Year 2 LCRS Section II 2017

NOTE: The options in bracket are given in random order + some phrases might not make
sense. If you need any clarity for revision purposes, let me know.

1. What does locus coeruleus secrete? (Noradrenaline, Adrenaline, Dopamine)

2. Which of these cells are derived from the neural crest? (Oligodendrocytes, astrocytes,
Schwann cells, ependymal cells)
3. What flexure give rises to telencephalon? (cephalic, pontine, cervical, lumbar)
4. An 86 year old patient has progressive memory loss, which is the most likely
haemorrhage? (Epidural, Subarachnoid, Subdural, intraparenchymal)
5. Which cause of vertigo gives the shortest duration vertigo? (BPPV, migraine, meinere’s
disease)
6. Which layer of the cerebral cortex receives input from the thalamus? (1,2,3,4,5)
7. The suprachiasmatic nucleus is involved in the control of sleep, stimulating melatonin
release from the pineal gland. Where does it receive its input from? (Retina, thalamus,
cortex)
8. A patient has loss of fear, which part of the limbic system is affected? (Amygdala,
hippocampus, hypothalamus)
9. A patient has severe head injury, what is the possible GSC score? (0,5,10,15,22)
10. A stroke in the anterior Cerebral artery has what symptoms?
11. What is the function of the intermediate lateral horn of spinal cord? (Autonomic
sensory, autonomic motor, nociceptive)
12. Which cranial nerves innervate the extra-ocular muscles? (234, 236, 346, 345, 356)
13. Parkinson’s disease results from a loss of neurones in the substantia nigra. Where do
these project to? (Caudate, cortex, thalamus)
14. What is the term given to loss of accommodation with age? (Emetropia, hypermetropia,
presbyopia)
15. What is immediately lateral to Globus pallidus? (Caudate, Lentiform nucleus, putamen)
16. What would be the immediate effect of damage to left hypoglossal nerve? (Deviation of
tongue to the left on protrusion, wasting of the left side of the tongue, paralysis of the
muscles of mastication, loss of taste to the anterior 2/3rds of the tongue)
17. If you cut the masseter too deeply, which structure will you damage? (Maxillary artery,
Lingual nerve, parotid duct, nasociliary nerve)
18. Infection in the nasal area is serious, which sinus can pathogens get through? (Superior
sagittal sinus, inferior sagittal sinus, cavernous sinus, straight sinus)
19. What is the main substance making up the annular fibrosus? (Fibrocartilage, hyaline
cartilage, collagen, synovial fluid)
20. What is the superior thyroid artery a branch of? (External carotid, internal carotid, facial)
21. What layer surrounds the Sternocleidomastoid muscle? (Carotid sheath, Pervertebral
layer, investing layer, superficial layer, pretracheal layer)

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22. Which lymph node is the main drainage of all head and neck? (Superficial cervical node,
deep cervical node, occipital node, submental node, axillary node)
23. What nerve gives sensation to the lip area (greatly paraphrased)? (Mental nerve,
superior alveolar nerve, lingual nerve, buccal nerve)
24. Which muscle is the primary abductor of the vocal fold?
25. Which joint is the only connection of the pectoral girdle to the axial skeleton and it
allows movement of the clavicle? (sternoclavicular joint, acromoclavicular joint,
glenohumeral joint, scapula thoracic joint)
26. What is the most important thing about the stabilisation of glenohumeral joint? (the
presence of glenoid labrum, the movement or rotator cuff muscle, the presence of joint
capsule surrounding the joint)
27. What bones can you feel in the anatomical snuffbox if there is a fracture of the bone?
28. A person with sensory loss on medial side of the leg and middle border of the foot, what
is the nerve that is damaged? (Sural nerve, Common Peroneal, Saphenous nerve,
Obturator nerve, Femoral nerve)
29. What is the proximal attachment of long head of triceps brachii? (infraglenoid tubercle
of scapula, supraglenoid tubercle of scapula, acromion process)
30. What does the posterior interosseous artery branched from?
31. What is the distal attachment of iliopsoas muscle?
32. What ligament prevents the excess movement of humerus posterior of the tibia?
(Anterior Cruciate ligament, posterior cruciate ligament, medial collateral ligament,
lateral collateral ligament)
33. What ligament is most likely damaged in overinversion of the foot (sprained ankle)?
(Anterior talofibular ligament, deltoid ligament, calcaneonavicular ligament, anterior
tibiofibular ligament)
34. What movement of the ankle is most susceptible to injury? (Dorsiflexion, Plantarflexion,
Inversion, Eversion, Supination)
35. Most of the innervation of the foot is from the plantar nerves. What is the medial
plantar nerve a branch of? Tibial, sural, saphenous
36. What is the underlying pathology of bouchard’s and heberden’s nodes? Osteophytes
37. What antibodies are commonly found in rheumatoid arthritis? Anti-cyclic citrullinated
peptide antibodies, anti-nuclear antibodies, anti-centromere antibodies
38. What antibodies are commonly found in SLE? Anti-cyclic citrullinated peptide antibodies,
anti-nuclear antibodies, anti-centromere antibodies?
39. What is the typical feature of gout?
40. What is a feature consistent with an inflammatory cause of arthritis? Joint deformity,
impairment of movement, worse with exercise, early morning stiffness
41. Which joint is particularly affected in osteoarthritis?
42. What is the pathology of rheumatoid arthritis?
43. What is the pathology of SLE? (Activation of complement, associated with HLA-B27)

