1 MODULE: THE CENTRAL NERVOUS SYSTEM AND SPECIAL SENSES (MODULE 9) WEEK: THREE NAME: DURATION: 2 HOURS PROPERTIES

OF RECEPTOR 1. Which of the following is true? A. Each receptor is most sensitive to many particular types B. The sensation that perceived as a result of stimulation of a receptor is called modality of sensation C. Receptor is only stimulated by its adequate stimulus not others stimulus D. Differential sensitivity of receptor is not illustrated by Muller law of specific nerve energies Where is the part of action potential generated? A. First node of Ranvier of the efferent sensory fibre B. Second node of Ranvier of the efferent sensory fibre C. First node of Ranvier of the afferent sensory fibre D. Second node of Ranvier of the afferent sensory fibre The receptor potential has the following properties except? A. It is a local and propagates B. It is graded potential C. No refractory period D. It is not blocked by local anaesthetics

2.

3.

4. Which of the following is the rapidly adapting (phasic) receptor? A. Pain B. Baroreceptors C. Touch D. All 5. All the following are mechanism of adaptation of the nerve except? A. Gradual closure of the Na+ channels B. Loss of the stimulus energy in the surrounding tissue C. Gradual decrease of the excitability of the first node of Ranvier D. Gradual increase of the excitability of the first node of Ranvier ADRENERGIC DEPRESSANT 6. Below is regarding the classification of Adrenergic depressant.Which is False? A. Adrenergic neuron blockers interfere also with the adrenergic receptor B. Divided into two main categories, either it is adrenolytics or sympatholytics C. Alpha,Beta and Combined adrenoceptors blockers are under sub-categories of adrenolytics D. Sympatholytics blocks sympathetics nerve function

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2 7. Choose the correct answers regarding alpha adrenoceptor antagonist I- It is classified into 3 main groups, which are Ergot alkaloids,selective and non-selective receptor antagonist II- Ergotamine is the most potent to cause vasoconstriction III-Prazosin & Terazosin are the selective alpha blockers IV-All natural and semisynthetics ergot may cause nausea and vomiting A. I,II,III B. I,III,IV C. I,II,IV D. All of the above 8. Choose the False statement regarding selective alpha blockers A. They are competitive blockers at postsynaptic alpha receptor which lead to vasodilatation B. They can be used in renal failure patient C. The examples are Labetalol and Carvedilol D. Use in treatment of hypertension and alternative to surgery in patient with benign prostatic hyperplasia 9. Choose the correct answers regarding adrenergic neuron blockers agents I- Drugs which act centrally by interrupting sympathetic funtions leaving receptor free II-Can cause inhibition of synthesis of noradrenaline and serotonin III-Decrease noradrenaline by inhibit the enzyme involved & also act as false transmitter IV-It can't pass blood brain barrier A. I,II,III B. II,III C. I,III,IV D. III,IV 10. Choose the False pair between the drugs and illness treated by it A. Ergotamine > Acute attack of migraine headache B. Ergometrine > Postpartum haemorhage C. Bromocriptine > Parkinsonism & Hemolytic anemia D. ALDOMET > Hemolytic anemia ANATOMY OF CEREBRAL CORTEX II 11. Which of the following gyrus of medial surface of cerebral cortex are responsible for the visceral and emotional activities? A. Cingulate gyrus B. Medial frontal gyrus C. Paracentral lobule D. Cuneus 12. Gyrus that lies below calcarine sulcus is termed A. Medial frontal gyrus B. Lingual gyrus C. Cuneus D. Precuneus Questions Maker Unit (QMU) 2011/2012

