Questions and Answers
What are the characteristic lesions seen in CT scans of patients with carbon monoxide poisoning associated with comas?
Globus pallidus
What will an MRI of the head show in a 68-year-old patient who is depressed following hip surgery with symptoms including dysarthria and weakness?
Periventricular white matter demyelination
What is the diagnosis for a patient with adult LP showing an opening pressure of 190, protein level of 110, glucose of 27, and leukocytes at 5,000?
Bacterial meningitis
What is the diagnosis for a 75-year-old male veteran with gradual cognitive decline, slurred speech, and a lumbar puncture showing 35 WBC and elevated protein?
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What condition is indicated by the inability to carry out motor activities on verbal command despite intact comprehension?
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What is the most common cause of aseptic meningitis?
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What roles does the cerebellum play in the human adult brain?
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What does the brain autopsy show for a 25-year-old male with severe symptoms such as akinetic mutism and seizures?
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What is the most likely medical cause of personality changes and olfactory and gustatory hallucinations?
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What is the most likely causative organism for a 52-year-old patient with severe headache and symptoms suggesting meningitis, along with specific LP findings?
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Where will damage show on MRI for a patient with 26 y.o. who presents with hand clumsiness and intention tremor?
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The mesolimbic dopamine pathway includes which structure?
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Cell bodies of dopaminergic neurons projecting to the nucleus accumbens reside in which area of the brain?
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Neural plasticity largely mediated through the capacity to rapidly change in number and morphology of which structures?
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The uncinated fasciculus connects which brain areas?
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What are cortical columns?
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Abnormal emotional expressions like pathological laughter or crying are caused by lesions affecting connections between frontal cortex, pons, and what other structure?
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Exposure to light affects which brain structure?
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When does synaptogenesis peak?
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Where does neuron morphology in the brain change the most?
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Threatening objects produce a startle response prior to conscious awareness by connecting the thalamus to what?
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Huntington's disease is characterized by the loss of neurons producing which neurotransmitter?
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Adult neurogenesis occurs in which area of the brain?
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A 17 y.o. is evaluated for binge eating associated with weight gain. A craniopharyngioma likely disrupts what structure?
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What is an accurate statement about the brain's default mode network?
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The most likely reason adults are superior to adolescents in abstract thinking is due to what process?
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The dorsal-lateral prefrontal cortex plays an important role in what activity?
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Drug abuse activates neurocircuits. Where does it generate signals and dopamine?
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What percentage of left-handed people develop left hemispheric dominance for language?
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Prostaglandin D2 increases extracellular levels of what?
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Which is a retrograde neurotransmitter?
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What are the characteristics of acetylcholine receptors in the cerebral cortex?
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What is the neurohormone for social bonding?
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What will CSF show in a patient with an ovarian mass and antibodies to NMDA receptors?
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Which neurotransmitter is responsible for the rewarding nature of drug abuse?
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What is the role of glycine at NMDA receptors?
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Low CSF levels of which neurotransmitter metabolite are associated with suicidality?
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What is the classification of the 5HT3 receptor?
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Pain by neurogenic inflammation is mediated by which substance?
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Decreased levels of which neurotransmitter are most associated with depressed mood, poor sleep, and poor impulse control?
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Psychological stress increases cortisol. Which hormone's increase is correlated with decreased PTSD severity due to its anti-glucocorticoid properties?
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What dysfunction is indicated by unsteady gait and appendicular ataxia with normal eye movement?
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Visual problems from a pituitary tumor compressing the optic chiasm lead to what?
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A 60 y.o. right-handed male who is getting lost and has left-sided hemi-neglect likely has a lesion where?
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Which cancer has the highest likelihood of metastasizing to the brain?
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A 66 y.o. with anxiety and mild impairment of upgaze most likely has what diagnosis?
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In the presence of vertical gaze impairment, mild rigidity, and bradykinesia, the diagnosis is likely what?
