the type of sleep (ii) the brain waves associated with it.

    • A.

      REM, beta waves

    • B.

      NREM, alpha waves

    • C.

      REM, theta waves

    • D.

      REM, spindle and k complexes

    • E.

      NREM, Delta waves

    Correct Answer
    A. REM, beta waves
    Explanation
    Narcolepsy is a sleeping disorder characterized by excessive sleepiness and sleep attacks. It is caused by intrusions of REM sleep during wakefulness. REM sleep is associated with beta waves in the brain.

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  • 2. 

    A 45-year old man complains of daytime fatigue and restless sleep. His wife persuaded him to go to the doctor because she’s unable to sleep with his loud snoring. On examination you note his BMI is >30 and his tonsils appear enlarged. Which sleeping disorder is this patient most likely suffering from?  

    • A.

      Sleep paralysis

    • B.

      Narcolepsy

    • C.

      Night Terrors

    • D.

      Sleep Apnea

    • E.

      Catalepsy

    Correct Answer
    D. Sleep Apnea
    Explanation
    This patient is most likely suffering from sleep apnea. The symptoms of daytime fatigue, restless sleep, and loud snoring are common in sleep apnea. The patient's BMI being greater than 30 suggests that he may be overweight or obese, which is a risk factor for sleep apnea. The enlarged tonsils could also contribute to the obstruction of the airway during sleep, further supporting the diagnosis of sleep apnea. Sleep paralysis, narcolepsy, night terrors, and catalepsy do not match the symptoms described by the patient.

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  • 3. 

    A 65-year old woman presents with a loss of pain and temperature sensation along her back and arms. An MRI reveals a cyst around the central canal. Name (i) the disorder and (ii) the tract that is affected.

    • A.

      Syringomyelia, Spinothalamic tract

    • B.

      Brown Séquard syndrome, Spinothalamic tract

    • C.

      Brown Séquard syndrome, Corticospinal tract

    • D.

      Syringomyelia, Corticospinal tract

    • E.

      Syringomyelia, Tectospinal tract

    Correct Answer
    A. Syringomyelia, Spinothalamic tract
    Explanation
    Syringomyelia is a disorder characterized by the formation of a cyst (syrinx) around the central canal of the spinal cord. This condition can lead to the compression and damage of various neural structures. In this case, the loss of pain and temperature sensation along the back and arms suggests an impairment of the spinothalamic tract. Therefore, the correct answer is Syringomyelia, Spinothalamic tract.

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  • 4. 

    The 3-neuron-arch of the vestibulo-ocular reflex consists of the following components:  

    • A.

      Vestibular nuclei-abducens nucleus of the same side – oculomotor nucleus of the other side

    • B.

      Vestibular nuclei – PPRF of the same side – abducens nucleus of the other side

    • C.

      Vestibular nuclei – abducens nucleus of the other side – oculomotor nucleus of the same side

    • D.

      Vestibular nuclei – abducens nucleus of the same side – trochlear nucleus of the other side

    • E.

      Vestibular nuclei – PPRF of the other side – oculomotor nucleus of the other side

    Correct Answer
    C. Vestibular nuclei – abducens nucleus of the other side – oculomotor nucleus of the same side
    Explanation
    The correct answer is "Vestibular nuclei – abducens nucleus of the other side – oculomotor nucleus of the same side." This is because the vestibulo-ocular reflex involves the coordination of eye movements with head movements to maintain stable vision. The vestibular nuclei receive input from the vestibular system and send signals to the abducens nucleus, which controls the lateral rectus muscle of the eye, and then to the oculomotor nucleus, which controls the medial rectus muscle of the eye. This pathway allows for the appropriate eye movement in response to head movements.

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  • 5. 

    Opioids remain the most commonly used drugs in the treatment of moderate to severe postoperative pain. Side effects related to opioid use have become well known and may be managed appropriately. However, it is perhaps respiratory depression that remains the main hazard of opioid use, because of the obvious risk of fatal outcome. Suppression of which of the following structures is responsible for this unwanted side effect?

