Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psychiatry Boards > Neurology/Neurocognitive Disorders/NeuroImaging > Flashcards

Neurology/Neurocognitive Disorders/NeuroImaging Flashcards

1
Q

What disease presents with abdominal pain + tachycardia + tingling in hands & feet + paranoia + hallucinations

A

Acute intermittent porphyria (AIP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Frontal lobe –> personality changes.

What part of frontal lobe is damaged to result in the following:
1) Mania
2) Depression
3) Apathy
4) Profane, irritable and irresponsible

A

1) R frontal lobe
2) L frontal lobe
3) medial frontal lobe (limited spontaneous mvmt or speech)
4) orbitofrontal lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the triad of Wernicke’s encephalopathy that is from alcoholism?

A

confusion + opthalmoplegia (weak eye muscles) + gait ataxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What diseases are represented by these findings on brain autopsy:
1) frontal & temporal lobe atrophy
2) substantia nigra depigmentation
3) hemorrhages in the periventricular grey matter (most likely around 3rd ventricle and superior vermis)
4) diffuse Lewy body in cortex
5) subcortical white matter lesions perpendicular to the ventricles

A

1) Pick’s disease aka FTD
2) Parkinsons
3) Wernicke’s encephalopahty
4) AZ or PD
5) “dawson’s fingers” , demyelinating dx — THINK MS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What neurological syndrome presents with generalized weakness with initial improvement in strength with minimal exercise and is often described in conjunction with small cell lung carcinoma?

What is the mechanism of this syndrome?

A

Lamber-Eaton myasthenic syndrome, it’s a paraneoplastic syndrome

MOA: immume-mediated directed at VG-calcium channels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A hemispheric stroke involving the corticospinal tract can result in appearance of what 2 signs in CL side?

A

Babinski & Hoffman’s sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What part of brain is damaged if you have a positive palmomental reflex and Myerson’s sign?

A

frontal lobe damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What part of brain must be damaged to have complete loss of gag reflex?

A

brain stem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What disorder presents with unilateral electric sharp pain to the face normally triggered by brushing teeth, chewing or gentle stimulation to face?

A

Trigeminal neuralgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What medication do you use to treat trigeminal neuralgia?

A

Carbamezapine (Tegretol)
Oxcarbezapine (Trileptal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What disease presents as a new or change in headache with fever, fatigue, myalgia, night sweats, weight loss and jaw tiring upon chewing?

A

Temporal arteritis aka Giant cell arteritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is most feared complication of temporal arteritis?

What is initial test for suspicion of temporal arteritis?

What is diagnostic test for temporal arteritis?

A

Central retinal artery occlusion

ESR

Temporal artery biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is difference between NF1 & NF2 (presentation and genes)?

A

NF! has cutaneous lesions, nerve lesions, neurofibromas & schwannomas, lisch nodules (pigmented iris harmartomas)

NF2 b/l vestibular (nerve 8) schwannomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What disease typically presents with the following clinical picture:
purplish skin rash (likely on face or eyelids) presents along with onset of muscle weakness

A

Dermatomyositis
- can also present on elbows, knees, neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is dermatomyositis hallmark finding on biopsy?

A

perifascicular atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the MOA of the following drugs:
-pergolide
-bromocriptine
-pramipexole
-ropinirole

What are they used to treat?

A

dopamine agonist

Parkinson’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which symptoms match with Wernicke’s vs. Brocas? identify location of lesion.

A) fluent speech, impaired auditory comprehension, impaired repetition, naming
- associated with R homononymous hemianopsis but NO sensory or motor loss

B) broken stuttering, staccato speech with intact comprehension, with impaired repetition
- associated with depression AND R hemiparesis and sensory loss

A

A) Wernicke’s: superior temporal gyrus

B) Broca’s: L posterior inferior frontal gyrus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How does conduction aphasia present and what area of brain is damaged?

