30. Hearing tests

  1. Weber test: a normal response is hearing the tuning fork similarly in both ears?
  2. Weber test: a patient with a conductive hearing loss will hear the tuning fork louder in the unaffected ear?
  3. Weber test: a patient with sensorineural hearing loss will hear the tuning fork louder in the unaffected ear?
  4. Weber test: a patient with sensorineural hearing loss will hear the tuning fork similarly in both ears?
  5. Rinne test: in a patient with normal hearing, the sound will still be heard after the mastoid test?
  6. Rinne test: in a patient with sensorineurineal hearing loss, the sound will still be heard after the mastoid test?

  1. T
  2. F
  3. T
  4. F
  5. T
  6. T

29. POUND score

  1. Pulsatile quality?
  2. Onset for 24-48 hours?
  3. Unilateral?
  4. Nystagmus?
  5. Disabling intensity?
  6. 2 or more points – 60% likelihood migraine?

  1. T
  2. F
  3. T
  4. F
  5. T
  6. F

28. Tremor

  1. Cerebellar tremor: lesion on one side of the cerebellum produces a tremor in that same side of the body?
  2. Dystonic tremor: is often relieved after ingestion of small amount of ethanol?
  3. Parkinsonian tremor: allmost allways starts bilatarally?
  4. Essential tremor: may be accompanied by other manifestations of ataxia?
  5. Psychogenic tremor: it usually decreases or disappears when the patient is distracted?
  6. Cerebellar tremor: finger-nose test is positive?

  1. T
  2. F
  3. F
  4. F
  5. T
  6. T

27. The extrapyramidal tracts are:

  1. Rubrospinal tract?
  2. Reticulospinal tract?
  3. Nigrospinal tract?
  4. Vestibulospinal tract?
  5. Tectospinal tract?
  6. Lateral corticospinal tract?

  1. T
  2. T
  3. F
  4. T
  5. T
  6. F

26. Clinical features of essential tremor

  1. Bilateral, mostly symmetrical postural or kinetic tremor in hands or forearms?
  2. May be aggravated by emotional stress, fatigue, hypoglycemia or caffeine?
  3. One of the characteristic presentations is isolated voice tremor?
  4. Is not associated with rigidity, slowness of movement, or difficulty with walking?
  5. Ethanol in small doses characteristically improves tremor?
  6. Additional or isolated head tremor (yes-yes or no-no) may be found?

  1. T
  2. T
  3. F
  4. T
  5. T
  6. T

25. Parkinson’s disease

  1. Is a neurodegenerative diseases characterised by the abnormal accumulation of aggregates of tau protein in neurons?
  2. The main pathological characteristic of the disease is cell death in the substantia nigra pars reticulata?
  3. There is a reduced risk of the disease in cigarette smokers and coffee and tea drinkers?
  4. Idiopathic Parkinson’s disease usually has bilateral, symmetrical onset of symptoms?
  5. Levodopa is typically more effective at controlling symptoms in Parkinson plus syndromes than in PD?
  6. Parkinson-plus syndromes are usually more slowly progressive than the idiopathic Parkinson’s disease?

  1. F
  2. F
  3. T
  4. F
  5. F
  6. F

24. Response fluctuations in Parkinson’s disease

  1. Wearing off: a sudden, brief inability to start movement or to continue repeated movements?
  2. Protein related offs: trans­port of levodopa across the intestinal wall is decreased because of competition for facilitated transport by large amounts of neutral amino acids?
  3. Delayed on: a prolongation of the time required for levodopa effect to appear?
  4. Peak-dose dyskinesias: occurs at the time of peak levodopa plasma concentrations?
  5. Freezing: reemergence of parkinsonian symptoms before the next scheduled levodopa dose?
  6. Diphasic dyskinesia: a dyskinesia in which involuntary movements occur during both peak and trough levodopa concentrations?

  1. F
  2. T
  3. T
  4. T
  5. F
  6. T

23. Corticospinal tract

  1. The corticospinal tract is a motor pathway starting at the cortex that terminates on motor neurons in the brainstem or spinal cord and is involved in the control of motor functions of the body?
  2. About 80% of corticospinal neurons originate in the primary motor cortex?
  3. Pyramidal cells of Betz are the largest neurons in the central nervous system?
  4. Lateral corticospinal tract appears on transverse section of the spinal cord as an oval area in front of the posterior column and medial to the posterior spinocerebellar tract?
  5. All the fibers of the lateral corticospinal tract cross the midline in the medulla oblongata and control the limbs and digits?
  6. The anterior corticospinal tract becomes smaller as it descends, ending at the level of the mid-thoracic spinal cord?

  1. F
  2. F
  3. T
  4. T
  5. F
  6. T

22. Caudate nucleus (Nucleus caudatus)

  1. Is a C – shaped structure that lies on the lateral side of the thalamus?
  2. Stria terminalis and thalamostriate vein lie between thalamus and caudate nucleus?
  3. Together with putamen it forms the ventral striatum?
  4. Its head forms the floor of the anterior horn of the lateral ventricle?
  5. Caudate nucleus nucleus has motor and behavioral functions?
  6. It is heavily innervated by serotoninergic neurons from substantia nigra?

  1. T
  2. T
  3. F
  4. T
  5. T
  6. F