Year 4 Neurology

Front 1

Which one of the following disease locations is indicated by a head tilt?

a) Forebrain
b) Brainstem
c) Cerebellar

d) Vestibular
e) Spinal Cord

Back 1

D. Can also be seen with circling/falling/wide head excursions and a crouched posture

Front 2

Which one of the following disease locations is indicated by a head turn?

a) Forebrain
b) Brainstem
c) Cerebellar

d) Vestibular
e) Spinal Cord

Back 2

A. Forebrain

Front 3

Which one of the following is most accurately indicated by a wide based stance and knuckling?

a) Vestibular Disease
b) Cerebellar Ataxia
c) Forebrain Disease

d) Proprioceptive Deficits
e) Weakness

Back 3

D. Proprioceptive deficits include those processed by the cerebellum, vestibular apparatus and cerebrum.

Front 4

Which one of the following postures is this dog demonstrating?

a) Decerebrate
b) Decerebellate
c) Schiff-Scherington

d) LMN disease
e) UMN disease

Back 4

B. The head is stretched and back legs are bent. Rarely seen, due to acute cerebellar injury

Front 5

Which one of the following postures is this dog demonstrating?

a) Decerebrate
b) Decerebellate
c) Schiff-Scherington

d) LMN disease
e) UMN disease

Back 5

A. Due to cerebral damage, lack of inhibition = over-reactive reflexes and tone

Front 6

Which one of the following postures is this dog demonstrating?

a) Decerebrate
b) Decerebellate
c) Schiff-Scherington

d) LMN disease
e) UMN disease

Back 6

C. IVD or acute injury to the spine (mostly the lumbar region) causing paralysis of the hindlimbs and rigidity of the forelimbs

Front 7

Which one of the following parameters can you not use to differentiate an UMN lesion from a LMN lesion?

a) Muscle Tone

b) Stride Length
c) Knuckling

d) Spinal Reflexes
e) Severity

Back 7

E. The severity can vary greatly in both lesions.

Front 8

Which one of the following would you expect to see with a UMN lesion, moreso than a LMN lesion?

a) Decreased muscle tone
b) Decreased stride length
c) Decreased spinal reflexes

d) Ataxia
e) Collapse

Back 8

D. Everything else will be increased, and weakness is more likely in LMN lesions as everything is weaker.

Front 9

Which of the following best defines 'Paresis'?

a) Decrease in involuntary movement
b) Decrease in voluntary movement
c) Uncoordination of movements

d) Loss of proprioception
e) Decreased postural reactions

Back 9

B.

Front 10

Which of the following is NOT a type of ataxia?

a) Appendicular
b) Proprioceptive
c) Postural

d) Vestibular
e) Cerebellar

Back 10

C. (A&B are the same type)

Front 11

A dog is brought to you as the owner has noticed she has started to 'tremble' whenever she gets up to do something. On physical exam her mentation is normal, but her postural reactions are a little delayed and she has no menace response in the left eye.

Which of the following can be determined so far?

a) It is a lesion on the LHS of the forebrain
b) It is a lesion on the RHS of the forebrain
c) It is a lesion on the LHS of the cerebellum

d) It is a lesion on the RHS of the cerebellum
e) It is a central lesion of the right vestibular system
f) It is a peripheral lesion of the left vestibular system

Back 11

C. Left cerebellum. The 'intention tremor' and poor postural reactions (esp. hopping) both point toward cerebellar disease. The menace response confirms this suspicion as it is in the pathway, seeing deficits in the ipsilateral (same) side as the lesion (ie the left).

Front 12

A dog presents with circling to his left. Upon examination you find the dog has loss of muscle tone in his jaw, a medial strabismus in the left eye and a vertical nystagmus.

Which of the following is most likely to be present?

a) Central vestibular lesion near CN 4-5 on LHS
b) Central vestibular lesion near CN 5-6 on LHS
c) Central brainstem disease

d) Peripheral vestibular disease on the LHS
e) Horner's Syndrome

Back 12

B. Central vestibular disease is confirmed by the nystagmus and strabismus. The medial strabismus indicates loss of action of the lateral rectus, which is innervated by CN VI. Loss of muscle jaw suggests involvement of CNV too.