A

Arcuate fasciculus

Pt cannot repeat things, has paraphasic errors, naming impaired but auditory comprehension is OKAY, R hemiparesis, R hemisensory loss, r hemianopsia and limb apraxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which aphasias present like Broca’s and Wernicke’s but repetition remains intact?

A

Transcortical motor aphasia (Broca’s)
Transcortical sensory aphasia (Wernicke’s)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Obese, young, AA woman presents with waxing and waning headache and intermittent visual blurring. Neuro exam may reveal papilledema. What is her dx? What test is diagnostic?

A

Pseudotumor cerebri (Benign ICH)
Do a LP and opening pressure will be >20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which brainstem stroke causes a person to have
- IL Horner’s syndrome
- IL loss of pain and temp in face
- CL loss of pain and temp to body
- cerebellar ataxia

A

Lateral medullary syndrome
AKA Wallenberg’s syndrome

caused by occlusion of vertebral arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Match the metabolic disorder with its appropriate enzyme:

Disorder
Lesch-Nyhan
Metachromatic leukodystrophy
Tay Sachs
Krabbe’s dx
Gaucher’s dx

Enzyme
A) hexosaminidase A
B) arylsulfatase A
C) galactocerebrosidase B-galactosidase
D) HGPRT (hypoxanthine-guanine phosphoribosyltransferase)
E) B-glucosidase deficiency

A

Metachromatic leukodystrophy: arylsulfatase A (chromosome 22)
Tay Sachs: hexosaminidase A (chromosome 15)
Krabbe’s dx: galactocerebrosidase B-galactosidase (chromosome 14)
Lesch-Nyhan: HGPRT
Gaucher’s: B-glucosidase deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the most common offending infectious agent in AIDS-related retinopathy?

A

CMV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which nerve rot innervates the following muscles resulting in the below mvmts?
- Hip flexor
- Leg extension
- Foot flexion
- Foot extension

A
  • Hip flexor: L1/L2/ L3
  • Leg extension: L3/L4
  • Foot flexion: L5
  • Foot extension: S1
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Footdrop is caused by a lesion to which nerve?

A

L5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which injury causes a person to have loss of
- IL motor control
- IL proprioception and vibration
- CL pain and temp (affected sensory level is usually 1 or 2 segments below the level of the lesion)
- cerebellar ataxia

A

Brown-Sequard syndrome (hemisection of the cord)
Traumatic or penetrating injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Where in the brain is the major site of serotonergic cell bodies?

A

Raphe nuclei (pons)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Where in the brain is NE made?

A

locus cereleus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Where in the brain is dopamine made?

A

substantia nigra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What drug interferes with the magnesium and ATP dependent uptake of biogenic amines –> depletion of dopamine, NE and 5HT NT –> relief from dystonia BUT can case depression and a parkinsons like syndrome?

A

Reserpine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Where is the major site for drainage of CSF into blood?

A

arachnoid granulations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What chromosome does FHM and migraines map onto?

A

chromosome 19 (brain specific calcium channel alpha subunit)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Name the disease, trinucleotide repeats and associated chromosome.

A) Adolescence presents with gait ataxia, loss of LE proprioception, absence of deep tendon reflexes (LE>UE), CNS involvement (dysarthria, +Babinski’s sign, abnormal eye mvmts)

B) ptosis, bifacial weakness, frontal baldness, drooping facies, motor weakness (distally > proximally), myotonia

A

A) Friedrich’s ataxia, GAA repeats, chromosome 9

B) Myotonic dystrophy, CTG repeats, chromosome 19

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What syndrome presents as the classic triad of:
gait ataxia + areflexia + ophthalmoplegia

A

Miller- Fisher syndrome
-variant of Guillain Barre syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Patient with absent DTR and recent GI infection gets a nerve conduction study which shows abnormalities of conduction block and prolonged F-wave latencies. Nerve biopsy shows complement fixing Ab to peripheral nerve myelin. What is this diagnostic of?

