LCRS 2016
Question 1:
a. Name 3 functions of the brain stem (3) Control of breathing, control of heart rate, control of blood pressure
b. Name the meningeal layer that is closely attached to the cortex of the brain (paraphrased) (1) pia mater
c. Describe the organization of grey and white matter in the spinal cord (4) grey matter (neuronal cell bodies)
surrounded by white matter (neuronal cell tracks/axons) with dorsal and ventral roots from the grey matter to
the white matter
d. Name 2 different types of hydrocephalus (2) communicating and non-communicating
Question 2:
a. Name 3 different subtypes of functional neurons (3) motor, sensory, interneurons
b. What can you find in the anterior, middle and posteriorly cranial fossa respectively? (3) Anterior=frontal lobe
of cerebral hemisphere. Middle=temporal lobe of cerebral hemisphere. Posterior=cerebellum
c. Name 4 physiological actions during the fight-flight response (4) Increase in heart rate, pupils dilate, increase
blood pressure, constriction of bladder sphincter
Question 3:
A. Name the enzyme that convert testosterone to dihydroxytestosterone; the enzyme that convert testosterone
to oestrone (2) aromatase=testosterone to oestrone. 5alpha reductase=testosterone to dihydroxytestosterone
B. Name the main plasma protein that binds to testosterone in blood (1) sex hormone binding globulin
B. Name 2 principal actions of androgens in an adult (2) growth spurt, masculinization, protein anabolism,
spermatogenesis
C. Name 2 principal actions of progesterone (2) Secretory effect on endometrium, stimulates alveolar system
growth in the breast, decreases renal NaCl re-absorption.
D. Define primary and secondary amenorrhoea (2) primary amenorrhea=never had periods before,
Secondary=previously had periods but have now stopped
E. Name one cause of secondary amenorrhoea (1) Pregnancy
Question 4:
A. Draw the adeno-hypophysial-adrenal axis including negative feedback (4)
Hypothalamus
Corticotrophin
releasing
Indirect –ve hormone (CRH)
feedback Adenohypophsis
Direct –ve
Cortisol feedback ACTH
Adrenal
B. Explain why in patients with primary adrenal failure has increase skin pigmentation (3) A lack of Cortisol being
produced means the negative feedback loop is disrupted and more ACTH is being produced. POMC is the
precursor for ACTH and when it is cleaved it also forms MSH which stimulates melanocytes to produce more
melanin leading to increased skin pigmentation.
C. What is the immediate treatment for someone suffering from Addisonian crisis? (3) Saline solution to increase
blood volume, glucose, glucocorticoid-hydrocortisone
SBAs
1. During which phase of the action potential does the voltage gated K+ channel open? depolarisation
2. A 40 year old patient has headaches, zigzag vision, and photophobia, symptoms subside within 12 to 24
hours, what is the best investigation to identify the cause? (clinical history, CT, MRI, PET, visual response test)
(paraphrased)
3. Which statement is true about the conduction velocity of peripheral axons? (velocity is increased when
temperature is low, velocity is increased with small diameter, velocity is decreased with myelination,
conduction velocity can be used to diagnose peripheral neuropathy)
4. Which is true about the cerebral hemisphere? (the primary visual cortex is in the temporal lobe, the auditory
cortex is in the occipital lobe, the temporal and frontal lobe is separated by the horizontal sulcus, postcentral
gyrus is the somatosensory cortex)
5. Which part of the brain is involved in somatosensory convergence? (greatly paraphrased) (options are:
thalamus, basal ganglia, cerebellum, brainstem)
6. Which is true about regeneration of peripheral nerve? (Macrophages guide the axonal sprouts in
regeneration, the conduction speed after regeneration will be faster, Schwann cells phagocytose the axonal
and myelin debris, the regeneration is more successful if the nerve is cut than compressed, the presence of
endoneurial sheath provides guidance for growth of axonal sprouts) (options are greatly paraphrased)
7. Which statement is true about autonomic sympathetic nervous system? (facilitate constriction of pupil,
vasodilation of internal urethral sphincter, correct statement forgotten)
8. Glutamate is a neurotransmitter involved in the CNS, which receptor mediates fast excitatory conductance?
(AMPA, NMDA)
9. What can you find in the dorsal root ganglion? Afferent nerve(Sensory)
10. What is the action of phenobarbital? (paraphrased) Epilepsy drug which keeps GABA receptor open for longer
11. What is function of Oligodendrocytes? Myelinate neurons in the central nervous system
12. Which cell is involved in formation of blood-brain barrier? Astroglia
13. Patient complained with fever, neck pain and subsequently found out that he has nuchal rigidity. What is the
most likely diagnosis? (Meningitis, embolism, Guillain-Barre syndrome, haemorrhagic stroke )
14. Another patient; details forgotten, has meningioma, something parasagittal plane with falx cerebri; what will
the lesion cause? (auditory deficiency, lack of motor movement, ptosis, loss in vision, loss of facial sensation)
(paraphrased)
15. What is the action of Somatotropin? Increase IGF1 and lead to protein anabolism
16. What is true about steroid hormone? (bind to intracellular receptor, stored in granules, synthesis involved a
precursor)
17. Insulin decrease glucose by what mechanism? Insulin decreases glucose in the blood by increasing uptake by
muscle and liver cells, increase glycolysis and glycogenesis
18. Which of the following finding is typical of a type 2 diabetes mellitus patient? (low HDL cholesterol, low C
peptide, normal triglyceride, high ketone bodies, BMI of 21)
19. The most common cause of Addison’s in the UK? (TB, Autoimmune)
20. Which symptom is a feature of primary hypothyroidism? (Tachycardia, cold intolerance, diarrhea)
21. What are the features of Cushing’s disease (abdominal striae, increase pigmentation, postural hypotension)
22. Which is true about the principal action of vasopressin? Vasopressin inserts AQP2 into the cortical collecting
duct of the kidney to increase water reabsorption
23. What is iodothyronines mainly bound to in blood? (albumin, thyroglobulin, thyroxine binding globulin,
transthyretin)
24. In Graves' disease, the antibody produced binds to what? (anti-thyroid receptor, anti-TSH receptor, anti
thyroxine receptor, anti TRH receptor)
25. What does Sertoli cell secrete? (LH, FSH, inhibin, oestrogen)
26. What is true about late follicular phase (surge in LH, surge in progesterone, suppressed 17-beta oestrodiol)
27. What cause PTH to be secreted (hypercalcaemia, hypocalcaemia)
28. What does calciferol do? (decrease absorption of calcium in small intestine, increase absorption of calcium in
small intestine, suppress osteoblast activity, suppress osteoclast activity)