3 13. Which sulci will form a Y-shaped arrangement at medial surface of cerebral cortex? I. Callosal sulcus II. Parieto-occipital sulcus III. Calcarine sulcus IV. Cingulate sulcus A. I and II B. II and III C. I and IV D. II and IV 14. Which of the following area is responsible for visual function? A. Cingulated gyrus B. Precuneus C. Medial frontal gyrus D. Cuneus 15. Which of the following is situated at the tentorial part of inferior surface of cerebral cortex? I. Rhinal sulcus II. Olfactory sulcus III. Lateral occipitotemporal gyrus IV. Uncus A. I,II B. II,III C. I,III,IV D. I,II,IV 16. Which of the following is FALSE regarding inferior surface of cerebral cortex? I. Collateral sulcus is situated at orbital part II. Uncus is bounded medially by rhinal sulcus III. Continuation of parahippocampal gyrus is lingual gyrus IV. Parahippocampal gyrus is bounded laterally by collateral sulcus A. I,II B. II,III C. I,II,III D. II,III,IV BETA ADRENERGIC RECEPTOR BLOCKERS 17. Which of the following is not the pharmacological property of -blockers? A. Central depressant effect B. Extrinsic sympathomimetic activity C. Relative affinity for 1 and 2 receptor D. Membrane stabilizing activity

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4 18. All of the following are true about the properties of the lipophilic agents except A. It is completely absorbed B. Not metabolized in the liver C. Has a short half life D. High incidence of CNS side effect 19. All of the following are false about the action of propranolol due to -blocking effect except A. Can cause bronchodilation B. It induce hyperglycaemia C. Has anti-anginal effect D. Increase blood pressure 20. Which of the following is not true about the therapeutic uses of -blockers? A. Hypertension B. Hyperthyroidism C. Treatment of migraine D. Mild myocardial infarction 21. All of the following are the contraindication for -blockers except? A. Severe heart failure B. Massive myocardial infarction C. Diabetic patients D. Hypertension SPINO-CEREBELLAR TRACTS (VENTRAL AND DORSAL) AND THERMORECEPTIVE SENSATION 22. What is the type of neuron in spino-cerebellar tracts? A. A B. A C. C D. A 23. Which of the following is true about dorsal spino-cerebellar tracts? A. vermis of cerebellum B. cerebellum C. D.

24. Deep pain is usually associated with bradycardia and hypotension. A. True B. False

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5 25. Lateral spinothalamic tracts transmit I. Thermal sensation II. Unconscious proprioceptive sensation III. Pain sensation IV. Conscious proprioceptive sensation A. I and II B. I and III C. II and III D. II and IV 26. In second order neurones of lateral spinothalamic tract, slow pain and thermal sensation will pass to A. Ventral posterolateral nucleus B. Intralaminar thalamic nuclei C. Vermis of the cerebellum D. Superior cerebellar peduncle 27. Neurones in the intralaminar thalamic nuclei will project through thalamic radiation to A. Cingulate gyrus B. Insular cortex C. Cerebellar cortex D. All part of cerebral cortex E. Both A and B ANATOMY OF CEREBRUM AND BLOOD SUPPLY 2 28. Choose the CORRECT border of Cerebral Hemisphere. I Superiomedial border II Inferolateral border III Medial border IV Superciliary border A. I, II and III B. I, II and IV C. I, III and IV D. All of the above 29. All the following are important sulci and gyri of temporal lobe, except A. Superior temporal sulcus B. Inferior temporal sulcus C. Superior temporal gyrus D. Postcentral sulcus 30. Cuneus and Lingual gyrus are responsible for A. Visual function B. Olfactory function C. Behaviour control D. Concentration function

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6 31. All the following are branches of internal carotid artery except? A. Opthalmic artery B. Posterior communicating artery C. Anterior spinal artery D. Anterior choroidal artery 32. Choose the arteries that participate in formation of Circle of Willis. I Anterior cerebral artery II Posterior communicating artery III Middle cerebral artery IV Internal carotid artery A. I, II and III B. I, II and IV C. I, III and IV D. All of the above PAIN 33. Which of the following is a TRUE statement about pain? A. It is due to temperature below 450C B. Neuropathic pain is due to stimularion of pain receptor C. Example of pain is intensive pressure D. None of above 34. Fast pain is: I. Short duration II. Well localized III. Conducted by unmyelinated C-fibres IV. Perceived by post-central sensory cortes A. I, II, AND III B. II, III AND IV C. I, III AND IV D. I, II AND IV 35. Which of the following are effects of somatic pain? A. Tenderness B. Produce chemical substances called Lewis P C. Parasympathetic effects may occur in severe cutaneous pain D. Producing ischaemic pain 36. Which of the following causes of visceral pain is FALSE? A. Visceral inflammatory processes and ulcerations B. Thrombosis of blood vessels supplying the viscus C. Withdrawal reflex by noxious stimulus D. Spasmodic contraction of hollow viscera

