USMLE Step 1 Qs (12)
50 Questions
| Total Attempts: 91
Questions from various sources for practicing
Questions and Answers
- 1.A 55-year-old female patient is admitted to the hospital for treatment of hypertension. Which of the following drugs is most appropriate to treat this disorder?
- A.
Yohimbine
- B.
Clonidine
- C.
Sodium lactate
- D.
Cholecystokinin
- E.
Carbon dioxide
- 2.A 55-year-old female patient is admitted to the hospital for treatment of hypertension. The treatment of this combination of symptoms by the appropriate drug is mediated by its actions on which of the following receptors?
- A.
Muscarinic ACh receptors
- B.
Dopaminergic receptors
- C.
alpha 2-adrenergic receptors
- D.
Serotonergic receptors
- E.
GABA receptors
- 3.As a result of a leg injury, a 30-year-old male developed chronic pain and was subsequently treated with morphine. Consequently, he developed an addiction to morphine. through which receptor it acts to develop an addiction ?
- A.
Opioid nociceptin receptor
- B.
Opioid mu receptor
- C.
Opioid delta receptor
- D.
Opioid kappa receptor
- E.
Dopamine D2-receptor
- 4.As a result of a leg injury, a 30-year-old male developed chronic pain and was subsequently treated with morphine. Consequently, he developed an addiction to morphine. In which a region of the brain has this receptor been shown through extensive research to be heavily concentrated?
- A.
Mammillary bodies
- B.
Precentral gyrus
- C.
Midbrain periaqueductal gray
- D.
Inferior olivary nucleus
- E.
Deep pontine nuclei
- 5.A 65-year-old male was admitted to the emergency room and was diagnosed with a stroke. Which of the following drugs might be given to the patient in order to reduce the deleterious effects of the stroke
- A.
GABA antagonist
- B.
Dopamine antagonist
- C.
Norepinephrine antagonist
- D.
NMDA antagonist
- E.
Serotonin antagonist
- 6.A 65-year-old male was admitted to the emergency room and was diagnosed with a stroke. Appropriate drug treatment could be effective by which of the following means?
- A.
Raising the blood pressure
- B.
Attempting to decrease disruption of the blood-brain barrier
- C.
Reducing seizure activity in the cerebral cortex and limbic system
- D.
Stabilizing body temperature
- E.
Reducing brain serotonin levels in the brainstem and cerebral cortex
- 7.A patient is admitted to the hospital after experiencing increasing episodes of temporal lobe seizure activity. To treat this disorder, which of the following drugs should be administered?
- A.
Physostigmine
- B.
Bicuculline
- C.
Pilocarpine
- D.
Kainate
- E.
Vigabatrin
- 8.A patient is admitted to the hospital after experiencing increasing episodes of temporal lobe seizure activity. Appropriate drug treatment is effective because of which of the following?
- A.
It blocks NMDA receptors
- B.
It activates noradrenergic receptors
- C.
It activates GABA receptors
- D.
It activates cholinergic receptors
- E.
It blocks dopamine receptors
- 9.A 46-year-old man finds that, over a period of time, he has progressive bilateral weakness of both upper and lower limbs beginning with the muscles of the hands. However, testing reveals that sensory functions appear normal. Eventually, this individual is found to have wasting of muscles, fasciculations, and evidence of upper motor neuron (UMN) dysfunction together with an increase in tendon reflexes. After a few additional months, the patient develops facial weakness and an inability to swallow (dysphagia). Further analysis reveals abnormalities in the electromyegram (EMG) of the upper and lower extremities, denervation atrophy. However, the cerebrospinal fluid (CSF) remains normal. This patient is most likely suffering from which of the following?
- A.
MS
- B.
Poliomyelitis
- C.
Amyotrophic lateral sclerosis (ALS)
- D.
Myasthenia gravis
- E.
A cerebral cortical stroke
- 10.A 46-year-old man finds that, over a period of time, he has progressive bilateral weakness of both upper and lower limbs beginning with the muscles of the hands. However, testing reveals that sensory functions appear normal. Eventually, this individual is found to have wasting of muscles, fasciculations, and evidence of upper motor neuron (UMN) dysfunction together with an increase in tendon reflexes. After a few additional months, the patient develops facial weakness and an inability to swallow (dysphagia). Further analysis reveals abnormalities in the electromyegram (EMG) of the upper and lower extremities, denervation atrophy. However, the cerebrospinal fluid (CSF) remains normal. The neuronal regions affected include which of the following?
- A.
Dorsal horns of the spinal cord
- B.
Lateral columns of the spinal cord
- C.
Ventral horns of the spinal cord
- D.
Dorsal columns and ventral horns of the spinal cord
- E.