    • A.

      Medullary reticular formation controlling breathing

    • B.

      Midbrain pneumotactic center

    • C.

      Reticulospinal tract innervating the diaphragm

    • D.

      Nucleus of the solitary tract receiving input from cranial nerves IX and X

    • E.

      Cholinergic transmission at the motor end plates of respiratory muscles

    Correct Answer
    A. Medullary reticular formation controlling breathing
    Explanation
    The medullary reticular formation is responsible for controlling breathing. When opioids are used, they can suppress the activity of this structure, leading to respiratory depression. This is a significant side effect because it can potentially result in a fatal outcome.

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  • 6. 

    Which statement is true for the amacrine cells?

    • A.

      Amacrine cells are specific inner ear cells, responsible for the K+ transport to the hair cells

    • B.

      Amacrine cells are found in the outer nuclear layer of the retina and synapse with the rod photoreceptors

    • C.

      Amacrine cells are bipolar interneurons situated in the pretectal nuclei to influence the pupillary reflex

    • D.

      Amacrine cells are olfactory interneurons, which receive primary input from the olfactory nerves and mitral cells

    • E.

      Amacrine cells are found in the inner nuclear layer of the retina, are interneurons and synapse mainly with the ganglion cells

    Correct Answer
    E. Amacrine cells are found in the inner nuclear layer of the retina, are interneurons and synapse mainly with the ganglion cells
    Explanation
    Amacrine cells are a type of interneuron found in the inner nuclear layer of the retina. They primarily synapse with the ganglion cells, which are responsible for transmitting visual information to the brain. This statement accurately describes the location and function of amacrine cells in the retina.

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  • 7. 

    A 21 y/o professional female basketball player was adviced by her coach to go to see her physician. She could not perform so well lately, she often did not notice the ball coming from the back and she had constant headaches. She said it was probably due to her emotional state, because she broke up with her boyfriend a few months ago. Even her period became very irregular the last few months. The coach wanted the doctor to prescribe some calming pills for her, but the doctor became suspicious that there were some other problems, since he found visual field loss on both temporal sides. His suspicion was confirmed later by MRI. Which of the following is most possible based on the symptoms?

    • A.

      Meningioma in the optic canal leading to compression of the optic nerve

    • B.

      Pituitary adenoma, causing compression of the optic chiasma and leading to hormonal deficiencies.

    • C.

      Carotid aneurysm leading to compression of the optic chiasma and constant headaches.

    • D.

      Multiple sclerosis, causing degeneration of the optic radiation leading to bitemporal hemianopia.

    • E.

      Multiple sclerosis based on her gender and young age, and the demyelination symptoms in both optic nerves.

    Correct Answer
    B. Pituitary adenoma, causing compression of the optic chiasma and leading to hormonal deficiencies.
    Explanation
    The symptoms described in the scenario, such as visual field loss on both temporal sides, constant headaches, and irregular periods, are indicative of a pituitary adenoma. Pituitary adenomas are tumors that develop in the pituitary gland and can cause compression of the optic chiasma, leading to visual field loss. Additionally, these tumors can disrupt hormonal production, explaining the irregular periods and hormonal deficiencies. This explanation aligns with the given symptoms and is the most likely scenario based on the information provided.

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  • 8. 

    A 45-year-old male patient was diagnosed with lung cancer on the apical part of the right lung, extending from the middle posterior mediastinal region into the supraclavicular region of the neck. He also had ptosis on the right side. What could be the relationship between the ptosis and the cancer?

    • A.

      The tumor is compressing the vagal nerve in the mediastinum, causing loss of parasympathetic innervation of the eyelid

    • B.

      The tumor is compressing the sympathetic trunk on the neck, leading to the loss of sympathetic innervations of the tarsal muscle, thus leading to ptosis

    • C.