Front 13

A dog presents with droopy upper eyelids that have progressively gotten worse over the past few weeks. Upon closer inspection, you find miosis and enopthalmus present, as well as some facial assymmetry. A Schirmer Tear Test reveals a results of 8 in both sides. The palpebral and menace response are both very small in both eyes too.

Dx?

a) Central Vestibular lesion from CNIII-CNVII
b) Central Vestibular lesion from CNIV-CNVII
c) Peripheral lesion of the osseous petrous temporal bone

d) Peripheral lesion between C8-T2
e) Grass seed migration to the caudal eye

Back 13

C. Horner's Syndrome is only seen in peripheral disease, and with vestibular signs and CNVII paralysis (low lacrimal gland secretion, menace and palpebral), can be refined to the OPT bone.

(Miosis = small pupils due to v symp)
(Enopthalmus = sunken eye due to v symp)

Front 14

Which one of the following is NOT tested by the Menace Response?

a) Forebrain
b) Brainstem
c) Cerebellum

d) CNII

e) CNIII
f) CNVII

Back 14

E. CNII -> FB -> Cerebellum -> BS -> VII

Front 15

Which one of the following is NOT tested by the PLR?

a) Forebrain
b) Brainstem
c) CNII

d) CNIII

e) Edinger-Westphal Nucleus

Back 15

A. CNII -> BS -> III -> EW Nucles -> Iris Sphincter Muscle

Front 16

Which TWO of the following are NOT included in the Palpebral Reflex?

a) CNIII
b) CNV
c) Brainstem
d) Forebrain
e) CNVII

Back 16

A. and D.

Front 17

Which of the following is the correct signal pathway for the Corneal Reflex?

a) CNIII -> Forebrain -> Brainstem -> CNVII
b) CNIII -> Forebrain -> Brainstem -> CNVI
c) CNIII -> Forebrain -> CN V
d) CNV -> Forebrain -> CN VI
e) CNV -> Forebrain -> CN VII

Back 17

D. It is the Abducens Nerve (CNVI) that innervates the Retractor Bulbi muscle and causes the reflex.

Front 18

Which of the following is abnormal is there is a lateral strabismus present?

a) CNIII
b) CNIV
c) CNV
d) CNVI
e) CNVII

Back 18

A. The Oculomotor Nerve

Front 19

A dog presents with his tongue sticking out of his mouth. Upon further examination you find that he has no gag reflex and no tone in his tongue at all. Dx and treatment?

a) Lesion from CNX-CNXII - EUTHANASIA
b) Lesion from CNX-CNXII - SURGERY
c) Lesion from CNIX-CNXII - EUTHANASIA
d) Lesion from CNIX-CNXII - SURGERY
e) Lesion in CNXII only - SURGERY

Back 19

C. IX and X control the gag reflex via the pharynx and XII controls the tongue tone and movement. Without either of these the animal will surely die from aspiration pneumonia, so euthanasia is recommended.

Front 20

What percent of dogs on average respond to AEDs?

a) 5%
b) 15%
c) 25%
d) 60%
e) 80%

Back 20

D. Approx 2/3

Front 21

Which of the following drugs is the first choice of treatment for a dog that has had a seizure?

a) Potassium Bromide
b) Phenobarbitone
c) Imepitoin
d) Gabapentin
e) Felbamate

Back 21

B

Front 22

Which of the following drugs is the SECOND choice of treatment for a dog that has had a seizure?

a) Potassium Bromide
b) Phenobarbitone
c) Imepitoin
d) Gabapentin
e) Felbamate

Back 22

A.