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A patient with right-side clumsiness and intention tremors on MRI shows damage where?
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In the context of 9 y/o with unexplained laughter who has recently started menstruating, likely diagnosis?
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In a 5 y/o with morning headaches, vomiting, and recent gait problems, a likely diagnosis is?
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In a 70 y/o who has flaccid paralysis post water intoxication, the likely diagnosis is?
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In elderly patients with confusion and seizures with serum sodium of 95 mEq/L, may develop what complication?
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In a young adult who gained weight and has severe headaches but normal brain CT, what is the goal of treatment?
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Superior homonymous quadrantic defects in visual fields are due to lesions in which structure?
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In a severe occipital headache with bilaterally elevated opening pressure in the lumbar puncture, likely condition is?
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In an elderly patient with exaggerated startle response, the diagnosis is likely what?
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Signs of lesions in one cerebellar hemisphere manifest as what?
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What is a sign of upper motor neuron lesion?
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What is indicated by a patient showing perseveration during clock draw test?
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Where is the optimal location for deep brain stimulation electrodes in Parkinson's treatment?
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In which brain structure is deep brain stimulation useful for primary generalized dystonia?
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What is the etiology of meningitis associated with fever, headache, and pleocytosis with lymphocyte predominance?
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Lesions in mammillary bodies produce what symptom?
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In a patient with several days of fever and confusion, what likely diagnosis is indicated by hyperintensity of the left temporal region on MRI?
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What is the most common solid tumor of the CNS in kids?
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What would CT show after removal of CSF in a 75 y.o. patient with cognitive decline?
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In a 41 y.o. patient with chronic fatigue and cognitive impairment, what is the likely diagnosis?
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What is the diagnosis for a 25 y.o. presenting with severe headaches and vomiting but with a normal brain CT?
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Histology for Jakob-Creutzfeldt disease shows what?
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A 32 y.o. patient with worsening headaches and episodic hallucinations likely has a tumor where?
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Benign intracranial hypertension may be caused by what condition?
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Which lesion causes bilateral coarse nystagmus worsening with visual fixation?
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Delayed neurological deterioration following carbon monoxide-induced coma is most likely manifested by what condition?
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In a patient with right-side vision issues, what is likely to develop later?
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Which finding is most reliable in CSF analysis for a patient with chronic progressive multiple sclerosis?
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What condition is a recognized forerunner of multiple sclerosis?
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What indicates difficulty with upward gaze and severe axial rigidity in an elderly patient?
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A patient with confusion, lethargy, and seizure has a serum sodium level of 95 mEq/L. What is likely?
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Study Notes
Cerebellum and Motor Control
- Damage in the cerebellum can be visualized on MRI, correlating with signs such as clumsiness and intention tremors.
- Rapid alternating movements, dysmetria, and overt tremor indicate cerebellar dysfunction.
Dopaminergic Pathways
- The mesolimbic dopamine pathway includes the ventral striatum, crucial for reward processing.
- Dopamine release in the nucleus accumbens is facilitated by projections from the ventral tegmental area, playing a significant role in addiction.
Neural Plasticity
- Dendritic spines are key components mediating neural plasticity through structural changes.
Brain Connectivity
- The uncinated fasciculus connects the anterior temporal and ventral pre-frontal regions, instrumental in emotional regulation and cognition.
Information Processing
- Cortical columns serve as functional units for processing information within the cortex.
Emotional Responses
- Abnormal emotional expressions such as pathological laughter are linked to lesions affecting the cortical-subcortical circuits including the cerebellum.
Circadian Rhythm
- The suprachiasmatic nucleus is the brain structure primarily affected by light exposure, regulating circadian rhythms.
Developmental Neuroscience
- Synaptogenesis peaks in the first four years of life, underlining the significance of early brain development.
- The prefrontal cortex undergoes substantial morphological changes, emphasizing its role in higher cognitive functions.