      There is metastasis in the mesencephalon, leading to trochlear nerve palsy, thereby causing ptosis

    • D.

      The tumor is compressing cranial nerve X on the neck, and this leads to sympathetic overstimulation of the eye muscles

    • E.

      The tumor is compressing the sympathetic trunk in the mediastinum, and therefore, the innervation of the orbital muscle is lost, and this leads to ptosis

    Correct Answer
    B. The tumor is compressing the sympathetic trunk on the neck, leading to the loss of sympathetic innervations of the tarsal muscle, thus leading to ptosis
    Explanation
    The ptosis on the right side is likely caused by the tumor compressing the sympathetic trunk on the neck. This compression leads to the loss of sympathetic innervation of the tarsal muscle, resulting in ptosis.

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  • 9. 

    Dr Moore Shown is a drawing of a portion of the iris of the eye.  What is the function of the structure located at the tip of the arrow?

    • A.

      Pigmentation of the iris

    • B.

      Movement of the lens

    • C.

      Supplies oxygen and nutrients to the iris

    • D.

      Pupil constriction

    • E.

      Pupil dilation

    Correct Answer
    E. Pupil dilation
    Explanation
    The structure located at the tip of the arrow is responsible for pupil dilation. Pupil dilation is the widening of the pupil, which allows more light to enter the eye. This is controlled by the muscles in the iris, which contract or relax to change the size of the pupil.

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  • 10. 

    This electron micrograph was taken of a section of the eye.  The positions of the landmarks "Photoreceptor outer segments" and "Cap" (designating a capillary) are shown.  Of the choices below, the arrow is pointing to the nucleus of which cell type?

    • A.

      Bipolar neuron

    • B.

      Pigmented retinal epithelium cell

    • C.

      Fibroblast

    • D.

      Melanocyte

    • E.

      Photoreceptor cell

    Correct Answer
    B. Pigmented retinal epithelium cell
    Explanation
    The correct answer is Pigmented retinal epithelium cell because the arrow in the electron micrograph is pointing to the nucleus of this cell type.

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  • 11. 

    A 45-year-old musician who played guitar for 26 years in a rock band noticed he was having difficulty hearing.  An otolaryngologist confirmed his loss of hearing and associated it with prolonged exposure to loud sounds.  Which of the following structures would show degenerative changes that would account for this man's hearing loss?

    • A.

      The epithelium lining the inner portion of the tympanic membrane

    • B.

      Hair cells in the organ of Corti

    • C.

      Hair cells in ampullae

    • D.

      Hair cells in the saccule

    • E.

      Ossicles in the middle ear

    Correct Answer
    B. Hair cells in the organ of Corti
    Explanation
    The hair cells in the organ of Corti are responsible for converting sound vibrations into electrical signals that can be interpreted by the brain. Prolonged exposure to loud sounds can cause damage to these hair cells, leading to hearing loss. Therefore, the degenerative changes in the hair cells in the organ of Corti would account for this man's hearing loss.

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  • 12. 

    Dr Benjamin   A 30 year old female visits her family doctor because she has noticed that one of her eyes appears to be sagging.  Following history and physical examination, her doctor confirmed that she had ptosis of her left eye and that that her left pupil is smaller than her right. Furthermore there was no sweating on the left side of her face.  During physical examination of this patient, when the light is dimmed which of the following is most likely to occur?  

    • A.

      A. Left pupil becomes smaller

    • B.

      B. Left pupil becomes larger

    • C.

      C. No change of both pupils

    • D.

      D. Right pupil becomes smaller

    • E.

