Movement
Neuroimmunology
Stroke
Dementia
Infections
100
70 year old man has a tremor in both hands that is gradually getting worse. You also notice a head tremor. Says his dad had the same tremor. Gets better with alcohol. What does he have?
Bonus point: what can be used to treat it?
Essential tremor
Propranolol and primidone
100
33 yo female comes in with an episode of right arm numbness. Says three months ago she had blurry vision that self-resolved. MRI shows hyperintensities along the ventricles. What does she likely have?
MS
100
75 year old alcoholic female falls and hits head. Now she has this:
subdural hematoma
100
Donepezil, rivastigmine and galantamine are used to treat Alzheimer's. What's their mechanism of action?
acetylcholinesterase inhibitors
100
Patient comes in with cognitive decline and spasticity. You notice that she appears to be foaming somewhat at the mouth. When she tries to drink a cup of water she seems to gag and spits it out. What infection are you concerned for?
Rabies encephalitis
200
Name three cardinal clinical features of Parkinson disease
Bradykinesia, resting tremor, cogwheel rigidity, gait instability
200
How do you diagnose multiple sclerosis?
Two lesions disseminated in time and space
200
What interesting CSF finding can be seen in subarachnoid hemorrhage?
Xanthochromia (yellow pigmentation)
200
70 year old female is brought in by husband for cognitive decline. Patient states she will randomly see things that aren't there. Also has parkinsonian symptoms. What does she have?
Dementia with Lewy Bodies
200
What is a fungus in immunosuppressed patients that can cause chronic meninigitis with elevated ICP?
Cryptococcus
300
5 yo female comes in with abnormal arms and finger movements. Doesn't have control of them. Mom also noticed she has been displaying tics lately. Interestingly had strep throat 3 months ago. What condition does she have?
Sydenham chorea
300
3 yo male comes in with abdominal distention and is found to have a big abdominal tumor. You notice that he has erratic eye movements, jerky movements of the extremities and seems off-balance when walking. What cancer does he have and what neurologic disorder does he have?
Neuroblastoma
Opsoclonus-myoclonus syndrome
300
67 year old male has right sided arm weakness, right facial droop and expressive aphasia. MRI shows a stroke. What artery was likely affected?
Left MCA
300
56 year old female is brought in by cognitive decline. She has been more irritable lately and engaging in spontaneous and risky behaviors. Family says her personality has changed. Memory seems relatively intact. What do you suspect?
Frontotemporal dementia
300
Name one bacteria associated with Guillian-Barre syndrome?
Mycoplasma
Campylobacter
400
45 year old man is brought in with his wife for abnormal arm movements. Has writhing, uncontrollable finger movements. Also has seemed very depressed and irritability over the last few years. What disease are you concerned about?
Huntington disease
400
4 year old male comes in with altered mental status and seizures. Exam shows right-sided weakness. Parents said he had a viral infection a week ago. MRI shows this:
ADEM (acute disseminated encephalomyelitis)
400
Name the stroke syndrome associated with ipsilateral Horner's, ipsilateral ataxia, loss of pain/temp sensation on ipsilateral face and contralateral body, and dysarthria and dysphagia
Bonus point: what artery is usually affected?
Wallenburg syndrome (lateral medullary syndrome)
400
43 year old male has rapidly progressive dementia. Is also mute, has seizures and an exaggerated startle response. CSF has elevated 14-3-3 protein. What neurodegenerative disease are you worried about?
Creutzfeld-Jakob disease
400
What virus causes encephalitis that is affects the temporal lobes and causes hemorrhages?
HSV-1
500
25 yo male with schizophrenia is treated with haloperidol. Later that day you notice his head is contracted to the right side. He said it's painful and he has no control over it. What happened?
bonus: how do you treat?
Acute dystonic reaction
Benadryl (or benztropine)
500
17 year old male comes in with new seizures. Has had five days of worsening psychosis. You also notice dystonia and patient intermittently seems catatonic. What group of disorders might he have? Hint: there was a book/movie made about it recently
Bonus points if you can name the specific disorder he has
Autoimmune encephalitis (book/movie is Brain on Fire)
anti-NMDA receptor encephalitis
500
31 year old female has recurrent strokes. Angiogram looks like this:
Moyamoya disease
500
45 year old male has progressive cognitive decline. Has progressive spasticity, weakness, ataxia and loss of vibration and proprioception. Works in a factory where he is exposed to nitrous oxide. What cause of dementia could he have?
B12 deficiency
500
Patient with HIV hasn't been taking their retrovirals. Comes in with congitive decline, vision changes and spasticity. JC virus titers are elevated. MRI looks like this:
Progressive multifocal leukoencephalopathy