Formative Test I NBSS 2021-2022 - Attempt Review

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Formative Test I NBSS 2021-2022
Started on Saturday, 7 May 2022, 12:22 PM
State Finished
Completed on Saturday, 7 May 2022, 2:35 PM
Time taken 2 hours 13 mins
Question 1
Complete Marked out of 1.00
According the scheme above, which of the major abnormalities will appear on neurological examination if
there is a lesion in the location indicated by the star?
A. Loss of reflexes and tactile sensation for that spinal segment
B. Loss of muscle tone and reflexes for that spinal segment
C. Loss of tactile sensation for that spinal segment
D. Loss of pain and temperature sensation for that spinal segment
E. Increase muscle tone and reflex activity for that spinal segment
Question 2
Lack of knowledge people in the community about the danger of COVID-19 cases among villagers can cause
spreading.Which of the following sentence is the most correct concept an ecological perspectives related to
behaviour theories that educators use in COVID-19 case.
A. Institutional factors
B. Community factors
C. Public policy
D. Interpersonal support
E. Interpersonal capacity
Question 3
As a doctor in the Emergency Department, you see an otherwise fit 51 year old man who has a metal fragment
embedded in his left index finger. You plan to remove this under a digital nerve block using local anaesthetic,
embedded in his left index finger. You plan to remove this under a digital nerve block using local anaesthetic,
 which prevents normal action potential conduction. What
LiVE ion traffic is mostly affected? 
A. Sodium
B. Calcium
C. Magnesium
D. Potassium
E. Chloride
Question 4
In a physiology practical class, when a steel rod was held against an area of skin with a constant force,
students noticed that the firing rate in the related cutaneous sensory nerve decreased. What property of the
sensory system most likely indicates this observation?
A. Change in receptive fields
B. Increasing sensitivity to the stimulus
C. Recruitment of receptors of a different modality
D. Adaptation of receptors
E. Adaptation of the central sensory mechanisms
Question 5
Mother takes her child to Primary Health Centre for BCG immunization. Which of the following statement is the
most correct example for type of health related behaviour:
A. Sick role behavior
B. Preventive health behavior
C. Illness behaviour
D. Bad behavior
E. Health behavior
Question 6
A 10-year-old boy is diagnosed as Acute poliomyelitis.Which following structure of nervous system is most likely
damaged?
 A. Cerebral motor cortex LiVE 
B. Frontal lobe
C. White matter of the spinal cord
D. Posterior column of the spinal cord
E. Anterior horn cells at the spinal cord
Question 7
082-SISTEM SARAF
::082-SISTEM SARAF::A 71 -year-old widower is brought to psychiatric clinic by his son with chief complaint that
his father has been acting unusual since last 6 months ago. He has become more forgetful and often
misplaces various items including his keys and purse. The patient has also had several episode s during which
he would walk to the mosque and not remember how to return home. He intermittently does not remember the
names of his friends. On examination the patients is unable to correctly state the date or place, but other wise
to be in good health. Which of the following is the most likely diagnosis of this patient?
A. Pseudo-dementia (depressive)
B. Organic personality syndrome
C. Delirium
D. Organic amnestic disorder
E. Dementia
Question 8
084-SISTEM SARAF
::084-SISTEM SARAF::An adult man had an injury in his head while he was have a motorbike ride. He was not
using a helmet. Head CT-scan showed left temporal bone fracture and slightly epidural hemorrhage. His left
nasolabial fold was flatted when he grimace, and he cannot closed his left eyes properly. Which of the following
is the most likely What kind of complication this patient?
A. Left CN III injury
B. Left CN VII injury
C. Left CN XII injury
D. Left CN V injury
E. Left CN V injury
Question 9
While playing hockey a boy falls and hits his head on the ice. X-rays reveal a linear fracture from just behind the
ear toward the foramen magnum and involving the jugular foramen.Which of the following might you most
likely expect to find?
A. The patient has difficulty opening his right eye
B. The patient will be unable to close his jaw properly
i i i f i i
C. There will be signs attributable to a hemorrhage of the middle meningeal artery
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D. He will have some difficulty swallowing
E. The patient has lost control of lip movements
Question 10
Monoamine oxidase (MAO) inhibitors are used to treat Parkinson's disease in which there is a loss of
dopaminergic neurons from the substantia nigra in the brain. Which mechanism of action is the most
appropriate to be used?
A. Block breakdown of dopamine
B. Block autoreceptors for feedback regulation on the terminal
C. Promote re-uptake of dopamine
D. Block autoreceptors for feedback regulation on the terminal
E. Promote dopamine synthesis
Question 11
Dana had implicit (non-declarative) memory loss. Which ONE of the following is TRUE regarding Dana?
A. She always had difficulty in remembering geographical facts
B. She had difficulty in learning tasks with motor skills
C. She most probably had a lesion in the amygdala
D. Dana forgot her own name
E. She forgot the details of the wedding of her friend which she attended last summer
Question 12
A 26 year old accountant visits his GP complaining of extreme fatigue and nightmares. On direct questioning,
he admits to abusing "crystal meth" (metamphetamine) over the past month, but now he is trying to quit. What
is the most appropriate mechanism of action in yielding the chief compliant?
A. Stimulation of presynaptic serotonin receptors
B. Antagonism of NMDA-type glutamate receptors
C. Increased release of monoaminergic neurotransmitters
D. Stimulation of the enzyme monoamine oxidase
E. Stimulation of GABA
Question 13
One of health education within communities is making a Health Campaign. What is the most correct thing
should be considered when organizing one?
g g
 A. Getting leader involved LiVE 
B. Campaign should have as many as health issues possible in order to gain interest of the community
C. The campaign should have short and catchy theme
D. Campaign can be planned to promote knowledge and skills of particular health issue.
E. Campaign is a long term activities so we need to plan carefully
Question 14
A 72-year-old woman has experienced progressive memory problems for several years. For the past year, she
has gotten lost while walking around her own neighborhood and has been unable to find the bathroom in her
own house or recognize family members. What would be the most likely neuropathology findings?
A. Many Lewy bodies in the substantia nigra.
B. Oligodendroglial cytoplasmic inclusion
C. Numerous neocortical senile plaques.
D. Neocortical neuronal Pick bodies.
E. Atrophy and gliosis of the caudate nuclei.
Question 15
073-SISTEM SARAF
::073-SISTEM SARAF::Establishment of emotional states and related behavioral drives are functions of certain
area. Which of the following structure is the most likely involved area?
A. Tectum
B. Mamillary bodies
C. Thalamus
D. Limbic system
E. Basal ganglia
Question 16
A subject is rotated clockwise in a swivel chair for one minute then suddenly stopped. Which directions of the
fast phases of nystagmic eye movements is the most correct?
A. Both anticlockwise
B. Anticlockwise and clockwise respectively
C. No change in eye movement
D. Both clockwise
E. Clockwise and anticlockwise respectively
Question 17
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086-SISTEM SARAF
::086-SISTEM SARAF::A 67-year-old man came to Neurology Clinic with chief complain stiffness all over his body,
with tremor on both hands especially at rest. He also walks in small step and difficult to turn. On physical
examination, there was cogwheel phenomenon (+), mask face (+), Pill rolling tremor (+). He is a high school
teacher, still on duty but not teaching regularly everyday. He hasn't sought medical treatment for this
complains. Which of the following neurotransmitter will decrease up to ±60% in this patient?
A. Glutamate
B. Serotonin
C. GABA
D. Dopamine
E. Acetylcholine
Question 18
088-SISTEM SARAF
::088-SISTEM SARAF::A-66-year-old woman was consulted to neurologist with chief complaint of recent memory
impairment. Which of the following is the most likely diagnosis:
A. Cerebral contusion
B. Anxiety
C. Depression
D. Dementia
E. Epilepsy
Question 19
You follow up on a patient who suffered spinal cord trauma 3 months ago. He presents with spastic paralysis of
his legs. Which of the following mechanism is the most correct?
A. Axon degeneration of the Alpha motoneuron
B. Secondary trauma to ascending pathways
C. Demyelination of the peripheral nerves
D. Demyelination of the peripheral nerves
E. Build-up of lactic acid in the muscle tissue
Question 20
A patient presents with loss of pain and temperature sensation in both hands, weakness and wasting of the
small muscles of the left hand, loss of pain and temperature sensibility in the right leg and a spastic paralysis of
the left leg.Where is the lesion most likely located?
A. Ventral lateral part of the right half of the medulla

