ENT 2
90% of nosebleeds originate from this area.
Bonus: for 500 points, what are the tributaries to this area, and where do they originate from?
Kisselbachs plexus
Anterior & Posterior Ethmoidal a. (V1)
Sphenopalatine a. & Greater Palatine a. (V2)
Superior Labial a. (Facial CN VII)
What ocular muscle is innervated by the trochlear nerve?
Superior oblique
What is the name of the screening test for autism spectrum disorder?
M-CHAT
What are the 3 main signs of Horner syndrome?
Ptosis, Anhidrosis, Miosis (aka “PAM”)
A 22 y/o male is brought to your clinic with a significant other with a history of obesity and migraines. The patient's partner says that the patient had two separate episodes of tense muscles all over, jerking movements, and passing out. A drug from the class of anti-epileptics may be useful in this situation. (What medication?)
Topiramate
A patient comes to the office with a midline neck mass that moves with swallowing. What is this?
Thyroglossal duct cyst
What optic nerve disease is this demonstrating?
Bonus: Why is checking the eye essential, especially in acute cases?
Papilledema (or blurring of the optic disc margins from increased ICP)
Want to assess for papilledema before doing an LP. LP with evident increased cranial pressure tends to cause herniation of brain parenchyma downward. (Not good or fun).
What medication is used to treat severe cases of serotonin syndrome?
Cyproheptadine
Splitting is an ego defense common in what personality disorder?
Bonus: What is typically used to treat this disorder?
Borderline Personality Disorder
DBT
You are a neonatology fellow checking in on your patients in the nursery. You notice a neonate with a particular pink marking on one side of their face and decide to check their eyes. Fundoscopy reveals papilledema. The condition this baby has exhibited is the following gene mutation and inheritance pattern.
GNAQ (mutation) and somatic mutation resulting in mosaicism
What is the parasympathetic innervation to the parotid gland?
Glossopharyngeal nerve (CN IX)
What congenital infection is known to cause cataracts?
Rubella
What is the treatment for Neuroleptic Malignant Syndrome (NMS)?
Bonus: What is the mechanism of action?
Bromocriptine & Dantrolene
Bromocriptine is a DA agonist; Dantrolene is a muscle relaxant that prevents calcium release from the muscle sarcoplasmic reticulum by inhibiting the RYR channel.
One of the key ways to tell a cocaine, LSD, or MDMA overdose from an opioid overdose is this physical exam finding.
Bonus: for 300 points, what is the medication that is the exception to this rule?
Pupil size (Mydriasis in cocaine, LSD, MDMA overdose, Miosis in an opioid overdose)
MyDriasis (D is for dilated pupil)
Meperidine
You're in your EM rotation and were notified by EMS that a patient who had just had the worst headache of their life had suddenly lost consciousness. The patient is en route to the hospital, and the attending tells you that this condition typically involves these vessels and is often associated with this genetic disorder.
ACOM - ACA junction
ADPKD or Ehler-Danlos Syndrome
What are the three most common bacteria responsible for otitis media?
Strep pneumonia, Haemophilus influenza, and Moraxella catarrhalis
You have a patient who's been brought to the clinic after their license was suspended. He was recently in a car accident in a local neighborhood after driving past a stop sign that he didn't see on his right side. On exam, you find that his right-sided vision (right visual field) is cut. A lesion to this location would result in this visual deficit.
The left optic tract
Which medication can be used to treat depression and can also stimulate the appetite?
Mirtazapine
According to Jean Piaget’s theory of cognitive development, object permanence is achieved by the end of this stage.
Sensorimotor stage (birth to 2 years old)
Of the movement disorders characterized by trinucleotide repeats, the two main disorders we've discussed result in atrophy in the following regions.
Caudate nucleus degeneration in Huntington's Disease (also frontal, temporal atrophy)
Spinal & cerebellar degeneration in Friedrieich's Ataxia (DCML, CST, and spinocerebellar tracts)
What is the Meniere's Disease Triad, and how do you treat it?
Vertigo, tinnitus, and hearing loss
A Low-salt diet. (Acetazolamide/HCTZ therapy)
What two systemic diseases are associated with lens dislocations?
Bonus: Where does the lens dislocate in both conditions?
Marfan Syndrome and Homocystinuria
Marfan - Up & Out
Homocystinuria - Down & In
Where is the master clock in the human body?
The Suprachiasmatic nucleus of the hypothalamus
Which hormone can dampen the amygdala/cingulate circuit and increase trust and social comfort?
Oxytocin
As seen in this demyelinating disease characterized by sudden onset, post-infectious/innocuous white matter degeneration often seen in children, multiple sclerosis also involves white matter degeneration caused by cells from this germ cell layer.
1. What is a disease similar to MS that affects kids?
2. What is the primary cause/offender in this demyelinating disorder?
3. What is the germ cell origin of this offending cell?
Mesoderm
1. Acute Demyelinating Encephalomyelitis (ADEM)
2. Causes by autobodies against oligodendrocytes
3. Autobodies are produced by plasma cells, which originate from mesoderm
** The damaged cells are oligodendrocytes, which originate from ectoderm (neuroectoderm) **