Ventral horns and lateral columns of the spinal cord
- 11.A 55-year-old man, who has been suffering from hypertension for the past 8 years, experiences attacks of pain in the regions of the pharynx and ear, which are usually preceded by swallowing and coughing spells. Each attack, which lasted for an average of 1 minute, occurred a number of times; ultimately, this condition showed remission. Although the neurological examination was basically normal, a subsequent MRI was taken and revealed an abnormality at the base of the skull. Which of the following cranial nerves is most likely involved in this disorder?
- A.
Nerve V
- B.
Nerve VII
- C.
Nerve IX
- D.
Nerve XI
- E.
Nerve XII
- 12.A 55-year-old man, who has been suffering from hypertension for the past 8 years, experiences attacks of pain in the regions of the pharynx and ear, which are usually preceded by swallowing and coughing spells. Each attack, which lasted for an average of 1 minute, occurred a number of times; ultimately, this condition showed remission. Although the neurological examination was basically normal, a subsequent MRI was taken and revealed an abnormality at the base of the skull. The motor component of this cranial nerve arises from the which of the following substances?
- A.
Otic ganglion
- B.
Nodose ganglion
- C.
Nucleus ambiguus
- D.
Inferior salivatory nucleus
- E.
Lateral reticular nucleus
- 13.A 55-year-old man, who has been suffering from hypertension for the past 8 years, experiences attacks of pain in the regions of the pharynx and ear, which are usually preceded by swallowing and coughing spells. Each attack, which lasted for an average of 1 minute, occurred a number of times; ultimately, this condition showed remission. Although the neurological examination was basically normal, a subsequent MRI was taken and revealed an abnormality at the base of the skull. The cell bodies of the sensory component of the affected nerve are located in which of the following structures?
- A.
Solitary nucleus
- B.
Superior ganglion
- C.
Geniculate ganglion
- D.
Vestibular nuclei
- E.
Trigeminal ganglion
- 14.A 55-year-old man, who has been suffering from hypertension for the past 8 years, experiences attacks of pain in the regions of the pharynx and ear, which are usually preceded by swallowing and coughing spells. Each attack, which lasted for an average of 1 minute, occurred a number of times; ultimately, this condition showed remission. Although the neurological examination was basically normal, a subsequent MRI was taken and revealed an abnormality at the base of the skull. The motor and sensory components of this nerve that were affected are respectively characterized as which of the following?
- A.
General visceral efferent and general visceral afferent
- B.
Special visceral efferent and general somatic afferent
- C.
General somatic efferent and special visceral afferent
- D.
Special visceral efferent and special visceral afferent
- E.
General somatic efferent and general somatic afferent
- 15.In a classic experiment performed by Sherrington in the cat, marked rigidity was demonstrated in a decerebrate preparation. Similarly, an 80-year-old woman displayed rigidity, which resembled that shown in the cat after having a stroke. Which of the following is the likely location of the stroke?
- A.
Thalamus
- B.
Hypothalamus
- C.
Upper midbrain
- D.
Pons
- E.
Spinal cord
- 16.In a classic experiment performed by Sherrington in the cat, marked rigidity was demonstrated in a decerebrate preparation. Similarly, an 80-year-old woman displayed rigidity, which resembled that shown in the cat after having a stroke. The rigidity can be accounted in part by the unopposed action of which of the following?
- A.
Rubrospinal tract
- B.
Lateral vestibulospinal tract
- C.
Corticospinal tract
- D.
Medial vestibulospinal tract
- E.
Lateral reticulospinal tract
- 17.An individual experiences an ipsilateral paralysis of the soft palate and pharynx, producing hoarseness and dysphagia (inability to swallow) and, in addition, displays a loss of the carotid sinus reflex. Which of the following nerve groups if most likely affected?
- A.
Cranial nerve XII
- B.
Cranial nerve XI
- C.
Cranial nerve X
- D.
Cranial nerve VII
- E.
Ventral horn cells of the cervical cord
- 18.An individual experiences an ipsilateral paralysis of the soft palate and pharynx, producing hoarseness and dysphagia (inability to swallow) and, in addition, displays a loss of the carotid sinus reflex. Which of the following nuclei is most likely damaged
- A.
Solitary and lateral reticular nuclei
- B.
Deep pontine and facial nuclei
- C.
Dorsal motor nucleus and nucleus ambiguus
- D.
Ventral horn of the cervical segment of the spinal cord
- E.
Inferior salivatory and medial vestibular nuclei
- 19.A 68-year-old woman had suffered from an infectious disorder for several weeks. Following recovery from this disorder, she experienced some loss of taste and an increase in salivation, together with pain spasms in the region of the pharynx, which extended into the ear. She also experienced some bradycardia and cardiac arrhythmia, as well as deviation of the uvula to the unaffected side. Which of the following cranial nerves is most directly involved in this deficit?