B. Left half of the cord at both lower cervical and upper lumbar levels
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C. Right internal capsule involving the thalamus
D. Left half of the lower cervical and upper thoracic spinal cord
E. Right cerebral cortex involving the pre- and post-central gyri
Question 21
Global warming refers to the rising average temperature of Earth's atmosphere and oceans and its related
effects. Which of the following is the most appropriate for the result of individual empowerment?
A. Frequent washing with clean water, wash hands, toys, vegetables, fruits, and furnitures
B. Using less toxic material and find less toxic alternative or method such as cleaning products
C. Reduce gaseous and volatile exposure via adequate ventilation usage of exhaust fans if necessary
D. Transporting exotic fruits and vegetables from one destination to another
E. Turn down, switch off, recycle and walk
Question 22
One of the challanges when organize health education in community is to obtain the participation of every
members, even in small groups. Which one of the statement below is NOT the way to encourage participation
of community member in community project?
A. Keep people informed about the activities being planned
B. Pick national holiday for meeting time
C. Set out specific tasks and jobs for everyone
D. Give explanation about how important their job to the success of whole project
E. Encourage them to give suggestions
Question 23
075-SISTEM SARAF
::075-SISTEM SARAF::A 42 years old man, married with two children, is noticed by his wife to be “not functioning
properly “during the previous 2 months. He calls the office frequently that he is ill, while actually he can not get
out of bed in the mornings, has lost appetite for food, his interest in sex, and is sleeping hours each day. He has
told his wife that he is unsure if he wants to go on living. There is no history of drug or alcohol use. He had a
thorough physical examination 3 months earlier and was told that he was in good health. His has lost of
appetite for food and his interest in sex as well as alterations in sleep suggest dysfunction of which of the
following organ?
A. The limbic system
B. The hippocampus
C. The basal ganglia
D. The hypothalamus
E. The prefrontal cortex

