MBBS 240

YEAR 2
SESSION 2020/ 2021

CENTRAL NERVOUS SYSTEM

PHYSIOLOGY SGS QUESTIONS

17/02/121 (Wednesday)

1. A 20-year-old male college student was brought to the emergency department after being
found lying in the front yard of his house. He was fasting and it was a hot day with
temperatures exceeding 37.8°C. His father noticed that he had been complaining of excessive
thirst, light-headedness, nausea, and profuse sweating while mowing the back yard. While
mowing the front yard, he became very confused and behaved oddly before finally losing
consciousness.

a) Explain the mechanism that regulates his body temperature.

b) State the most likely condition that he suffered from while mowing the back yard. Explain
your answer.

c) In the emergency department, he had tachycardia, rapid shallow breathing with temperature
of 40.6°C. He is lethargic and his skin is red, hot but dry. State the most likely diagnosis and
reasons for his condition.

2. A 19-year-old female university student was presented to a clinic with symptoms of cough
with mucopurulent sputum, rhinitis, mild fever and malaise since yesterday at home.

a) With reference to the thermoregulatory mechanism, explain how she developed the
mild fever.
b) State the best way for her to reduce fever and explain briefly how this method does reduces
her fever.

3. A 21-year-old female medical student was listening to her Physiology lecturer who was
explaining on the regulation of food intake in human. It was 1 o’clock and suddenly she felt
hungry. With an aid of a diagram, describe the role of the hypothalamus in enhancing her
appetite towards food.

4. Describe the mechanism of colour vision

5. a) Using a diagram, describe the neural pathway of vision.

b) Discuss the effect of lesions at different level of the visual pathway.

6. Describe the mechanism by which the eye focusses images for far and near objects

7. Describe the changes in electrical potentials in the retinal cells before and during a light
stimulus.
8. A mother brought her five-year child to a clinic because she was concerned that her child was
not able to see the alphabet on the blackboard.
Which of the following statements are correctly related to this child’s condition:

I the child’s eyes may have longer focal length

Ii light rays coming into the eyes are focused behind the retina
(the light rays are focused in front of the retina)
Iii the child might have multiple focal points
(the statement applies to astigmatism)
Iv the child’s corneal surface might be uneven
(this statement applies to astigmatism)
v presence of denatured protein in the lens that might have blocked the light rays
(applies to cataract)
vi biconcave lenses may be prescribed

9. A 32-year-old man presents to you complaining of headache, blurred and distorted vision. He
has not seen an ophthalmologist in years. On examination, you find areas of uneven curvature
of his corneas.

a) Indicate the possible refractive error that might occur in this case.

b) State how your answer in a) affect his point of focus / focal point?

c) Can his vision be corrected?

Upon examination, he was found to have a visual acuity of 6/9.

d) Explain the visual acuity result of this man.

e) Explain the procedure used to assess his visual acuity.

10. Please fill in the blanks:

The sense of taste, or _______ begins when food molecules stimulate taste buds located on the bumps
of the tongue called________. Each taste cell in these structures has microvilli that project into a _______
to increase its receptive surface area. Taste buds at the rear of the tongue are most sensitive to
______chemicals; those along the sides of the posterior half of the tongue are most sensitive to acids,
which produce the ____ taste sensation; and those at the tip of the tongue are most sensitive to
_____ , _________and _______ sensations. All taste fibers project to the ________ in the brain.

Receptor, supporting and basal cells for smell form ________ in the roof of the nasal cavity. ________
forms the first-order neuron in the olfactory pathway and is regenerated by basal cells. Axons of
olfactory nerve synapse with ______cells in the ________ in the _______. The _______-order neuron from
olfactory tract (mainly made of axons of mitral cells) will________, and ________the olfactory
impulses leading to the _________. Smell is then perceived/recognized.

11. Briefly describe the pathway from olfactory receptor cell to olfactory tract.

12. Describe the process of stimulation of olfactory receptors.

13. An 18-month-old toddler presented with 1 week history of running nose (rhinorrhoea) and
cough. She had also developed a high grade fever. On examination, the toddler appeared
irritable and was diagnosed with upper respiratory tract infection. Otoscopic examination of
the right ear revealed a bulging, erythematous tympanic membrane. The child was not
responding to sounds coming from the right side.

a) State the most likely diagnosis and give THREE reasons

b) State the type of deafness that developed in this toddler.
c) i) Describe the impedance matching function of the middle ear.
ii) With reference to c)i), briefly discuss how hearing is impaired in this patient.

14. Aiman, a 37- year old demolition worker, has been working on site since the past 8 months.
Recently, he started to notice that he was having difficulty in hearing high-pitched tones
especially at his left ear.

a) State the type of deafness that developed in Aiman.

b) State how the auditory hair cells of the left ear are affected in Aiman’s condition.
c) Describe the transduction of impulses by hair cells in the auditory pathway in
i) a person with normal hearing.
ii) Aiman’s left ear.

d) Briefly describe your findings when you performed the tuning fork tests to
i) a person with normal hearing.
ii) Aiman.

Rinne Weber

Method

i) Normal hearing

ii)Sensorineural
deafness (Aiman
left ear)

e) One day, a concrete block fell from the 3rd floor from a building near to Aiman’s
construction site. The loud noise lasted couple of miliseconds. Nevertheless, Aiman suddenly
felt fullness of his left ear and he could not hear his friends and thought his friends were
speaking too softly.

i) Why was he unable to hear his friends speak immediately after the block fell?
ii) State the type of deafness he is most likely to suffer now in his left ear. State your findings
when you performed both Rinne and Weber tests to Aiman after this event.

Rinne Weber

Method

i) Normal hearing

ii)Sensorineural deafness
(Aiman left ear)

iii) Conduction deafness

(left ear)

iv) Aiman is now suffering

both conduction and
sensorineural deafness at
his left ear.