A

Guillain Barre syndrome
- acute inflammatory demyelinating polyneuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Patient with absent DTR and recent GI infection gets a CSF draw which shows elevated protein with an acellular fluid. What is this diagnostic of?

A

Guillain Barre syndrome
- acute inflammatory demyelinating polyneuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the most common organism that causes Guillain Barre syndrome?

A

Campylobacter jejuni

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

In isolated 3rd nerve palsy it can present 2 ways which is caused by what?

  1. inability to adduct eye nasally+ pupil reactive to light + eyelid ptosis
  2. inability to adduct eye nasally+ dilated pupil + eyelid ptosis
A
  1. Diabetes (ischemia)
  2. internal carotid posterior communicating artery aneurysm (pushing against pupillomotor fibers)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the best treatment for an agitated patient with delirium?

A

Low dose haloperidol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Epidural hematomas can be deadly and result most often from a tear in what vessel of the brain?

A

Middle meningeal artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Subdural hematomas can be present for years and occur from tear in what vessel in the brain?

A

Bridging veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Describe the change (Up, down or normal) in CSF assay for glucose, lymphocytes/neutrophils and protein for the following infections:

1) viral (or aseptic) meningitis
2) bacterial meningitis
3) fungal meningitis
4) TB meningitis
5) Guillain barre syndrome

A

1) viral (or aseptic) meningitis
Normal glucose, mildly increased lymphocytes, mildly elevated protein

2) bacterial meningitis
Low glucose, increased NT, increased protein

3) fungal meningitis
Decreased glucose, increased lymphocytes, increased protein

4) TB meningitis
Decreased glucose, increased lymphocytes, huge increased protein

5) Guillain barre syndrome
Normal glucose, absent or no lymphocytes, lots of protein (aka ctyoalbuminologic protein)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What brain tract when blocked results in Parkinsonism symptoms?

A

Nigrostriatal tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Through which brain tract do antipsychotics affect both positive and negative symptoms of Schizophrenia?

A

Mesolimbic-meso cortical tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What type of cancer has highest risk of having brain mets?

A

Non small cell lung cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the most common myopathy in those over 50years of age?

A

Inclusion body myositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the infection associated with tropical spastic paresis (a chronic progressive myelopathy associated with UMN weakness)?

A

HTLV-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is the process by which the brain creates a decreased response to repeated stimuli? Allows brain to ignore inconsequential information and retain only important information.

A

Habituation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

A patient has HIV/AIDS and we are concerned about a brain lesion. How do you differentiate between lymphoma & toxoplasmosis on their SPECT image?

A

lymphoma has increased uptake
toxoplasmosis has decreased uptake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What 2 diagnoses are they trying to help us differentiate by showing a PET scan?

A

Alzheimers (reduced uptake in back) vs FTD (reduced uptake in front)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Where is the lesion in a person who suddenly can’t read or write (alexia w/agraphia)?

A

L angular gyrus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What artery is damaged if a person develops aprosodia (loss of prosody in speech, very monotone)?

A

R MCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What is damaged when a person on exam can speak fluently (don’t make sense when they speak) and follow commands but have trouble with repeating?

A

Arcuate fasciculus (they have developed what’s known as conduction aphasia)

54
Q

Pt develops sudden ignoring of L side of body (unilateral neglect). What part of brain is damaged?

A

R parietal

55
Q

A PCA stroke affects what 2 structures?

A

hippocampus & occipital cortex

can develop homonymous hemianopsia, VH

56
Q

What is a key thing they want us to know about behavioral changes associated with orbitofrontal or anterior thalamus lesions?

A

Disinhibition, emotional lability, impulsive, lack empathy, psychosis
often times from a TBI or frontal meningioma
can masquerade as mania

57
Q

What is a key thing they want us to know about behavioral changes associated with dorsolateral frontal cortex lesions?

A

Memory issues, problems with planning or executive fxn

58
Q

What is a key thing they want us to know about behavioral changes associated with anterior cingulate lesions?