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Question 24
074-SISTEM SARAF
::074-SISTEM SARAF::A 35 year old man was admitted to neurological ward with sudden weakness on the left
side of his body when walking to his office. His speech was slurred and his mouth deviated to the right side.
During the attack his consciousness was good. Electrocardiography examination showed atrial fibrillation. From
patient with neurologic abnormalities above, select the type of stroke that is most likely as clinical diagnosis:
A. Artery-to-artery embolic stroke
B. Atherotrombotic infarction stroke
C. Subarchnoidal hemorrhagic stroke
D. Cardioembolic infarction stroke
E. Intracerebral hemorrhagic stroke
Question 25
You examine an 8 year old's hearing with a tuning fork. She consistently hears the tuning fork applied to her
mastoids louder than when held approximate to both meati. However when the tuning fork is applied to her
forehead she hears it louder on the left. What is the most correct intepreation of the examination?
A. Bilateral sensineural loss greater in R ear
B. Unilateral sensineural and conductive loss
C. Bilateral sensineural loss and R conductive loss
D. Bilateral conductive loss greater on the left
E. Right sensineural loss
Question 26
072-SISTEM SARAF
::072-SISTEM SARAF::A 4 -year -old boy is brought to the clinic by his parents. His parents recall that his speech
was delayed. His mother had his hearing tested. His hearing was normal, but his mother continued to notice
that he did not usually turn his head toward her when she spoke to him. He was unable to share toys and never
joined in group activities. Sometimes he became overly excited and hyperactive and ran around the room with
no apparent goal. Which of the following would be most helpful in distinguishing between expressive language
disorder and autistic disorder?
A. Impairment in social interaction
B. Normal hearing test
C. Hyperactivity
D. Overly excited
E. Delayed speech
Question 27
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In testing pupillary function, light is shone into the LEFT eye and both left and right pupils constrict. As the light is
swung to the RIGHT eye and shone into the RIGHT eye, both pupils dilate and remain dilated (swinging flashlight
test). The pupils again constrict when the light is swung over to the LEFT eye.Which cranial nerves is most likely
altered?
A. Left optic (cranial nerve II)
B. Left oculomotor (cranial nerve III)
C. Right oculomotor (cranial nerve III)
D. Sympathetic nervous system (Horner's syndrome)
E. Right optic (cranial nerve II)
Question 28
098-SISTEM SARAF
::098-SISTEM SARAF::A 78-year-old male, has memory loss and personality alternation. There is no
unconsciousness. No sensory or motor deficit. What is the most possible nerve structure disorder in this patient?
A. Brainstem
B. Cerebellum
C. Brain
D. Cerebrum
E. Spinal Cord
Question 29
A 18 years old woman came to Hospital to get a treatment. She wanted to get her nose higher because she said
that she often felt difficult to breath. After more anamnesis and physical examination as well as supporting
examination, you did not find any anatomical nor physiological dysfunction. The patient keep said that she
really wants to do the measure.Should physicians perform interventions on this patient?
A. Physician only responsible for proposing a method to achieve the patient’s goal
B. Because it is to prevent stigmatization, it is compatible with the medical ethic to do such measure
C. The physician should avoid the risks as much as he can
D. The medical profession is going to compromised if the measure is not done
E. The physician should do the measures since the patient have medical indication
Question 30
095-SISTEM SARAF
::095-SISTEM SARAF::A 60 years old man was admitted with chief complaint of weakness in right side of the body
where its attack during working in the garden. He does not can speak anything and not understood if we talk to
him. He was still conscious, not vomit and headache. In physical examination: blood pressure: 170/100 mmHg,
right hemiparesis, central, right CN VII and XII paresis. Physiologic reflexes were increased in the right side of the
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body and Babinski reflex was positive in the right side of the body. These clinical manifestations were maximal
at onset. The result of ECG examination was atrial fibrillation. In the first three days of ward he was conscious,
but in fourth days his conscious was decrease. For this condition the second CT-scan was done. Which of the
following is the most likely diagnosis of this patient?
A. Cardioembolic stroke
B. Lacunar infarction stroke
C. Intracerebral hemorrhage stroke
D. Subarchnoid hemorrhage stroke
E. Atherothrombotic infarction stroke
Question 31
A farm worker inhales a pesticide which blocks acetylcholinesterase in the neuromuscular junction. He presents
with breathlessness. Which of the following mechanisms is the most likely cause of his difficulty in breathing?
A. Rapid breakdown of acetylcholine in the synapse
B. Decreased amount of acetylcholine in the smooth muscle
C. Blockade of the acetylcholine receptors by acetylcholine
D. Lack of acetylcholine production at the synapse
E. Reduction in acetylcholine reuptake
Question 32
A one year old girl is diagnosed as having congenital deafness. This abnormality may be caused by abnormal
development of the tympanic cavity. The development of the ear begins with the development of which one of
these parts?
A. Meatal plug
B. Mesoderm layer
C. Utricle
D. Auricle
E. Otocyst
Question 33
085-SISTEM SARAF
::085-SISTEM SARAF::The velocity of nerve conduction is increased with a decreased in which of the following?
A. Space constant of the nerve fiber
B. Capacitamce of the nerve fiber membrane
C. Resting membrane potential
D. Diameter of the nerve fiber
E. Degree of myelinization
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Question 34
You are a general practitioner seeing a 65 year old man who had recently been to see his optician for a routine
eye check where he was found to have intraocular pressures of 33 and 35 mm Hg (Normal value: 11-21 mmHg).
He was started on treatment and has now come to see you for a repeat prescription. You referred him to
hospital for further management, and after an outpatient consultation the diagnosis of chronic glaucoma was
confirmed.What is the most appropriate mechanism for the disease development ?
A. Excessive production of aqueous humour
B. Micro-haemorrhages in the vitreous humour
C. Loss of inhibition to the sympathetic nerve supply to the eye
D. Blocked drainage of aqueous humour
E. Development of post vitreous attachment
Question 35
A patient is receiving local anaesthetic for a root canal treatment in his upper molar. The dentist injects
novocaine. This stops pain by blocking nerve conduction. What is the most appropriate underlying mechanism?
A. G-protein-coupled mechanisms indirectly influence ion channels
B. This is an all-or-none response for the generator potential
C. It causes the membrane to become refractory
D. Decrease of the signal intensity will decrease the action potential
E. A blockade of voltage-gated Na+ channels blocks action potentials
Question 36
A 21-year-old man has an acute earache. He tells you that he has been swimming and surfing the previous
week. His ear is discharging. What is the most likely diagnosis?
A. Acute mastoiditis
B. Acute otitis externa
C. Impacted wisdom tooth
D. Acute otitis media
E. Ear trauma
Question 37
There are many communication methods and media that are used in communicating health messages in
community. you are to give health education to high school students about Sexuality. Which method is most
appropriate?
 A. School Radio LiVE 
B. Talkshow
C. Small Groups Talk
D. Displays, such as Posters, Wall Magazine, etc
E. Messages in social media
Question 38
Which of the following conditions requires the most enabling factor in the case to prevent COVID-19 spread?
A. Lack of information from village officer about reporting systems related to sudden death of the poultry
B. Disinfectants fluid not available in the every village
C. People`s believe that consume the sick poultry is safe
D. Many poultries died during rainy season is normal for community
E. People remove the used mask to the river
Question 39
096-SISTEM SARAF
::096-SISTEM SARAF::A 33 -years-old man show odd behaviors, speech with himself and everyday he collect
things which putting from the street. This behavior occurs since 6 months ago. He had been hospitalized in
mental hospital for 5 times since age of 18 years. As his discharge from the hospital, he always refused taking
the medication because he felt that he was healthy, therefore his disorder become recurrent. Which parts of the
brain are primarily involved in neuropathological basis for his mental disorder?
A. The limbic system and the basal ganglia
B. Midbrain and the cerebellum
C. The frontal lobe and the occipital lobe
D. Temporal and the parietal lobes
E. The basal ganglia and hypothalamus
Question 40
094-SISTEM SARAF
::094-SISTEM SARAF::A 25-year-old woman complained headache. The headache was almost limited to the left
side but sometimes to the right side of her head. She would know that that the headache was coming because
of changes in her vision that preceded the headache by 15 min. She would see scintillating light just to the left of
her center vision. This visual aberration would expand and interfere with her vision. The duration of headache
for about three hours and usually associated with nausea and vomiting. What is most likely diagnosis?
A. Vertebro-basilar migraine
B. Chronic Paroxysmal Hemicranias
C. Tension type headache
D. Common migraine ( migraine without aura )

