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PRITE > Neurology: Brain Lesions > Flashcards

Neurology: Brain Lesions Flashcards

1
Q

Visual problem in pituitary tumor compressing optic chiasm: (10x)

A

BITEMPORAL HEMIANOPSIA

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2
Q

Unsteady gait, appendicular ataxia in LE only and normal eye
movement. Walks with lurching broad-based gait. Dx? (8x)

A

CEREBELLAR DEGENERATION (ALCOHOLIC)

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3
Q

66 yo c/o frequent falls, several-month hx of anxiety, unwillingness
to leave home. On exam, mild impairment of vertical gaze on
smooth pursuit/saccades, mild axial rigidity & minimal rigidity of
upper extremities, along w/ mild slowness of movement on finger
tapping, hand opening & wrist opposition. Posture nml. Gait
tentative/awkward, but w/o shuffling, ataxia, tremor. Pt is slow in
arising from a chair. Most likely dx: (8x)

A

PROGRESSIVE SUPRANUCLEAR PALSY

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4
Q

Severe occipital HA, BL papilledema and no other abnormalities.
Chronic acne treated with isotretinoin. Lumbar puncture elevated
opening pressure with no cells, 62 mg/dl glucose, and 22mg/dl
protein. CT is normal. Dx? (7x)

A

PSEUDOTUMOR CEREBRI

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5
Q

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: (5x)

A

SPONGIFORM ENCEPHALOPATHY

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6
Q

Pt presents with a slowly progressive gait disorder, followed by
impairment of mental function, and sphincteric incontinence. No
papilledema or headaches are reported. Likely diagnosis? (4x)

A

NORMAL PRESSURE HYDROCEPHALUS

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7
Q

65 yo pt fell several times past 6 mos. MSE nml. Smooth pursuit,
saccadic movements impaired. Worse w/ vertical gaze. Full ROM w/
doll head maneuver. Mild symmetric rigidity/bradykinesia, no
tremor. MRI/CSF/labs unremarkable. Dx? (4x)

A

PROGRESSIVE SUPRANUCLEAR PALSY

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8
Q

Pt w/ acute onset of pain and decreased vision in the R eye. Colors
look faded when viewed through the R eye. On exam, has a R
afferent pupillary defect and a swollen right optic disc. Pt
spontaneously recovers over the next 6 wks. Likely to develop later:
(4x)

A

MULTIPLE SCLEROSIS

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9
Q

28yo with emotional lability and impulsivity. LFT’s elevated. Close
relative had similar sx and died at 30 yo from hepatic failure. Which
blood level would be diagnostic? (3x)

A

CERULOPLASMIN

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10
Q

Pt with several days of fever and severe headaches presents to ED
b/o generalized seizure. Pt is confused and somnolent. Also
reported to have been irritable and has c/o foul smells. T2 MRI
displayed (hyperintensity of left temporal). Dx? (3x)

A

HERPES ENCEPHALITIS

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11
Q

9YO 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?

A

HYPOTHALAMIC HAMARTOMA

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12
Q

5 yo with 4 month history of morning HA, vomiting, and recent
problems with gait, falls, and diplopia: (2x)

A

MEDULLABLASTOMA

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13
Q

70 yo develops flaccid paralysis following severe water intoxication.
He develops dysphagia and dysarthria without other cranial nerve
involvement. Sensory exam is limited but grossly normal, DTR’s are
symmetric, and cognition is intact. Likely dx: (2x)

A

CENTRAL PONTINE MYELINOLYSIS

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14
Q

Young adult gained 70 lbs in last year c/o daily severe headaches
sometimes associated with graying out of vision. Papilledema
present. CT and MRI brain no abnormalities but ventricles smaller
than usual. Goal of treatment in this case: (2x)

A

PREVENT BLINDNESS

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15
Q

Superior homonymous quadrantic defects in the visual fields result
from lesions to which of the following structures? (2x)

A

TEMPORAL OPTIC RADIATIONS

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16
Q

TREMOR WITH A FREQUENCY OF AROUND 3 HZ, IRREGULAR AMPLITUDE, MOST EVIDENT TOWARD THE END OF REACHING MOVEMENTS. DX?

A

CEREBELLAR TUMOR

17
Q

Acute onset of fever, sore throat, diplopia, & dysarthria. Exam
reveals an inflamed throat, left adductor nerve palsy w/ impairment
of vertical pursuit, diffuse hyperreflexia w/ bilateral clonus, lower
ext spasticity, & mild right hemiparesis. CT is uninformative. Spinal
fluid has protein of 24, 10 mononuclear cells, and glucose of 70. Dx?
(2x)

A

MULTIPLE SCLEROSIS

18
Q

Which is the most reliable finding from CSF analysis for a pt with
multiple sclerosis in the chronic progressive phase of the dz? (2x)

A

PRESENCE OF OLIGOCLONAL BANDS

19
Q

Benign intracranial HTN etiology: (2x)

A

HYPERVITAMINOSIS A

20
Q

Gait abnormality, slow movement, asymmetric UE rigidity. Difficulty
in voluntary vertical upward/downward gaze. Slowness/rigidity
improved slightly with levodopa. Later has problems with horizontal
& vertical gaze. Oculocephalic reflexes normal. Involuntary saccades.
Dx? (2x)

A

PROGRESSIVE SUPRANUCLEAR PALSY

21
Q

Pt presents with personality changes, cognitive difficulties, affective
lability, and olfactory and gustatory hallucinations. The most likely
medical cause of this presentation is: (2x)

A

HERPES SIMPLEX VIRUS INFECTION

22
Q

WHAT CONDITION IS A FORERUNNER OF MS? (2X)

A

TRANSVERSE MYELITIS

23
Q

Location of characteristic lesions seen in CT scans of pt with carbon
monoxide poisoning associated comas: (2x)

A

GLOBUS PALLIDUS

24
Q

43 yo newly w/ AIDS. Pt has increasing social withdrawal and
irritability over several weeks. Can’t remember phone number,
unable to do chores, appears distracted. Mild right hemiparesis, left
limb ataxia, and bilateral visual field defects. LP: normal cell counts,
protein, and glucose. T2 Scan is shown. What is the diagnosis? (2x)

A

PROGRESSIVE MULTIFOCAL LEUKOENCEPHALITIS

25
Q

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? (2x)

A

BROCA’S APHASIA

26
Q

Hx of dementia and myoclonus shows what pathologic changes with
crystal violet changes?

A

CYTOSOLIC VACUOLATION OF NEUROGLIA WITH PRION INCLUSIONS

27
Q

WHAT IS THE PRESENTATION EXPECTED WITH WERNICKE’S ENCEPHALOPATHY?

A

AMNESIA, CONFABULATION, LACK OF INSIGHT

28
Q

An 80-year old female that lives in a nursing home believes she lives in
a hospital dorm and is working with maintenance staff. No distress,
alert, oriented, calm, organized speech and behavior otherwise. This
is an example of what memory disturbance?

A

CONFABULATION

29
Q

AIDS pt with new onset headache and cognitive decline, MRI shows
multiple ring-enhancing lesions, cause?

A

TOXOPLASMOSIS GONDII

30
Q

Neuropsychological test that examines both visual/spatial and
executive functions?

A

CLOCK DRAWING

31
Q

Image of a clock, with all the numbers drawn only on the right hand
side

A

PARIETAL LOBE

32
Q

Head injury with personality changes, impulsivity and euphoria. Site of
injury?

A

ORBITOFRONTAL CORTEX

33
Q

specific pathology of cerebellum

A

ipsilateral limb ataxia

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