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7 37. Which of the following are TRUE match? I. Referred pain pain felt away from its original site II. Somatic pain have two types of afferent fibres III. Muscle pain have effects as cutaneous hyperalgesia IV. VIisceral pain all viscera contain no pain receptors A. I and II B. II and III C. III and IV D. I,III and IV ANALGESICS 38. What is the characteristic of non- opioid analgesics? A. Can produce addiction B. Is an antipyretics C. Effective in treatment of coronary thrombosis D. The most powerful analgesics is Mu receptor 39. Which of following are false about morphine ? I. The major side effects are respiratory depression, addiction and constipation II. It is contraindication to pregnancy, chronic pulmonary disease such as emphysema, hypotension and advanced liver disease III. Can be used alone to relieves pain and treat acute abdomen IV. When sudden withdrawal or sudden antagonist of morphine is given, mydriasis, vomiting, diarrhea and yawning will happen V. Morphine addiction can be treated by hospitalization, hypnotics, physiotherapy, and substitution therapy with methadone for a week A. II, III, and IV B. I, III and V C. II, III and V D. I, II, IV and V 40. All of following are correct about center that depressed and stimulated by morphine EXCEPT A. Severe miosis ( Pin Point Pupil-PPP ) occur due to inhibition of inhibitory effect of EdingerWestphal nucleus of 3rd cranial nerve B. Respiration is depressed and the sensitivity of the respiratory center to amount of CO2 in blood is reduced C. Morphine stimulate emetic chemoreceptor trigger zone ( CTZ ) in the thalamus and hypothalamus D. Morphine causes analgesic effect by alteration of respond to pain and elevation of the threshold of pain perception in the sensory area

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8 41. All of following are false about the pharmacological action of morphine EXCEPT A. Decrease the tone of smooth muscle and spasm of sphincters B. Decrease of GIT secretion, peristaltic activity, and segmentation movement and unawareness of defecation reflex can lead constipation C. May precipitate bronchoconstriction in normal individuals as morphine is histamine releaser D. Decrease in biliary tract pressure and metabolic rate E. Urine retention due to central release of ADH 42. Which of following are related to tolerance and therapeutic uses of morphine? I. Tolerance develops to the analgesic and respiratory depressant action of morphine after 10-20 days II. Morphine addict always has constipation and PPP III. Morphine can be used in acute left ventricular failure (pulmonary congestion and dyspnoena) to make dyspnoea less severe as patient is calm IV. Morphine is useful in all level of cough as it make cough center less sensitive A. II and III B. I and IV C. I, II and III D. All of above BLOOD SUPPLY OF THE BRAIN 43. The brain is supplied by the following arteries system I-Carotid system II-Vertebra basilar system III-Brachial system IV-Spinal system A. I, and II B. I, II, and III C. I, and IV D. All of the above 44. The following are the branches of vertebral artery,EXCEPT: A. Anterior spinal artery B. Posterior spinal artery C. Anterior inferior cerebellar artery D. Posterior inferior cerebellar artery 45. The internal carotid artery pass into the carotid canal, foramen lacerum, pass through the cavernous sinus and terminate as anterior cerebral artery and middle cerebral artery. A. True B. False 46. The following structure lies in the middle of circulus arteriosus (circle of willis) I-Optic chiasma II-Infundibulum of Pituitary gland III-Cerebellum IV-Perforated substance Questions Maker Unit (QMU) 2011/2012