- A.
Cranial nerve VII
- B.
Cranial nerve IX
- C.
Cranial nerve X
- D.
Cranial nerve XI
- E.
Cranial nerve XII
- 20.A 68-year-old woman had suffered from an infectious disorder for several weeks. Following recovery from this disorder, she experienced some loss of taste and an increase in salivation, together with pain spasms in the region of the pharynx, which extended into the ear. She also experienced some bradycardia and cardiac arrhythmia, as well as deviation of the uvula to the unaffected side. Which of the following is the likely site of the lesion affecting this nerve
- A.
Upper medulla
- B.
Lower medulla
- C.
Lower pons
- D.
Upper pons
- E.
Base of the skull
- 21.Julie is a 29-year-old office worker with diabetes, who awoke one morning with the inability to close her left eye and a left facial droop. Her left eye felt a bit dry, as well. She had run out of sick days and, hoping that the problem would go away, went to work. After several coworkers noticed that her face was drooping and that she was especially sensitive to loud noises on her left side, they convinced her to go to the nearest emergency room in order to make sure that she did not have a stroke. She was examined right away in the emergency room because of her age. The doctor noted right away that her mouth drooped on the left side. Her left eye was slightly closed. He tested her speech and mental status, which were normal, other than some slight slurring of her speech. Her vision and eye movements were also normal. Sensation and jaw movement were also normal, but when she was asked to wiggle her eyebrows, only the right side of her forehead moved. When asked to close her eyes tightly, and not allow him to open her eyes, her right eye would not open, but her left eye could not oppose the force. She was not able to hold air in her cheeks when asked to hold her breath, and when asked to smile, only the right side of her mouth elevated. She was very sensitive to noise on her left side. When asked to protrude her tongue, it did not deviate to either side, but if she closed her eyes and sugar water was placed on the left side of the anterior portion of her tongue, she could not identify it. The remainder of her examination was normal. A nurse asked if a head CT should be ordered in order to look for a stroke or tumor, but the doctor said that it wasn't necessary. He told Julie that he would draw some blood and give her a medication to take for a while. Assuming that the doctor was correct, and that this isn't a stroke, where in the nervous system has the damage occurred?
- A.
Buccinator muscle
- B.
Trigeminal nerve
- C.
Facial nerve
- D.
Glossopharyngeal nerve
- E.
Hypoglossal nerve
- 22.Julie is a 29-year-old office worker with diabetes, who awoke one morning with the inability to close her left eye and a left facial droop. Her left eye felt a bit dry, as well. She had run out of sick days and, hoping that the problem would go away, went to work. After several coworkers noticed that her face was drooping and that she was especially sensitive to loud noises on her left side, they convinced her to go to the nearest emergency room in order to make sure that she did not have a stroke. She was examined right away in the emergency room because of her age. The doctor noted right away that her mouth drooped on the left side. Her left eye was slightly closed. He tested her speech and mental status, which were normal, other than some slight slurring of her speech. Her vision and eye movements were also normal. Sensation and jaw movement were also normal, but when she was asked to wiggle her eyebrows, only the right side of her forehead moved. When asked to close her eyes tightly, and not allow him to open her eyes, her right eye would not open, but her left eye could not oppose the force. She was not able to hold air in her cheeks when asked to hold her breath, and when asked to smile, only the right side of her mouth elevated. She was very sensitive to noise on her left side. When asked to protrude her tongue, it did not deviate to either side, but if she closed her eyes and sugar water was placed on the left side of the anterior portion of her tongue, she could not identify it. The remainder of her examination was normal. A nurse asked if a head CT should be ordered in order to look for a stroke or tumor, but the doctor said that it wasn't necessary. He told Julie that he would draw some blood and give her a medication to take for a while. Julie's facial weakness is characteristic of which of the following?
- A.
A muscle lesion
- B.
A lesion of the internal capsule
- C.
A superior brainstem lesion
- D.
A UMN seventh-nerve lesion
- E.