E. Classic migraine ( migraine with aura)
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Question 41
099-SISTEM SARAF
::099-SISTEM SARAF::A 17- year-old boy, was got motorcycle accident when going home from school. He was
severe head injury. In the ER, doctor in charge found that he was in soporous, his pupil was anisocor (The
diameter was : Left pupil = 6 mm, Right pupil 2 mm), The light reflex was decreased . His right extremities react
more slowly than left side. The pathway that most possibly damage was :
A. Left Corticospinal pathway and right Corticobulber pathway
B. Right Corticospinal pathway and Left Corticobulber pathway
C. Right Corticospinal pathway and right Corticobulber pathway
D. Left Corticospinal pathway and right Corticobulber pathway
E. Both Corticospinal pathway and Corticobulber pathway
Question 42
Before the surgeon cut the tissue in one operation, he injected a Local anesthetic. What is the most appropriate
mechanism of action of this drug?
A. Increasing the level of cholinesterase
B. Raising the firing threshold
C. Inhibiting the specific increase in sodium conductance
D. Preventing repolarization of the nerve
E. Depolarizing the nerve above the critical firing level
Question 43
A 55 year old man presents to your office complaining of vision difficulty. On examination he has been found to
have a right homonymous hemianopia.The lesion of damage is at:
A. Left optic tract
B. Ig DRight lateral geniculate body
C. Right optic radiation
D. Left optic nerve
E. Optic chiasma
Question 44
A health worker is researching causes of hypertension. He is working on the autonomic nervous system. Which
one of the following five statements about the autonomic nervous system is correct?
o eo e o o g es a e e s abou e au o o c e ous sys e s co ec ?
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A. Pupillary dilatation is mediated by the parasympathetic system
B. An anticholinergic medication will give rise to bladder urgency
C. Secretomotor nerves of the lacrimal gland course with the facial nerve
D. Vascular smooth muscle is innervated by parasympathetic adrenergic neurons
E. Secretomotor nerves of the lacrimal gland course with the facial nerve
Question 45
A 60-year-old healthy man is being treated for insomnia with a benzodiazepine (chlordiazepoxide). Now he
comes to you complaining of daytime sleepiness. What is the MOST likely explanation for this recent problem?
A. His phase II reactions are suppressed due to kidney failure
B. The chlordiazepoxide is being metabolized to active compounds
C. He has liver disease and his microsomal oxidase system is not functioning well
D. The development of tolerance
E. A decrease in hepatic blood flow
Question 46
A 30-year-old man was admitted to ER RSHS and complained of back pain radiating to inguinal fold. Pain
worsened and persisted during walking, sitting or lying down. The enkephalin is a substance that decrease the
pain sensation.Which of the following is the function of enkephalin ?
A. Function as synaptic inhibitor
B. Compete with acetylcholine for receptor sites
C. Decrease the release of substance P by first order pain fibers
D. Increase intestinal motility
E. Increase the release of substance P by first order pain fibers
Question 47
078-SISTEM SARAF
::078-SISTEM SARAF::A 30-year-old woman came to clinic with right aural fullness since 3 days. From history
taking, she has had cough and rinorrhea since 1 week. Physical examination revealed no cerumen from both
ear. Which one of this following is the most likely to occured in tuning fork examination?
A. Negative right Rinne test and lateralization to right on Weber test
B. Negative right Rinne test and lateralization to left on Weber test
C. Positive right Rinne test and lateralization to right on Weber test
D. Positive right Rinne test and lateralization to left on Weber test
E. Negative right Rinne test and no lateralization on Weber test
Question 48
Question 48
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087-SISTEM SARAF
::087-SISTEM SARAF::A 18-year-old woman had been referred to unit emergency of RSHS because worsen of
weakness and numbness of the extrimities beginning 7 days ago and no complaints of urination, defecation, no
double vision, no mouth asymmetry nor difficulties in breath. Which of the following level of the Nervous System
the symptoms related?
A. Spinal cord
B. Brain cortex
C. Brain stem
D. Peripheral nerve
E. Cerebellum
Question 49
A right-handed 65-year-woman suddenly feels weakness of her right arm and hand and subsequently finds
that she cannot move them voluntarily. During the examination she has slow and hesitant speech. She can
move her legs normally, her vision is normal, her finger-to-nose test is normal, and there is no sign of
disequilibrium.Which of the following arteries is most likely to have been affected?
A. Anterior cerebral artery
B. Middle cerebral artery
C. Anterior choroidal artery
D. Basilar artery
E. Superior cerebellar artery
Question 50
A fit 60 year old man develops shingles in the distribution of the right T8 dermatome. Four weeks later he has
persistent severe dermatomal pain disrupting his daytime activities despite regular paracetamol and codeine
tablets. Amitriptyline is added to his therapy.What is the most important mechanism of pain relief by this
agent?
A. Relief of associated depression
B. Peripheral anticholinergic activity
C. Enhancement of descending spinal inhibitory nerve activity
D. Stimulation of afferent C fibres
E. Promotion of normal sleep
Question 51
An 8-year-old child presents with complete left facial palsy and complete failure of abduction of the left
eye What is the most likely anatomical site of the lesion?
eye.What is the most likely anatomical site of the lesion?
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A. Brain stem
B. Cerebellum
C. Thalamus
D. Parietal lobe
E. Temporal lobe
Question 52
You are a casualty officer. A 43-year-old man is brought in by his wife after a turn at home. He had complained
of a nasty taste and then felt very strange. His wife says he was not answering her and seemed absent and
then started to smack his lips and twitch. The patient cannot remember any of this. He appears confused some
two hours after the episode.What type of seizure is this?
A. Complex partial seizure
B. Myoclonic seizure
C. Myoclonic seizure
D. Tonic clonic Seizure
E. Absence seizure
Question 53
A 70-year-old woman is brought by her family to the Emergency Room with chief complain difficulty in
breathing and feel to unconsciousness. After fast but thorough examination she needs intubation. What should
you do as a physician?
A. Refer her to another competence physician
B. Ask the nurse to do the intubation
C. Performed intubation immediately
D. Explain the procedure and result to the patient’s family, but the decision is them
E. Consider refusing the patient because of her unrealistic condition
Question 54
A 4 year old child has suffered a global neurodevelopmental insult from viral encephalitis in the neonatal
period. You are asked to assess his neurodevelopmental age from the following observations:He drinks from a
cup but is unable to wash his hands.He scribbles but cannot draw a line.He has 3 words.He walks but cannot
run.What is the correct neurodevelopmental age?
A. 6 - 12 months
B. 12 - 18 months
C. 18 - 24 months
D. 24 - 30 months
E. 30 - 36 months
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Question 55
A 70 year old woman presents with pain in the upper arm after a fall. On examination she has pain, swelling and
tenderness over the distal humerus. In addition she is unable to actively extend her fingers, thumb or wrist. X-
rays reveal an oblique minimally displaced fracture at the junction of the middle and distal thirds of the
humerus. What is the most likely site of neurological injury?
A. Radial nerve
B. Ulnar nerve
C. Brachial plexus
D. T1 nerve root
E. Median nerve
Question 56
091-SISTEM SARAF
::091-SISTEM SARAF::A 68-year-old married man was first evaluated 9 years ago when the wife observed his
changes. At this time he was still employed as a security guard. He said that he frequently forgot his keys or
would go into the house to get something and then forget what he wanted If on examination of his sensorium
he was disoriented about place and date and he missed the actual date by 2 years and 1 month, what kind of
symptom was that?
A. Disturbance in content of thought
B. Disturbance of process of thinking
C. Disturbance of form of thought
D. Disturbance of attention
E. Disturbance of consciousness
Question 57
A 21-year-old student is admitted to A and E after falling down a flight of stairs at a nightclub. He localises pain,
opens his eyes to pain and utters incomprehensible sounds. When you telephone the neurosurgical registrar he
asks you to describe his Glasgow Coma Scale. Which of the following is correct?
A. Eyes 1, Motor 2, Verbal 2; Total 5/15
B. Eyes 4, Motor 5, Verbal 2; Total 11/15
C. Eyes 1, Motor 2, Verbal 2; Total 5/15
D. Eyes 3, Motor 4, Verbal 3; Total 10/15
E. Eyes 2, Motor 5, Verbal 2; Total 9/15
Question 58

