Neuroanatomy
66 yo with HTN develops vertigo, diplopia, nausea, vomiting, hiccups, L face numbness, nystagmus, hoarseness, ataxia of limbs, staggering gait, and tendency to fall to the left. Dx?
LATERAL MEDULLARY STROKE
DA release in what structure represents common final event associated w/ reinforcing effects of opiates, cocaine, amphetamines, nicotine, PCP, and alcohol?
Nucleus accumbens
79 yo pt with a deteriorating mental state over a 3-week period has an exaggerated startle response with violent myoclonus that is elicited by turning on the room lights, speaking loudly, or touching the pt. Myoclonic jerks are also seen. Diagnosis:
SPONGIFORM ENCEPHALOPATHY
68 yo pt w/ hypertension develops rapidly progressing right arm and leg weakness, with deviation of the eyes to the left. Within 30 minutes of the onset of this deficit, pt became increasingly sleepy. Two hours after the onset, the patient became unresponsive. On exam: dense right hemiplegia, eyes deviated to the left, pupils: equal and reactive, a right facial weakness to grimace elicited by noxious stimuli. Cough and gag reflexes: present. Which CT finding is most likely?
LEFT PUTAMINAL HEMORRHAGE
Which neurocognitive disorder has more severe EPS SEs from antipsychotics?
Lewy body disease
In addiction, dopaminergic neurons project to nucleus accumbens. Cell bodies of these neurons reside in which area of the brain?
VENTRAL TEGMENTAL AREA
Name the rate-limiting enzyme in the synthesis of norepinephrine and dopamine:
Tyrosine hydroxylase
9 yo F has 3 month h/o seemingly unprovoked bouts of laughter. Worse when not sleeping well. Pt does not feel happy during these episodes. Started menstruating 6 months ago, and at Tanner stage 4. Dx?
HYPOTHALAMIC HAMARTOMA
61 yo with left frontal lobe damage secondary to cerebrovascular accident may be predisposed to which psychiatric syndrome?
MDD
74 yo F suspicious, poor ADLs, personality changes, most likely dx:
pick’s disease
Which dopaminergic pathway includes the nucleus accumbens and also mediates addiction and associated behaviors/ reinforcing?
MESOLIMBIC
Neurotransmitter with highest affinity for human CB-1 receptor:
ANANDAMIDE
Benign intracranial HTN etiology:
HYPERVITAMINOSIS A
As opposed to strokes caused by arterial embolism or thrombosis, those caused by cerebral vein or venous sinus thrombosis are:
Associated with seizures at onset
Which brain pathology is associated with 69 yo female with progressive behavioral changes, rudeness, interrupting conversations, watching excessive TV (turned off), large meals despite no hunger, stooped posture w/ slow shuffling gait: amyloid deposition, dopamine depletion, intraneural tau deposits, ubiquitinated inclusions, alpha synuclein accumulation?
interneural tau deposits
Which of the following cortical regions is a key component of the salience network?
ANTERIOR CINGULATE CORTEX
Neurotransmitter that stimulates AMPA receptors:
Glutamate
57 yo has new onset speech difficulty cannot name objects and sometimes cannot say "yes or no" and cannot repeat "ifs, ands or buts" but can follow verbal and written commands. No problems with chewing/swallowing. What is the condition?
Brocca’s aphasia
70 yo pt w/ attacks of ”whirling sensations” w/n/v, diplopia, dysarthria, tingling of lips. Occurs several times daily for 1 minute, severe that pt collapses and is immobilized when symptoms start. No residual s/s, no tinnitus, hearing impairment, ALOC or association with any particular activity. Dx?
VERTEBROBASILAR INSUFFICIENCY
MRI of brain shows ventriculomegaly of 65 yo with progressive cognitive decline. Normal opening pressure of LP. Likely to be found on exam?
gait apraxia
Biogenic amine made in Locus Coeruleus:
norepinephrine
Where are the major clusters of cell bodies containing serotonin in the brain?
RAPHE NUCLEUS IN THE BRAIN STEM
5 yo presents w/ sudden onset of slurred speech and gait difficulty. Exam shows truncal ataxia and nystagmus, mild dysarthria and extensor plantar responses. Recent h/o measles. MRI, UA, blood work unremarkable. Dx?
ACUTE CEREBELLITIS
62 yo w/ bilateral posterior cerebral artery strokes reports trouble seeing because lights were dim or glasses were not on. What describes his visual problem?
ANOSOGNOSIA
A med that is most likely to slow the progression of vascular dementia:
Aspirin