A

Akinetic mutism, apathy

59
Q

What is a key thing they want us to know about behavioral changes associated with mesial temporal lesions?

A

Memory

60
Q

What is a key thing they want us to know about behavioral changes associated with amygdala lesions?

A

Loss of anger and fear, hypersexuality

61
Q

In what 2 psychiatric diseases has the MRI finding of smaller hippocampi been consistent?

A

1) MDD
2) PTSD

62
Q

In schizophrenia is there increased or reduced grey matter in the prefrontal, singular and temporal cortices?

A

Reduced

63
Q

What is the relation of brain volume at birth in ASD and ADHD?

A

ASD: larger brain volume
ADHD: smaller brain volume (hypoactivity in premotor and prefrontal areas as well)

64
Q

If a patient comes in with a reading disorder, where would you expect to see less normal size asymmetry?

A

In the planum temporale which is part of Wenicke’s language area
think temporal lobe

65
Q

On fMRI they show a patient with overactivity in their orbitofrontal cortex and anterior cingulate gyrus (R>L)–what disorder are they hinting at?

A

OCD

66
Q

Patient with Tourette’s has overactivity in the PFC and ventral striatum (seen on PET or MRI). Where would additional overactivity be if they also are yelling out things inappropriately?

A

They have coprolalia
Overactivity in Broca’s and Wernicke’s language areas

67
Q

They give you a vignette where a person has AIDS and there’s a lesion in the brain. What do you get to distinguish between a secondary infection and AIDS dementia?

A

SPECT (not PET)

68
Q

What is the difference between central cord syndrome and cauda equina syndrome?

A

central cord syndrome: compresses CST and spinothalamic tract, damaged UE >LE

cauda equina: damage LE > UE

**Both have sensory sparing **

69
Q

What spinal cord compressive syndrome results in numbness, back pain, loss of LE reflexes, impotence and incontinence?

A

Brown-sequard syndrome

70
Q

What differentiates Major NCD, mild severity vs. moderate severity vs. severe severity

A

mild: difficulties with instrumental activities of daily living (housework, shopping, money)

moderate: difficulties in basic activities of daily living (feeding, dressing, bathing)

severe: fully dependent

71
Q

Which type of memory would remain after one damages their hippocampus?

A

implicit and procedural learning

**they would forget semantic (fact-based) and autobiographical memory

72
Q

Name area of brain damaged & most common associated illness with the following gaits:

A) Magnetic gait
B) Wide-based (ataxic) gait
C) Festinating gait (problems initiating, small steps, slow, forward balance, low arm swing)

A

A) Magnetic gait
- peri–ventricular white mattter
- subcortical microvascular disease, NPH (remember urinary incontinence, they might single it out to get you to say peri-ventricular white matter)

B) Wide-based (ataxic) gait
- cerebellum
- Wernicke’s encephalopathy, alcoholism

C) Festinating gait
- Parkinson’s dx, EPS

73
Q

In neurocognitive disorders if you have damage to the cortical location (grey matter), it results in loss of cognitive function meaning what?

A

4A’s—-develop
Amnesia
Aphasia
Agnosia (inability to recognize)
Apraxia

74
Q

In neurocognitive disorders if you have damage to the subcortical location (white matter), it results in loss of coordination of cognitive function meaning what?

A

4D’s—-develop
Dysmnesia (recognize but probably can’t recall)
Delay (slow thinking)
Depletion (lack of motivation, effort)
Dysexecutive

will also see apathy, gait and urinary disturbance here

frontal lobe is working just cant communicate

75
Q

If you suspect a patient has Lewy body disease but there MRI comes back normal, what test could you order next to confirm dx?

A

PET or SPECT –> reveals abnormal metabolism in basal ganglia

76
Q

In a patient with dementia with severe distress that you start an AP on, what is the suggestion for monitoring?