 LiVE 
Neurotransmitter metabolism involves physiologically active amines that are derived from amino acids are
further metabolized to carboxylic acids. Which of the following enzymes is involved in this process?
A. MoAmino acid
B. Catechol-O-methyltransferase
C. Dopamine beta-oxidase
D. Amino acid decarboxylase
E. Amino acid oxidase
Question 59
Skin has several sensory receptors. Which of the followings is most likely correct?
A. Pacinian corpuscles: have big receptive fields, slowly adapting
B. Meissner's corpuscles: found in superficial skin layers, slowly adapting
C. Free nerve ending: rapidly adaptive and found deep in the skin
D. Merkel's discs: deep in the skin, rapidly adapting
E. Ruffini ending: slowly adapting
Question 60
A child with Down syndrome is referred to a stimulation centre for therapy. The mother is concerned that at the
age of three years the little boy is not yet speaking in sentences. He is running and is starting to undress himself.
She would like to know whether he will develop in the same way as his brother, who does not have the
syndrome, if he attends the centre.How will the little boy develop if he attends the stimulation centre?
A. The main benefit of the centre is that the little boys parents will be relieved of the burden of caring for the child
B. The extra stimulation will ensure that he develops normally like his sibling who does not have Down syndrome
C. The stimulation will assist the little boy in reaching his own potential but he is unlikely to develop at the same rate as his sibling
D. The stimulation at the centre will be of no benefit to the child and the mother is wasting her money
E. Children with Down syndrome do not live for very long therefore there is no benefit in spending time and money on stimulating the
child
Question 61
A 63-year-old man complains of burning numbness in his feet and weakness of his legs. Examination shows
reduction of the tendon reflexes and superficial sensation in the legs. The muscles are weak and tender.
What is the most likely diagnosis?

What is the most likely diagnosis?
 LiVE 
A. Peripheral neuropathy.
B. Lumbar disc prolapse.
C. Polymyositis
D. Hypokalemia.
E. Multiple sclerosis.
Question 62
090-SISTEM SARAF
::090-SISTEM SARAF::A 17 -year old male with blurred vision, lethargy , and severe headache is being seen in the
emergency room. Tests of ocular movement indicate possible early stage right ophthalmoplegia. During the
physical examination, the doctor in charge note a large, indurated pustule on the right side of the nose .In
addition, the right retina appears somewhat engorged. Retina engorgement indicates blockage of venous
return. Drainage of the eye and orbit to the cavernous sinus is primarily through the:
A. superior orbital fissure
B. inferior orbital fissure
C. cribriform plate
D. annulus of Zinn
E. orbital canal
Question 63
A 50-year-old man felt tingling and mild pain in his left leg. Four weeks later, the symptoms extended to the
lower left quadrant of the abdomen. Pain sensation on the right side was normal.Which of the following is the
most likely cause of his condition?
A. Viral infection of the spinal ganglia
B. Herniation of intervertebral discs
C. Stenosis of the intervertebral foramina
D. Compression of the spinal cord by tumor
E. Demyelination of peripheral nerves
Question 64
A 73 year-old patient with a 15-year history of Parkinson's Disease comes to your office with severe ataxia and a
loss of facial expression. The medication he has been on is no longer effective. You discuss the possibility of
treating him with deep brain stimulation of the subthalamic nucleus.What is the rationale behind this
treatment?
A. Restoration of the output from the substantia nigra
B. Increased input to the caudate nucleus
C. Increased inhibition of the thalamus
D Restoration of tonic firing pattern from the subthalamic nucleus