      E. Right pupil becomes larger

    Correct Answer
    E. E. Right pupil becomes larger
    Explanation
    In this scenario, the patient is presenting with ptosis of her left eye, a smaller left pupil, and no sweating on the left side of her face. These symptoms suggest a condition known as Horner's syndrome, which is caused by damage to the sympathetic nerves that control the pupil and sweat glands. In Horner's syndrome, the affected pupil is smaller (miosis) due to the loss of sympathetic innervation. When the light is dimmed, the normal response is for both pupils to dilate (become larger) to allow more light into the eyes. Therefore, in this patient with Horner's syndrome, the right pupil, which is not affected by the condition, would be expected to dilate (become larger) when the light is dimmed.

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  • 13. 

    Dr Chaudhary A 5-year old boy is brought to ER who reports that he swallowed a fish bone. The boy is crying and coughing. With the aid of an endoscope, the physician removes the bone from the pharynx. Which is the MOST LIKELY place for foreign body to lodge in the pharynx?  

    • A.

      Pharyngeal recess

    • B.

      Vestibule

    • C.

      Tonsillar fossa

    • D.

      Piriform recess

    • E.

      Rima vestibule

    Correct Answer
    D. Piriform recess
    Explanation
    The piriform recess is the most likely place for a foreign body to lodge in the pharynx. This is because the piriform recess is a narrow space located between the aryepiglottic fold and the thyroid cartilage, making it easier for small objects like fish bones to become trapped in this area. The symptoms of crying and coughing in the 5-year old boy are consistent with a foreign body lodged in the pharynx, further supporting the likelihood of it being in the piriform recess.

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  • 14. 

    Because of the frequency of middle ear infection (otitis media), it is clinically important to note the anatomy of walls of the middle ear cavity. Which one of the following combinations is CORRECT?

    • A.

      Roof ----- Jugular foramen

    • B.

      Lateral wall ----- Tegmen tympani

    • C.

      Floor ----- Auditory tube

    • D.

      Anterior wall ----- Oval window

    • E.

      Medial wall ----- promontory

    Correct Answer
    E. Medial wall ----- promontory
    Explanation
    The medial wall of the middle ear cavity is indeed associated with the promontory. The promontory is a bony ridge formed by the cochlea of the inner ear, which is located along the medial wall of the middle ear. This anatomical feature is important to note because it can affect the placement of surgical instruments or the spread of infection within the middle ear.

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  • 15. 

    A 60-year-old man is unable to open his mouth because of tetanus resulting from a penetrating wound from a rusty nail. Which of the following muscles would most likely be paralyzed?

    • A.

      Masseter

    • B.

      Buccinator

    • C.

      Lateral pterygoid

    • D.

      Medial pterygoid

    • E.

      Temporalis

    Correct Answer
    C. Lateral pterygoid
    Explanation
    Tetanus is caused by the toxin produced by the bacterium Clostridium tetani, which affects the nervous system. The muscles affected by tetanus are those controlled by the motor neurons that are influenced by the toxin. The lateral pterygoid muscle is responsible for opening the mouth, so if the man is unable to open his mouth, it suggests that this muscle is paralyzed due to the tetanus infection.

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  • 16. 

    Dr Reglodi A 63-year-old female with serous carcinoma of ovary was admitted on postoperative day 14 for her first cycle of cisplatin chemotherapy. Four days after the cycle, she suffered acute onset of bilateral tinnitus and hearing loss. What is the probable cause of these symptoms?

    • A.

      Neurotoxic side effects of cisplatin affecting the cochlear nerve

    • B.

      Ototoxic side effects of cisplatin affecting the inner hair cells

    • C.

      Ototoxic side effects of cisplatin causing degeneration of the outer hair cells

    • D.

      Neurotoxic side effects of cisplatin leading to lesion of the superior olivary complex

    • E.

      Acute general toxic effects of the chemotherapy, causing edema in the area of internal acoustic meatus

    Correct Answer
    C. Ototoxic side effects of cisplatin causing degeneration of the outer hair cells
    Explanation
    The probable cause of the patient's symptoms is ototoxic side effects of cisplatin causing degeneration of the outer hair cells. Cisplatin is known to have ototoxic effects, meaning it can damage the structures in the inner ear responsible for hearing. In this case, the patient experienced acute onset of bilateral tinnitus and hearing loss, which are consistent with damage to the outer hair cells in the cochlea. This is a known side effect of cisplatin chemotherapy.

