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Basic Sciences in Neurology

Basic Sciences in Neurology

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Question 1 of 20

1. Question

Which structural feature is primarily responsible for the restrictive permeability of the blood-brain barrier?

Tight junctions between capillary endothelial cells
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Fenestrations between endothelial cells
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Pericyte contractile activity
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Astrocyte foot process pinocytosis
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Thin basement membrane of cerebral capillaries
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Question 2 of 20

2. Question

Which of the following changes produces cerebral vasodilation and an increase in cerebral blood flow?

A rise in arterial PaCO2
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A rise in arterial PaO2
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A rise in CSF pH
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A fall in intracranial pressure in isolation
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Systemic sympathetic activation
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Question 3 of 20

3. Question

Which enzyme catalyses the rate-limiting step in catecholamine biosynthesis?

Tyrosine hydroxylase
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Dopa decarboxylase
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Dopamine beta-hydroxylase
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Monoamine oxidase
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Catechol-O-methyltransferase
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Question 4 of 20

4. Question

The characteristic decremental response on repetitive nerve stimulation in myasthenia gravis is best explained by:

Antibody-mediated loss of functional postsynaptic acetylcholine receptors
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Impaired presynaptic acetylcholine release
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Blockade of voltage-gated calcium channels
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Demyelination of the motor nerve
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Deficiency of acetylcholinesterase
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Question 5 of 20

5. Question

What is the classic cerebrospinal fluid finding in Guillain-Barré syndrome?

Albuminocytological dissociation
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Lymphocytic pleocytosis with low glucose
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Neutrophilic pleocytosis with raised protein
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Oligoclonal bands with normal protein
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Elevated glucose with normal protein
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Question 6 of 20

6. Question

What is the genetic basis of Huntington disease?

A CAG trinucleotide repeat expansion in the huntingtin gene
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An autosomal recessive point mutation on chromosome 4
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A mitochondrial DNA deletion
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A CTG repeat expansion on chromosome 19
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An X-linked dystrophin gene mutation
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Question 7 of 20

7. Question

The motor features of Parkinson disease result primarily from degeneration of dopaminergic neurons in the:

Substantia nigra pars compacta
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Globus pallidus internus
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Subthalamic nucleus
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Ventral tegmental area
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Caudate nucleus
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Question 8 of 20

8. Question

A lentiform hyperdensity that does not cross cranial suture lines on CT is most characteristic of:

Extradural haematoma
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Subdural haematoma
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Subarachnoid haemorrhage
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Intraventricular haemorrhage
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Diffuse axonal injury
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Question 9 of 20

9. Question

A patient presents with contralateral weakness predominantly affecting the lower limb, with relative sparing of the face and upper limb. The occluded vessel is most likely the:

Anterior cerebral artery
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Middle cerebral artery
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Posterior cerebral artery
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Basilar artery
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Posterior inferior cerebellar artery
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Question 10 of 20

10. Question

What is the pattern of sensory loss in Brown-Séquard (hemicord) syndrome?

Ipsilateral loss of proprioception and contralateral loss of pain and temperature below the lesion
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Bilateral loss of pain and temperature below the lesion
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Contralateral loss of proprioception and ipsilateral loss of pain and temperature
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Bilateral loss of all sensory modalities
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Isolated loss of proprioception bilaterally
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Question 11 of 20

11. Question

Following an acute occlusion of the anterior spinal artery, which sensory modality is characteristically preserved?

Proprioception and vibration
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Pain sensation
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Temperature sensation
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Crude touch
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Visceral sensation
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Question 12 of 20

12. Question

In the retina, light striking a photoreceptor causes:

Hyperpolarisation and decreased glutamate release
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Depolarisation and increased glutamate release
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Opening of cGMP-gated sodium channels
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Increased intracellular cyclic GMP
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Sustained dark current
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Question 13 of 20

13. Question

Which of the following is required, in addition to glutamate, as a co-agonist for activation of the N-methyl-D-aspartate (NMDA) receptor?

Glycine
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Aspartate
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Dopamine
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Magnesium
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Serotonin
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Question 14 of 20

14. Question

A patient with suspected optic neuritis undergoes visual evoked potential (VEP) testing. Which abnormality is most characteristic of demyelination of the optic nerve?

Prolonged latency
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Absent waveform
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Decreased amplitude with normal latency
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Increased amplitude
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Shortened latency
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Question 15 of 20

15. Question

The corticospinal (pyramidal) fibres descending from the motor cortex pass through which part of the internal capsule?

Posterior limb
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Anterior limb
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Genu
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Retrolentiform part
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Sublentiform part
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Question 16 of 20

16. Question

The gene encoding the amyloid precursor protein (APP) is located on which chromosome?

Chromosome 21
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Chromosome 1
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Chromosome 14
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Chromosome 19
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Chromosome X
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Question 17 of 20

17. Question

A decremental response on low-frequency repetitive nerve stimulation during nerve conduction studies indicates dysfunction at which anatomical structure?

Neuromuscular junction
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Microtubule within the axon
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Muscle spindle
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Node of Ranvier
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Sarcoplasmic reticulum
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Question 18 of 20

18. Question

A woman presents with longitudinally extensive transverse myelitis and bilateral optic neuritis.

Which autoantibody target is most specifically associated with this condition?

Aquaporin-4
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Acetylcholine receptor
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Ganglioside GM1
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Glutamic acid decarboxylase
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Myelin-associated glycoprotein
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Question 19 of 20

19. Question

A patient presents with sudden severe headache, complete ptosis, an eye resting in a “down and out” position, and a dilated poorly reactive pupil.

Which underlying lesion is most likely responsible?

Posterior communicating artery aneurysm
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Diabetic microvascular ischaemia
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Internuclear ophthalmoplegia
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Lateral medullary infarction
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Thyroid eye disease
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Question 20 of 20

20. Question

What is the principal mechanism by which pregabalin exerts its analgesic effect in neuropathic pain?

Binding to the α2δ subunit of voltage-gated calcium channels
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Depletion of substance P
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Enhancement of GABA-A receptor function
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Inhibition of cyclo-oxygenase
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Partial agonism at mu-opioid receptors
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