Cognitive Problems

Question 0

2 - Loss of vibration sense distally? Localization and disease state

Answer 0

Tabes dorsalis, localized to dorsal columns

Demyelination occuring in untreated syphillus

Question 1

2 - Argyll-Robertson pupils and associated disease

Answer 1

Pupils that react to accommodation but not to light

Happens in neurosyphillis

Question 2

5 - Neuro/psych sequelae of coronary artery bypass surgery? Mechanism?

Answer 2

“Pump-head” cognitive impairment in patients after undergoing bypass surgery. Patients may have executive function or general cognitive impairments after being on bypass. Mechanism though to be from multiple micro-emboli

Question 3

4 - anti-Ma antibody association

Answer 3

Paraneoplastic syndrome invovling testicular malignancy and affecting the hippocampi.
Remember, many paraneoplastic syndromes assoc with lung cancers (anti-Hu, Yo, Ma). Be wary of smokers!

Question 4

6 - Post-concussion syndrome manifestations

Answer 4

Lightheadedness, nausea, trouble concentrating, trouble sleeping

Question 5

8 - Cognitive disorder associated with hoarding

Answer 5

Alzheimer’s disease. Hoarding it often associated with early disease

Question 6

10 - Cold caloric testing. What is it, and explain physiology of response

Answer 6

Used in testing of comatose/unresponsive patients. Cold (or warm) water poured into one ear. Cold water decreases vestibular firing on that side causing horizontal nystagmus toward contralateral side. Nystagmus always occurs toward the side of increased vestibular firing