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  • 17. 

    A 24-year-old woman, presented to her primary care physician with excessive worry and symptoms of depression.  The physician suggests that she try a drug that blocks the reuptake of one neurotransmitter; this drug is an antidepressant and works to heal anxiety disorders and depression.  Which neurotransmitter is likely being enhanced?

    • A.

      Acetylcholine

    • B.

      Serotonin

    • C.

      GABA

    • D.

      Glutamate

    • E.

      Adenosine

    Correct Answer
    B. Serotonin
    Explanation
    The correct answer is Serotonin. Serotonin is a neurotransmitter that plays a crucial role in regulating mood, anxiety, and depression. Blocking the reuptake of serotonin increases its availability in the brain, leading to improved mood and alleviation of anxiety symptoms. This is the mechanism of action of many commonly prescribed antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs).

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  • 18. 

    A 20-year-old woman was brought to the emergency room presenting with bizarre behaviors.  She was speaking very fast and she was talking about voices she heard.  She had run out into the street because she thought aliens were chasing her.  She was given a drug that was an antagonist, which helped block the voices and fear she was experiencing.  This drug blocked the actions of which neurotransmitter?

    • A.

      Glutamate

    • B.

      GABA

    • C.

      Acetylcholine

    • D.

      Dopamine

    • E.

      Serotonin

    Correct Answer
    D. Dopamine
    Explanation
    The drug that was given to the woman acted as an antagonist, meaning it blocked the actions of a neurotransmitter. The symptoms described, such as speaking very fast, talking about voices, and feeling fear, are consistent with psychosis. Dopamine is known to play a role in regulating emotions, cognition, and perception. Excessive dopamine activity has been implicated in psychosis and disorders like schizophrenia. By blocking dopamine, the drug helped alleviate the woman's symptoms, suggesting that dopamine was the neurotransmitter involved in her psychosis.

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  • 19. 

    A 42-year-old man was brought to the emergency room.  He was seizing and had been in this state for over 30 mins.  What is a possible mechanism of action of a drug that would decrease neuronal firing in this emergency situation?

    • A.

      Block GABA neuronal firing

    • B.

      Enhance GABA neuronal firing

    • C.

      Enhance glutamate neuronal firing

    • D.

      Enhance dopamine neuronal firing

    • E.

      Block serotonin neuronal firing

    Correct Answer
    B. Enhance GABA neuronal firing
    Explanation
    Enhancing GABA neuronal firing would decrease neuronal firing in this emergency situation. GABA is an inhibitory neurotransmitter that reduces the activity of neurons in the brain. By enhancing GABA neuronal firing, the drug would increase the inhibitory effects of GABA, leading to a decrease in neuronal activity and potentially stopping the seizure.

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  • 20. 

    Dr Coffin   A 24-year-old man presents at the emergency room anxious, talking fast, had a racing heart rate and afraid he is having a heart attack.  History revealed he had taken an illicit drug that results in an increase in dopamine in dopaminergic synapses.  What mechanism of action might this drug have?  

    • A.

      Dopamine enzyme enhancer

    • B.

      Glutamate agonist

    • C.

      Serotonin uptake inhibitor

    • D.

      Dopamine uptake inhibitor

    • E.

      Dopamine autoreceptor agonist

    Correct Answer
    D. Dopamine uptake inhibitor
    Explanation
    The correct answer is dopamine uptake inhibitor. This drug inhibits the reuptake of dopamine, leading to an increase in dopamine levels in the synapses. This increase in dopamine can result in symptoms such as anxiety, increased heart rate, and a feeling of impending doom, which the patient is experiencing.

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  • Mar 20, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Feb 11, 2012
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    Chachelly
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