Nervous System Anatomy
Man with difficulty forming words. Imaging shows damage to inferior frontal gyrus
Broca's aphasia
oxazepam, alprazolam, lorazepam, clonazepam are _____-acting benzodizepines
intermediate (6-50 hours)
19-year-old college student presents with a sudden onset of fever, headache, stiff neck, and altered mental status. CSF analysis shows normal glucose with elevated lymphocytes. This class of organism is responsible.
Virus (most commonly echovirus, consider HSV if temporal lobe is mentioned)
Normal glucose -> virus bc it doesn't eat
If glucose is low, elevated neutrophils means bacteria and elevated lymphocytes means fungi
28-year-old man reports believing he can predict future events through his dreams and often speaks about 'sensing hidden messages' in everyday occurrences. He has no close friends and is dressed oddly. He has this personality disorder.
Schizotypal
mutations of ____ cause optic pathway gliomas, cutaneous manifestations
NF1
Stroke in ____ artery causes contralateral homonymous hemianopia (macula spared)
Posterior cerebral artery
Lisdexamfetamine is a ___(drug class)___, treatment for this eating disorder
stimulant; binge eating disorder
45-year-old man presents with progressive ascending paralysis and areflexia following a diarrheal illness 2 weeks prior. You'll see this in his CSF.
Albuminocytologic dissociation (GBS)
35-year-old male with a history of schizophrenia has failed trials of risperidone and olanzapine. His psychiatrist wants to start clozapine, so he'll have to continually check this lab.
ANC (Absolute neutrophil count)
mutations of ______ cause cerebellopontine angle masses, clear renal carcinomas, pheochromocytomas
VHL
Lesions in the _______ cause contralateral lower quadrantanopia.
Superior optic radiations
Irritability, anxiety, depressed mood, insomnia, and decreased appetite are withdrawal symptoms from _____
cannabis
62-year-old man presents with rapidly progressive cognitive decline and ataxia. Neurological examination reveals startle myoclonus and an unsteady gait. You'll see this on biopsy.
Spongiform changes (Creutzfeldt-Jakob disease)
35-year-old woman presents with a 2-year history of recurrent headaches, fatigue, and abdominal pain. She has seen many physicians and had had many tests, all with normal results. She is worried about having a serious undiagnosed illness. Physical examination is unremarkable. She has ___.
Somatic symptom disorder (illness anxiety would have no symptoms, conversion disorder would have neurologic symptoms)
25-year-old woman presents with worsening occipital headaches triggered by coughing, along with dizziness, hand numbness, and mild ataxia. You'll see this on MRI.
Tonsillar herniation (Chiari I)
This part of the basal ganglia mediates reward and pleasure and plays an important role in addiction.
Nucleus accumbens
adverse effects of this skeletal muscle relaxant can cause malignant hyperthermia
succinylcholine
28-year-old man who recently immigrated from Guatemala presents with seizures and headaches. His history reveals consumption of undercooked pork. Treat him with this drug (2 choices).
Albendazole or praziquantel
24-year-old male with schizophrenia recently started on a new antipsychotic. He now presents to the emergency department with severe muscle rigidity, diminished reflexes, and hyperthermia. His new medication inhibits ___.
D2 receptors (serotonin syndrome has INCREASED reflexes, to the point of clonus)
Newborn infant presents with cleft palate, holoprosencephaly, aplasia cutis, and polydactyly. The infant has 3 copies of this chromosome.
Chromosome 13 (Patau)
chromosomes 13-15-21: Patau-Edwards-Down (PEDs)
Children Have Awful Prognosis w/ Patau
(Cleft palate, holoprosencephaly, aplasia cutis, polydactyly, polycystic kidneys), along with severe midline defects
Brown-Sequard syndrome results from hemisection of the spinal cord. Characterized by _____ paralysis due to corticospinal tract injury; _____ loss of proprioceptive, and light tough sensation; and _____ loss of pain, temperature, and crude touch sensation
ipsilateral, ipsilateral, contralateral
65-year-old man with a history of MDD is started on a new antidepressant. Two weeks later, he reports difficulty urinating, dry mouth, and constipation. This is the class of medication he was started on.
TCA (anti-HAM effects)
Newborn born to a mother with no prenatal care presents with seizures, jaundice, and hepatosplenomegaly. Physical exam reveals hydrocephalus and chorioretinitis. Brain imaging shows intracranial calcifications. His mom was exposed to ___
Cat feces
25-year-old man with a 3-week history of decreased sleep, anhedonia, fatigue, loss of interest, and voices telling him that he is "worthless". He has experienced auditory hallucinations since childhood, and has had similar episodes in the past. His diagnosis is ____.
Schizoaffective disorder (the schizophrenia is the MAIN disorder because he's had schizophrenia without depression, but never depression without schizophrenia)
14-year-old girl presents with progressive ataxia and falls over the past year. She has dysarthria, absent lower extremity reflexes, a high foot arch, and a systolic murmur. This is the genetic problem she has.
GAA trinucleotide repeat (Friedreich's ataxia)