Jeopardy!!!

Question 1

Result of Weber’s and Rinee’s test in case of conductive hearing loss

Answer 1

Bone conduction greater than air conduction
Webers test would lateralize TO affected side
Perceived as louder in side with conductive hearing loss

Question 2

Chronic alcoholic findings on exam:

• Both eyes medially deviated in primary position with horizontal nystagmus, inability to move eyes AT ALL when tracking a target except for convergence
• Positive Romberg and unsteady gait
• lack of orientation

Answer 2

Wernicke encephalopathy

Tx: thiamine

Question 3

Presence of this psychiatric disorder in a 12 year old boy markedly increases his vulnerability for substance abuse

Answer 3

Conduct disorder

Question 4

This psychiatric disorder is characterized by chronic low level depression with a bout of major depression

Answer 4

Double depression

Question 5

Initiation of pharmacotherapy with an SSRI in a pt with Bipolar disorder I is likely to result in this condition

Answer 5

Manic episode

be careful when starting antidepressants

Question 6

Pt can look laterally, but eyes cannot look medially w/o convergence

Answer 6

MLF lesion

(ie: left MLF lesion if left eye cannot follow medially)
- III nerve is in tact, communication btwn VI nerve complex is not in tact

Question 7

Lesion location with several weeks of numbness in the absence of pain on butt and under dorsal thighs
- loss of bowel, bladder, and sexual fxn over same period of time

Answer 7

conus medularis syndrome

cauda equina: pain is an early feature, bowel, bladder, sexual fxn is lost at a LATER point in time

Question 8

ocular findings in a right fourth nerve palsy

Answer 8

when you look down and in: eyes go in and up. Pt will often times tilt their head away from side of the lesion.
(SO normally depresses the eye when it faces medially and intorts the eyes when it faces laterally)

Question 9

Blocker of opioid receptor in the nucleus accumbens, in combo with psychotherapy has modest success in the tx of alcoholism

Answer 9

naltrexone

orally and shot in the butt every month

Question 10

this general anesthetic is associated with higher incidence of malignant hyperthermia that can be managed with this blocker of a ryanodine sensitive calcium channel

Answer 10

Halothane

tx with dantrolene

Question 11

route of administration of most rapid onset of CNS action

Answer 11

inhalation

Question 12

pathogenesis and four most locations for spontaneous hypertensive intracerebral hemorrhage

Answer 12

PONS
Cerebellum
Caudate
Lenticulate striate vessels (small ones that come off of large ones) that are affected

Chronic HTN: deposition of collagen in the vessels, weakening the walls (charcot buchard aneurysms)

Question 13

position of eye in primary gaze, and other findings in a case of a complete third nerve palsy

Answer 13

ptosis
dilated pupil (mydriasis)
opthalmoparesis
down and out

Question 14

Appendymoma

Answer 14

4th ventricle
pediatric/young adult
rosettes

(FYI: homer rosette: medulloblastoma)

Question 15

CN affected in pt with R tongue deviation
where do we find nucleus
umn or lmn lesion?

Answer 15

R hypoglossal n. lesion
nucleus is right in the mid line
LMN lesion (not a cortico contralateral lesion bc of atrophy + fasciculation )

Question 16

action of typical anti-psychotic agents on this brain pathway is responsible for their side effect of hyperprolactinemia

Answer 16

tuberoinfundibular pathway

not mesolimbic, mesocortical, nigrostriatal

Question 17

most common type of anxiety disorder with prevalence of 13.5%

Answer 17

social anxiety

Question 18

afferent pupillary defect

Answer 18

swinging flashlight test

affected eye will dilate (less light is being recieved by affected eye)

Question 19

afffected nerve root and the forament through which it exits the spinal canal, in the case of a pt with radiculopathy causing numbness over the anterior and medial leg, weakness of quads, and diminished patellar reflex on affected side

Answer 19

L4 nerve root

exits spinal canal btwn L3,L4?

Question 20

You would perform these tests to evaluate the fxnal pathways associated with 5th CN

Answer 20

Corneal blink reflex (V1)
Jaw jerk reflex / m. of mastication
Pain + temp + vibration sensation

(not really proprioception)

Question 21

anencephaly: failure of this event occuring

Answer 21

failure of closing of rostral neuropore during 3rd week when neural tube closes

Question 22

LMN lesion

Answer 22

flaccid paresis (not spastic)
fasciculation
muscle weakness
atrophy
hypotonia
hyporeflexia

Question 23

drug of abuse eliminated by zero order kinetics

Answer 23

ethanol

Question 24

likely dx of a pt who presents with progressive weakness in all 4 extremities over months, with diffuse hyperreflexia, atrophy, and fasciculations

Answer 24

ALS

upper and LMN lesion

Question 25

Brown seguard syndrome

Answer 25

dmg to 1 hemisphere –>
UMN synd. affecting contralateral muscle for dexterity (limb)
BUTT!! core muscles will remain innervated bc corticospinal fibers from the intact hemisphere innervates these LMN bilaterally

(above level of injury, everything is fine)
below dysfxn in:
contra - STT
IPS - DCML + CST