D. Restoration of tonic firing pattern from the subthalamic nucleus
 E. Increased inhibitory output from the subthalamic nucleus LiVE 
Question 65
081-SISTEM SARAF
::081-SISTEM SARAF::A 64-year-old woman came with complains that her eyelids are dropping so more than
previously. On physical examination the physician find that besides her eyes are dropping, her face is not
sweating, even in very hot weather. Which of the following part is most likely to damage?
A. Trigeminal nerve
B. Optic nerve
C. Abducens nerve
D. Facial nerve
E. Oculomotor nerve
Question 66
Following a lumbar puncture, patients often experience headache. What is the most appropriate primary
reason?
A. Distension of the scalp vessels
B. Bleeding in the subarachnoid space
C. Stretching of the dura
D. Irritation of the meningeal arteries
E. Accumulation of fluid in the subdural space
Question 67
The parents of a 2 month old baby girl raise concern about her vision in that she doesn't seem to be able to
fixate. Examination reveals reduced red reflex bilaterally together with some haziness noted over the lens
region.What could be the cause of her problem?
A. Delayed visual maturation
B. Squint
C. Hypermetropia
D. Congenital rubella
E. Normal variation
Question 68
A patient, aged 70 years and who has high myopia, gives a history of seeing flashes, floaters and loss of partial
field of vision in the right eye. Which of the following methods of fundus examination will be ideal to diagnose
 LiVE 
and assess the condition?
A. Binocular indirect ophthalmoscopy
B. Direct ophthalmoscopy
C. Gonioscopy
D. Distant direct ophthalmoscopy
E. Biomicroscopy/slit lamp Exam
Question 69
A 22 year old man presents at your surgery, very upset. His girlfriend has just walked out following an argument.
As a consequence of this type of stress several hormones can be shown to be elevated. What part of the brain
mediates this neuro-hormonal response?
A. Pineal Gland
B. Thalamus
C. Hypothalamus
D. Cortex
E. Pituitary Gland
Question 70
A 35 year old man presents with fever, severe headache, drowsiness and a stiff neck. He has also developed a
faint rash on his arms and trunk.A lumbar puncture is performed and shows a large number of the cells shown
below.Which of the following tissue is most likely to be injured?
A. Muscle
B. Cerebrum
C. Meninges
D. Nerve
E. Spinal cord)
Question 71
A 49 year old man presents to the Emergency Department for the fifth time in a month complaining of atypical
chest pain with radiation into the neck and down both arms. As on previous occasions, his ECG is normal. He is
noted to have tachycardia with rapid shallow breaths.What is the most likely psychiatric diagnosis?
A. Schizophrenia
B. Major depression
C. Panic disorder
D. Generalised anxiety disorder
E. Bi-polar disorder
 LiVE 
Question 72
The ophthalmologist diagnoes Mrs. HO that she suffered from diabetic retinopathy and advised her to undergo
surgery. Which of the followings is the origin of the altered structure?
A. Surface ectoderm
B. Lens vesicle
C. Otic vesicle
D. Mesenchyme cells
E. Optic vesicle
Question 73
A 72 year old man trips over an uneven pavement and strikes his forehead on the ground. He states that his
arms were immediately too weak to push himself up off the ground. When brought in to the hospital he has
grade 2 dorsiflexion of the wrists, grade 2 weakness of elbow extension and no movement of the intrinsic hand
muscles. He has a partial sensory level to light touch and pinprick to C7. His biceps and supinator reflexes are
normal but the triceps reflexes are absent. He has grade 4+ power in the lower limbs and brisk reflexes the
morning after admission. He can weight bear, but only with assistance. Sphincter control appears to be
retained. What is the most likely site of neurological damage?
A. Cervical nerve roots
B. Cervical cord
C. Medulla
D. Brachial plexus
E. Frontal lobe
Question 74
You are on duty in the Emergency Department and are called to see a woman of 31 who has been brought in
having developed a very severe headache whilst shopping 2 hours earlier, saying, “I felt I had been hit by a
hammer”. A witness to the episode said she collapsed to the ground at the time and was unconscious for about
a minute. She vomited shortly after the episode, and the headache is still severe though slightly easier. She is
normally on no treatment and has no relevant medical history. On examination she is drowsy, though responds
to commands, and is orientated in time and place. Her blood pressure is 165/95 mmHg and heart rate 55/min.
There are no focal neurological abnormalities. What is the most likely diagnosis?
A. Sub-arachnoid haemorrhage
B. Cerebral artery thrombosis
C. Migraine
D. Meningitis
E. Extradural haematoma
Question 75
 Complete Marked out of 1.00 LiVE 
The benzodiazepines, effective antianxiety medications, are now thought to act by altering the action of which
of the following neurotransmitters?
A. Dopamine
B. Histamine
C. GABA (gamma amino butyric acid)
D. Noradrenaline
E. Substance "p"
Question 76
Ozone depletion as the result of increased CFC from industries or technology devices such as refrigerator and
air conditioner potentially causes the following health problems:
A. Malnutrition
B. Skin cancer
C. Skin burn
D. Degenerative diseases
E. Respiratory diseases
Question 77
A 72-year-old woman is referred with progressive memory loss and disturbed night time behaviour. After
psychometric assessment and brain imaging she is diagnosed with Alzheimer's disease. What class of drugs
would improve the neurotransmitter deficit?
A. Tricyclic antidepressants
B. Anticholinergics
C. Monoamine-oxidase inhibitors
D. Anticholinesterases
E. Antihistamines
Question 78
A patient presents with involuntary, continuous but irregular movements that go from side to side. He has a
positive family history of similar conditions.Which part of the CNS is most likely affected in this patient?
A. Sensory cortex
B. Primary motor cortex
C. Basal ganglia
D. Cerebellum
 LiVE 
Question 79
076-SISTEM SARAF
::076-SISTEM SARAF::A 20-year-old female, admitted in Hospital came with unconscious due to motor cycle
accident. His hand is decortications, his voice is mumble and his eye closed with pain stimuli.This patient also
has multiple trauma. Which of the following is the most appropriate prompt treatmen?
A. Perform Blood Gas Analysis
B. Skull X-ray
C. Airway, Breathing and Circulation evaluation
D. Head CT scan
E. Asses the level of conciousness with GCS
Question 80
A child with having nightmare as a chief complaint was referred to the sleep laboratory and was diagnosed to
have a sleep disturbance. Which of the following statements is most correct appear in anamnesis?
A. Her sleep disturbance occurred mostly during sleep stage II
B. Her condition is very common in young children
C. Her sleep disturbance occurred mostly during the first two hours of sleep
D. Her nightmares usually happened during REM sleep
E. She could not be awakened easily from her nightmare attack, and she remembered nothing afterwards
Question 81
Neurons are supported by glial cells. Which ONE of the following cells plays an important role in maintaining the
integrity of the blood brain barrier?
A. Schwann cells
B. Golgi cells
C. Microglia
D. Oligodendrocytes
E. Protoplasmic astrocytes
Question 82
Vulnerable subject needs to be reconsidered when they are faced with decision of their health intervention.
Which of the following that is not included ones?
A. pregnant women
B. poor people
C. children
 LiVE 
D. elderly people
E. mentally illness
Question 83
083-SISTEM SARAF
::083-SISTEM SARAF::A 17 years old boy was involved in a motor vehicle accident. He developed a back injure and
was unable to walk. Which of the following cells is located in the outer part of the injured organ?
A. Ependyma
B. Schwann cells
C. Neuron sensoris
D. Oligodendrocyte
E. Neuron motoris
Question 84
You found out that most of your study group member consumed unhealthy amount of instant noodle. The
reason: they did not like their own cooking. Being an avid cook, you decided to provide free training sessions for
your friends on how to prepare healthy food in simple ways. Within a month, at least some of your friends were
more confident to prepare their own healthy meals. What you have just improved:
A. Outcome expectation
B. Self-efficacy
C. Facilitation
D. Incentive motivation
E. Decisional balance
Question 85
079-SISTEM SARAF
"::079-SISTEM SARAF::A 6-month-old boy is able to lift head and chest off flat surface on extended forearms and
rolls over prone to supine. He can not localize to sound and respond to names. Which of the following aspect of
developmental milestones is disturbed with this child age?
"
A. Behavioral
B. Gross motor
C. Language
D. Fine motor
E. Personal social
Question 86
 Complete Marked out of 1.00 LiVE 
A patient had been confirmed to a vessel obstruction of the anterior spinal artery. The doctor need further
evidence by planning several exam such as motoric and sensoric examinations. Which ONE of the following
features will most likely be found on examination of this patient?
A. Muscle weakness in both left limbs but the right limbs are normal
B. Normal reflexes in all four limbs
C. Muscle wasting in all the four limbs
D. Bilateral loss of pain and temperature sensations below the site of the lesion
E. Loss of tactile discrimination bilaterally below the site of the lesion
Question 87
092-SISTEM SARAF
::092-SISTEM SARAF::A 21-year-old woman has a pervasive and excessive need to be taken care of that leads to
submissive and clinging behaviour and fears of separation. She has difficulty making everyday decisions
without an excessive amount of advice and reassurance from others. She also has difficulty expressing
disagreement with others because of fear of loss of support approval. What is the most likely diagnosis for his
personality?
A. Avoidant personality disorder
B. Dependent personality disorder
C. Depresive personality disorder
D. Passive - Aggressive personality disorder
E. Histrionic personality disorder
Question 88
100-SISTEM SARAF
::100-SISTEM SARAF::A 37-year-old Male, suffered with Paraplegia caused by an accident. He has been classified
as Spinal Cord Injury with ASIA Impairment Scale B. What kind of tract for Motor Function?
A. Rubrospinal Tract
B. Ventral Corticospinal Tract
C. Olivospinal Tract
D. Vestibulospinal Tract
E. Tectospinal Tract
Question 89
077-SISTEM SARAF
::077-SISTEM SARAF::A 46-year-old-man fell down from a staircase about 3 meters high and finds it is hard to
walk because of back pain since then. The conscious perception of pain is reduced in the body by which of the
walk because of back pain since then. The conscious perception of pain is reduced in the body by which of the
 following? LiVE 
A. Stimulation of cold receptor
B. Strong tactile stimulation from same area
C. Suppression of nociception in the epidermis
D. Reduction of mechanoreceptor activity in the skin
E. Enkephalin promotes the release of substance P
Question 90
097-SISTEM SARAF
::097-SISTEM SARAF::A 74 years woman was brought to emergency room by her family. She was diagnosed by a
GP as having typhoid fever. She is unkempt, dirty and foul smelling. She does not look at the interviewer and is
apparently confused and unresponsive to most of the questions. She knows her name but not the address, the
day or the month. She is unable to describe the events that led to her admission. She had not eaten for 2 days.
She has no psychiatric history. The diagnosis of this patient :
A. Panic disorder
B. Schizophrenia
C. Alzheimer's dementia
D. Depression
E. Delirium
Question 91
093-SISTEM SARAF
::093-SISTEM SARAF::A 52-year-old woman was referred by internist to Psychiatric Department with complaints
of persistent back pain & multiple other complaints. She was disabled from her job as a machine operator at a
shoe factory. Her physical examination was within normal limits. Which of the following condition related to her?
A. Schizophrenia
B. Conversion disorder
C. Major depressive disorder
D. Somatization
E. Psychosomatic disorder
Question 92
A patient has the following signs and symptoms: Parkinsonlike tremor; dermatitis and slight jaundice; mild
hypertension with tachycardia; oculogyric crisis. Which of the following drugs most likely produced the
syndrome?
A. Mephenesin
B. Reserpine
C. A monoamine oxidase inhibitor