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44. Which molecule is particularly associated with pathogenesis of Rheumatoid Arthritis?
(TNF alpha)
45. Osteoporosis can be diagnosed by DEXA scan, which gives a T score. What is a T-score?
Bone mass compared to an age matched individual, total bone mass, bone mass
compared to a young adult
46. What is the main component of articular cartilage
47. What is the main substance in synovial fluid making it viscous
48. What is the correct order of Piaget’s stages of cognitive development? Sensorimotor,
pre-operational, concrete operational, formal operational
49. A smoker recognises that his smoking is a problem. What stage is he at in the trans-
theoretical model? Action, contemplation, pre-contemplation, maintenance
50. Patient quitting alcohol, given disulfiram which induces nausea and vomiting when drink
alcohol, linking as the conditioned stimulus, what is true? (unconditioned response of
taste aversion, conditioned response of taste aversion, conditioned response to taste
extinction, positive reinforcement of sth, negative reinforcement of sth)
51. Which statement about crystalized and fluid intelligence is correct? Fluid intelligence
declines with age and crystalized intelligence increases with age (variations on this)
52. A patient thinks that her heart disease is incurable, using Leventhal Illness
representation, which dimension is the issue? (Identity, Cause, Consequence, timeline,
control)
53. What is the correct sequence of Kubler Ross Stage Theory of Adjustment to Dying?
54. A patient can greet to you, but some words doesn’t make sense, he can’t understand
what you are saying, what is the pathology?
55. A cardiologist does a shift in A & E and more patients are sent for cardiac investigations
than ever. What may explain this? Representativeness heuristic, availability heuristic,
gambler’s fallacy, anchoring
56. What is the correct definition of perception?
57. What is the most likely reason for non-adherence? (personality issue, concern about
treatment side effect, personal budget)
58. One guy doesn’t like to talk to people and worry too much about stuff, interpret that
using Big Five personality theories (difference combinations of HIGH/LOW OCEAN)
59. What is the stage of general adaptation syndrome that produce noadrenaline?
(paraphrased) (Resistance, exhaustion, alarm)

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SAQ
Question One: Neuro
a) Label the A-D (4)
b) Place the letters next to each of the corresponding lesion:

complete loss of visual field on one side (match with the diagram labels) (4)
c) Give a cause of lesion to B (2)

Question Two: Neuro

a) Label (4 marks)
b) Which level is this and what is the name of the space pointed by
the arrow and name the cranial nerve emerging through it? (4
marks)
c) What membrane covers it and what structure is present there in
vivo? (2 marks)

Question Three: Psychology

a) A doctor suggests that the asthmatic patient should get influenza vaccine but she is
unsure. Using the components of health belief model, suggest and explain 2 other
factors that the doctor can use when giving advice to her. (4) *greatly paraphrased
b) In the Transtheoretical Model, what is the factor influencing intention, apart from
‘Attitudes towards behaviour’ and ‘Perceived behavioural control’? In addition, explain
this missing component. (2)
c) Define ‘Self-efficacy’ and state 2 factors that can improve self-efficacy. (3)

Question Four: Lower Limb

a) The Dorsal Venous Arch of the foot gives rise to Great saphenous vein and short
saphenous vein, into which vessels do these superficial veins usually drain to? (2)
b) What are their relationships to the malleoli as they cross the ankle? (2)
c) Draw a simple diagram of the communication between the superficial and deep veins in
the lower limb. Indicate the normal direction of blood flow. (3)
d) What is the consequence when blood flows in the wrong direction in these veins? (1)
e) Give two clinical consequences of abnormal blood flow in them?

Question Five: Upper Limb

Write down the corresponding nerve lesion and the location of the nerve damage? (2 marks
each)

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a) Unable to extend the wrist and the foreman
b) Unable to extend the wrist but can extend forearm
c) Unable to flex the forearm
d) Claw hand, unopposed flexion of Interphalangeal joint of
4th and 5th finger, rest is fine.
e) Unable to oppose the thumb but can flex finger 2 and 3

Question Six: HNS

a) Label A-H (4 Marks)
b) List 3 things that drains into the middle meatus (3 marks)
c) Describe what happens when air enters the nasal cavity (3
marks)

Question Seven: HNS

a) Label bony features of a vertebra and name its position.
b) What vertebral level is it from (2)
b) What are the movements of: i) Atlanto-occipital joint (1) ii)
Atlanto-axial joint (1)
c) List 3 common abnormalities of spinal curvature and describe
them (3)

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