Front 23

Which of the following is suitable for treatment with Imepitoin due to completion of clinical trials?

a) Cluster seizures
b) Status Epilepticus
c) Cats
d) Dogs under 5 kilos
e) Epilepsy in dogs over 5 kilos
f) All of the above

Back 23

E. Trials in all other categories are yet to be completed.

Front 24

Which of the following is NOT a main aim of medication?

a) Reduce memory of event
b) Reduce fear
c) Reduce anxiety
d) Reduce postictal signs
e) Improve prognosis

Back 24

D

Front 25

Which of the following is an example of a tricyclic antidepressant?

a) Amitriptyline
b) Clomipramine:
c) Fluoxetine
d) Setraline

Back 25

A

Front 26

What are tricyclic antidepressants the choice of treatment for?

a) Separation Anxiety
b) Compulsive Disorder
c) Noise Phobias
d) Aggression
e) Feline Interstitial Cystitis

Back 26

E.!

Front 27

What are Serotonin Selective Reuptake Inhibitors the choice of treatment for?

a) Separation Anxiety
b) Compulsive Disorder
c) Noise Phobias
d) Aggression
e) Feline Interstitial Cystitis

Back 27

C.

Front 28

Benzodiazopene is an example of which type of drug?

a) AED
b) Gaba-ergic
c) Serotonergic
d) Dopaminergic
e. All of the above

Back 28

B. Pscyhoactive med

Front 29

Which of the following is not a part of the pain perception pathway?

a) Modulation
b) Transmission
c) Projection
d) Sensitisation
e) Perception
f) Transduction

Back 29

D.

Front 30

Which of the following drugs is a mixed agonst-antagonist?

a) Butorphanol
b) Buprenorphine
c) Morphine
d) Naxolone
e) Tramadol

Back 30

A.

Front 31

Which of the following drugs is a partial mu-agonist?

a) Butorphanol
b) Buprenorphine
c) Morphine
d) Naxolone
e) Tramadol

Back 31

B.

Front 32

Which of the following drugs is a mu-antagonist?

a) Butorphanol
b) Buprenorphine
c) Morphine
d) Naxolone
e) Tramadol

Back 32

D.

Front 33

Which of the following is the ONLY local anaesthetic drug licensed for cattle in the UK?

a) Procaine
b) Lidocaine
c) Mepivacaine
d) Ropivacaine
e) Levobupivacaine

Back 33

A.

Front 34

Which of the following is a non-selective COX inhibitor?
a) Mavacoxib
b) Meloxicam
c) Carprofen
d) Phenylbutazone
e) Firocoxib

Back 34

D. as well as Aspirin and Ketoprofen

Front 35

Which of the following is a selective COX-2 inhibitor?
a) Mavacoxib
b) Meloxicam
c) Carprofen
d) Phenylbutazone
e) Firocoxib

Back 35

E. As well as Robenocoxib

Front 36

Which of the following human NSAIDs can be used in canine cases of Transitional Cell Carcinoma?

a) Ibuprofen
b) Naproxen
c) Piroxicam

d) Mefanamic Acid
e) Diclofenac

Back 36

C.

Front 37

Which layer do Embryonic Stem Cells come from?

a) Endometrium
b) Inner Cell Mass
c) Trophoblasts

d) Blastocyst Cavity
e) Epiblast

Back 37

B.

Front 38

Chlorambucil is an example of which of the following drug groups?

a) Alkylating Agent
b) Anti-metabolite
c) Mitotic Inhibitor

d) Calcineurin inhibitor
e) All of the above

Back 38

A

Front 39

Azothioprine is an example of which of the following drug groups?

a) Alkylating Agent
b) Anti-metabolite
c) Mitotic Inhibitor

d) Calcineurin inhibitor
e) All of the above

Back 39

B.

Front 40

Vincristine is an example of which of the following drug groups?

a) Alkylating Agent
b) Anti-metabolite
c) Mitotic Inhibitor

d) Calcineurin inhibitor
e) All of the above

Back 40

C.

Front 41

Ciclosporin is an example of which of the following drug groups?

a) Alkylating Agent
b) Anti-metabolite
c) Mitotic Inhibitor

d) Calcineurin inhibitor
e) All of the above

Back 41

D.