 D. Chlorpromazine LiVE 
E. Guanethidine
Question 93
A 30-year-old man beliefs that he has headache, photophobia and nausea. What is the correct about the
likelihood of his condition?
A. Perceived severity
B. Perceived benefit
C. Perceived threat
D. Perceived barriers
E. Perceived susceptibility
Question 94
A seven year-old, unimmunized boy was brought to Emergency with history of fever, loss of weight and
vomiting for the last two weeks. He lives in a two bedroom house along with his grandfather, who had a history
of chronic cough. On examination the child had neck stiffness and was constantly fitting. A lumbar puncture
was done on this child after excluding signs of raised intracranial pressure.Which of the following findings is
expected to be seen in his cerebrospinal fluid?
A. Increased number of polymorphs
B. A low sugar count
C. A high sugar count
D. Numerous red blood cells
E. A low protein count
Question 95
Prevention of nutrition-related illness in the population is important to maintain good quality of health. Which of
the following is most correct example of primary prevention?
A. Legislation and enforcement to ban or control the use of hazardous products
B. Weight loss programs offered through community agencies
C. Oral vaccination against infectious diseases
D. Nutritional services for underweight children
E. Dietary Guidelines
Question 96
A patient in the neurological ward has been suspected to have an extensive bilateral lesions of the amygdaloid
A patient in the neurological ward has been suspected to have an extensive bilateral lesions of the amygdaloid
 nuclei. Which of the following sign is the most probableLiVE
to be found on examination? 
A. Motor aphasia
B. Loss of proprioceptive sensation in all the four limbs
C. Difficulty in recognition of emotional facial expressions (especially of fear) of other people
D. Hypotonic paralysis in both lower limbs
E. Difficulty in naming objects presented to the left visual field
Question 97
080-SISTEM SARAF
::080-SISTEM SARAF::A mother brings her 3 year old son to the ER with fever and altered consciousness. The
mother said for the last 2 days her son had fever, was irritable and suffered from seizures. The next morning her
son looked sleepy and had difficulty in waking up. There is history of recurrent foul smelling ear discharge.
Physical examination revealed pyrexia, appeared somnolent with positive neck stiffness and Brudzinski I. Which
is the following is the most likely diagnosis?
A. Acute otitis media
B. Enchepalitis
C. Meningitis
D. Febrile seizure
E. Epilepsy
Question 98
A 55-year-old woman, came with chief complain hyper pigmented macula and aging at her face. She wants
her face become white, smooth, and supple without wrinkle and looks younger like a 25-year-old woman, in a
month.What should you do as a physician?
A. Refer her to another competence physician
B. Explain the procedure and result to the patient, but the decision is in her hand
C. Consider to refuse the patient because of her unrealistic expectation
D. Refuse the patient because of her big motivation
E. Performed chemical peeling twice weekly for a month
Question 99
In testing pupillary function, light is shone into the LEFT eye and only the right pupil constricts.This indicates
dysfunction of which cranial nerve?
A. Left optic (cranial nerve II)
B. Left oculomotor (cranial nerve III)
C. Right optic (cranial nerve II)
D. Right oculomotor (cranial nerve III)
E S h i (H ' d )
E. Sympathetic nervous system (Horner's syndrome)
 LiVE 
Question 100
An agitated 24 year old man is brought to the Emergency Room in handcuffs by the police after he was found
wandering along the road in a confused state. The patient becomes mute and appears to be calm.What is the
next most appropriate step in managing this patient?
A. Administer a sedative intramuscularly
B. Take a history from the police
C. Remove the handcuffs to make the patient comfortable
D. Talk with the patient about his impulse control
E. Advise detention under the Mental Health Act
Finish review
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 LiVE 