9 A. B. C. D. I, II I, and IV I, II, and III I,II, and IV

47. Thrombus in anterior cerebral artery may lead to defect in which physiological function? A. Motor and sensory to upper limb B. Motor and sensory to lower limb C. Vision D. Hearing (auditory) ANALGESIC DRUGS 48. Pharmacologic actions of acetylsalicylic acid include all of the following EXCEPT: A. Analgesic B. Antipyretic C. Anti-inflammatory D. Promotion of platelet aggregation E. Inhibition of synthesis of prostaglandins 49. Aspirin is used in treatment of: A. Vertigo B. Peptic ulcer C. Acute left ventricular failure D. Acute bronchial asthma E. Acute rheumatic fever 50. Aspirin could be used prophylactically for which one of the following condition? A. Bronchial asthma B. Thromboembolism C. Paroxysmal atrial tachycardia D. Peptic ulcer E. Tachycardia 51. Which one of the following drugs could be used as analgesic-antipyretic in a patient with peptic ulcer? A. Aspirin B. Phenylbutazone C. Chloroquine D. Paracetamol 52. Toxic dose of paracetamol cause: A. GIT bleeding B. Cardiac arrhythmias C. Sharp rise in blood pressure D. Hepatic necrosis E. Extrapyramidal reaction

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10 HISTOLOGY OF CEREBRAL CORTEX AND BLOOD BRAIN BARRIER 53. Which of the following is false regarding the histological examination of cerebral cortex section? A. Four layers can be identified in a paraffin section stained with H&E B. In H&E section neuropil appears pale blue grey distinctly structured substance C. Nuclei of small neurons and supporting neuroglia cells are found D. By E.M. neuropil appears like a conglomerate of cell bodies and astrocytes processes 54. The following are the types of neurons in cerebral cortex except: A. Cells of Martinotti B. Pyramidal cells C. Neuroglial proper D. Granule cells 55. The followings are false statement regarding arrangement of layers of cerebral cortex except: A. The third layer from surface inwards is the inner granular layer B. External granular layer has cell bodies which are the small horizontal neurons of Cajal C. Plexiform layer consists chiefly of fibers and few cell bodies D. Multiform layer has small and medium sized pyramidal cells 56. Choose the false statement regarding the cyto-architecture of some cerebral cortex: A. Motor area has few scattered granule cells B. Precentral gyrus has well developed and large pyramidal cell layers C. Sensory area contains ill defined pyramidal layers D. Post central gyrus is of agranular type 57. Which is the correct statement regarding the histology of the meninges: A. Tender mother is the innermost layer which is intimately applied to surface of CNS B. Arachnoid layer consists primarily of thin flat epithelial cells and delicate C.T. fibers C. Dura mater or tough mother consists of numerous network of trabeculae of delicate C.T D. Pia mater contains venous sinuses that drain the CSF ANATOMY OF THE SPINAL CORD 58. The following are true regarding spinal cord EXCEPT A. An elongated cylindrical cord about 45cm long B. Starts at upper border of C1 vertebra and ends at lower border of L1 vertebra C. The cervical enlargement extends from C3 to T2 and corresponds to the origin of brachial plexus where as lumbosacral enlargement extends from L1 to S3 and it corresponds to the origin of lumbar and coccygeal plexuses D. The spinal cord is differentiated into 31 segments with 31 pair of spinal nerves 59. The following are true EXCEPT A. During the 3rd month of intra-uterine life, the spinal cord occupies the whole length of the vertebral canal B. At birth, due to differential growth, the spinal cord ends at the level of L3 vertebra C. The lower end of the spinal cord lies opposite the lower border of L1 vertebra D. The dura and pia mater end at the level of S2 vertebra Questions Maker Unit (QMU) 2011/2012

