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KATHMANDU UNIVERSITY
University Examination
January/February 2026
Level: MBBS
Paper: VIII Central Nervous System and Special Senses
Exam: II MBBS
Time: 2 hours 30 minutes
Marks: 50
Date: February 23, 2026
#INSTRUCTION TO THE CANDIDATE
• Answer each section in separate answer book.
• Write your answers with relevant and legible answers.
• Illustrate your answer with well labeled diagrams wherever required.
• All questions are compulsory.
#SECTION “B”
#Short Answer Questions
a. Draw a well labeled diagram showing the arterial supply of superolateral surface of cerebrum. [3]
b. Enumerate the layers of scalp. Give a brief description on third layer. [3]
c. Mention the internal structure of spinal cord. [3]
Explain the Wald’s Visual Cycle. [2]
Describe pathogenesis and laboratory diagnosis of poliomyelitis. Add a note on available vaccines. [2+1=3]
Write short note on Retinoblastoma. [3]
a. Discuss the differences between benzodiazepines and barbiturates. [3]
b. Enlist the important therapeutic uses and adverse effects of Morphine. [2]
a. Describe the composition, circulation and functional importance of the cerebrospinal fluid. [3]
b. Compare and contrast the following:
i. Decerebration and decortication [3]
ii. Superficial reflex and deep tendon reflex [2]
#SECTION “C”
#Problem Based Questions
#Problem – I
A 6-year-old boy was brought to emergency room with high fever, severe headache, vomiting, neck rigidity and altered sensorium. His cerebrospinal fluid (CSF) was collected which was grossly turbid and on microscopic examination showed 1,200 cells/cumm with 98% neutrophils.
a. Name the structure involved in this case. Mention the layers of involved structure with their extents. [Anatomy] [1+1+1=3]
b. What are the common pathogens associated with the above condition in children? Mention 3 CSF parameters that help to distinguish bacterial and viral meningitis. [Microbiology] [1+3=4]
c. Discuss the biochemical findings of CSF examination in this case. [Biochemistry] [3]
#Problem – II
A 63-year-old man having a worsening tremor at rest and difficulty in walking is brought to his physician. He has a mask-like facial expression with little blinking. He is noted to have a fine tremor at rest in a “pill-rolling manner”. He has muscular rigidity and a stooped posture. On walking, the patient is noted to have rapid propulsion forward with an inability to stop. He shows no signs of dementia or depression and no family history of these conditions.
a. Explain the clinical features of the patient in relation to Basal Ganglia functions. [Physiology] [4]
b. Describe the pathogenesis of Parkinsonism. [Pathology] [3]
c. What is the mainstay of treatment of this case? Give the rationale. [Pharmacology] [3]