Started on Saturday, 7 May 2022, 12:22 PM

Completed on Saturday, 7 May 2022, 2:35 PM

Time taken 2 hours 13 mins

Complete Marked out of 1.00

A. Loss of reflexes and tactile sensation for that spinal segment

B. Loss of muscle tone and reflexes for that spinal segment

C. Loss of tactile sensation for that spinal segment

D. Loss of pain and temperature sensation for that spinal segment

Complete Marked out of 1.00

Complete Marked out of 1.00

Complete Marked out of 1.00

A. Change in receptive fields

B. Increasing sensitivity to the stimulus

C. Recruitment of receptors of a different modality

E. Adaptation of the central sensory mechanisms

Complete Marked out of 1.00

A. Sick role behavior

B. Preventive health behavior

Complete Marked out of 1.00

C. White matter of the spinal cord

D. Posterior column of the spinal cord

E. Anterior horn cells at the spinal cord

Complete Marked out of 1.00

B. Organic personality syndrome

D. Organic amnestic disorder

Complete Marked out of 1.00

A. Left CN III injury

B. Left CN VII injury

C. Left CN XII injury

Complete Marked out of 1.00

A. The patient has difficulty opening his right eye

B. The patient will be unable to close his jaw properly

E. The patient has lost control of lip movements

Complete Marked out of 1.00

A. Block breakdown of dopamine

B. Block autoreceptors for feedback regulation on the terminal

C. Promote re-uptake of dopamine

D. Block autoreceptors for feedback regulation on the terminal

E. Promote dopamine synthesis

Complete Marked out of 1.00

A. She always had difficulty in remembering geographical facts

B. She had difficulty in learning tasks with motor skills

C. She most probably had a lesion in the amygdala

D. Dana forgot her own name

Complete Marked out of 1.00

A. Stimulation of presynaptic serotonin receptors

B. Antagonism of NMDA-type glutamate receptors

C. Increased release of monoaminergic neurotransmitters

D. Stimulation of the enzyme monoamine oxidase

Complete Marked out of 1.00

C. The campaign should have short and catchy theme

E. Campaign is a long term activities so we need to plan carefully

Complete Marked out of 1.00

A. Many Lewy bodies in the substantia nigra.

B. Oligodendroglial cytoplasmic inclusion

C. Numerous neocortical senile plaques.

D. Neocortical neuronal Pick bodies.

E. Atrophy and gliosis of the caudate nuclei.

Complete Marked out of 1.00

Complete Marked out of 1.00

B. Anticlockwise and clockwise respectively

C. No change in eye movement