Startle Response and Fear
- The connection between the thalamus and the amygdala is pivotal for the startle response initiated by perceived threats.
Neurotransmitter Dynamics
- Huntington's disease is characterized by the loss of GABA-producing neurons.
- Adult neurogenesis occurs in the hippocampus, highlighting its capacity for regeneration.
Hypothalamic Functions
- Craniopharyngioma in a young patient disrupts the ventromedial hypothalamus, affecting appetite and weight.
The Default Mode Network
- The brain's default mode network is involved in reprocessing previously experienced stimuli, essential for memory consolidation.
Synaptic Pruning
- Synaptic pruning enhances abstract thinking capabilities in adolescents, marking a critical developmental stage.
Cognitive Function and Memory
- The dorsal-lateral prefrontal cortex is vital for working memory, supporting executive function tasks.
Neurohormonal Influences
- Oxytocin functions as a neurohormone for social bonding, impacting interpersonal relationships.
Autoimmune Neurology
- Anti-NMDA receptor encephalitis presents with psychiatric symptoms, seizures, and ovarian masses in young women.
Reward Mechanisms
- Dopamine is intricately linked to the rewarding nature of drug abuse, driving addictive behaviors.
Neurotransmitter Characteristics
- Endocannabinoids function as retrograde neurotransmitters, influencing synaptic transmission.
Pain Pathways
- Substance P is crucial for mediating pain via neurogenic inflammation processes.
Mood Disorders
- Low levels of serotonin are associated with depressive symptoms, indicating its role in mood regulation.
Stress Physiology
- DHEA is a hormone correlated with reduced PTSD severity due to its anti-glucocorticoid properties.
Cerebellar Disorders
- Cerebellar degeneration presents with unsteady gait and appendicular ataxia, often related to alcohol use.
Visual Field Deficits
- A pituitary tumor can cause bitemporal hemianopsia due to compression of the optic chiasm.
Cognitive Decline
- Right parietal lobe lesions can manifest in left-sided hemispatial neglect, affecting awareness of the environment.
Tumor Metastasis
- Lung cancer has the highest likelihood of metastasizing to the brain, significant in clinical considerations.
Movement Disorders
- Progressive supranuclear palsy (PSP) is characterized by postural instability, cognitive changes, and ocular abnormalities.
Pediatric Tumors
- Medulloblastoma presents with symptoms common in children, including headaches and gait issues.
Meningitis
- Coxsackie virus can cause viral meningitis, characterized by elevated lymphocytes in CSF.
Cognitive Impairment in Infections
- Hepatitis C infection can lead to cognitive impairments, reinforcing the importance of neurological evaluation in systemic infections.
Immune Responses
- The presence of oligoclonal bands in CSF is a reliable indicator for multiple sclerosis diagnosis.
Neurological Disorders
- Spongiform encephalopathy is characterized by myoclonus and cognitive decline, associated with prion diseases.
Diagnostic Indicators
- Characteristics such as gradual cognitive decline and personality changes can indicate neurological tumors, particularly in the frontal lobe.
Hydrocephalus
- Normal pressure hydrocephalus presents with gait abnormalities, urine incontinence, and cognitive decline.
Neurodegeneration
- Hippocampal atrophy is found in several disorders, including major depressive disorder, Alzheimer's disease, and PTSD.
Substance Management
- Treatment for pseudotumor cerebri focuses on preventing blindness due to elevated intracranial pressure.
Memory Disorders
- Amnesia and confabulation may arise from lesions in the mammillary bodies, impacting memory processing.
Vasculitis and Infections
- Bacterial meningitis causes elevated leukocytes, signaling severe infection requiring immediate attention.
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Test your knowledge on key concepts from the Ninja PRITE exam with these flashcards. This quiz covers essential topics such as the cerebellum, mesolimbic dopamine pathways, and addiction neuroscience. Challenge yourself and enhance your understanding of critical neuroanatomy and neurophysiology.