11 60. The following statements are true about spinal cord EXCEPT I. The end of spinal cord is called conus medullaris which is conical in shape II. The lower end of conus medullaris is attached to filum terminale which is attached to the 2nd piece of coccyx III. Cauda equina is formed of spinal nerves of last thoracic, all lumbar, sacral and coccygeal in addition with filum terminale IV. Intermediate nucleus are found in T1-L1 and in S2-S4 A. I, II and III B. I and II C. II and III D. I and IV 61. The following are true EXCEPT A. Radicular arteries anastomese with anterior and posterior spinal arteries around the circumference of the cord and form longitudinal anastomotic arterial channels on the surface of cord B. The posterior spinal arteries supply the posterior third while the anterior spinal artery supply the anterior two third of the spinal cord C. Radicular arteries arise from superior and inferior intercostals, deep cervical and upper lumbar arteries D. The six longitudinal veins of the spinal cord anastomose with segmental veins through radicular veins 62. The following are true EXCEPT A. Posterointermediate sulcus is found only in cervical and upper thoracic segments only B. Substantia gelatinosa are nuclei found at the apex of dorsal horn of grey matter and act as the main sensory nuclei C. The majority of tracts present in the anterior white column are motor tracts whereas in the lateral white column are sensory tracts D. The ventral root arise from the anterolateral sulcus LOCAL ANESTHETICS 63. All the following are local anesthetics route of administrations EXCEPT A. Surface anesthesia B. Spinal anesthesia C. Infiltration anesthesia D. Inhalation anesthesia 64. What is the effect of local infection on the local anesthesia? A. Alkalosis B. Decrease gap between pH and pKa C. Increase disassociation of drug fraction D. Faster onset time

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12 65. Arrange the following nerve fibers according to their sensitivity from the greatest to the lowest. I. Pain nerves II. Motor nerves III. Temperature nerves IV. Autonomic nerves V. Touch nerves A. I, V, IV, III, II B. IV, I, III, V, II C. II, V, III, I, IV D. II, IV, III, V, I 66. All the following is the systemic side effects of local anesthetics that can be avoided EXCEPT A. Convulsion at the beginning B. Cardiovascular collapse & ventricular tachycardia C. Metabolites para-amino-benzoic acid production D. Respiratory failure at high blood concentration E. Inflammation and irritation 67. Which one of the following is Amides local anesthetic? A. Bupivacaine B. Procaine C. Atropine D. Covocaine E. Adrenaline PHYSIOLOGY OF SPINAL CORD 68. The sensory areas in the brain which is the cortex works in close association with the thalamus. This is called : A Thalamocortical system B Primary somatic area I and II C Spinothalamic tracts D Dorsal column tract 69. Primary sensory area I give these characters EXCEPT I It only receives sensations from all the opposite side of the body II The body is represented an an inverted manners except for the face III Areas of representation are changeable IV Size of the area of representation is not determined by number of receptors. A I , II, III B II , III C III, IV D All of the above

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13 TRUE [ A] or FALSE [B] 70. Somatosensory area I acts in all sensation that pass through dorsal column lemniscus ascending tract 71. All the areas for this somatosensory areas lies in frontal lobe. 72. Without association area [ Brodmans area 5 and 7] , a person can feel touch sensation and recognize the object while closing the eyes.

"Kurang semangat mengakibatkan lebih banyak kegagalan berbanding kurangnya kebijaksanaan atau kemahiran." ~ Flower A. Newhouse

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14 Answer: 1.B(pg.100) 2.D(pg.101) 3.A(pg.102) 4.C(pg.102) 5.D(pg.103) 6.A(pg.83-91) 7.D 8.C 9.A 10.D 11.A(pg.147) 12.B(pg.148) 13.B(pg.148) 14.D(pg.148) 15.C(pg 148-149) 16.A(pg148-149) 17.B((pg86.87) 18.B(pg.87) 19.A(pg.88) 20.C(pg.59) 21.D(pg.90) 22.B 23.A 24.A 25.B 26.B 27.B 28.A(pg.145) 29.D(pg.146) 30.A 31.C(pg.157) 32.B(pg.152) 33.C 34.D 35.A 36.C 37.A 38.B(pg.123) 39.B(pg.126) 40.C(pg.123-124) 41.E(pg124,126) 42.A(pg.124-125) 43.A 44.C 45.A 46.D 47.B 48.D 49.E 50.B 51.D 52.D 53.B(pg.164) 54.C(pg.165) 55.C(pg.166) 56.D(pg.168) 57.A(pg.168) 58.C(pg.186-187) 59.D(pg.187) 60.C(pg.187-188) 61.C(pg.188-189) 62.B 63.D(pg.138-139) 64.C(pg.139) 65.B 66.E(pg.140-141) 67.A(pg.141) 68.A(pg.176) 69.B(pg.177) 70.A(pg.178) 71.B(pg.176) 72.B(pg.179)

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