A
  • monitor response monthly during use and afterward
  • d/c in 4 weeks if not effective or not well tolerated
  • if benefit seen, attempt to taper in 4 months
77
Q

What is next line of treatment for management of agitation/psychosis in a pt with dementia after 1)treating underlying cause
2) non-pharmacologic interventions

A

3) IF THEY HAVE Alzheimers or Lewy Body dx —> cholinesterase inhibitors OR add memantine

4) start AP
Pimavanserin (in Alzheimers and LBD but try to avoid AP in LBD

5) antidepressant : citalopram in Alzheimers

6) Prazosin

7) mood stabilizer

8) Benzos (short half life)

78
Q

Apo E, epsilon 4 allele is the main genetic risk (susceptibility risk, risk conferring allele) of what neurocognitive disorder?

A

Alzheimer’s dx

79
Q

What helps to best differentiate mild NCD from major NCD?

A

in mild NCD the pt maintains their INDEPENDENCE

80
Q

What 3 autosomal dominant missense genetic mutations is associated with early-onset family Alzheimer’s disease? (if you have this you will get it as these are causative genes) These mutations cause abberant cleavage of APP –> increased amyloid beta 42 —> formation of amyloid plaques –> calcium coming into cells leading to death.

A

Presinilin 1 gene (protease)
Presinilin 2 gene (protease)
Amyloid precursor protein (APP) — chromosome 21

81
Q

Which of the amyloid beta (Abeta) peptides is more prone to aggregation and potentially more pathogenic?
Aß1-40 vs Aß1-42

A

Aß1-42

82
Q

Alzheimer’s disease has 3 pathological findings that lead to early neuronal loss in the hippocampus. Describe what makes each of them up:
1) amyloid plaques (extracellular)
2)neurofibrillary tangles (intracellular)
3) cerebral amyloid angiopathy

A

1) amyloid plaques (extracellular)
abnormal neuronal processes + glial cells (astrocytes) + Amyloid Beta

2)neurofibrillary tangles (intracellular)
- helical (cytoskeletal) filaments
- microtubular proteins: ubiquitin + phosphorylated tau

3) amyloid-beta forms arterial plaques –> small vascular disease

83
Q

T or F: Alzheimer’s dx is a vascular disease.

A

True: amyloid-beta form arterial plaques as well
Name of it is cerebral amyloid angiopathy

84
Q

Which allele of ApoE is protective from developing Alzheimers?

A

Apo E epsilon 2 allele

85
Q

If you have a patient with Alzheimer’s dx AND liver issues which medication would you try first?

A

Rivastigmine b/c it’s not metabolized by the liver

86
Q

How does Caprylidene “FDA approved medical food” help in mgmt of Alzheimers?

A

The neurons are diseased and less able to use glucose as energy source which leads to cell death.
Caprylidene increase ketones in the brain to serve as an alternate source of energy to protect neuron.

87
Q

In ADHD, there is a reduction in size of the caudate and globus pallidus (both parts of BG). How does this lead to symptoms associated with ADHD?

A

Normally there is a high density of dopamine receptors in the caudate and GP.
Reduced size –> altered dopamine signaling –> altered reinforcement sensitivity

88
Q

Pt with NCD presents and on path you see an abnormal aggregation of proteins, largely alpla-synuclein. What type of NCD does this patient suffer from?

A

Lewy body dementia

89
Q

What are the 3 core diagnostic features of Lewy body dementia?

A

1) fluctuating cognition
2) recurrent VH
3) Parkinson motor symptoms start AFTER cognitive decline

90
Q

What are the 2 suggestive diagnostic features of Lewy body dementia?

A
  1. REM behavior disorder present
  2. Super sensitive to neuroleptics
91
Q

In a patient with LBD or PD w/hallucinations if pt is having moderate to severe psychosis and they are failing without medication what 2 drugs could you try?

A
  1. Pimavanserin (Nulpazid)
  2. Clozapine
92
Q

What is the other name for the known NCD that is a subcortical small-vessel disease called subcortical leukoencephalopathy (affecting white matter)?