An LMN seventh-nerve lesion
- 23.Julie is a 29-year-old office worker with diabetes, who awoke one morning with the inability to close her left eye and a left facial droop. Her left eye felt a bit dry, as well. She had run out of sick days and, hoping that the problem would go away, went to work. After several coworkers noticed that her face was drooping and that she was especially sensitive to loud noises on her left side, they convinced her to go to the nearest emergency room in order to make sure that she did not have a stroke. She was examined right away in the emergency room because of her age. The doctor noted right away that her mouth drooped on the left side. Her left eye was slightly closed. He tested her speech and mental status, which were normal, other than some slight slurring of her speech. Her vision and eye movements were also normal. Sensation and jaw movement were also normal, but when she was asked to wiggle her eyebrows, only the right side of her forehead moved. When asked to close her eyes tightly, and not allow him to open her eyes, her right eye would not open, but her left eye could not oppose the force. She was not able to hold air in her cheeks when asked to hold her breath, and when asked to smile, only the right side of her mouth elevated. She was very sensitive to noise on her left side. When asked to protrude her tongue, it did not deviate to either side, but if she closed her eyes and sugar water was placed on the left side of the anterior portion of her tongue, she could not identify it. The remainder of her examination was normal. A nurse asked if a head CT should be ordered in order to look for a stroke or tumor, but the doctor said that it wasn't necessary. He told Julie that he would draw some blood and give her a medication to take for a while. Damage to which area may have produced the defect in taste in the anterior two-thirds of her tongue?
- A.
Intermediate nerve
- B.
Glossopharyngeal nerve
- C.
Lingual nerve
- D.
Facial nerve, distal to the chorda tympani nerve
- E.
Facial nerve, proximal to the chorda tympani nerve
- 24.Julie is a 29-year-old office worker with diabetes, who awoke one morning with the inability to close her left eye and a left facial droop. Her left eye felt a bit dry, as well. She had run out of sick days and, hoping that the problem would go away, went to work. After several coworkers noticed that her face was drooping and that she was especially sensitive to loud noises on her left side, they convinced her to go to the nearest emergency room in order to make sure that she did not have a stroke. She was examined right away in the emergency room because of her age. The doctor noted right away that her mouth drooped on the left side. Her left eye was slightly closed. He tested her speech and mental status, which were normal, other than some slight slurring of her speech. Her vision and eye movements were also normal. Sensation and jaw movement were also normal, but when she was asked to wiggle her eyebrows, only the right side of her forehead moved. When asked to close her eyes tightly, and not allow him to open her eyes, her right eye would not open, but her left eye could not oppose the force. She was not able to hold air in her cheeks when asked to hold her breath, and when asked to smile, only the right side of her mouth elevated. She was very sensitive to noise on her left side. When asked to protrude her tongue, it did not deviate to either side, but if she closed her eyes and sugar water was placed on the left side of the anterior portion of her tongue, she could not identify it. The remainder of her examination was normal. A nurse asked if a head CT should be ordered in order to look for a stroke or tumor, but the doctor said that it wasn't necessary. He told Julie that he would draw some blood and give her a medication to take for a while. Assuming that Julie had no prior problems with her ears or cochlear nerve, damage to the nerve supply of which muscle could cause the sensitivity to or distortion of noises?
- A.
Digastric
- B.
Platysma
- C.
Buccinator
- D.
Geniohyoid
- E.
Stapedius
- 25.Julie is a 29-year-old office worker with diabetes, who awoke one morning with the inability to close her left eye and a left facial droop. Her left eye felt a bit dry, as well. She had run out of sick days and, hoping that the problem would go away, went to work. After several coworkers noticed that her face was drooping and that she was especially sensitive to loud noises on her left side, they convinced her to go to the nearest emergency room in order to make sure that she did not have a stroke. She was examined right away in the emergency room because of her age. The doctor noted right away that her mouth drooped on the left side. Her left eye was slightly closed. He tested her speech and mental status, which were normal, other than some slight slurring of her speech. Her vision and eye movements were also normal. Sensation and jaw movement were also normal, but when she was asked to wiggle her eyebrows, only the right side of her forehead moved. When asked to close her eyes tightly, and not allow him to open her eyes, her right eye would not open, but her left eye could not oppose the force. She was not able to hold air in her cheeks when asked to hold her breath, and when asked to smile, only the right side of her mouth elevated. She was very sensitive to noise on her left side. When asked to protrude her tongue, it did not deviate to either side, but if she closed her eyes and sugar water was placed on the left side of the anterior portion of her tongue, she could not identify it. The remainder of her examination was normal. A nurse asked if a head CT should be ordered in order to look for a stroke or tumor, but the doctor said that it wasn't necessary. He told Julie that he would draw some blood and give her a medication to take for a while. If Julie did not have the loss of taste and noise sensitivity, but did have the inability to move her left eye to the left, which area would now be damaged?
- A.
The trigeminal and abducens nerves
- B.
The facial and trigeminal nerves, distal to their exit from the brainstem
- C.
The facial and abducens nerve nuclei within the pons
- D.
The facial nerve, distal to the chorda tympani nerve
- E.
The facial nerve, distal to the geniculate ganglion
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