(NEWEST 2026) MSRA TEST QUESTIONS AND CORRECT
ANSWERS
1. Q: What is the role of the C3 and C4 nerve roots in limb innervation?
ANSWER These nerves do not significantly contribute to the arm or forearm;
they primarily supply neck muscles like the trapezius (involved in shrugging)
alongside the accessory nerve (CN XI).
2. Q: Are the C6 and C7 nerve roots involved in the triceps reflex?
ANSWER No; while they supply various arm muscles, the triceps reflex
specifically tests C7-C8. C6 is the predominant root for the brachioradialis
reflex.
3. Q: What are the nerve roots and the expected action for the ankle reflex?
ANSWER S1-S2 ("buckle my shoe"); results in plantar flexion at the ankle.
4. Q: Which nerve roots are tested by the knee reflex?
ANSWER L3-L4.
5. Q: What are the nerve roots and the expected action for the biceps reflex?
ANSWER C5-C6; results in flexion at the elbow.
6. Q: What are the nerve roots and the expected action for the triceps reflex?
ANSWER C7-C8; results in extension of the forearm.
7. Q: What are the characteristics of an innocent ejection murmur in a child?
ANSWER It is a soft-blowing or short buzzing murmur, localized (no
radiation), varies with posture, has no diastolic component, no thrill, and no
added sounds; the child is otherwise asymptomatic.
8. Q: What characterizes dry macular degeneration?
, ANSWER It accounts for 90% of cases and involves slow deterioration of
macula cells; it is characterized by "drusen" (yellow round spots in Bruch's
membrane).
9. Q: What is Step 1 treatment for hypertension?
ANSWER For patients <55 or with Type 2 Diabetes: ACE inhibitor or ARB.
For patients $\ge 55$ or of Black African/African-Caribbean origin: Calcium
Channel Blocker (CCB).
10.Q: What is Step 2 treatment for hypertension?
ANSWER A combination of an ACE-i/ARB plus a CCB or a Thiazide-like
diuretic ($A+C$ or $A+D$).
11.Q: What is Step 3 treatment for hypertension?
ANSWER A triple combination: ACE-i/ARB + CCB + Thiazide-like diuretic
($A+C+D$).
12.Q: What is Step 4 treatment for hypertension (resistant hypertension)?
ANSWER Check adherence and confirm with ABPM; if Potassium $<4.5$
mmol/l, add low-dose spironolactone. If Potassium $>4.5$ mmol/l, add an
alpha- or beta-blocker.
13.Q: What are common side effects of Carbamazepine?
ANSWER Dizziness, ataxia, and diplopia.
14.Q: What are common side effects of Topiramate?
ANSWER Weight loss, cognitive impairment, and kidney stones.
15.Q: What are common side effects of Sodium Valproate?
ANSWER GI disturbances, tremor, and hair loss.
16.Q: What are common side effects of Lamotrigine?
ANSWER Skin rashes (including Stevens-Johnson syndrome), headache, and
dizziness.
17.Q: What are the specific side effects of Phenytoin?
ANSWERS
1. Q: What is the role of the C3 and C4 nerve roots in limb innervation?
ANSWER These nerves do not significantly contribute to the arm or forearm;
they primarily supply neck muscles like the trapezius (involved in shrugging)
alongside the accessory nerve (CN XI).
2. Q: Are the C6 and C7 nerve roots involved in the triceps reflex?
ANSWER No; while they supply various arm muscles, the triceps reflex
specifically tests C7-C8. C6 is the predominant root for the brachioradialis
reflex.
3. Q: What are the nerve roots and the expected action for the ankle reflex?
ANSWER S1-S2 ("buckle my shoe"); results in plantar flexion at the ankle.
4. Q: Which nerve roots are tested by the knee reflex?
ANSWER L3-L4.
5. Q: What are the nerve roots and the expected action for the biceps reflex?
ANSWER C5-C6; results in flexion at the elbow.
6. Q: What are the nerve roots and the expected action for the triceps reflex?
ANSWER C7-C8; results in extension of the forearm.
7. Q: What are the characteristics of an innocent ejection murmur in a child?
ANSWER It is a soft-blowing or short buzzing murmur, localized (no
radiation), varies with posture, has no diastolic component, no thrill, and no
added sounds; the child is otherwise asymptomatic.
8. Q: What characterizes dry macular degeneration?
, ANSWER It accounts for 90% of cases and involves slow deterioration of
macula cells; it is characterized by "drusen" (yellow round spots in Bruch's
membrane).
9. Q: What is Step 1 treatment for hypertension?
ANSWER For patients <55 or with Type 2 Diabetes: ACE inhibitor or ARB.
For patients $\ge 55$ or of Black African/African-Caribbean origin: Calcium
Channel Blocker (CCB).
10.Q: What is Step 2 treatment for hypertension?
ANSWER A combination of an ACE-i/ARB plus a CCB or a Thiazide-like
diuretic ($A+C$ or $A+D$).
11.Q: What is Step 3 treatment for hypertension?
ANSWER A triple combination: ACE-i/ARB + CCB + Thiazide-like diuretic
($A+C+D$).
12.Q: What is Step 4 treatment for hypertension (resistant hypertension)?
ANSWER Check adherence and confirm with ABPM; if Potassium $<4.5$
mmol/l, add low-dose spironolactone. If Potassium $>4.5$ mmol/l, add an
alpha- or beta-blocker.
13.Q: What are common side effects of Carbamazepine?
ANSWER Dizziness, ataxia, and diplopia.
14.Q: What are common side effects of Topiramate?
ANSWER Weight loss, cognitive impairment, and kidney stones.
15.Q: What are common side effects of Sodium Valproate?
ANSWER GI disturbances, tremor, and hair loss.
16.Q: What are common side effects of Lamotrigine?
ANSWER Skin rashes (including Stevens-Johnson syndrome), headache, and
dizziness.
17.Q: What are the specific side effects of Phenytoin?