A

Biswanger’s disease

93
Q

Young pt (20-40 y/o) presents w/ HTN with symptoms of vascular NCD and is found to have CADASIL (cerebral AD arteriopathy with subcortical infarcts and leukoencephalopathy. Where is the mutation?

A

Notch 3 gene on chromosome arm 19q12

94
Q

Pt with uncontrolled laughing or crying sometimes without trigger and can be at times incongruent with situation or mood. Pts often have insight into pathologic nature of symptoms. What is the dx and tx?

A

Dx: Pseudobulbar affect -from subcortical white matter damage

Tx: Dextromethorphan/quinidine combo (Nuedexta)

95
Q

In Pick’s dx what is the predominant protein in the Pick bodies?

A

tau-protein

96
Q

What is the MOA for Edaravone, a new tx for ALS?

A

It’s a “free radical scavenger”: reduces reactive oxygen species to reduce neuronal damage

—halts ALS progression in early stages

97
Q

What is the name and MOA of the well-known medication used to treat ALS?

A

Riluzole
MOA: blocks glutamatergic transmission (keeps it out of the synapse)

98
Q

In a patient with classic (sporadic) vs. variant (acquired from beef) Creutzfeldt-Jakob disease?

What is typical age/presentation?

Where would you see abnormal signal on a MRI?

EEG findings?

A

Classic:
- older person (~65y/o)
- dementia, live 4-5 months
- MRI: caudate and putamen
- periodic EEG sharp waves
on path might see gray matter vacuoles in classic CJD

Variant: bovine spongiform encephalopathy
- younger person (20-30s)
- neuropsychiatric symptoms, painful dysesthesias, live ~1yr
- MRI: Pulvinar sign on thalamus
- no sharp waves on EEG

99
Q

What medication do you use to treat chorea 2/2 Huntington’s dx?

A

Tetrabenazine and deutetrabenazine
-VMAT 2 inibitors –> depletion of monoamines –> reduced severity of chorea
- BUT it does increase risk of depression and suicide since you are depleting the monoamines including serotonin

100
Q

What type of MRI would you want to order to help with dx of CTE?

A

MRI-diffusion tensor imaging (shows white matter damage well)

101
Q

What is the timing of symptoms that helps differentiate NCD due to Lewy bodies from NCD due to Parkinson’s?

A

NCD due to Lewy bodies: must confirm that motor symptoms began AT LEAST ONE YEAR AFTER onset of cognitive decline

Parkinson’s disease:
motor disturbances occur years before the onset of cognitive debility.

102
Q

What malabsorption syndrome is caused by Tropheryma whipplei and causes skin rashes, diarrhea, arthritis, and cognitive decline?

A

Whipple’s disease

103
Q

What are the typical lab findings in Wilson’s disease? – ceruloplasmin
- serum copper
- urine copper

A

Low serum ceruloplasmin
low serum copper
high urine copper levels

104
Q

TDP-43 proteinopathy is a neuropath finding connected to what NCD?

A

FTD or Pick’s disease

105
Q

What acetylcholinesterase inhibitor is FDA approved for treatment of anticholinergic delirium?

A

Physostigmine
- b/c reverses both central and peripheral anticholinergic effects, short half life, rapid metabolism

106
Q

Stiff person syndrome is caused by what antibodies?

A

anti-GAD Antibodies
GAD is responsible for synthesis of GABA

107
Q

Pt presents with cognitive decline, behavioral (personality changes), balance and visual (difficulty in mvmt of eyes up and impaired voluntary eye saccades) issues. What is the dx?

A

Progressive supranuclear palsy (PSP)

108
Q

On fMRI they show a patient with hyperactivity in the caudate & thalamus what disorder are they hinting at?

A

OCD

109
Q

Deficiency of what mineral is common in those who have undergone gastric bypass surgery and mimics symptoms of B12 deficiency of subacute degeneration?

A

Copper

110
Q

What cells are the following derived from?
A) Microglia

B) Glial cells (oligodendrocytes , astrocytes) & Ependymal cells

C) Neurons

A

A) mesenchymal cells

B) neuroepithelial cells

C) neuroblasts

111
Q

Deep-brain stimulation targets for Parkinson’s disease include which 2 brain areas?

A
  1. sub thalamic nucleus
  2. globus pallidum
112
Q

HIV-dementia is most prevalent in what 2 parts of the subcortical brain?

A

1) Basal ganglia
2) hippocampus

113
Q

Identify what type of seizure occurs from involvement in the following brain areas?

A) Thalamocortical system
B) subcortical areas

A

A) Absence seizures
B) focal and generalized seizures

114
Q

Which chromosome is associated with fronto-temporal dementia?

A

chromosome 17 (tau gene here)

115
Q

What are the 2 most common causes of sensory neuropathy or dorsal root ganglionopathy?

A
  1. paraneoplastic disease
  2. Sjogren’s syndrome
116
Q

What injectable compound used for muscle strength can cause the rapidly progressive neurodegenerative disease, CJD?

A

Human growth hormone (HGH)

117
Q

Which neurological disorder has the following neuropath:
Distinctive, enlarged vacuolar neurons with argentophilic neuronal inclusions in the cytoplasm

A

FTD (Pick’s cells)

118
Q

Which neurological disorder has the following neuropath: Aggregates of hyperphosphorylated tau

A

Alzheimer’s dx

119
Q

Which neurological disorder has the following neuropath: Large, spherical, brightly eosinophilic inclusion bodies

A

Parkinson’s dx (Lewy bodies)

120
Q

Which neurological disorder has the following neuropath: Degeneration of large anterior horn cells of the spinal cord

A

ALS

121
Q

In MDD, on neuroimaging you can see ______ (atrophy or hypertrophy) of the caudate nuclei

A

atrophy

122
Q

What is drug class of choice to help control cognitive symptoms of Lewis body dementia?

A

acetylcholinesterase inhibitors
ie rivastigmine donepezil

123
Q

Which NT has been shown to use the mesocorticolimbic pathway to play a role in social cognition (as can be seen in ASD).

A

dopamine

124
Q

Which one of the following brain areas is most often affected by Alzheimer’s disease?
A. Primary visual cortex
B. Precentral gyrus
C. Entorhinal cortex
D. Wernicke’s area
E. Broca’s area

A

C

125
Q

3-methoxy-4-hydroxyphenylglycol (MHPG) is decreased in the CSF and urine of patients with anorexia nervosa and is also the metabolite of what neurotransmitter?

A

Norepinephrine

126
Q

What are the 3 first-line medications used for fibromyalgia?

A

SNRIs (milnacipran and duloxetine) and pregabalin

127
Q

What type of headaches are benign, recurrent headaches that occur exclusively during sleep in individuals usually older than 50 years of age. They are thought to occur during REM sleep, and treatment is with caffeine, indomethacin, or lithium carbonate.

A

Hypnic headaches

128
Q

Which arteries supply with part of the optic tract?
optic tract, optic chiasm, optic radiations

A) Anterior cerebral arteries and rami from the internal carotid arteries
B) Anterior choroidal and posterior communicating arteries
C) Middle and posterior cerebral arteries

A

A) optic chiasm
B) optic tract
C) optic radiations

129
Q

_________ is the only drug that can increase survival in ALS patients, but edaravone can decrease functional impairment.

A

Riluzole

130
Q

HIV associated dementia is a subcortical dementia and is known to affect what 2 structures?

A

Basal ganglia
Hippocampus

131
Q

What symptoms differentiate Whipples disease from pellagra (niacin deficiency)?

A

Both have skin rash and diarrhea
Whipples has arthritis AND malabsorption

Psychiatry Boards (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions